History Of Non-suicidal Self-injury Research Articles

Are the functions of non-suicidal self-injury associated with its persistence and suicide risk in university students? Insights from a network analysis

BackgroundTo date, a number of intra- and interpersonal functions of non-suicidal self-injury (NSSI) have been identified. Yet, their association with persistence of NSSI and suicide risk remains unknown. The study aimed to investigate which functions of NSSI are associated with its persistence and suicide risk in university students using a network analysis.MethodsAltogether, 830 university students reporting a lifetime history of NSSI were enrolled. The persistence of NSSI was defined as its presence over preceding 12 months.ResultsPersistent NSSI was directly connected to the nodes representing two functions of NSSI: affect regulation and self-punishment. Suicide risk was directly connected to the anti-suicide function of NSSI. The shortest pathway from persistent NSSI to suicide risk led through depressive symptoms. Other likely pathways (three mediating nodes) led through the functions of NSSI (affect regulation or self-punishment, anti-dissociation, and anti-suicide). Depressive symptoms had the highest centrality. However, it did not differ significantly compared to some functions of NSSI (marking distress, anti-dissociation, toughness, and affect regulation).DiscussionIn university students, persistent NSSI might be directly associated with its functions related to affect regulation and self-punishment, while suicide risk might be directly associated with the anti-suicide function. The observations posit a role of intrapersonal functions in shaping the outcomes of NSSI. Depressive symptoms and some NSSI functions might be the most promising targets for interventions in this population.

Prospectively predicting 6-month risk for non-suicidal self-injury among adolescents after psychiatric hospitalization based on a predictive model

BackgroundIt is challenging to predict the occurrence of non-suicidal self-injury (NSSI) among adolescents over short periods. Moreover, the predictive value of indices for NSSI remains elusive. Thus, this study aimed to identify predictors of NSSI within 6 months among adolescents after psychiatric hospitalization by establishing a risk assessment model.MethodsA total of 632 high-risk participants were included in this study. The distribution characteristics of adolescent NSSI were initially assessed through a cross-sectional survey, following which risk factors were identified using logistic regression analysis. The risk score method was then used to construct a 6-month risk assessment model for NSSI. Lastly, the predictive effect of the model was evaluated by indicators such as the area under the receiver operating characteristic (ROC) curve and the positive predictive value.ResultsAfter 6 months, 412 cases of NSSI were identified. According to the logistic regression model, the frequency of relapses, medication status, and NSSI history were identified as influencing factors. Higher scores on the Impulsive Behavior Scale and Pittsburgh Sleep Quality Index were associated with a higher risk of NSSI. Conversely, higher scores on the Pain and Belief Perception Scale were correlated with a lower risk of NSSI. Moreover, the area under the ROC curve for the predictive model was 0.9989, with a 95% confidence interval of (0.9979, 0.9999), highlighting its high predictive ability and accuracy. The predictive model was validated using 78 patients, yielding an area under the ROC curve of 0.9703 and a 95% confidence interval of (0.9167, 0.9999), demonstrating outstanding predictability.ConclusionThese results collectively showed that the predictive model could accurately predict adolescent NSSI. Thus, the model’s primary variables may be applied to predict the risk of NSSI in the clinical setting.

The effectiveness and acceptability of formal versus informal mindfulness among university students with and without recent self-injury: A randomized controlled trial.

Mindfulness instruction comprising both formal (FM) and informal (IM) mindfulness practice is increasingly offered to university students. FM involves sustaining attention on thoughts, emotions and bodily sensations through structured practices, while IM involves incorporating mindfulness into daily activities. However, recent evidence suggests that FM may pose challenges for students with recent non-suicidal self-injury (NSSI), whereas the flexibility and brevity inherent in IM may be better tolerated. This randomized controlled trial compared a FM induction, IM induction and control task among university students with (n = 103) and without (n = 123) past-year NSSI in terms of acceptability and pre-post state mindfulness, stress and well-being. Notably, results did not differ as a function of NSSI history. Two-way ANOVAs revealed that only IM was consistently preferred over the control task. Furthermore, three-way mixed ANOVAs revealed that-when assessed using brief Visual Analogue Scales-state well-being increased in all conditions, state mindfulness increased after both IM and FM, and state stress only decreased after IM. Notably, these differences by condition appeared to be of short duration as they were not found with lengthier measures. Results highlight the potential promise of IM and the importance of measurement selection when assessing the transient effects of mindfulness inductions in research.

