Despite an increased awareness and research of self-injurious behaviors among adolescents [3], epidemiological studies of the risk factors of self-harm remain relatively scarce [13,14,15]. Even less is known about potentially shared or unique factors associated with self-harm and suicidal behaviors. While self-harm is a major risk factor for suicide [16,17,18,19], the extent to which self-harm and suicidal behavior overlap in community samples of vulnerable youth is less known. Moreover, few studies have examined the risk factors that contribute to self-harm, while considering the impact of suicidal history [20,21]. This is an important area for research because self-harm is typically a means of expressing self-directed anger or resisting suicidal thoughts [22] suggesting possible separate etiologies. Self-harm is also used to signal distress and distract from painful feelings when other communication strategies have failed [23]. Furthermore, empirical research findings indicate that those who engage in self-harming often have psychological problems including depression, anxiety, impulsivity, low self-esteem and suicidal ideation [2,7,8,21,24,25,26,27].
