Engagement In Nonsuicidal Self-injury Research Articles

Examining the Neurobiology of Non-Suicidal Self-Injury in Children and Adolescents: The Role of Reward Responsivity.

Although prior work has shown heightened response to negative outcomes and reduced response to positive outcomes in youth with a history of non-suicidal self-injury (NSSI), little is known about the neural processes underlying these responses. Thus, this study examined associations between NSSI engagement and functional activation in specific regions of interest (ROIs) and whole-brain connectivity between striatal, frontal, and limbic region seeds during monetary and social reward tasks. To test for specificity of the influence of NSSI, analyses were conducted with and without depressive symptoms as a covariate. We found that NSSI was associated with decreased activation following monetary gains in all ROIs, even after controlling for depressive symptoms. Exploratory connectivity analyses found that NSSI was associated with differential connectivity between regions including the DS, vmPFC, insula, and parietal operculum cortex when controlling for depressive symptoms. Disrupted connectivity between these regions could suggest altered inhibitory control of emotions and pain processing in individuals with NSSI. Findings suggest dysfunctional reward processes in youth with NSSI, even very early in the course of the behavior.

Depressive Symptoms, Perceived Stress, Self-Compassion and Nonsuicidal Self-Injury Among Emerging Adults: An Examination of the Between and Within-Person Associations Over Time.

Many emerging adults report experiencing mental health challenges (e.g., depressive symptoms and perceived stress) during the transition to university. These mental health challenges often coincide with increased engagement in nonsuicidal self-injury (NSSI; e.g., self-cutting or burning without lethal intent), but longitudinal research exploring the nature of the associations among depressive symptoms, perceived stress, and NSSI are lacking. In the present study, it was examined whether depressive symptoms and perceived stress predicted increased risk for NSSI over time (or the reverse), and whether these effects were mediated or moderated by self-compassion. The sample consisted of 1,125 university students (Mage = 17.96 years, 74% female), who completed an online survey three times in first year university. A random intercept cross-lagged panel model revealed that higher depressive symptoms, perceived stress, NSSI, and lower self-compassion often co-occurred, but only NSSI predicted increased perceived stress over time. Theoretical and practical implications are discussed.

A test of the interpersonal function of non-suicidal self-injury in daily life

Theoretical models of non-suicidal self-injury (NSSI) posit that individuals use NSSI to influence others, but this remains largely untested. We used ambulatory assessment to test the interpersonal function of NSSI in the daily lives of 51 women with DSM-5 NSSI disorder. Participants reported NSSI events, urges, motives, and positive/negative interpersonal events (IPEs) for 14 days, providing five semi-random daily assessments and event-related NSSI reports. We analyzed 3,498 data-points, including 155 NSSI events, using multilevel models. We observed a positive concurrent association between the number of negative IPEs and NSSI engagement. Additionally, perceived distress of negative IPEs was positively associated with concurrent NSSI events and urges, and predicted later events. We saw no reduction in negative or increase in positive IPEs following NSSI. In a trait-level interview, participants endorsed interpersonal motives only minimally, but indicated that others often trigger NSSI. In daily life, participants rarely endorsed the motive ‘get help/attention’. The results suggest that negative IPEs trigger NSSI, but that individuals in this sample rarely used NSSI for interpersonal motives and did not experience interpersonal reinforcement of NSSI. We discuss limitations of and possible solutions for under-reporting of interpersonal motives and benefits of studying interpersonal triggers (rather than outcomes) in future studies.

