Non-suicidal Self-injury Behaviors Research Articles

Psychological Inflexibility and Non-Suicidal Self-Injury (NSSI) Behavior among Emerging Adults: Life Satisfaction as Moderator

This study aims to examine the role of life satisfaction level as a moderator in the correlation between psychological inflexibility and NSSI behavior. Self-harm behavior without any intention to commit suicide (non-suicidal self-injury (NSSI)) is now widely practiced by adolescents and young adults. Participants in this study were 224 participants aged 18-29 years (average age 22.21 years, 81.3% female). Life satisfaction levels were measured using the Satisfaction with Life Scale (SWLS), psychological inflexibility was measured using the Acceptance and Action Questionnaire-II (AAQ-II), and NSSI behavior was measured using the Non-Suicidal Self-Injury Function Scale (NSSI-FS). Moderation analysis was done using Hayes 4.0. The results of the moderation analysis show that level of life satisfaction significantly moderates the relationship between psychological inflexibility and NSSI behavior. This is consistent with the research hypothesis, namely the level of life satisfaction can weaken the relationship between psychological inflexibility and NSSI behavior. Therefore it can be concluded that individuals can weaken the effects of psychological inflexibility by increasing their life satisfaction.

Non-suicidal self-injury in adolescents with mood disorders and the roles of self-compassion and emotional regulation.

We aimed to investigate the characteristics and psychological mechanism of non-suicidal self-injury (NSSI) in adolescents with mood disorders. We examined how self-compassion and emotional regulation affected NSSI and tested the mediating role of self-compassion in the link between emotional regulation and NSSI. We recruited outpatient and inpatient adolescent patients with bipolar and related disorders or depressive disorders (DSM-5), with a focus on NSSI. We also recruited healthy controls from the community. We collected demographic and clinical data. The Adolescent Self-injury Questionnaire, Self-compassion Scale (SCS), and Emotion Regulation Questionnaire (ERQ) were used to assess the frequency and severity of NSSI, level of self-compassion, and emotional regulation. In total, we recruited 248 adolescent patients with mood disorders (N = 196 with NSSI, and 52 without NSSI) and 212 healthy controls. NSSI was significantly associated with the female sex, lower levels of education and less use of cognitive reappraisal strategies, lower levels of self-warmth, and higher levels of self-coldness. Multivariate analysis of variance showed that there were significant differences in the scores of ERQ, cognitive reassessment score, and the scores of SCS among the three groups, but no statistical differences in expressive suppression score among the three groups. Self-warmth had a mediating effect between cognitive reappraisal and NSSI behavior. NSSI is prevalent among adolescent patients with mood disorders in clinical settings, especially among girls and those with lower levels of education and less cognitive reappraisal strategies. More clinical attention is needed. Self-compassion and its factors may mediate the association between emotional regulation and NSSI. Clinical implications and future research directions were discussed.

Persistence and Cessation of Nonsuicidal Self-Injury Under Psychotherapy

Abstract: This study examines factors associated with recovery from nonsuicidal self-injury, comparing the characteristics of nonsuicidal self-injury behavior, clinical history, and psychological features of one group of patients who recovered from nonsuicidal self-injury within 12 months of psychotherapy and one group of patients who did not. Both groups received three components of treatment: feedback on psychological assessment results, psychoeducation on stress and emotional control, and acquisition of stress-coping skills. The Rorschach Comprehensive System was used for the measurement of participants’ psychological characteristics. Results indicated that the nonrecovery group ( N = 14) remembered significantly fewer self-harm episodes than the recovery group ( N = 16). The Rorschach showed differences in variables indicative of thinking and cognitive problems: PTI positivity and X-% were significantly higher in the nonrecovery group, while X+%, XA%, and WDA% were significantly lower in the nonrecovery group. Results suggest that the recovery group interrupted self-injury behaviors in a relatively short period by acquiring self-understanding and coping skills. Additional treatment for thinking, cognitive deficits, and dissociation may be necessary for the nonrecovery group.

