Archives of Suicide Research最新文献

{"title":"Assessing the Utility of Social Determinants of Health Data in Suicide Prediction Models.","authors":"Matthew D Castner, Christopher Kitchen, Christelle Xiong, Mark J Bittle, Paul S Nestadt, Holly C Wilcox, Hadi Kharrazi","doi":"10.1080/13811118.2026.2722144","DOIUrl":"https://doi.org/10.1080/13811118.2026.2722144","url":null,"abstract":"<p><strong>Objective: </strong>This study seeks to explore the utility of social determinants of health (SDoH) variables in suicide prediction models. We aim to assess the impact of individual- and geographic-level SDoH factors on improving the performance of suicide prediction models and the identification of individuals at high risk for suicide.</p><p><strong>Methods: </strong>A retrospective sample of 1214 deaths by suicide and 815,544 living patients was identified in the Maryland Suicide Data Warehouse (MSDW) and linked to census tract data through geo-coding. Three machine learning algorithms were trained and validated with cross-validation to assess model performance across different data category combinations, including demographics, clinical features, and individual and geographic level SDoH.</p><p><strong>Results: </strong>Models incorporating clinical information demonstrated substantial improvements in predictive performance compared with demographic-only baselines across all algorithms. In the absence of clinical data, the addition of individual level SDoH significantly improved performance compared to baseline models, where 73% of individual level SDoH factors were identified as significant. Conversely, geographic level SDoH provided limited improvement in model performance, with only 7% of variables showing significance marginally.</p><p><strong>Conclusions: </strong>Within SDoH data, most individual level SDoH are among the most important risk factors associated with death by suicide, with improvement in model performance over just clinical and demographic information. Geographic level SDoH appeared to have limited added value.</p>","PeriodicalId":8325,"journal":{"name":"Archives of Suicide Research","volume":" ","pages":"1-15"},"PeriodicalIF":2.2,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148811876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supporting Technology Engagement for Suicide Prevention: An Open Trial with College Students At-Risk for Suicide.","authors":"Jazmin A Reyes-Portillo, Amy So, Emily Judd, Helen-Maria Lekas, Cheryl King, Jude Uy, Christopher Karr, Carrie Masia Warner","doi":"10.1080/13811118.2026.2713052","DOIUrl":"https://doi.org/10.1080/13811118.2026.2713052","url":null,"abstract":"<p><strong>Background: </strong>With the marked increase of suicidal thoughts and behaviors among students, counseling centers are struggling to meet the mental health demand on college campuses. Digital mental health interventions (DMHIs) have significant promise for increasing treatment availability and addressing barriers specific to this population. However, evaluations of DMHI effectiveness have been limited by low uptake and treatment adherence.</p><p><strong>Objective: </strong>Using focus group data from students at-risk for suicide, we developed Supporting Technology Engagement for Prevention (STEP), an intervention designed to increase student engagement in DMHIs. This open trial evaluated the feasibility, acceptability, and initial promise of STEP plus an empirically-based DMHI (Therapist Assisted Online [TAO]) with at-risk students.</p><p><strong>Method: </strong>Participants were 30 ethnoracially diverse college students, ages 18 to 29, reporting elevated depression or anxiety symptoms and active suicidal ideation. Participants received STEP+TAO for 7 weeks. Satisfaction, engagement with TAO (uptake and adherence), and mental health symptoms were assessed at pre-intervention, 3-weeks, and 7-weeks.</p><p><strong>Results: </strong>TAO uptake was high, with most students (93%, <i>n</i> = 28) completing at least one session. Adherence was also high, with 63% (<i>n</i> = 19) completing at least 50% of sessions and 50% (<i>n</i> = 15) completing at least 80%. Most participants (80%, <i>n</i> = 24) reported being at least moderately satisfied. Significant reductions in depression, anxiety, and suicidal ideation were also observed.</p><p><strong>Discussion: </strong>Results suggest that STEP is acceptable, feasible, and associated with high DMHI uptake and adherence and decreased mental health symptoms among at-risk students. Findings demonstrate potential of enhancing treatment engagement among at-risk students who would otherwise not seek help.