TPC Journal Volume 11 Issue 2

228 The Professional Counselor | Volume 11, Issue 2 SIB (including nonsuicidal and suicidal SIB; Tuisku et al., 2014), the high lifetime rates of SIB found in both samples in the current study are noteworthy for service providers. Specifically, our results suggest that universities and other institutions concerned with mental health in college students should consider utilizing SIB screening tools. Additionally, the high prevalence of students with a lifetime history of any SIB suggests the need for widespread intervention programs for student populations. For example, some research (e.g., Kannan et al., 2021) has examined the implementation of DBT skills groups in college counseling centers for students with a variety of presenting issues, including SIB. Such intervention programs could benefit a wider range of students and help improve quality of life for many, especially those struggling with SIB. Given that psychological distress predicted total SIB, it may be beneficial for counselors to regularly assess the level of psychological distress in all clients, including those with BPD and college students. Clients with high psychological distress, including anxiety, depression, obsessive-compulsion, and interpersonal sensitivity, will likely engage in more SIB than those with low psychological distress, and thus the counselor may be able to intervene before the client escalates to a high frequency of SIB. Assessing and tracking affective distress levels may be common with suicide assessment and safety planning, but there may be less awareness about the need for this with SIB. Treatment protocols could also focus on lowering psychological distress to see if that will decrease SIB. For example, DBT, which emphasizes psychological distress tolerance, has been increasingly implemented in college campus counseling centers (see Chugani, 2015). However, given that the current study’s findings are not causal, we cannot definitively conclude that lowering psychological distress will affect SIB. Importantly, the interaction between psychological distress and sample type is noteworthy given that it contributes to the small extant evidence of divergence between populations of individuals with symptoms of BPD and other, more community-based populations like college students. Specifically, we found differences in SIB prevalence, in lifetime frequency, and in one predictor (i.e., psychological distress) in our two samples. This aligns with Turner et al.’s (2015) findings that individuals who engaged in SIB with and without BPD differed in SIB frequency, severity, and comorbid affective symptomology. It is also worth noting that the correlational analysis revealed a difference between these two samples in social functioning. In particular, there was a statistically significant negative correlation between total SIB and positive social support in the student sample, but not in the BPD-Tx sample. Because of this, although we only found one statistically significant interaction between psychosocial predictors and sample type, it is plausible that there are other notable differences in SIB risk factors between these two populations. Thus, when treating SIB, it may be worth assessing for other symptoms of BPD to form a more accurate representation of a client’s experience and to help form a specific treatment plan. Limitations and Future Studies One potential limitation of the current study is that we included only individuals who reported engaging in SIB in the past year because we wanted to examine current predictors of current SIB. However, it is possible that psychological distress and social support are more effective predictors of future SIB acts. In other words, the current study examined predictors of the frequency of SIB using current psychosocial functioning, yet the psychosocial variables might have been better at predicting whether or not an individual will engage in SIB in the future. This theory aligns with Heath et al.’s (2009) interpretation of their lack of results linking social support to lifetime rates of nonsuicidal SIB. Specifically, that social support may better relate to differences between those who will engage in SIB compared to those who will not, as opposed to the degree (i.e., frequency) of SIB. It is unclear how the results may have differed if we included a comparison group of individuals who do not engage in SIB or have never engaged in SIB.