Efficacy of therapy for non-suicidal self-injurious behavior in a bulimia nervosa patient (a clinical case report)

Non-suicidal self-injurious behavior is almost never monosymptomatic. It is frequently combined with eating disorders, in particular bulimia nervosa. A description of a clinical case of improvement in the condition of a patient with non-suicidal self-injurious behavior and bulimia nervosa when using topiramate as part of combination therapy is presented.

A comparison of retrospectively reported and ecological momentary assessment-reported perceived social support in predicting ecological momentary assessment-reported non-suicidal self-injury.

Non-suicidal self-injury (NSSI) urges and behaviors are associated with lower perceived social support and related constructs (e.g., perceived rejection). However, no studies have examined the concordance of retrospective (baseline) and ecological momentary assessment (EMA) perceived social support assessments. Retrospective and EMA reports are often only weakly to moderately correlated; measurement approaches may, therefore, impact observed associations between variables. We tested whether average EMA-reported perceived emotional social support uniquely predicts EMA-reported NSSI urges and behaviors above baseline-reported retrospective self-report of perceived emotional social support alone. 93 young adults (ages 18-34) with past-month NSSI urges or behaviors and lifetime NSSI behaviors completed a semi-structured interview, self-report surveys, and a 2-week EMA protocol. Baseline- and EMA-reported perceived emotional social support were positively correlated (Kendall's tau-b = 0.51). Average EMA-reported social support was uniquely associated with EMA-reported NSSI urges but not NSSI behaviors. EMA-reported perceived emotional social support captured information not represented by baseline reports alone, but improvement in model fit was modest. EMA-reported social support may further improve the estimation of EMA-reported NSSI urges if modeled as a proximal predictor of NSSI. Further work is needed to clarify temporal directions between social support and NSSI urges. Limitations are discussed.

An Action Study of Feminist Group Counseling on the Self-Identity of Children Who Self-Injured

<p>本研究旨在以女性主義取向團體輔導方案的介入，探討具有自傷行為兒童在團體歷程中的自我認同發展。本研究採取行動研究，招募五名國小六年級學童為研究對象（四女一男），進行每週一次，一次四十分鐘，為期八次的小團體輔導。團體設計以女性主義諮商理論為本，涵蓋身份覺察、賦能、敘說、平權等重要議題。透過省思札記、成員及師長的訪談記錄、觀察員的觀察與回饋等多種方式蒐集資料，結合三角驗證方式分析，以瞭解具有自傷行為兒童在女性主義團體輔導歷程之經驗內涵。重要結果如下：一、女性主義取向強調團體敘說、平權關係與支持關懷，促使學童有機會自我揭露生命故事，從而連結彼此。二、女性主義團體輔導方案的介入，有助於學童對社會角色的覺察，轉化以正向觀點定義自己，增進改變的行動力。三、學童在團體的普同經驗，促使學童降低孤獨感，進而坦然面對自傷與真實自我。四、學童覺察與肯定其優勢能力，提升我能感，促使增進自信心與自我認同。五、在團體歷程中的行動與改變，促進學童對自我的賦權，進而提升自我認同與悅納，進而將改變實踐於日常生活。</p> <p> </p><p>This study explored the self-identity development of children with non-suicidal self-injury behavior through a feminist-oriented group counseling program intervention. This study adopted an action research approach and included five participants from the sixth grade: four females and one male. The group met once a week for 40 minutes each time, for eight weeks. The group project involved doctrines of feminist counseling theory, including awareness, empowerment, narrative, and equality. Data were collected through the researcher’s reflections, observer’s notes, and interviews with the participants and with the participants’ teachers and parents. The researcher analyzed data and verified the analysis by using the triangulation method. This study’s findings are summarized as follows: 1. The narratives, equality, and supportive care that the feminist group counseling approach emphasizes provided the self-harm student participants the opportunities to tell and re-tell their life stories; disclosing their stories helped them connect to the other participants. 2. The group counseling intervention helped students aware of their social roles, transform their thoughts into a positive perspective, and enhance their capacities to change. 3. The common experience that the students shared during the group process helped reduce their loneliness, rethink their self-harm behaviors, and face their true selves openly. 4. Through the group process, students gained more awareness and confidence regarding their strengths in abilities, enhanced their sense of power, and fostered a strong sense of self-identity. 5. The action and change during the group process facilitated the students’ self-empowerment, enriched their self-identity and self-acceptance, and finally, helped them implement changes in everyday life.</p> <p> </p>

Early Adverse Family Experiences and Elevated Adrenocorticotropic Hormone Predict Non-Suicidal Self-Injury in Females with Non-Psychotic Mental Disorders and Suicidal Ideation.