</p>","PeriodicalId":8325,"journal":{"name":"Archives of Suicide Research","volume":" ","pages":"1-21"},"PeriodicalIF":2.2,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What Do We Mean by Self-Harm Ideation? A Scoping Review of More Than 30 Years of Evidence.","authors":"Katerina Kavalidou, M Isabela Troya, Faraz Mughal, Andrea Vaughan, Sarah Spafford, Aileen Callanan, Eibhlín Walsh, Mary Joyce, Daisy Wiggin, Sarah Greenley","doi":"10.1080/13811118.2026.2718277","DOIUrl":"https://doi.org/10.1080/13811118.2026.2718277","url":null,"abstract":"<p><strong>Objective: </strong>Attention has been given on the terminology used for suicidal behaviors, however, there is paucity of research on the terminology used for those with thoughts of self-harm and this is imposing a risk of overlooking sub-groups within the suicidality spectrum. This review therefore aimed to map the existing evidence on the conceptualization and measurement of self-harm ideation.</p><p><strong>Method: </strong>A two-stage search strategy was employed. In stage one, MEDLINE, Embase, PsycINFO, CINAHL, and Web of Science Core Collection were searched were searched in June 2020 for records published from database inception onwards, using database-specific index terms and title/abstract keywords related to self-harm ideation/thoughts. In stage two (2020-2025), a targeted title only search was conducted to identify studies explicitly foregrounding self-harm ideation. Data were synthesized using descriptive narrative methods.</p><p><strong>Results: </strong>The majority of studies (68%) used standardized instruments, most commonly items embedded within broader mental health scales, particularly item 9 of the Patient Health Questionnaire-9 (PHQ-9) and item 10 of the Edinburgh Postnatal Depression Scale (EPDS) in female perinatal samples. A smaller number of studies used the Self-Injurious Thoughts and Behaviors Interview (SITBI) items assessing non-suicidal self-injury thoughts. Publication output increased substantially after 2013 and was largely concentrated in high-income Western countries. Across all years examined, explicit use of the terms self-harm ideation or thoughts in titles remained consistently low (10%).</p><p><strong>Conclusions: </strong>Future research should prioritize participatory approaches involving clinicians and individuals with lived experience to refine the terminology surrounding self-harm ideation and support more accurate identification and targeted prevention strategies.</p>","PeriodicalId":8325,"journal":{"name":"Archives of Suicide Research","volume":" ","pages":"1-33"},"PeriodicalIF":2.2,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Network Analysis of Personal Recovery After a Suicidal Episode.","authors":"Yosef Sokol, Sofie Glatt, Marianne Goodman","doi":"10.1080/13811118.2026.2719717","DOIUrl":"https://doi.org/10.1080/13811118.2026.2719717","url":null,"abstract":"<p><strong>Objectives: </strong>Personal recovery following a suicidal episode is multifaceted and understudied. Network analysis of the Post Acute Suicidal Episode (PASE), the recovery period that follows an acute episode of suicidal consideration, planning, or attempt, may clarify the multidimensional structure of this recovery and identify clinical intervention points.</p><p><strong>Methods: </strong>An online sample with a history of a suicidal episode (<i>N</i> = 940) completed the Recovery Evaluation and Suicide Support Tool (RESST). We applied exploratory graph analysis (EGA) to identify recovery clusters, expected influence and bridge centrality to identify central features, and network comparison tests (NCTs) to compare network structure by suicide attempt history. Dimensional stability was additionally tested across a three-week interval.</p><p><strong>Results: </strong>EGA identified four stable clusters mirroring the RESST domains, and dimensional structure was consistent across the three-week interval. Central features included life worth, positive self-regard, feeling valued, and connectedness. The strongest bridge items included feeling that life is worth living and having meaning and purpose. NCTs did not identify structural divergence by suicide attempt history.</p><p><strong>Conclusion: </strong>PASE recovery showed a stable multidimensional structure, with no divergence detected by suicide attempt history or across a three-week interval. Central and bridge features (life worth, meaning, connectedness) are promising candidate intervention targets that need prospective testing. Findings support aftercare that addresses multiple recovery domains rather than a single symptom target.