Distinguishing Pathways from Negative Emotions to Suicide Ideation and to Suicide Attempt: the Differential Mediating Effects of Nonsuicidal Self-Injury

Negative emotion (NE) is one of the most widely examined risk factors for suicide ideation (SI) and suicide attempt (SA). However, little is known about the possibly different mechanisms underlying the pathways from NE to these two different suicide phenomena. Nonsuicidal self-injury (NSSI) is related to both negative emotions and suicidality. Thus, the present study aimed to test the differential roles of NSSI in the pathways from NE (specified by depression, anxiety, and stress) to SI and from NE to SA. This study hypothesized that NSSI served as a mediator in the relationship from NE to SA, but not in the relationship from NE to SI. We assessed the study variables among 3600 Chinese students (56.6% females, mean age = 14.63 years) for 3times at 6-month intervals. Structural equation modeling was used to test the hypotheses. Results partly supported the hypothesized longitudinal mediation model, such that NSSI fully mediated the relation from NE to SA in females, while partially mediated the relation from NE to SI in both females and males. Findings of this study may help to better understand the distinct mechanisms underlying the relationships from NE to SI and SA. Moreover, our finding regarding gender differences suggests the different emphases in suicide prevention and intervention programs across genders.