# Nonsuicidal Self Injury in Veterans

> **NIH VA I01** · DURHAM VA MEDICAL CENTER · 2021 · —

## Abstract

There is a critical need to identify risk factors associated with increased suicidality in Veterans. Nonsuicidal
self-injury (NSSI) refers to the deliberate destruction of body tissue without conscious intent to die. Among
civilians, recent evidence suggests that NSSI is a robust predictor of suicide attempts, outperforming a number
of well-established risk factors in prediction models. Patients with NSSI Disorder also report great functional
impairment and higher levels of treatment utilization than psychiatric patients without NSSI Disorder. However,
to date, this important clinical issue has been largely overlooked among Veterans.
 We recently documented alarming lifetime rates of NSSI among help-seeking Veterans. Specifically, we
found that 57-66% of male Veterans seeking treatment for PTSD endorsed lifetime NSSI, and 45-55% reported
engaging in NSSI during the previous two weeks. We have also shown that NSSI is uniquely associated with
suicidal ideation in Veterans, even after accounting for PTSD and depression. More work is needed to: (1)
Define the long-term functional outcomes associated with NSSI and NSSI Disorder in Veterans, and (2)
Identify modifiable treatment-relevant mechanisms that maintain NSSI in Veterans. This knowledge will be a
critical first step toward our long-term goal, which is to develop effective screening and intervention strategies
that will reduce NSSI and other forms of self-injurious behavior (i.e., suicidal behavior) among Veterans.
 The overall objective of this application is to identify the long-term effects of NSSI on Veterans’ functioning
as well as the specific antecedents and consequences that maintain this destructive behavior. Consistent with
our conceptual model, our central hypothesis is that NSSI is preceded by exacerbations in psychiatric distress
and maintained through both intrapersonal (e.g., temporary reductions in psychiatric symptoms) and
interpersonal reinforcement (e.g., increased attention from others). The rationale for the proposed research is
that the identification of factors that underlie and maintain NSSI in Veterans will facilitate the development of
treatment approaches that are specific to the needs of these Veterans.
 In Aim 1, we will conduct a 1-year longitudinal study of Veterans with a history of recent NSSI (N = 120) to
evaluate the long-term functional outcomes associated with this destructive behavior. We hypothesize that
baseline NSSI frequency and baseline NSSI Disorder status will prospectively predict increased functional
disability, greater treatment utilization, increased suicidal behavior, and increased NSSI frequency at 1-year
follow-up after accounting for psychiatric comorbidity and known risk factors. In Aim 2, we will use ecological
momentary assessment (EMA) to identify antecedents that predict the occurrence of NSSI as well as the
consequences that serve to maintain this behavior in a subset of Veterans from Aim 1 who meet criteria for
NSSI Disorder (N = 40). W...

## Key facts

- **NIH application ID:** 10314014
- **Project number:** 5I01CX001486-05
- **Recipient organization:** DURHAM VA MEDICAL CENTER
- **Principal Investigator:** Nathan A. Kimbrel
- **Activity code:** I01 (R01, R21, SBIR, etc.)
- **Funding institute:** VA
- **Fiscal year:** 2021
- **Award amount:** —
- **Award type:** 5
- **Project period:** 2017-01-01 → 2021-12-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10314014

## Citation

> US National Institutes of Health, RePORTER application 10314014, Nonsuicidal Self Injury in Veterans (5I01CX001486-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10314014. Licensed CC0.

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