Predictors and consequences of non-suicidal self-injury in relation to life, peer, and school factors

IntroductionNumerous life, peer, and school-related factors have been found to be associated with non-suicidal self-injury (NSSI) among adolescents; however, most studies have not explored the possible reciprocal nature of these associations. The aim of the current study was to examine bidirectional and longitudinal associations between NSSI and several life, peer, and school-related factors (i.e., stressful life events, peer relationships, academic achievement, and attitudes towards school). MethodCommunity-based adolescents completed questionnaires assessing the variables of interest at three time points; age 12 (T1; 55.09% girls), age 13 (T2; 56.95% girls), and ages 14–15 (T3; 57.41% girls). In total, 529 adolescents provided complete data across all three-time points. ResultsAnalyses showed a bidirectional association between NSSI and both attitudes towards school and stressful life events. Specifically, stressful life events at T2 predicted engagement in NSSI at T3, and NSSI at T2 predicted increased risk of stressful life events at T3. Similarly, having negative attitudes towards school predicted NSSI at T2, which, in turn, predicted negative attitudes towards school at T3. Further, academic achievement at T1 was negatively associated with NSSI at T2. Peer relationships were neither a predictor nor a consequence of NSSI. ConclusionsOur results suggest that NSSI can be both a predictor and a consequence of various life, and school factors. Focus on these factors in prevention and intervention efforts for NSSI among adolescents may be warranted.

Treating Adolescent Non-Suicidal Self-Injury: Guidelines for Clinical Practice

Self-injurious behaviors affect millions of adolescents each year, indicating a public health problem needing attention and intervention. Non-suicidal self-injury (NSSI) is the act of purposefully hurting oneself without the conscious intent to die, such as self-cutting, burning, or carving. As the rate of engagement in NSSI is growing among adolescents, mental health practitioners are increasingly faced with responding to NSSI behaviors among adolescent clients. These mental health practitioners must adequately and efficiently identify the behaviors and determine the course of treatment to best support the client and reduce the NSSI behaviors. This article aims to educate practitioners around NSSI behaviors, assessment techniques, and the current evidence-based interventions available to treat adolescents who struggle with NSSI to determine the best practice for this high-risk population by using a case example. Due to the lack of research on NSSI, there is a significant gap in knowledge related to interventions for adolescents who engage in NSSI. Practitioners often report having little training specific to the issues and needs of adolescents who engage in NSSI.

Short-term associations between nonsuicidal and suicidal thoughts and behaviors: A daily diary study with high-risk adolescents

BackgroundIn this daily dairy study of adolescents at elevated suicide risk, we examined proximal associations between nonsuicidal self-injury (NSSI) and suicidal thoughts as well as behaviors. We also investigated the prominence of the anti-suicide function underlying NSSI engagement, relative to intrapersonal and interpersonal motives. MethodsSeventy-eight adolescents (67.9% female; ages 13-17) hospitalized due to suicide risk completed daily surveys assessing NSSI and suicidal thoughts for four weeks after discharge (n=1621 observations). Suicidal behavior (actual, aborted, interrupted suicide attempts) was assessed at 1-month follow-up. ResultsOver and above lifetime NSSI, adolescents who generally experienced more enduring (OR=2.54, p=<.001) and intense (OR=1.87, p=.002) suicidal ideation were more likely to engage in NSSI on a given day. Moreover, NSSI likelihood increased when adolescents experienced more enduring (OR=1.99, p<.001) and intense (OR=1.66, p<.001) ideation relative to their typical levels. This pattern was consistent for those with recent NSSI. The anti-suicide function of NSSI was frequently endorsed at hospitalization and when NSSI occurred daily (65.6% of the time), alongside the intrapersonal-negative motive (to avoid aversive states). Exploratory analyses suggest adolescents with suicidal behavior within the month after discharge experienced higher NSSI levels reported daily over the same period (Hedge's g=1.26, p=<.001). LimitationsDaily-level associations were examined concurrently and generalizability of results is limited by sample characteristics. ConclusionsThe notable proximal associations between NSSI and suicidal thoughts and behaviors, as well as the prominence of the anti-suicide function, point to the importance of intervention efforts targeting these intersecting phenomena among adolescents at elevated suicide risk.

The Interplay of Chronic Interpersonal Stress and Rumination on Nonsuicidal Self-Injury in Youth.