“I have some people who actually really care:” Young sexual minority women’s lived experiences of non-suicidal self-injury disclosure

Sexual minority youth are more likely to engage in Non-Suicidal Self-Injury (NSSI) than their heterosexual peers, and sexual minority women demonstrate greater risk of NSSI than their sexual minority male counterparts. However, a lack of research exists on NSSI among young sexual minority women, particularly their NSSI disclosure experiences. We used a descriptive-interpretive, qualitative design with semi-structured interviews to examine young sexual minority women’s lived experiences disclosing NSSI and of others’ responses to these disclosures. The sample included 65 sexual minority women aged 14-30 recruited via paid social media advertising from across the U.S. We performed an inductive thematic analysis of transcripts from 58 participants (89%) who reported a history of NSSI. Participants shared reasons for disclosure (wanting help, communicating distress) or nondisclosure (cultural stigmas), types of disclosure (accidental/involuntary, and direct/voluntary), and recipients of a disclosure (friends, partners, mental health providers, and parents). They also described responses to, and feelings after, NSSI disclosure, revealing two themes: i) Unhelpful/stigmatizing responses (based on fear, anger, and apathy) and ii) Helpful/destigmatizing responses (expressions of concern, emotional support, and alternative coping strategies). Overall, young sexual minority women’s disclosure experiences were consistent with those of other populations, highlighting the need to further reduce stigma about NSSI, as well as sexual minority identities, and provide universal education promoting helpful responses to NSSI disclosure.

Risky decision-making and nonsuicidal self-injury among university students: Examining the role of criticism feedback.

Risky decision-making putatively contributes to nonsuicidal self-injury (NSSI) yet empirical support for this association is inconsistent. Studies have not simulated socioemotional contexts most closely linked to NSSI, which may partially explain mixed findings. Accordingly, we examined the association between NSSI and risky decision-making following the receipt of criticism from a close other, a key interpersonal context. The study included 286 university students (Mage = 21.11) oversampled for a lifetime history of NSSI. Participants completed a modified Iowa Gambling Task, in which they chose to play or pass on "good" and "bad" decks associated with monetary gains and losses. Participants also completed the Criticism Gambling Task, which was identical to the Iowa Gambling Task except critical audio comments preceded each block of trials. Based on results of multilevel growth curve analyses, decreases in risky decision-making were steeper on the Iowa Gambling Task compared to the Criticism Gambling Task, suggesting poorer learning in the context of criticism. Further, how past-month NSSI was related to changes in risky decision-making across blocks differed between the two tasks, b = -0.004, t(3140.00) = 2.48, p = .013. On the Iowa Gambling Task, all participants decreased their risky decision-making, whereas on the Criticism Gambling Task, higher past-month NSSI frequencies were associated with riskier decision-making. Our findings support associations between risky decision-making and NSSI in negative socioemotional contexts, consistent with functional models of NSSI.

Implicit associations with non-suicidal self-injury: Examination in a clinical sample by borderline personality symptomatology.

We examine correlates and predictors for implicit associations with non-suicidal self-injury (NSSI) with the Self-Injury Implicit Association Test (SI-IAT) in a treatment-seeking sample. We also examine group differences in the SI-IAT among those with low/none, moderate and high/clinically significant borderline personality disorder (BPD) symptomatology in a treatment-seeking sample. Participants (N = 111; 58% female; 89% White; Mage = 30.25) completed the SI-IAT and self-report measures at two time points. Higher BPD symptom scores were significantly, positively correlated with implicit identification with NSSI, and predicted NSSI identity when controlling for depression indices, history of NSSI and other covariates. With Time 1 SI-IAT scores entered as a covariate, BPD scores no longer significantly predicted Time 2 SI-IAT scores. Individuals with moderate and high/clinically significant symptom counts of BPD had higher/stronger implicit associations with NSSI identity than those with no/low BPD symptoms. Individuals with symptoms of BPD may implicitly identify with NSSI more than other clinical groups; examination of implicit assessments in BPD in future research is needed to further explore implicit identification with NSSI in this patient group to further understand both cross-sectional and prospective relations.

