of convenience, and several studies report high  rates of false intent declaration. Individu-
als with a history of frequent nonsuicidal se lf-injury episodes have learned that a session
of cutting, while painful, is, in the short-term, largely benign. Be cause individuals with
nonsuicidal self-injury can and do attempt and commit suicide,  it is important to check
past history of suicidal behavior and to ob tain information from a third party concerning
any recent change in stress exposure and mo od. Likelihood of suicide intent has been as-
sociated with the use of multiple  previous methods of self-harm. 
In a follow-up study of cases of “self-harm” in males treated at one of several multiple
emergency centers in the United Kingdom, in dividuals with nonsuicidal self-injury were
significantly more likely to commit suicide th an other teenage individuals drawn from the
same cohort. Studies that have examined the relationship be tween nonsuicidal self-injury
and suicidal behavior disorder  are limited by being retrospe ctive and failing to obtain ver-
ified accounts of the method used during pr evious “attempts.” A significant proportion of
those who engage in nonsuicidal self-injury have responded positively when asked if they
have ever engaged in self-cutti ng (or their preferred means of self-injury) with an intention
to die. It is reasonable to co nclude that nonsuicidal self-injury, while not presenting a high
risk for suicide when first manifested, is an  especially dangerous form of self-injurious
behavior.
This conclusion is also supported by a mult isite study of depressed adolescents who had
previously failed to respond to  antidepressant medi cation, which noted th at those with pre-