Nonsuicidal self-injury (NSSI) describes deliberate self-destructive behaviors without the intention to die. Little is known about what factors contribute to NSSI especially among youth. The current study tested two conceptual models for how chronic interpersonal stress and rumination may contribute to NSSI engagement across 18months in a community sample of youth: (1) a mediation pathway based on the Emotional Cascade Model (i.e., stress contributes to rumination and then to subsequent NSSI), and (2) a moderation model based on the cognitive vulnerability-stress framework (i.e., rumination moderates the relation between stress and NSSI). 516 youth aged 7-16 (Mage = 12.0; 56% female; 90% Non-Hispanic or Non-Latinx) reported on ongoing interpersonal stress occurring between T1-T2 (every 6months from T1 to 12months) via the Youth Life Stress Interview, rumination via the Children's Response Styles Questionnaire (at T1 and 18months later, T2), and NSSI engagement every six months from 18 to 36months (T2-T3) via the Self-Injurious Thoughts and Behaviors Interview. Interpersonal stress predicted later rumination (b = .43, p < .01), rumination forecasted later NSSI occurrence (OR = 1.06, p < .01), and mediation was supported via a significant indirect effect of interpersonal stress on NSSI through rumination (b = .03, 95% CI = .01, .07). Rumination did not significantly moderate the relation between stress and NSSI. The prospective relation between chronic interpersonal stress and NSSI engagement was partly explained by rumination, aligning with the Emotional Cascade Model's prediction that rumination contributes to NSSI. Youth may conduct NSSI to interrupt rumination elicited by chronic interpersonal stress.

Associations between social contagion, group conformity characteristics, and non-suicidal self-injury

Objective: The current study aimed to better understand the relationship between exposure to non-suicidal self-injury (NSSI) through peers, group conformity characteristics (i.e., over-dependency, need-to-belong), and personal NSSI engagement. Methods: One hundred thirty-eight undergraduate students (n = 40 with history of NSSI) completed an online survey about NSSI history and exposure as well as their interpersonal dependency and need-to-belong in a group. Results: Results indicated that NSSI participants (NSSI+) were more likely to be exposed to NSSI in-person (IP+). NSSI+/IP + participants were more likely to think about NSSI post-media exposure and reported higher over-dependency and need-to-belong than NSSI−/IP−. Conclusions: Findings suggest that being exposed to NSSI in-person and having higher over-dependency and need-to-belong are associated with personal NSSI engagement.

The epidemiology of non-suicidal self-injury: lifetime prevalence, sociodemographic and clinical correlates, and treatment use in a nationally representative sample of adults in England.

Although the clinical importance of non-suicidal self-injury (NSSI) has received increasing recognition, relatively little is known about its epidemiology. The objective of this study was to estimate the lifetime prevalence of NSSI in adults and its association with sociodemographic characteristics, psychiatric disorders, and lifetime treatment for NSSI. A nationally representative face-to-face survey was conducted with 7192 adults aged ≥18 years in England. Respondents were interviewed about engagement in NSSI, psychiatric illness, suicidal thoughts and behavior, and treatment history for this behavior. The estimated lifetime prevalence rate of NSSI was 4.86%. Younger age, growing up without biological parents in the household, being unmarried, and impoverished backgrounds were associated with NSSI. The majority of respondents with lifetime NSSI (63.82%) had at least one current psychiatric disorder. Most psychiatric conditions were associated with greater odds of lifetime NSSI in multivariate models. NSSI was strongly associated with suicidal ideation and suicide attempts, respectively, even after accounting for psychiatric disorders and sociodemographic covariates. A substantial proportion of respondents with NSSI history (30.92%) have engaged in medically severe self-harm, as indexed by requiring medical attention for this behavior. The majority of respondents with NSSI (56.20%) had not received psychiatric care for this behavior. NSSI is prevalent in the general population and associated with considerable psychiatric comorbidity. A high rate of unmet treatment needs is evident among those with this behavior. Those at the greatest lifetime risk for NSSI may also be particularly limited in their resources to cope with this behavior.