Associations of military sexual harassment and assault with nonsuicidal self-injury: Examining gender and sexual orientation as moderators

Military sexual harassment (MSH) and assault (MSA) are prevalent among service members and are linked to negative psychosocial outcomes, including self-directed violence. Veterans identifying as women or as sexual or gender minorities are at heightened risk for both MSH/MSA and self-directed violence, but their relationship remains understudied in these populations. We examined associations of MSH and MSA with nonsuicidal self-injury (NSSI) and tested whether relations varied by self-identified gender or sexual orientation in two national samples of U.S. veterans. Sample 1 included post-9/11 veterans who had recently discharged from service (n = 1,494); sample 2 included veterans from any service era (n = 1,187). Veterans self-reported MSH, MSA, gender identity and sexual orientation, and lifetime and past-month histories of NSSI. We estimated logistic regressions to examine the associations of MSH and MSA history with NSSI and evaluated gender (man or woman) and sexual orientation as moderators of these relations. Results suggested significant associations of both MSH and MSA with NSSI but largely failed to support moderation of these associations by either gender or sexual orientation identity. Screening for both MSH and MSA in veterans across gender and sexual orientation identities appears indicated in clinical assessment of NSSI.

Comparing hospitalized adult patients with chronic anorexia nervosa with versus without prior hospitalizations

BackgroundAnorexia nervosa (AN) is a severe psychiatric disorder, from which recovery is often protracted. The role of prior specialized inpatient treatment on subsequent treatment attempts for adults with chronic AN and predictors of treatment response for severe and enduring AN (SE-AN) are needed to improve outcomes.MethodParticipants (N = 135) with chronic AN (ill ≥7 years) admitted to an integrated inpatient-partial hospitalization eating disorders (ED) unit with prior ED hospitalization(s) (+ PH; n = 100) were compared to those without prior ED hospitalizations (-PH; n = 35) on admission characteristics (BMI, length of illness, outpatient ED treatment history, symptomatology (ED, anxiety, and depressive), history of suicide attempts or non-suicidal self-injury (NSSI)), treatment motivation and recovery self-efficacy, and discharge outcomes (discharge BMI, rate of weight gain, length of stay, clinical improvement).ResultsGroups were similar with regard to age, years ill, and admission BMI. The + PH group had lower desired weight, lifetime nadir BMI and self-efficacy for normative eating, and higher state and trait anxiety than the -PH group. +PH were also more likely to endorse history of NSSI and suicide attempt. Regarding discharge outcomes, most patients achieved weight restoration at program discharge (mean discharge BMI = 19.8 kg/m2). Groups did not differ on rate of weight gain, likelihood of attending partial hospital, partial hospital length of stay, program discharge BMI, or likelihood of clinical improvement (p’s > 0.05) although inpatient length of stay was longer for the + PH group.ConclusionsParticipants with chronic AN + PH exhibited more severe psychiatric comorbidity and lower self-efficacy for normative eating than AN -PH, however short-term discharge outcomes were similar. Future research should determine whether weight restoration and targeting comorbidities impacts relapse risk or need for rehospitalization among chronic and severe + PH. Despite similar illness durations, those with chronic AN -PH may be able to transition to partial hospital earlier. Conversely there is risk of undertreatment of chronic AN + PH given the recent shift promoting briefer self-directed admissions for adults with SE-AN. Research comparing + PH and -PH adults with chronic AN may facilitate efforts to individualize care and characterize relapse risk following intensive treatment.

A multi-modal assessment of self-knowledge in adolescents with non-suicidal self-injury: a research domains criteria (RDoC) study.

Adolescence is a critical period for brain development, consolidation of self-understanding, and onset of non-suicidal self-injury (NSSI). This study evaluated the RDoC (Research Domain Criteria) sub-construct of Self-Knowledge in relation to adolescent NSSI using multiple units of analysis. One hundred and sixty-four adolescents assigned female at birth (AFAB), ages 12-16 years with and without a history of NSSI entered a study involving clinical assessment and magnetic resonance imaging (MRI), including structural, resting-state functional MRI (fMRI), and fMRI during a self-evaluation task. For imaging analyses, we used an a priori defined Self Network (anterior cingulate, orbitofrontal, and posterior cingulate cortices; precuneus). We first examined interrelationships among multi-level Self variables. We then evaluated the individual relationships between NSSI severity and multi-level Self variables (self-report, behavior, multi-modal brain Self Network measures), then conducted model testing and multiple regression to test how Self variables (together) predicted NSSI severity. Cross-correlations revealed key links between self-reported global self-worth and self-evaluation task behavior. Individually, greater NSSI severity correlated with lower global self-worth, more frequent and faster negative self-evaluations, lower anterior Self Network activation during self-evaluation, and lower anterior and posterior Self Network resting-state connectivity. Multiple regression analysis revealed the model including multi-level Self variables explained NSSI better than a covariate-only model; the strongest predictive variables included self-worth, self-evaluation task behavior, and resting-state connectivity. Disruptions in Self-Knowledge across multiple levels of analysis relate to NSSI in adolescents. Findings suggest potential neurobiological treatment targets, potentially enhancing neuroplasticity in Self systems to facilitate greater flexibility (more frequently positive) of self-views in AFAB adolescents.