</p>","PeriodicalId":8325,"journal":{"name":"Archives of Suicide Research","volume":" ","pages":"1-16"},"PeriodicalIF":2.2,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148787594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prediction of Suicide Attempts Among Adolescents in Acute Mental Health Crisis.","authors":"Tormod Stangeland, Ketil Hanssen-Bauer, Johan Siqveland","doi":"10.1080/13811118.2026.2714308","DOIUrl":"https://doi.org/10.1080/13811118.2026.2714308","url":null,"abstract":"<p><strong>Objective: </strong>Suicide attempts among adolescents in acute mental health crisis are frequent but difficult to predict. Our study aimed to examine whether suicide attempts and patient states at baseline predicted subsequent suicide attempts, and whether suicide lethality increased in repeated attempts.</p><p><strong>Methods: </strong>We assessed 119 adolescent inpatients at intake using self-report measures (Interpersonal Needs Questionnaire and Fearlessness About Death) and a behavioral measure (Implicit Association Test Death/Suicide). For adolescents with a recent suicide attempt, we used clinician-rated measures of suicide lethality and intent (Risk-Rescue Rating Scale and Suicide Intent Scale). Using logistic regression models, we examined whether these variables prospectively predicted suicide attempts during a six-month follow-up, and we compared the lethality of first-time and repeated attempts.</p><p><strong>Results: </strong>Eighteen participants attempted suicide during follow-up. The combination of elevated unmet interpersonal needs and fearlessness about death predicted subsequent suicide attempts (OR = 2.81, p= .004) substantially better than either variable alone. Implicit association with death, suicidal intent, and lethality did not predict suicide attempts, and repeated attempts did not increase in lethality.</p><p><strong>Conclusions: </strong>The self-reported measures performed better than the behavioral and clinician-rated measures in prospective prediction of suicide attempts. The lack of predictive ability of suicide lethality, particularly the absence of escalation in repeated attempts, underscores the importance of adolescents' reports of distress over medical severity in understanding suicidal behavior.</p>","PeriodicalId":8325,"journal":{"name":"Archives of Suicide Research","volume":" ","pages":"1-20"},"PeriodicalIF":2.2,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148766581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suicide and Medical Illness: A Latent Class Analysis of Coroner Records in Toronto.","authors":"Umair Tahir, Daniel Sanchez Morales, Prudence Po Ming Chan, Ayal Schaffer, Jennifer M Dmetrichuk, Rachel H B Mitchell, Rosalie Steinberg, Lisa Fiksenbaum, Simon Hatcher, Mark Sinyor","doi":"10.1080/13811118.2026.2713720","DOIUrl":"https://doi.org/10.1080/13811118.2026.2713720","url":null,"abstract":"<p><strong>Objective: </strong>People with chronic illnesses are at elevated risk of suicide. Prior research has focused on risk with specific diagnoses and/or comparisons with living controls; the profiles of medically ill people who die by suicide remain largely unknown. This study aims to identify characteristics and subgroups among suicide decedents with medical illnesses.</p><p><strong>Methods: </strong>We conducted a retrospective chart review of 5288 suicide deaths in Toronto, Canada (1998-2020) using coroner records. Bivariate and logistic regression compared decedents with and without reported medical illness across demographics, stressors, psychiatric history, and suicide-related characteristics. Latent class analysis (LCA) identified subgroups based on patterns of medical illness and sociodemographic characteristics. Post-hoc comparisons assessed additional differences across classes.</p><p><strong>Results: </strong>Among suicide decedents, 33.6% had a reported medical illness. Compared to other suicide decedents, they were older, more likely to die at home, experience depression, and use self-poisoning. Latent class analysis identified four distinct profiles defined by medical and sociodemographic characteristics: (1) older men with cardiovascular disease and/or diabetes; (2) middle-aged individuals with pain, neurological, and/or musculoskeletal conditions and a balanced sex distribution; (3) younger-to-middle-aged men with mixed medical conditions, including HIV/AIDS and respiratory illness; and (4) older men with reported malignancy. Exploratory post-hoc comparisons suggested additional differences across psychiatric, psychosocial, and suicide-related characteristics, including depression, substance misuse/use disorder, and suicide methods.</p><p><strong>Conclusions: </strong>Our results indicate that the characteristics of suicide among medically ill populations are heterogeneous. Tailored, integrated prevention strategies that address both medical illness and psychosocial context are important elements for addressing suicide in this group.