OBJECTIVE Nonsuicidal self-injury (NSSI) is often cited as a key risk factor for future suicidal behavior. Capability for suicide has been repeatedly cited as an important mechanism that can account for this association. Despite this, direct tests of this hypothesis have been rare and methodologically constrained. In the present study, we conducted a direct test of this hypothesis while addressing several constraints of prior literature. METHOD In a large sample of suicidal and self-injuring adults (n = 1,020), we tested whether changes in fearlessness about death (FAD), a core facet of the capability for suicide, accounted for the relationship between NSSI and future suicide attempts at 28-day and 2-year follow-up. FAD was assessed using the gold-standard self-report form (ACSS-FAD), an implicit test of suicide-related affect (affect misattribution paradigm-Suicide), and explicit affective ratings of suicide-relevant images. Mediation with bootstrapping was implemented to test our main hypotheses. RESULTS As anticipated, lifetime NSSI frequency was significantly associated with suicide attempt frequency at follow-up; however, FAD failed to consistently mediate this association. Results were largely consistent across all three measures of FAD. Post hoc power analyses indicated sufficient power to detect small effects. CONCLUSIONS Taken together, these results fail to support the hypothesis that capability for suicide explains the link between NSSI and future suicidal behavior. We discuss the implications of our results for research and theory, situating our findings in the context of recent advances in the understanding of suicide risk more broadly. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

中文翻译：

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对死亡的无畏是否介导了 NSSI 和自杀未遂之间的关联？对 1,000 多名高危个体的纵向研究。

目的 非自杀性自伤 (NSSI) 通常被认为是未来自杀行为的关键风险因素。自杀能力被反复引用为可以解释这种关联的重要机制。尽管如此，对该假设的直接测试很少见，并且在方法上受到限制。在本研究中，我们对这一假设进行了直接检验，同时解决了先前文献的几个限制因素。方法 在大量自杀和自伤成年人样本（n = 1,020）中，我们测试了无畏死亡 (FAD)（自杀能力的核心方面）的变化是否解释了 NSSI 与未来自杀企图之间的关系。 28 天和 2 年的随访。使用黄金标准自我报告表 (ACSS-FAD) 评估 FAD，与自杀相关的情感（情感错误归因范式-自杀）的内隐测试，以及与自杀相关图像的外显情感评级。使用引导进行调解来测试我们的主要假设。结果 正如预期的那样，终生 NSSI 频率与随访时的自杀未遂频率显着相关；然而，FAD 未能始终如一地调解这种关联。结果在 FAD 的所有三个指标中基本一致。事后功效分析表明有足够的功效来检测小影响。结论 综上所述，这些结果无法支持自杀能力可以解释 NSSI 与未来自杀行为之间的联系的假设。我们讨论我们的结果对研究和理论的影响，将我们的发现置于更广泛地理解自杀风险的最新进展的背景下。（PsycInfo 数据库记录 (c) 2021 APA，保留所有权利）。