Gender similarities and differences in non-suicidal self-injury in an adolescent clinical sample

ABSTRACT Non-suicidal self-injury (NSSI) continues to be an important problem in adolescents, and it was aimed to investigate the relationship between suicide probability, cyberbullying, impulsivity, and aggression with NSSI history in the adolescent clinical population on the basis of gender. 267 adolescents with a history of NSSI and 210 without were included. They filled the Inventory of Statements About Self-Injury (ISAS), Cyberbullying and Online Aggression Screening Scale (COASS), Buss-Perry Aggression Questionnaire (BPAQ), Suicide Probability Scale (SPS), Barratt Impulsiveness Scale-11-Short Form (BIS-11-SF). Four subscales and total scores of SPS, BPAQ, BIS-11-SF total scores were found to be significantly higher in males with a history of NSSI. BPAQ, BIS-11-SF motor, and attention impulsiveness, BIS-11-SF total scores, four subscales, and total scores of SPS were found to be significantly higher in females with a history of NSSI. Lower BIS-11-SF non-planning impulsivity, higher SPS/suicide ideation and hostility scores, and lower father’s education level were found to be the best predictive factors for ISAS total scores in males. In females, experience cyberbullying, lower age, higher SPS/suicide ideation and total scores were the best predictors. Knowing the factors associated with NSSI and the differences between genders will be effective in both preventing NSSI and shaping treatment modalities.

Attentional Biases and Nonsuicidal Self-Injury Urges in Adolescents

Nonsuicidal self-injury (NSSI) is a significant clinical concern among adolescents. Exposure to NSSI-related content on social media platforms has been suspected to potentially act as a trigger for NSSI. To use free-viewing eye-tracking and dot-probe paradigms to examine attentional bias and psychophysiological responses to NSSI-related pictorial and textual stimuli in adolescents with and without a history of NSSI. From June 2022 to April 2023, adolescent participants in Vienna, Austria with and without a history of NSSI were exposed to NSSI-related stimuli in this nonrandomized controlled trial. Data were analyzed from December 2023 to January 2024. Exposure to NSSI-related stimuli. During both tasks, subjective arousal, NSSI urges, and autonomic nervous system activity were assessed. A total of 50 adolescents in 2 groups, 25 who engaged in NSSI (mean [SD] age 15.86 [1.14] years; 19 female participants [76%]) and 25 who did not (mean [SD] age 16.40 [1.71] years; 19 female participants [76%]) were included. Adolescents with a history of NSSI-but not those without a history of NSSI-showed a clear attentional bias toward NSSI-related images during eye-tracking, as indicated by increased initial fixations (500 ms stimulus presentation mean difference, 28.64%; 95% CI, 18.31%-38.98%; P < .001; 1000 ms stimulus presentation mean difference, 18.50%; 95% CI, 9.05%-27.95%; P < .001) and longer fixation durations (500 ms mean difference, 29.51 ms; 95% CI, 4.3-54.72 ms; P < .001; 1000 ms mean difference, 39.83 ms; 95% CI, 6.90-72.76 ms; P < .001), regardless of stimulus duration. This bias was associated with a heightened urge to engage in NSSI (d = 1.22; 95% CI, 0.69-1.73; P < .001), a trend not seen in adolescents without a history of NSSI. Similarly, in the dot-probe task, only the NSSI group showed an attentional bias toward NSSI images but not toward trauma images, emphasizing the specificity of their attentional bias. Physiological measures revealed no significant differences, suggesting that viewing NSSI images is not associated with increased autonomic arousal. Textual NSSI content did not provoke an attentional bias or heighten NSSI urges in either group. In this nonrandomized controlled trial of 50 adolescents, results highlighted a specific attentional bias toward NSSI-related pictorial stimuli in adolescents with a history of NSSI, particularly a difficulty in disengaging from NSSI images. These findings contribute to understanding maladaptive information processing in NSSI and suggest implications for clinical management and cognitive models addressing NSSI triggers. German Clinical Trials Register identifier: DRKS00025905.

