Intrapersonal Functions of Nonsuicidal Self-Injury Statistically Mediate the Effect of Posttraumatic Stress Disorder Symptoms on Fearlessness About Death

Objective: Although not all trauma-exposed individuals develop posttraumatic stress disorder (PTSD) symptoms or nonsuicidal self-injury (NSSI), it has been suggested that those who use NSSI as a means of coping with PTSD symptoms increase their acquired capability for suicide. This study sought to test the relationship between PTSD symptom clusters, functions of NSSI, and suicide capability (i.e., fearlessness about death [FAD]) in a trauma-exposed sample of individuals with a history of self-injury. Method: Self-report data were collected from undergraduates (N = 58) who ranged in age from 18 to 38 years (M = 19.62, SD = 3.28). Participants were primarily female (86.2%). Most participants were identified as White (81%), 12.1% as African American/Black, 1.7% as Asian, 1.7% as American Indian/Alaskan Native, and 3.5% as Biracial. A parallel mediation model was employed. Results: Global PTSD symptoms exhibited a statistically significant positive relationship with intrapersonal (e.g., emotion regulation) and interpersonal (e.g., social) functions of NSSI. However, only intrapersonal functions were statistically significantly related to FAD. Although PTSD symptoms did not demonstrate a direct relationship with FAD, there was an indirect effect of PTSD symptoms on FAD through intrapersonal functions of NSSI. Conclusions: Engaging in NSSI for the purpose of managing PTSD symptoms may contribute to FAD beyond the presence of PTSD symptoms or NSSI. Clinical interventions that promote adaptive emotional regulation strategies may help to thwart increases in FAD for trauma-exposed samples.