Nonsuicidal self-injurious behavior (NSSI), prevalent in patients with non-psychotic mental disorders (NPMD), is associated with numerous adverse outcomes. Despite active research into the clinical and psychological aspects of NSSI, the underlying biological mechanisms remain obscure. Early adverse experiences are believed to induce long-lasting changes in neuroendocrine mechanisms of stress control playing a key role in NSSI development. The aim of the study was to evaluate parameters potentially predicting development of NSSI in female patients with NPMD and suicidal ideation. Eighty female patients over 18 years with NPMD and suicidal ideation (40 with and 40 without NSSI) and 48 age matching women without evidence of mental illness (healthy controls) were enrolled. Diagnostic interviews and self-report measures were used to assess childhood maltreatment, presence, frequency, and characteristics of suicidal and self-injurious thoughts and behaviors, the Beck Depression Inventory scale to assess severity of depression. Hypothalamic-pituitary-adrenal axis markers, hormones, and neurotrophic factors were measured in blood serum. The likelihood of developing NSSI in patients with NPMD and suicidal ideation was associated with early adverse family history and elevated adrenocorticotropic hormone levels. Dysregulation of hypothalamic-pituitary-adrenal axis as a result of early chronic stress experiences may represent critical biological mechanism promoting the development of NSSI behaviors in patients with NPMD.

Prevalence of non-suicidal self-injury in medical students of Rawalpindi; its socio-demographics, methods, and functions

Objective: To investigate the prevalence of non-suicidal self-injury among Pakistani medical students, its association with demographic variables, and the distribution of its methods and functions. Method: The cross-sectional study was conducted in from April 2021 to March 2022 at Rawalpindi Medical University, Rawalpindi, Pakistan, and comprised medical students regardless of gender and year of study. Data was collected using the inventory of statements about self-harm scale to assess their socio-demographics, non-suicidal self-injury behaviors and functions. Data was analyzed using SPSS 28. Results: Of the 411 subjects approached, 386(94%) correctly filled the forms; 170(44%) males and 216(55.9%) females. The overall mean age was 19.7 ±1.5 (range: 17-27 years). There were 132(34.1%) students from first year, 146(37.8%) second year, 44(11.3%) third year, 54(13.9%) fourth year and 10(2.5%) from the final year. There were 110(28.4%) with non-suicidal self-injury; 60(54.5%) males and 50(45.4%) females (p=0.008). There were 18(4.7%) subjects aged 18 years, and, of them, 14(77.7%) exhibited self-harm behavior. Among specific non-suicidal self-injury behaviors, ‘interfering with scabs and wound healing’ was the most common method 80(72.7%). As for the functions of non-suicidal self-injury behavior, there was a significant difference between intrapersonal and interpersonal functions (p<0.05). Conclusion: Non-suicidal self-injury was highly prevalent among the young subjects, and it needs proper intervention for timely management. Key Words: Behavior, Behavior mechanisms, Pakistan, Personality inventory, Self-injurious behavior, Young adult.

Impacts of difficulties with emotion regulation on the longitudinal relationship between peer victimization and changes in adolescent nonsuicidal self-injury.