A Qualitative Study on Understanding the Process of Nonsuicidal Self-injury

Background: Intentional self-harm presents a significant challenge within the mental health system, yet misconceptions persist regarding its nature, particularly the view that nonsuicidal self-injury (NSSI) serves as a mere call for attention and represents impulsive behavior. This study aimed to explore the process and experiences of self-harm among young adults in India to address this stigmatization. Methods: Semi-structured interviews were conducted with eight participants aged 21–24 years, encompassing diverse psychiatric diagnoses and a history of NSSI. These interviews aimed to delve into the nuanced experiences and perspectives surrounding self-harm in this demographic. Results: Thematic analysis of the interviews unveiled six overarching themes: distal risk factors, proximal risk factors, methods and conditions to self-harm, during the act, after the act, and considerations to be taken while planning intervention. These themes shed light on various factors influencing self-harm behaviors and the context in which they occur. Conclusion: The findings underscore the necessity of incorporating individuals’ unique processes of self-harm into intervention planning to effectively support those at risk of self-harm. By understanding the complex interplay of factors involved, mental health professionals can develop targeted and comprehensive interventions to address NSSI effectively.

A Prospective Examination of Sexual Orientation and Suicidal and Nonsuicidal Self-Injurious Thoughts and Behaviors Among a Diverse Sample of At-risk Young Adult Women.

Minoritized sexual orientation is an established correlate for suicide ideation (SI) and nonsuicidal self-injury (NSSI); however, prospective associations between sexual orientation and SI and NSSI is limited. The current study builds on existing literature by examining sexual orientation as a prospective distal risk factor for SI and NSSI risk among a diverse sample of young women after adjusting for histories of SI and/or NSSI and empirically supported correlates and risk factors. Participants were 135 young adult women (aged 18-24), who were predominately Black with approximately half of the sample experiencing poverty. Participants completed an interview that assessed SI and NSSI at baseline and 6- and 12-month follow-ups. A single item was used to collect participants' self-identified sexual orientation at baseline. Minoritized sexual orientation was strongly associated with NSSI history and future SI and NSSI, adjusting for baseline correlates and predictors of interest. Psychological and physical victimization, race, and poverty were non-significant prospective predictors of SI and NSSI. Race and poverty did not moderate the associations between sexual orientation and follow-up SI and NSSI. These findings suggest young adult women who self-identify as lesbian, gay, bisexual, queer, or questioning (LGBQ) are more likely than those who identify as heterosexual to experience both SI and NSSI in the following year. Sexual orientation should be part of a culturally-informed comprehensive risk assessment. A culturally-informed intersectionality approach may be necessary to identify culturally-specific risk and resiliency factors for SI and NSSI that can guide effective prevention and intervention strategies for LGBQ individuals.

The familial transmission of suicide and non-suicidal self-injury in different income levels in town.

Prior researches have established that suicide and non-suicidal self-injury (NSSI) exhibit familial transmission patterns. However, the extent to which these patterns vary across different income levels remains unclear, as well as the specific factors that influence them. This study aimed to explore these questions. We analyzed data from 13,988 parent-child pairs in Chongqing, China, where the children were aged from 7 to 12 years old. Six income levels were considered, and the children's depression and anxiety symptoms were assessed using standardized scales (the Center for Epidemiological Studies Depression Scale for Children, [CES-DC], and the Screen for Child Anxiety Related Emotional Disorders [SCARED], respectively). Binary logistic regression analysis was employed to examine the transmission of suicide and NSSI across different income levels. Familial transmission of suicide was significant difference in all income levels except the highest, while familial transmission of NSSI was significant difference in all income levels except the lowest. Notably, in both low- and high-income levels, suicide and NSSI transmissions primarily occurred among male children, mothers with higher education, and children who spent long time with their mothers. Additionally, the transmissions were mediated partially or entirely by children's depression and anxiety symptoms. Future studies should investigate the separate effects of fathers' and mothers' suicide and NSSI histories on familial transmission patterns. The familial transmissions of suicide and NSSI exhibited distinct patterns across different income levels.

Structured clinical interview for diagnosing obsessive-compulsive spectrum disorders.

