Intrapersonal and Interpersonal Functions as Pathways to Future Self-Harm Repetition and Suicide Attempts

Kathryn Jane Gardner*, Elise Paul, Edward A Selby, E David Klonsky, Becky Mars

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

10 Citations (Scopus)
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Background: Research has identified functions of non-suicidal self-harm/self-injury (NSSH) but whether functions change over time, from adolescence to early adulthood, or predict the continuation of the behavior prospectively remains unclear. This study aimed to prospectively explore whether intrapersonal and interpersonal NSSH functions in adolescence predict repetition of self-harm (regardless of suicidal intent) and incident suicide attempts in early adulthood.

Methods: Participants were 528 individuals with NSSH at age 16 years from the Avon Longitudinal Study of Parents and Children (ALSPAC), a population-based birth cohort in the UK. Descriptive statistics were used to explore changes in functions over time from age 16 to 21, and logistic regression used to examine associations between NSSH functions and repeat self-harm and suicide attempts at age 21, 24, and 25 years.

Findings: The majority of 16-year-olds with NSSH endorsed intrapersonal (e.g., affect regulatory) functions only (73% at 16 years and 64% at 21 years). Just under half of adolescents (42%) and three quarters of 21 years olds reported more than one function simultaneously. A greater number of intrapersonal functions at 16 years independently predicted future repetition of self-harm at ages 21–25 years, over and above interpersonal functions (OR = 1.46, 95% CI 1.06–2.01). Interpersonal functions during adolescence did not predict repeat self-harm or suicide attempts in adulthood.

Discussion: Our findings suggest that intrapersonal but not interpersonal NSSH functions are a prospective risk factor for future self-harm and might also predict incident suicide attempts. The results highlight the central role of underlying affective difficulties and motivations in self-harm maintenance.
Original languageEnglish
Article number688472
Number of pages12
JournalFrontiers in Psychology
Publication statusPublished - 19 Jul 2021

Bibliographical note

Funding Information:
BM was supported by a University of Bristol Vice Chancellor’s Fellowship, the National Institute for Health Research (NIHR) Biomedical Research Centre at the University Hospitals Bristol National Health Service Foundation Trust, and the University of Bristol (Bristol, UK). The UK Medical Research Council and Wellcome Trust (grant reference 217065/Z/19/Z) and the University of Bristol provide core support for the Avon Longitudinal Study of Parents and Children. A comprehensive list of grants funding is available on the ALSPAC website (; the data used in this research were specifically funded by the Wellcome Trust (grant reference GR067797MA), Norwegian University of Science and Technology, and the NIHR (grant reference PR-RS-0912-11023 and 1215-20011). The views expressed in this publication are those of the authors and not necessarily those of the National Health Service, NIHR, or UK Department of Health. The authors will serve as guarantors for the contents of this paper.

Publisher Copyright:
© Copyright © 2021 Gardner, Paul, Selby, Klonsky and Mars.

Structured keywords

  • SASH


  • Avon Longitudinal Study of Parents and Children
  • self-harm
  • non-suicidal self-injury
  • non-suicidal self-harm
  • suicide attempt
  • non-suicidal self-harm functions


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