Non-suicidal self-injury in the context of COVID-19: The importance of psychosocial factors for female adolescents

The COVID-19 pandemic presents a unique context in which to study the impact of protective and risk factors for non-suicidal self-injury (NSSI) in adolescents under circumstances of heightened stress. Female participants ( N = 91, aged 12–16) enrolled in an ongoing study of NSSI completed self-report questionnaires that assessed NSSI recency, internalizing symptoms (anxiety, depressive), stress perception (stress, family conflict, loneliness), and coping resources (emotion regulation, friend and family support). Parents reported on experiences during the pandemic (family's financial status, health, and schooling). We compared protective and risk factors among three groups of adolescents: those with no history of NSSI (Never), those who did not continue to engage in NSSI in the early months of the COVID-19 pandemic (Desist), and those with a history of NSSI who did (Persist). Participants in the Persist group reported higher levels of perceived stress and loneliness and lower family support than those in the Desist group. A larger set of coping resources (emotion regulation difficulties, friend support) also differed between the Persist and Never NSSI groups. These findings largely remained significant when controlling for possible contributing factors. A strength is the longitudinal study design. Limitations include the inability to assess changes in rate of NSSI engagement, small sample size, inclusion of only female participants, reliance primarily on self-report, and a design not suitable for making causal inferences. In the context of the COVID-19 pandemic, factors such as family support may protect against NSSI engagement and offer avenues for treatment.

Bullying Victimization: Investigating the Unique Contribution of Homophobic Bias on Adolescent Non-suicidal Self-injury and the Buffering Role of School Support

Research on bullying victimization has expanded to specific forms of harassment based on discriminatory bias, which involve aggressive behavior targeting an individual's identity characteristics, such as sexual orientation and/or gender expression. Recent studies have documented elevated health risks associated with victimization based on homophobic bias, above and beyond general victimization. The aim of the current study was to test the unique contribution of homophobic victimization on adolescent non-suicidal self-injury (NSSI) and to analyze the buffering role of teachers and classmates support. Participants were 770 adolescents (55.5% females; Mage = 15.35, SD = 1.62) enrolled in Italian public schools in grade nine (N = 483) and 12 (N = 287). All measures were collected during Spring 2016 using self-reported questionnaires. Zero-inflated Poisson regression analyses suggested that homophobic victimization had a unique contribution on NSSI frequency of engagement once initiated, but not on the probability of engaging in NSSI at least once. High classmates support was negatively associated with adolescents’ engagement in NSSI. Furthermore, higher levels of classmates support were associated with a lower NSSI frequency only for youth who reported low levels of homophobic victimization. In contrast, the association between classmates support and NSSI frequency was nonsignificant when youth reported high levels of homophobic victimization. No significant effects were found for teachers support. Overall, our findings underscore the need to address the serious concern of homophobic victimization within schools and the importance of promoting healthy and positive identity development in adolescence.

Exploring the role of anger in nonsuicidal self-injury in veterans

Up to 14% of veterans engage in nonsuicidal self-injury (NSSI) in their lifetime and this behavior is a relatively strong predictor of suicidal behavior compared to other identified risk factors. Further, NSSI is a clinically relevant behavior in its own right; it is associated with more severe psychopathology as well as bodily harm that sometimes requires medical intervention. Therefore, a better understanding of NSSI may help inform suicide prevention efforts as well as mental healthcare strategies for veterans. Anger may be relevant to understanding NSSI in veterans. Over 60% of veterans report difficulties managing anger and this emotion is strongly associated with engagement in NSSI. However, no research has explored the extent to which anger is present prior to NSSI or whether anger is associated with specific NSSI methods or functions in veterans. The purpose of this study was to explore whether anger was associated with engagement in specific NSSI methods, and whether anger uniquely predicted any functions of NSSI while controlling for the presence of other basic negative emotions (fear and sadness). An existing dataset of 61 veterans who reported engaging in NSSI in the past year was analyzed. Results indicated anger was the most common emotional antecedent to NSSI. Further, anger was associated with several methods of NSSI including burning oneself with a cigarette, carving pictures, designs or other marks into skin, sticking sharp objects into skin, severely scratching oneself, head banging, punching oneself, and punching walls or objects. Finally, when controlling for the presence of other negative emotions, anger was associated with engaging in NSSI to relieve tension, stop feeling numb, communicate with others, feel alive, get help from others, and prove to oneself how bad things are. These results highlight the importance of assessing and treating dysregulated anger in veterans who engage in self-harming behavior.