BackgroundThere are several established structured diagnostic interviews that cover common mental disorders seen in general psychiatry clinics. The administration of more focused diagnostic interviews may be useful in specialty clinics, such as OCD clinics. A semi-structured clinician-administered interview for obsessive-compulsive spectrum disorders (SCID-OCSD) was developed and adapted for DSM-5/ICD-11 obsessive-compulsive and related disorders as well as other putative obsessive-compulsive spectrum conditions. ObjectiveTo introduce a semi-structured diagnostic interview for in-depth assessment of obsessive-compulsive spectrum disorders (OCSDs), and to report on its implementation in adults with primary OCD attending an OCD-specialized unit. MethodsPatients with primary OCD were interviewed using the SCID-OCSD. The SCID-OCSD assesses disorders drawn from several diagnostic categories that share some core features of obsessive-compulsive phenomenology and that are often comorbid in OCD (e.g., obsessive-compulsive related disorders, impulse-control disorders, and a spectrum of compulsive-impulsive conditions such as tics, eating disorders, non-suicidal self-injury, and behavioral addictions. Participants had to be at least moderately symptomatic on the Yale-Brown Obsessive-Compulsive Severity scale (YBOCS, i.e., a total score ≥ 14) to be included in the current study. ResultsOne hundred and one adult patients with current OCD (n = 101, 37 men and 64 women), took part in the study. Forty-two participants (n = 42) had OCD and one or more current or past comorbid OCSDs, with excoriation (skin-picking) disorder (n = 16) and body dysmorphic disorder (n = 14) being the most common. Nine (n = 9) participants reported a history of non-suicidal self-injury, and 6 participants reported a history of comorbid tics. ConclusionsIn OCD clinics, the SCID-OCSD may help diagnose the full range of putative OCSDs, and so facilitate treatment planning and research on these conditions.

Early maladaptive schemas, distress tolerance and self-injury in Iranian adolescents: serial mediation model of transdiagnostic factors.

Non-suicidal self-injury (NSSI) is prevalent behaviour among adolescents. Although there are different etiological models of NSSI, there is a general lack of evidence-based, comprehensive and transdiagnostic models of NSSI in adolescents. The aim of this study was to investigate a model of transdiagnostic factors of NSSI in adolescents, testing a serial mediation model of the relationship between early maladaptive schemas (EMS), distress tolerance and NSSI through experiential avoidance and rumination. A community sample was identified of 1014 adolescents aged 13-17, of whom 425 had a history of NSSI. A serial mediation path analytic method was utilised to examine the relationships between NSSI and its associated functions as criterion variables, EMS and distress tolerance as predictors, experiential avoidance as the first mediator and rumination as the second mediator. The path analytic model fit indices were good (X2/d.f. = 2.25, goodness of fit index = 0.98, normed fit index = 0.97, comparative fit index = 0.98, root mean square error of approximation = 0.054, standardised root mean squared residual = 0.028). Rumination significantly mediated the relationship between schemas of 'vulnerability to harm', 'emotional deprivation', 'social isolation', 'insufficient self-control', and NSSI frequency and intrapersonal functions. In serial fashion, experiential avoidance mediated the role of rumination in the relationship between social isolation, and insufficient self-control and NSSI frequency and intrapersonal functions. All indirect effects were significant. Key indirect effects were found linking maladaptive schemas and distress tolerance to NSSI frequency, and NSSI intrapersonal functions via experiential avoidance and rumination. Thus, it is important to address these transdiagnostic factors with particular emphasis on the sequential mediating role of experiential avoidance and rumination in conceptualisation and therapeutic interventions for NSSI.

Revealing suicide risk of young adults based on comprehensive measurements using decision tree classification

Predicting suicide risk based on risk and protective factors is a critical and complex endeavor. In this study, we combined insights from comprehensive aetiological theories on suicide with the methodological strengths of machine learning techniques. Our primary objectives were twofold: a) to identify hazardous feature combinations that characterize a high risk of suicide, and b) to enhance our understanding of the potential interactions between risk and protective factors related to suicide. We established an interpretable decision tree model to classify young adults at high risk of suicide, utilizing fifty-five variables covering distal, developmental, proximal, and social context factors from a large-scale cross-sectional survey (N = 88,214). The results highlighted the significance of variables such as self-compassion and non-suicidal self-injury (NSSI), and the accumulation of depressive symptoms, medium-to-low self-compassion, and a history of NSSI as substantial indicators of heightened suicide risk. This study serves as a valuable reference for the clinical identification of individuals at risk of suicide.