Research has found that peer victimization is associated with adolescent nonsuicidal self-injury (NSSI) behavior; however, most of these studies ignored the association between these constructs at the within-person level. Additionally, the association between peer victimization and NSSI may vary among adolescents with different personal characteristics. With a longitudinal design, this study investigated whether and how emotion regulation (ER) difficulties moderate the relationship between peer victimization and changes in NSSI, with particular attention given to the unique moderating role of different dimensions of ER difficulties. The study sample comprised 3,561 adolescents aged between 10 and 17 years old (Mage = 13.22, SD = 0.85; 56.9% males). Self-report assessments were administered in December 2021 and June 2022 in Shanxi province, China. The latent change score model showed that the adolescent NSSI increased during our assessments, with peer victimization as a significant predictor. ER difficulties moderated the association between peer victimization and NSSI changes, but interestingly, in an unexpected pattern. Specifically, peer victimization significantly predicted NSSI changes among adolescents with low ER difficulties but not for those with high ER difficulties. Moreover, among the multiple dimensions of ER difficulties, only nonacceptance of emotional responses and limited access to emotion regulation strategies interacted with peer victimization to predict NSSI changes and showed interaction patterns similar to those at the overall level of ER difficulties. The current study revealed the moderating role of ER difficulties in the relationship between peer victimization and changes in NSSI. These findings provide intervention implications for adolescents who engage in NSSI.

Psychiatric Hospitalization for Psychopathological Disorders and Self-Injurious Behaviors in Italian Children and Adolescents during COVID-19.

The evidence shows that the COVID-19 pandemic dramatically increased the number of urgent psychiatric consultations for children and adolescents in hospital emergency departments (EDs). However, what needs to be further investigated are the characteristics of psychiatric hospitalization in children and adolescents admitted to the Child and Adolescent Neuropsychiatry Unit wards in EDs. Specifically, this retrospective study aimed to examine changes in (i) the number of inpatients and (ii) the distribution of psychopathological disorders and self-injurious behaviors in our Child and Adolescent Neuropsychiatry Unit ward during the COVID-19 lockdown in Italy (March-June 2020; October 2020-January 2021) compared with the same months of previous years. We found a significantly lower number of inpatients during the first four quarantine months than the first four reference months and a higher number of inpatients during the second four quarantine months than the second four reference months. Additionally, we found an increased frequency of mood disorders, non-suicidal self-injurious behavior, and suicidal ideation during the COVID-19 lockdown compared to the reference periods. Our findings underline the need to develop psychological healthcare services for future emergency periods in order to identify and treat psychological distress in children and adolescents early, reducing the risk of psychiatric hospitalization.

Early maladaptive schemas and the risk of nonsuicidal self-injury in college students: A retrospective study.

Early maladaptive schemas (EMSs) may be closely related to nonsuicidal self-injury (NSSI). The present study aimed to discuss the relationship between EMS and a personal history of NSSI. This was a retrospective study. A total of 1339 Chinese college students between 16 and 29 years old were asked to complete a questionnaire survey regarding their personal history of NSSI and EMSs. 116 college students reported a history of NSSI (NSSI group), who differed significantly in terms of all EMS-related scores than non-NSSI group(n = 1223). Logistic regression analysis showed that the scores in the disconnection/rejection schema domain exhibited by subjects who were the only child in their family could help differentiate between college students with or without NSSI. The emotional deprivation schema was significantly associated with the lifetime frequency of NSSI behaviors; the vulnerability to harm or illness schema was significantly associated with the internal emotion regulation function and pain associated with NSSI; and the enmeshment/underdeveloped self schema was significantly associated with the addictive features of NSSI. The self-sacrifice schema was significantly associated with the external emotion regulation function of NSSI; the enmeshment/underdeveloped self schema was positively related with the sensation-seeking function of NSSI; and the abandonment/instability schema was negatively related the sensation-seeking function of NSSI. The disconnection/rejection schema domain was highly related with NSSI behaviors. EMS is significantly associated with the history, functions, addictive features, and severity of NSSI. Every EMS is worthy of further investigation and discussion with patients in the context of NSSI behaviors during clinical therapy.