Examining the Relationship Between Mindfulness, Self-Compassion, and Emotion Regulation in Self-Injury

Objective The objective of the current study was to investigate whether mindfulness and self-compassion are negatively associated with engagement in non-suicidal self-injury (NSSI) and whether emotion dysregulation would mediate this relation. Method 343 participants (82.2% female; M age = 23.98; SD = 7.47) were recruited from university and community settings, and completed online questionnaires. Two groups of participants were created: those with lifetime engagement in NSSI (n = 153) and a comparison group with no prior engagement in NSSI (n = 190). Results First, two one-way MANOVAs revealed significant mean differences (NSSI/comparison) across the self-compassion dimensions and specific mindfulness facets. Second, logistic regressions revealed that the self-coldness dimension of self-compassion significantly predicted engagement in NSSI, and specific mindfulness facets (nonjudging and acting with awareness) were found to negatively predict NSSI engagement. Lastly, mediation analyses revealed that emotion dysregulation fully mediated the relationships between both mindfulness total and self-coldness, and NSSI group status. Conclusion The present study demonstrates preliminary support for the protective role of key mindfulness facets and potential risk of the self-coldness aspect of self-compassion in NSSI engagement. Implications for potential use of treatment protocols may include teaching key aspects of mindfulness and self-compassion as healthier and kinder alternatives to coping with dysregulated emotions. Highlights Mindfulness and self-compassion significantly differ between NSSI/comparison groups Key mindfulness facets and self-compassion dimensions negatively predict engagement in NSSI Emotion dysregulation fully mediates self-coldness and mindfulness with NSSI group status

Maternal Emotion Socialization of Adolescent Girls Engaging in Non-Suicidal Self-Injury.

Non-suicidal self injury (NSSI) is a transdiagnostic maladaptive behavior that is highly prevalent in adolescence. A greater understanding of the mechanisms leading to NSSI is needed to guide the development of prevention efforts. The current study examined the relationship between maternal socialization of emotions and NSSI behaviors in their children. Female adolescents (N = 90, 12-17years old) who demonstrated a range of NSSI lifetime episodes from none to very frequent were included in this sample. Maternal responses to their children's displays of sadness, anger, and happiness were assessed. Principal components analysis was used to categorize items into supportive and unsupportive maternal emotion socialization responses for the three emotions. Adolescents whose mothers reported less supportive maternal responses to child's expressions of sadness and anger had more lifetime NSSI episodes. Many of these patterns remained when follow-up analyses considered an extreme group approach (e.g., high counts of NSSI versus no NSSI), when analyses focused on specific diagnostic subgroups (e.g., depression and anxiety), and to some extent (socialization of anger) when current NSSI was considered. While the cross-sectional study design prevents causal conclusions, transactional theories raise the possibility that mothers' emotion socialization may impact offspring NSSI and offspring engagement in NSSI may result in mothers altering their socialization practices to accommodate their child's unique needs. Future research should employ longitudinal methodology to examine the time course, consider the role of emotion regulation as an explanatory mechanism, and consider intervention methods that may teach effective emotion socialization for parents.

The Association of Nonsuicidal Self-Injury with Quality of Life and Mental Disorders in Clinical Adolescents-A Network Approach.