</p>","PeriodicalId":8325,"journal":{"name":"Archives of Suicide Research","volume":" ","pages":"1-17"},"PeriodicalIF":2.2,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148758273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Transdiagnostic Brief Behavioral Therapy on Suicide Reduction for Depressed Hispanic/Latine Youth.","authors":"Megan E Morillas, Francesca E Rodriguez, Pauline Goger, Karen T G Schwartz, David A Brent, Araceli Gonzalez, Giovanna Porta, Frances L Lynch, John F Dickerson, V Robin Weersing","doi":"10.1080/13811118.2026.2711088","DOIUrl":"10.1080/13811118.2026.2711088","url":null,"abstract":"<p><strong>Objective: </strong>Identifying effective interventions for suicidal thoughts and behaviors (STBs) among Hispanic/Latine youth is a public health priority. Anxiety and depression often precede STBs, and non-suicide-specific treatments for internalizing problems may mitigate the development of serious suicidality. Transdiagnostic therapy for anxiety and depression has shown strong outcomes for Hispanic/Latine youth and some evidence of non-targeted effects on STBs. However, it remains unclear whether transdiagnostic treatments impact STBs in high-risk subgroups, such as depressed, Hispanic/Latine youth. The current study explored whether Hispanic/Latine ethnicity and depression moderated intervention-driven changes in suicidality within a transdiagnostic therapy for pediatric anxiety and depression.</p><p><strong>Method: </strong>Archival data were analyzed from the Brief Behavioral Therapy (BBT) trial for this hypothesis-generating study. Youths aged 8.0 to 16.9 were randomly assigned to receive BBT or assisted referrals to community care (ARC). Parent- and youth-reported suicidality was assessed at baseline and post-treatment (week 16). Multiple regression models were estimated in a subset of youth (<i>n</i> = 163) to test if ethnicity (Non-Hispanic White [NHW], Hispanic/Latine) and clinically significant depression moderated the impact of BBT on suicidality.</p><p><strong>Results: </strong>Results indicated a significant three-way interaction between ethnicity, depression, and treatment, with significantly greater reduction in suicidality for depressed, Hispanic/Latine youth in BBT relative to community care by week 16.</p><p><strong>Conclusions: </strong>Findings demonstrate the promise of transdiagnostic interventions for reducing suicidality among depressed, Hispanic/Latine youth, a population that experiences elevated risk for STBs compared to NHW counterparts. Confirmatory trials are needed to test whether transdiagnostic treatment accrues specific benefits for suicidality for this vulnerable group.</p>","PeriodicalId":8325,"journal":{"name":"Archives of Suicide Research","volume":" ","pages":"1-17"},"PeriodicalIF":2.2,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13676924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148764115","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Suicidal Cognitions and Suicidal Ideation Severity: The Moderating Effect of Psychological Inflexibility About Suicidal Ideation.","authors":"Joseph W Boffa, Kirsten H Dillon, Jaclyn C Kearns, Rachel L Zelkowitz","doi":"10.1080/13811118.2026.2715598","DOIUrl":"10.1080/13811118.2026.2715598","url":null,"abstract":"<p><strong>Objective: </strong>Most self-report measures of suicidal ideation (SI) index thoughts or behaviors but broadly fail to contextualize the degree to which SI is perceived to impair quality of life. Theories of suicide propose that psychological inflexibility (i.e., metacognitive distress) about SI may compound suicidal cognitions and impact suicide risk. This study tested whether suicidal cognitions and psychological inflexibility about SI interact to amplify SI severity.</p><p><strong>Methods: </strong>Self-report measures of suicidal cognitions, psychological inflexibility, and SI severity were collected from U.S. military veterans (<i>N</i> = 87) with current SI at a health care system in the Southeast United States. The sample primarily identified as male (70%) and White/Caucasian (45.6%). A moderation model tested main and interactive effects of suicidal cognitions and psychological inflexibility about SI on SI severity.</p><p><strong>Results: </strong>There was a significant interaction between suicidal cognitions and psychological inflexibility about SI, such that the statistically significant relationship between suicidal cognitions and SI severity increased at each level (-1 SD, mean, and +1 SD) of psychological inflexibility about SI.</p><p><strong>Conclusions: </strong>Psychological inflexibility about SI may amplify SI severity, which has theoretical implications for ideation-to-action frameworks of suicide. In addition to treating underlying suicidal cognitions, patients may benefit from addressing concerns about the meaning and impact of SI itself.