Nonsuicidal Self-Harm and Suicide in Borderline Personality Disorder

Nonsuicidal self-injury (NSSI) and suicide have been mentioned as public mental health problems worldwide which are common among adolescents and adults. A large body of research about why individuals attempt suicide and do self-harm behaviors has been done in recent decades, and almost most of them have suggested several risk factors belong to specific categories, including biological, psychological, and social/environmental. Decreased self-esteem, elevated self-hate, loathed self-image, self-minimization, high self-criticism, and lack of emotional regulation strategies can be personality characteristics of individuals who do engage in NSSI. NSSI and suicidal thoughts and attempts are substantially prevalent among individuals with borderline personality disorder (BPD). Moreover, it was mentioned that the presence of NSSI and suicidal behaviors have been proposed as major risk factors for the development of BPD pathology, and several theoretical and empirical explanations were suggested to conceptualize these associations. Emotion regulation issues, emotion dysregulation, neuroticism, distress tolerance difficulties, biological-genetic factors, emotional and cognitive avoidances, and impulsivity are prominent factors that can explain the development and maintenance of the associations between NSSI and suicide and BPD. Furthermore, numerous theories have tried to explain the associations between NSSI and suicide and BPD pathology, such as emotion regulation perspective, biosocial development of BPD and suicidal behavior, experiential avoidance model, and the emotional cascade theory.