Association of white matter microstructural alteration with non-suicidal self-injury behavior and visual working memory in adolescents with borderline personality disorder

Non-suicidal self-injurious behavior (NSSI) is the core characteristic of adolescent borderline personality disorder (BPD) and visual working memory is involved in the pathological processes of BPD. This study aimed to investigate alterations in white matter microstructure and their association with NSSI and visual working memory in adolescents with BPD. 53 adolescents diagnosed with BPD and 39 healthy controls (HCs) were enrolled. White matter microstructure was assessed with the fractional anisotropy (FA) and mean diffusivity (MD) from diffusion tensor imaging (DTI). Correlation analysis was performed to assess the association between FA/MD and core features of BPD. A mediation analysis was performed to test whether the effects of white matter alterations on NSSI could be mediated by visual working memory. Adolescents with BPD showed a reduced FA and an increased MD in the cortical-limbic and cortical-thalamus circuit when compared to the HCs (p<0.05). Increased MD was positively correlated with NSSI, impulse control and identity disturbance (p<0.05), and was negatively correlated with the score of visual reproduction. Reserved visual working memory masked the effects of white matter microstructural alterations on NSSI behavior. White matter microstructural deficits in the cortical-limbic and cortical-thalamus circuits may be associated with NSSI and visual working memory in adolescents with BPD. Reserved visual working memory may protect against NSSI.

How does emotional abuse affect adolescents' non-suicidal self-injury urges? A moderated chain mediation model

BackgroundStudying non-suicidal self-injury (NSSI) among adolescents has high clinical significance. Its urges have been identified as a potential predictor of NSSI behavior and may serve as a crucial intervention target. ObjectiveThis study uses a moderated chain mediation model to explore the relationship between emotional abuse and adolescent NSSI urges. Additionally, we examine the mediating roles of ego depletion and self-esteem and the moderating effect of resilience. Participants and settingWe recruited 1129 Chinese adolescents (age M = 16.68; SD = 0.78; 49.4 % men) from secondary vocational schools in China. MethodsWe assessed emotional abuse, ego depletion, self-esteem, and NSSI urges in a longitudinal investigation across two time points (T1: March 2023, T2: June 2023). ResultsAfter controlling for age, sex, NSSI urges and self-esteem at T1, our study validates a moderated chain mediation model and finds that the mediating effect via self-esteem is 0.026 (95%CI = [0.011,0.046]), and the chain mediating effect via ego depletion and self-esteem is 0.031 (95%CI = [0.022,0.045]), whereas the direct effect of emotional abuse T1 on NSSI urges T2 is not significant (DE = 0.082, 95%CI = [−0.002, 0.167]) and the mediating effect via ego depletion is also not significant (IE = −0.003, 95%CI = [−0.022, 0.015]). Resilience moderates the impact of emotional abuse on ego depletion (β = 0.09, p < 0.01). ConclusionsThese findings suggest that ego depletion and self-esteem are potential mechanisms related to emotional abuse and adolescents' NSSI urges, whereas resilience can play a moderating role in reducing ego depletion.

Functions of nonsuicidal self-injurious behavior in Russian patients with suicidal ideation.

Nonsuicidal self-injurious behavior (NSSI) is an important risk factor for future suicide attempts. Previous research has identified a number of motivations for engaging in NSSI. The aim of the present study was to translate the Inventory of Statements About Self-Injury (ISAS) into Russian and then to evaluate its psychometric properties in a sample of patients with non-psychotic mental disorders and suicidal ideation (SI). Other aims were to determine the prevalence of specific NSSI functions in this population and to assess the relationship between different NSSI functions and clinical and psychological parameters. The study was conducted at the largest center for non-psychotic mental disorders in Moscow. All admitted patients with both NSSI and SI completed the Russian version of the ISAS-II, underwent the Self-Injurious Thoughts and Behaviors Interview, and completed the Personality Inventory for DSM-5 and ICD-11 Brief Form Plus-Modified, the Beck Depression Inventory, and the State-Trait Anxiety Inventory. A total of 614 patients were included in the study. 543 (88.4%) patients were assigned female at birth with a mean age of 24.86 (7.86) years. Factor analysis supported a two-factor structure (Intrapersonal and Interpersonal) of the Russian version of the ISAS-II, but in contrast to the original study, the "Marking distress" function loaded more strongly on the Interpersonal factor. In people with non-psychotic mental disorders and SI, Interpersonal functions of NSSI are associated with more severe depressive symptoms (r = 0.34), 12 months history of NSSI (r = 0.30), higher number of NSSI methods (r = 0.41), likelihood of future NSSI (r = 0.35) and psychoticism (r = 0.32). The Russian version of the ISAS-II is a valid and reliable instrument for assessing NSSI functions in a population at high risk for suicide attempts. Interpersonal functions are associated with a number of unpleasant clinical and psychological features.