</p>","PeriodicalId":8325,"journal":{"name":"Archives of Suicide Research","volume":" ","pages":"1-11"},"PeriodicalIF":2.2,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13502992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762217","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Historic and Recent Suicide Risk: Does Causality Orientation Matter?","authors":"Christopher Rainbow, Ruth Tatnell, Glenn A Melvin","doi":"10.1080/13811118.2026.2715597","DOIUrl":"https://doi.org/10.1080/13811118.2026.2715597","url":null,"abstract":"<p><strong>Objective: </strong>Low perceived control over suicidal urges has been associated with greater suicide risk. Within Self-Determination Theory, causality orientations are stable motivational drivers shaping beliefs about control over external events. Orientations are three separate but related dimensions varying in levels of perceived agency (autonomous, control, impersonal). This study is believed to be the first to explore relationships between causality orientations and suicidal thoughts and behaviors (STBs).</p><p><strong>Methods: </strong>Participants were users of an Australian suicide safety planning smartphone app (<i>N</i> = 589) with a lifetime history of STBs. Measures included causality orientation, past-month suicidal ideation, future suicide intent, and lifetime suicidal behaviors. Correlations, logistic, and multiple regressions explored cross-sectional associations between causality orientations and STBs.</p><p><strong>Results: </strong>Low agency (impersonal orientation) was associated with higher past-month suicidal ideation and future suicide intent. Autonomous orientation was associated with greater odds of a lifetime suicide plan. Participants high on both impersonal and autonomous orientations reported higher past-month suicidal ideation and greater likelihood of a past-month suicide attempt. All effect sizes were small.</p><p><strong>Conclusions: </strong>Causality orientations explain limited variance in lifetime and past-month STBs. Motivational beliefs reflecting futility (impersonal) or conflicted agency (impersonal + autonomous) may contribute modestly to suicidal distress alongside other risk factors. Future studies could examine real-time motivational drivers of STBs.</p>","PeriodicalId":8325,"journal":{"name":"Archives of Suicide Research","volume":" ","pages":"1-15"},"PeriodicalIF":2.2,"publicationDate":"2026-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148757211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Young Adults With and Without Non-Suicidal Self-Injury History: A Moderated Mediation Model of Friends' Social Support Between Depression and Loneliness.","authors":"Genta Kulari, Inês Vides Ferreira","doi":"10.1080/13811118.2026.2713719","DOIUrl":"10.1080/13811118.2026.2713719","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to investigate the differences in perception of depressive symptoms, loneliness, and social support from friends between young adults with and without Non-Suicidal Self-Injury (NSSI) engagement in the past year. Moreover, we proposed a model analyzing the moderating effect of NSSI engagement in the mediating role of perceived social support from friends between depressive symptoms and loneliness.</p><p><strong>Method: </strong>A total of 320 young adults with a history of NSSI (aged 18-35 years) were assigned to two groups: NSSI engagement within the last 12 months (<i>n</i> = 160) and no NSSI episode in the previous 12 months (<i>n</i> = 160). Hayes' PROCESS macro for mediation analysis in SPSS was used to test the hypothesized model.</p><p><strong>Results: </strong>Participants with NSSI engagement in the last 12 months manifested significantly higher levels of depressive symptoms and loneliness. Conversely, young adults without NSSI engagement in the last 12 months manifested higher levels of social support from friends. This study found that social support from friends mediated the relationship between depressive symptoms and loneliness. Moreover, the moderation model was significant, explaining that the indirect effect of social support from friends was significantly stronger among participants without NSSI engagement in the last 12 months.</p><p><strong>Conclusions: </strong>This study highlights the intricate interplay between depressive symptoms, loneliness, and social support from friends in a sample of Portuguese young adults with NSSI engagement behaviors in the last 12 months. These findings emphasize the need for a better understanding of factors that contribute to NSSI engagement behaviors particularly among young adults.</p>","PeriodicalId":8325,"journal":{"name":"Archives of Suicide Research","volume":" ","pages":"1-18"},"PeriodicalIF":2.2,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148719996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}