Non-suicidal self-injury at a Canadian paediatric emergency department.

Our primary objective was to determine agreement between non-suicidal self-injury recorded at triage and during subsequent mental health assessment. The secondary objective was to describe patients who reported non-suicidal self-injury. This is a health records review of patients aged 12-18years who had an Emergency Mental Health Triage form on their health record from an ED visit June 1, 2017-May 31, 2018. We excluded patients with diagnoses of autism spectrum disorder or schizophrenia. We abstracted data from the Mental Health Triage form, Emergency Mental Health and Addictions Service Assessment forms and Assessment of Suicide and Risk Inventory. We calculated Cohen's Kappa coefficient, sensitivity, and negative predictive value to describe the extent to which the forms agreed and the performance of triage for identifying non-suicidal self-injury. We compared the cohort who reported non-suicidal self-injury with those who did not, using t-tests, Wilcoxon rank-sum tests, and chi-square tests. We screened 955 ED visits and included 914 ED visits where 558 (58.4%) reported a history of non-suicidal self-injury. There were significantly more females in the group reporting non-suicidal self-injury (82.1%, n = 458) compared to the group not reporting non-suicidal self-injury (45.8%, n = 163). Patients reporting non-suicidal self-injury did so in triage and detailed Mental Health Assessment 64.7% of the time (Cohen's Kappa Coefficient 0.6); triage had sensitivity of 71.5% (95% CI 67.3-75.4) and negative predictive value of 71.2% (95% CI 68.2-74.0). Cutting was the most common method of non-suicidal self-injury (80.3%). Screening at triage was moderately effective in identifying non-suicidal self-injury compared to a detailed assessment by a specialised mental health team. More than half of children and adolescents with a mental health-related concern in our ED reported a history of non-suicidal self-injury, most of which were female. This symptom is important for delineating patients' coping strategies.

The Effectivity of a School-Based Early Intervention Targeting Psychological Complaints and Non-Suicidal Self-Injury in Adolescents.

Background: Recent research suggests a concerning trend of non-suicidal self-injury (NSSI) and suicidal behaviors emerging at younger ages (as early as age 12). Early onset of NSSI is linked to more severe outcomes. While universal school-based prevention programs have shown promise in addressing suicidal behaviors, there is limited research on their effectiveness in preventing NSSI onset among adolescents. This study aims to evaluate the efficacy of a universal prevention program in schools for NSSI and mental complaints while enhancing resilience and mental health in 11-14-year-old adolescents. Methods: In total, 329 Flemish secondary school students (55.6% female), aged 11 to 14 years, participated in a 4 h classroom universal prevention, with a focus on emotion regulation, mental health, and specific strategies to prevent NSSI and reduce stigma. For both the intervention and control group (N = 124), a pre-, post-, and one-month follow-up questionnaire was administered, containing reliable and valid measures for NSSI and suicidality, emotion regulation, help-seeking behaviors, well-being, and psychological distress. Results: The prevention program effectively reduced NSSI and psychological distress, particularly for adolescents with a history of NSSI. Conclusions: These findings support previous research on the effectiveness of school-based programs in reducing mental complaints and suggest promising outcomes for NSSI prevention.

Negative self-perceptions and severity of NSSI: Testing the benefits and barriers model.

Nonsuicidal self-injury (NSSI) is theorized to be caused by negative associations with the self, including low self-esteem, but the mechanisms explaining why low self-esteem is related to more severe NSSI are unclear. The current study aimed to address this limitation by evaluating a mediation model, proposing that low self-esteem would relate to more severe NSSI through increasing self-punishment motivations. Data came from 468 undergraduate students with a history of NSSI who completed an online survey measuring NSSI characteristics and functions, self-esteem, and self-punishment motivations for NSSI. Mediation was tested using a structural equation model using bootstrapped 95% percentile-corrected confidence intervals in which NSSI severity was modeled as a latent variable composed of NSSI frequency, recency, and versatility of methods. The total model was significant and the indirect effect of self-esteem on NSSI severity through self-punishment motives was significant. Self-esteem also retained significant direct effects on NSSI severity, indicating partial mediation. These results provide support for the benefits and barriers model of NSSI, suggesting that negative self-views increase risk for more severe NSSI through self-punishment motivations. Clinical interventions that emphasize self-compassion and focus on modifying self-punishment motivations may help reduce NSSI behavior.