Although earlier research has highlighted that psychiatric disorders significantly impair patients’ quality of life (QoL), few studies have examined the relationship between nonsuicidal self-injury (NSSI) and QoL. Our aim was to investigate whether QoL mediates the mental disorder–NSSI relationship, and to study the QoL ratings agreement of self and parents in a clinical population of adolescents. We involved 202 adolescents from Vadaskert Child Psychiatric Hospital and Outpatient Clinic, Budapest, aged 13–18 years. All participants completed the Deliberate Self-Harm Inventory, Inventar zur Erfassung der Lebensqualität bei Kindern und Jugendlichen, and the Mini International Neuropsychiatric Interview Kid. To map the interrelationship between the NSSI, mental disorders, and QoL dimensions, Mixed Graphical Models were estimated. Adolescents with a history of NSSI rated their QoL to be significantly lower than adolescents without NSSI. Self and parents’ QoL ratings are closer in the NSSI sample than in the no-NSSI sample. Among all QoL dimensions, only family problems had a direct significant association with NSSI engagement. Our results highlight that, contrary to our hypothesis, the presence of mental disorders mediates the relationship between most QoL dimensions and the occurrence of NSSI. Our results draw attention to the potential causal effect of environmental factors (e.g., peer problems) on mental disorders that, in turn, result in NSSI. The present paper highlights the importance of network modelling in clinical research.

Explicit and implicit measurement of nonsuicidal self-injury in the prediction of concurrent and prospective self-injury.

The relationship between explicit nonsuicidal self-injury (NSSI) behavior and implicit identification with NSSI is important to understand considering the under-reported nature of NSSI and the subsequent elevated risk of more severe NSSI. It was expected that implicit assessment of NSSI at baseline would be associated with past-year NSSI frequency assessed at baseline and that it would more strongly associate with NSSI frequency than self-reported future likelihood of NSSI at a 6-month follow-up. Data were collected from 420 young adults (mean age=19; 83% women, 87% White) with recent NSSI at baseline, and 324 were assessed at 6-month follow-up. Participants completed self-report measures and the Self-Injury Implicit Association Task (SI-IAT) at each time point. Baseline implicit NSSI scores significantly predicted NSSI frequency at baseline but not at 6-month follow-up. However, explicit ratings were strongly and significantly associated with future NSSI frequency. These findings suggest that although implicit identification with oneself and NSSI is important to understand, there are limitations regarding the possible utility of the SI-IAT in predicting future NSSI engagement and further research is needed to fully understand why NSSI continues to be such a strong predictor of future NSSI behavior, and suicidal ideation and behavior.

Anger precedes and predicts nonsuicidal self-injury in veterans: Findings from an ecological momentary assessment study

Veterans have high rates of suicide, and nonsuicidal self-injury (NSSI) is one of the strongest predictors of suicide risk; however, there is presently little known about antecedents of NSSI that might inform intervention efforts. Accumulating research suggests that anger and hostility play an important role in NSSI, but whether these emotions precede and predict NSSI is currently unknown. The aim of the current study was to examine the temporal relationships between anger/hostility and NSSI urges and behavior among veterans diagnosed with NSSI disorder. Our hypothesis was that angry/hostile affect would predict subsequent NSSI urge and engagement, but not vice versa. Forty veterans with NSSI disorder completed a 28-day ecological momentary assessment study with three daily prompts to report on their affect and NSSI urges and engagement. Multilevel cross-lagged path modeling was used to determine the direction of effects between angry/hostile affect and NSSI urges and engagement over time. Consistent with our hypothesis, results indicated that the lagged effects of angry/hostile affect on subsequent NSSI urge and engagement were significant, whereas the lagged effects of NSSI urge and engagement on angry/hostile affect were not significant. Findings highlight the importance of assessing and treating anger among veterans who engage in NSSI.