Nonsuicidal self-injury characteristics: A mixed methods analysis of differences between veterans and civilians

Nonsuicidal self-injury (NSSI) is a well-established risk factor for suicidal behavior, with certain NSSI characteristics being associated with increased risk. In the United States (U.S.), the veteran suicide rate is elevated, though lifetime prevalence rates of NSSI appear similar between veterans and civilians. There is limited research that directly compares veterans and civilians across multiple NSSI characteristics to examine between-group differences in NSSI behavior and provide important context for the application of NSSI research with the veteran population. This study examined differences between U.S. veterans and civilians with a history of suicidal ideation across several NSSI characteristics, including method, severity, age of onset, shame, distress, and reason for initial NSSI engagement. A sample of 527 veterans and civilians completed measures of direct and indirect NSSI behaviors along with supplemental questions designed to further assess endorsed NSSI behaviors. Additionally, respondents provided written responses to an open-ended question about their reasons for initial engagement in NSSI, which were coded for post-hoc analysis. Chi-square difference tests and t-tests were conducted, revealing significant group differences between veterans and civilians in NSSI method, lifetime versatility, age of onset, age at last occurrence, and reasons for initial engagement. No significant differences were found in NSSI frequency, severity, shame, or distress. These findings provide valuable information on similarities and differences in NSSI behavior characteristics between U.S. veterans and civilians with lifetime suicidal ideation to inform future research and the assessment of NSSI in these populations.

Enhanced reactive inhibition in adolescents with non-suicidal self-injury disorder.

To investigate whether the core of the pathophysiology underlying non-suicidal self-injury (NSSI) relates to poor impulse control due to impaired motor inhibition (i.e. the ability to inhibit a preplanned motor response). We conducted a case-control study to compare the proficiency of two domains of motor inhibition, that is, reactive and proactive inhibition, by giving the reaching arm version of the stop-signal task and a go-only task to 28 drug-naive adolescents with NSSI disorder (NSSID) (mean age [SD] 15 years 8 months [1 year 4 months]; three males and 25 females) and 28 typically developing adolescents (mean age 15 years 8 months [1 year 5 months]; three males and 25 females). Reactive inhibition, as determined by the duration of the stop-signal reaction time, was enhanced in adolescents with NSSID compared to typically developing controls (194.2 [22.5 ms] vs 217.5 [17.3 ms], p < 0.001). By contrast, proactive inhibition was similar in both groups. Lastly, the level of impulsivity, assessed using the Barratt Impulsiveness Scale Version 11, did not differ between typically developing adolescents and adolescents with NSSID. However, adolescents with NSSID were more impulsive than controls in a subscale of the UPPS-P Impulsive Behavior Scale. NSSID is not driven by heightened motor impulsivity. Instead, adolescents with NSSID exhibited greater proficiency in reactive inhibition, a proxy for motor impulsivity. We suggest that the enhancement of reactive inhibition strengthens action control, allowing adolescents to suppress their self-protection instinct and perform NSSI behaviours.

A machine learning algorithm-based model for predicting the risk of non-suicidal self-injury among adolescents in western China: A multicentre cross-sectional study

The prevalence of non-suicidal self-injurious (NSSI) in adolescents is high. However, few studies exist to predict NSSI in this population. This study employed a machine learning algorithm to develop a predictive model, aiming to more accurately assess the risk of NSSI in Chinese adolescents. Sociodemographic, psychological data were collected in 50 schools in western China. We constructed eXtreme Gradient Boosting (XGBoost) model and multivariate logistic regression model to predict the risk of NSSI and nomograms are plotted. Data from 13,304 adolescents were used for model development, with an average age of 13.00 ± 2.17 years; 617 individuals (4.6 %) reported non-suicidal self-injury (NSSI) behaviors. The results of the XGBoost model showed that depression and anxiety were the top two predictors of NSSI in adolescents. The results of the multivariate logistic regression model showed that the risk factors for adolescent NSSI behaviors include: gender (being female), Age, Living with whom (father), History of psychiatric consultation, Stress, Depression, Anxiety, Tolerance, Emotion abreaction. The XGBoost prediction and multivariate logistic regression model showed good predictive ability. Nomograms can serve as clinical tools to assist in intervention measures, helping adolescents reduce NSSI behaviors and improve their mental and physical well-being.

