Thwarted belongingness, burdensomeness, and self-injury and suicidal behavior in college students: A thematic analysis

Objective: Engagement in non-suicidal self-injury (NSSI) is one of the strongest risk factors for suicide attempt. However, the specific mechanisms underlying the relationship between NSSI and suicide attempt is not well-understood and limits the ability to predict future suicidal behaviors among people who engage in NSSI. The purpose of this study was to explore the relationship of NSSI and suicide attempt based on the integrated motivation – volitional modelCitation1 (IMV; O’Connor, 2011) that might have a salient impact on informing suicide prevention in a U.S. college student sample using a qualitative, narration-based design approach. Method: Participants were 4 college students (Mage = 24) who have engaged in NSSI in the past. Interviews were conducted via Zoom. Reflective thematic analysisCitation2 (Bruan & Clarke, 2019) was applied to identify key themes in the transcripts. Results: Analysis yielded nine major themes related to the following: (a) characteristics of NSSI, (b) relationship between NSSI and suicidal behaviors and moderators, and (c) resources and future direction. More specifically, it was worth noting that burdensomeness and impulsivity each played a prominent role in NSSI behaviors and suicidal behaviors which aligned with the IMV model that posits burdensomeness as a motivational moderator while impulsivity as a volitional moderator. Early intervention and interdisciplinary care are needed to prevent and reduce these behaviors. Conclusion: Findings from the present study are expected to assist service providers in implementing risk assessments when working with college students with poor self-image and impulsive behaviors and continue developing effective interventions to minimize future risks.