Characteristics of Disclosure of Suicidal and Nonsuicidal Behaviors in a Clinical Sample of Adolescents

Many adolescents fear disclosing self-injurious thoughts and behaviors (SITBs) due to stigma or concern about responses from others. The current study examined rates of disclosure for nonsuicidal self-injury (NSSI), suicide ideation, and suicide attempts in a clinical sample of adolescents, and identified the individuals to whom they disclosed their SITBs. Differences in reasons for living (parent and peer support, future optimism, self-acceptance, and fear of suicide) were examined across disclosure groups. The sample included 100 adolescent inpatients (mean age = 14.61). Rates of disclosure were relatively high: 77% for NSSI, 75% for suicide ideation, and 83.7% for suicide attempts. Adolescents who disclosed NSSI reported higher scores on subscales of self-esteem and future optimism compared to those who did not disclose. No differences were found for adolescents disclosing to parents vs. others; only the fear of suicide subscale was significantly different, and was lower for adolescents who disclosed NSSI to peers vs. others. Adolescents with suicide ideation disclosure reported more parent support compared to those who had not disclosed, those with peer disclosure reported lower fear of suicide than those disclosing to others, and there were no differences for disclosing to parents vs. others. For suicide attempts, only self-acceptance subscale scores were significantly different, and lower for adolescents who disclosed to peers vs. others. There were no differences for disclosing suicide attempts to parents versus other people. The willingness to disclose self-harm behaviors seems influenced by the perception of safety and anticipated support from parents or others to whom adolescents disclose.