Abstract
BackgroundNon-suicidal self-injury (NSSI) has become a substantial public health problem. NSSI is a high-risk marker for the development and persistence of mental health problems, shows high rates of morbidity and mortality, and causes substantial health care costs. Thus, there is an urgent need for action to develop universal prevention programs for NSSI before adolescents begin to show this dangerous behavior. Currently, however, universal prevention programs are lacking.MethodsThe main objective of the present study is to evaluate a newly developed universal prevention program (“DUDE – Du und deine Emotionen / You and your emotions”), based on a skills-based approach in schools, in 3200 young adolescents (age 11–14 years). The effectiveness of DUDE will be investigated in a cluster-randomized controlled trial (RCT) in schools (N = 16). All groups will receive a minimal intervention called “Stress-free through the school day” as a mental health literacy program to prevent burnout in school. The treatment group (N = 1600; 8 schools) will additionally undergo the universal prevention program DUDE and will be divided into treatment group 1 (DUDE conducted by trained clinical psychologists; N = 800; 4 schools) and treatment group 2 (DUDE conducted by trained teachers; N = 800; 4 schools). The active control group (N = 1600; 8 schools) will only receive the mental health literacy prevention. Besides baseline assessment (T0), measurements will occur at the end of the treatment (T1) and at 6- (T2) and 12-month (T3) follow-up evaluations. The main outcome is the occurrence of NSSI within the last 6 months assessed by a short version of the Deliberate Self-Harm Inventory (DSHI-9) at the 1-year follow-up (primary endpoint; T3). Secondary outcomes are emotion regulation, suicidality, health-related quality of life, self-esteem, and comorbid psychopathology and willingness to change.DiscussionDUDE is tailored to diminish the incidence of NSSI and to prevent its possible long-term consequences (e.g., suicidality) in adolescents. It is easy to access in the school environment. Furthermore, DUDE is a comprehensive approach to improve mental health via improved emotion regulation.Trial registrationGerman Clinical Trials Register (DRKS) DRKS00018945. Registered on 01 April 2020, https://www.drks.de/drks_web/navigate.do?navigationId=trial.HTML&TRIAL_ID=DRKS00018945
Highlights
Non-suicidal self-injury (NSSI) has become a substantial public health problem
Du Und Deine Emotionen (DUDE) is tailored to diminish the incidence of NSSI and to prevent its possible long-term consequences in adolescents
Given that NSSI is a common and highly recurrent behavior that peaks in adolescence around the age of 16 years [11, 12], there is an urgent need for action, especially in the area of universal prevention, prior to the age of 11 to 14 years when adolescents begin to show these dangerous behaviors
Summary
Non-suicidal self-injury (NSSI) has become a substantial public health problem. NSSI is a high-risk marker for the development and persistence of mental health problems, shows high rates of morbidity and mortality, and causes substantial health care costs. There is an urgent need for action to develop universal prevention programs for NSSI before adolescents begin to show this dangerous behavior. NSSI is characterized by the intentional and self-inflicted destruction of body tissue without suicidal intent [3] All, it is a high-risk marker for the development and persistence of mental health problems in adolescents, and has been highlighted by researchers all over the world. Given that NSSI is a common and highly recurrent behavior that peaks in adolescence around the age of 16 years [11, 12], there is an urgent need for action, especially in the area of universal prevention, prior to the age of 11 to 14 years when adolescents begin to show these dangerous behaviors
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