Long Story Short, I Survived: An Exploration of the Meaning-making Stories of Suicide Attempt Survivors

This study aimed to explore how suicide attempt survivors construe meaning in their experiences. Using the case study approach by Robert Yin (2009), qualitative research was employed. Purposive and snowballing techniques were used to gather data from primary interviews, key informants, and psychological assessment tools. The analytic techniques were thematic and cross-case syntheses. The findings revealed the participants' earlier experiences such as relationship breakdowns and prior nonsuicidal self-injury behaviors were risk indicators of suicide attempt. However unique cases were due to same-sex attraction and gender identity issues. Protective factors included social support, effective control over situations, and reason for living. The study identified five themes of meaning-making: strengthening social connections, positive religious coping: a belief in the presence of a Higher Power (God), developing new perspective to life, value positioning on gratitude and grit, and optimism. The study highlights the importance of holistic approach that recognizes the physical, psychological, social, and spiritual aspects of suicide. This study has implications for families, social communities, practitioners and future researchers to investigate and broaden the breadth of these relationships for theory and practice. In conclusion, the urgency of this research stemmed from the need to address the rising global suicide rate and enhance suicide prevention efforts. By amplifying the perspectives of suicide attempt survivors and exploring the multifaceted nature of suicide, this research can be ultimately contributing to the preservation of lives and the reduction of the worldwide burden associated with suicide.

The relationship between family cohesion and adaptability and non-suicidal self-injury behavior in ethnic minority adolescents: a moderating mediation model.

To explore the relationship between family cohesion and adaptability and non-suicidal self-injury behavior among ethnic minority adolescents, as well as the mediating effect of depression and the moderating effect of school connectedness, this study adopts the Family Adaptability and Cohesion Scale, the Non-Suicidal Self-Injury Behavior Questionnaire, the Center for Epidemiological Studies Depression Scale, and the School Connectedness Scale to collect behavioral data from 949 ethnic minority middle-school students. Descriptive statistical analysis and correlation analysis, as well as the mediating and moderating effects, were performed using SPSS 25.0 and the PROCESS macro program. We found that family cohesion and adaptability significantly and negatively predicted non-suicidal self-injury in ethnic minority adolescents (β = -0.28, p < 0.001); depression mediated the relationship between family cohesion and adaptability and non-suicidal self-injury in minority adolescents, with a confidence interval (mediating effect size -0.15, and a Bootstrap 95% CI) of [-0.19, -0.12]. School connectedness moderated the second half of the mediating effect (β = -0.08, p < 0.01).

Effects of physical exercise on non-suicidal self-injury in adolescents: the chain mediating role of perceived social support and self-concept.

To study the effect of physical exercise on non-suicidal self-injury in adolescents and to verify the chain mediating role of perceived social support and self-concept. Methods: A survey study was conducted on 1,426 adolescents in Chengdu, Sichuan Province. A chain mediation model was used to verify whether perceived social support and self-concept played a mediating role. Physical exercise was significantly negatively associated with non-suicidal self-injury in adolescents (β = -0.53, p < 0.01) and significantly positively associated with perceived social support and self-concept (β = 0.52, 0.54, p < 0.01), and perceived social support and self-concept were significantly negatively associated with non-suicidal self-injury (β = -0.59, p < 0.01; β = -0.64, p < 0.01), and perceived social support was able to significantly and positively associate self-concept (β = 0.76, p < 0.01). Perceived social support and self-concept play a chain mediating role in the effect of physical exercise on non-suicidal self-injury in adolescents, and it is recommended that the development of perceived social support and self-concept be emphasized during adolescents' development, which has the potential to reduce the incidence of non-suicidal self-injurious behaviors in adolescents.