Salivary beta-endorphin in nonsuicidal self-injury: an ambulatory assessment study

Nonsuicidal self-injury (NSSI) is a prevalent and impairing behavior, affecting individuals with and without additional psychopathology. To shed further light on biological processes that precede and result from NSSI acts, we built on previous cross-sectional evidence suggesting that the endogenous opioid system, and especially β-endorphin, is involved in the psychopathology of NSSI. This is the first study assessing salivary β-endorphin in daily life in the context of NSSI acts. Fifty-one female adults with repetitive NSSI participated over a period of 15 days in an ambulatory assessment study. Salivary β-endorphin was assessed before and after engagement in NSSI, during high urge for NSSI, and on a non-NSSI day. Furthermore, NSSI specific variables such as pain ratings, as well as method, severity, and function of NSSI were assessed. We found that β-endorphin levels immediately before an NSSI act were significantly lower than directly after NSSI. However, there was no difference between β-endorphin during high urge for NSSI and post NSSI measures. We found a positive association between severity of the self-inflicted injury and β-endorphin levels, but no significant association between β-endorphin levels and subjectively experienced pain. The results of the present study indicate that it is possible to assess salivary β-endorphin in daily life in the context of NSSI. Furthermore, our results provide a first indication that NSSI acts could be associated with a momentary increase of β-endorphin, and this might reinforce NSSI engagement. More research is needed to replicate and extend our findings on peripheral β-endorphin in daily life.

Psychometric Assessment of Adverse Childhood Experiences International Questionnaire (ACE-IQ) with Adults Engaging in Non-Suicidal Self-Injury

Background: The current study aimed to investigate the psychometric properties of the Adverse Childhood Experiences – International Questionnaire (ACE-IQ) with individuals engaging in non-suicidal self-injury. Numerous studies have supported the association of adverse childhood experiences with non-suicidal self-injury. However, the majority of the measures used were limited to basic forms of abuse and neglect, indicating a need for the use of a more inclusive measure, such as the ACE-IQ. The psychometric properties of the measure though have only been briefly investigated with other populations, suggesting that a more thorough examination might be beneficial before its use. Method: Two hundred eighty-four adult participants (77.5% females) with a mean age of 23.4 (SD=5.7) were recruited online via specific self-harm groups on social media platforms. Participants were asked to complete an online survey consisting of three self-report measures regarding early childhood experiences and engagement in non-suicidal self-injury. Results: The findings of this study supported ACE-IQ’s reliability (Cronbach’s alpha = 0.854), convergent validity (r= 0.85, p<0.001 with the CTQ-SF), predictive validity (R 2 = 0.12, p=0.001 of the SHI total score) and discriminant validity (F-value = 13.90, p<0.001). An exploration of the factor structure demonstrated a 5-factor solution (physical abuse, sexual abuse, emotional abuse, exposure to violence, family environment). Conclusions: It was concluded that ACE-IQ is a reliable and valid measure to be used for research or clinical purposes with individuals engaging in non-suicidal self-injury, although further research is needed on its factor structure. Research and clinical implications are discussed.

Emotional Consequences of Participating in Research: How Does a History of Non-Suicidal Self-Injury and Trauma Exposure Affect Participants' Experiences?

Although research into trauma and non-suicidal self-injury (NSSI) is critical to informing evidence-based interventions, IRB committees express caution about the potential safety concerns these questions pose to participants. The present study examined the emotional consequences of participating in research asking questions about trauma and NSSI. A total of 544 participants completed self-report questionnaires assessing trauma exposure, NSSI, and reactions to research participation. Results indicated that trauma exposure was positively related with emotional reactions, and NSSI engagement was associated with higher incidences of trauma. Additionally, those with a history of NSSI reported greater emotional reactions and perceived drawbacks after participation. However, overall, individuals with a history of NSSI still indicated a positive research experience. Implications for how to safely conduct research with participants who have a history of NSSI and previous trauma exposure are discussed.