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Introduction <p>Anxiety is a salient risk factor of suicide, though the mechanism underlying increased risk remain unclear. The acquired capability theory presents that suicide capability is strengthened through rehearsal, including non-suicidal self-injury (NSSI), offering a useful framework for investigating the relationship between anxiety and suicide (Van Orden et al., <CitationRef CitationID="CR42">2010</CitationRef>). This study clarifies the association between anxiety symptom severity and suicide capability, testing whether NSSI moderates the relationship between the two.</p> Methods <p>Patients enrolled in a partial hospitalization program (<i>N</i> = 287) completed self-report measures of suicide capability, NSSI, and anxiety symptoms at admission.</p> Results <p>After adjusting for age and gender, both lifetime and recent NSSI history moderated the relationship between anxiety symptom severity and fearlessness of death. Contrary to hypotheses, fearlessness of death <i>decreased</i> as anxiety symptoms worsened among those with NSSI. Additionally, NSSI did not moderate the relationship between anxiety and preparation for suicide; however, those with lifetime and recent NSSI reported significantly higher preparation independent of anxiety severity. Older age associated with lower preparation for suicide but greater fearlessness of death across all models.</p> Conclusions <p>NSSI may play a complex, conditional role in acquired capability, with differential effects across its subscales that may be influenced by temporal and demographic factors.</p>

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Exploring the Moderating Effect of Non-suicidal Self-injury on Anxiety and Suicide Capability

  • 期刊论文

  • 发表日期：

    2026年7月8日

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  • Campbell Linker,
  • Emma Moscardini,
  • Juliet Bockhorst,
  • Courtney Beard

摘要

Introduction

Anxiety is a salient risk factor of suicide, though the mechanism underlying increased risk remain unclear. The acquired capability theory presents that suicide capability is strengthened through rehearsal, including non-suicidal self-injury (NSSI), offering a useful framework for investigating the relationship between anxiety and suicide (Van Orden et al., 2010). This study clarifies the association between anxiety symptom severity and suicide capability, testing whether NSSI moderates the relationship between the two.

Methods

Patients enrolled in a partial hospitalization program (N = 287) completed self-report measures of suicide capability, NSSI, and anxiety symptoms at admission.

Results

After adjusting for age and gender, both lifetime and recent NSSI history moderated the relationship between anxiety symptom severity and fearlessness of death. Contrary to hypotheses, fearlessness of death decreased as anxiety symptoms worsened among those with NSSI. Additionally, NSSI did not moderate the relationship between anxiety and preparation for suicide; however, those with lifetime and recent NSSI reported significantly higher preparation independent of anxiety severity. Older age associated with lower preparation for suicide but greater fearlessness of death across all models.

Conclusions

NSSI may play a complex, conditional role in acquired capability, with differential effects across its subscales that may be influenced by temporal and demographic factors.