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BACKGROUND: Suicide is the second leading cause of death in 12- to 17-year-old adolescents in the USA. Research on biological mechanisms contributing to self-harm risk that could be targeted in treatment could help to prevent suicide and self-harm episodes. AIMS: We aimed to evaluate whether markers of inflammation, interleukin-6 (IL-6) and C-reactive protein (CRP), predict self-harm over 3 months within a sample selected for elevated suicide/self-harm risk at project entry. METHOD: Fifty-one adolescents aged 12-19 years selected for elevated suicide/self-harm risk completed three clinical interviews about suicide attempts and non-suicidal self-injury, 3 months apart. At baseline and 3 months, youth also provided blood samples, from which we assayed levels of IL-6 and CRP. RESULTS: Using generalised mixed models, we found that greater levels of IL-6 predicted more self-harm episodes (odds ratio [OR] = 3.3, 95% CI: 1.1, 10.0) and specifically, non-suicidal self-injury (OR = 3.5, 95% CI: 1.1, 11.2), over 3 months. CONCLUSIONS: The study findings increase our understanding of whether and how inflammation may be implicated in risk of self-harm. IL-6 may be a viable biological marker of short-term risk for self-harm.

Objectives Methods Results Conclusions 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. [ABSTRACT FROM AUTHOR]

Objective: The prominence of suicidal ideation, suicide attempts and death by suicide among people diagnosed with Borderline Personality Disorder (BPD) underscores the importance of conducting relevant and informative risk assessment. The purpose of this study was to examine risk assessment protocols used in state public mental health services to assess whether and in what manner they include factors specific to suicidality/self-harm risk in people with BPD. Method: A qualitative evaluation of risk assessment protocols from nine of the thirteen (70%) of Victoria's public mental health was undertaken. Content analysis methodology was utilised to identify themes and compare these to recommendations for risk assessment of BPD as outlined in Australian clinical guidelines Results: The risk assessment protocols comprised suicide risk factors generally relevant to psychiatric disorders. Only one protocol incorporated BPD-specific risk assessment principles. Conclusions: Fully incorporating BPD-specific risk factors into mental health service risk assessment protocols will better inform service responses and potentially improve clinical outcomes for people with BPD whose presentation includes chronic suicidality and/or high lethality non-suicidal self-injury. Key Points: What is already known about this topic: Borderline Personality Disorder (BPD) is associated with frequent deliberate self-injury, chronic suicidal ideation, and suicidal behaviour. Specific clinical features of BPD such as chronic suicidality and impulsivity can reduce the applicability of more general psychiatric risk assessments and desensitise clinicians to high-risk situations. BPD-specific risk assessment training enables mental health professionals to differentiate between low versus high risk, chronic versus acute risk, and be alert to changes in the risk profile. What this topic adds: The majority of risk assessment protocols surveyed in public mental health services comprised suicide risk factors related to psychiatric disorders in general. Risk factors specific to chronic suicidality, deliberate self-injury, and changes in the pattern of risky behaviours in people with BPD are not systematically incorporated within public mental health risk assessment protocols. Incorporating existing evidence-based risk assessment protocols that incorporate factors specific to people with BPD may improve the consistency and accuracy with which suicide risk is assessed in public mental health services. [ABSTRACT FROM AUTHOR]

The presence of adverse childhood experiences (ACEs) in adolescents diagnosed with depression has been associated with an extensive range of mental health issues, including non-suicidal self-injury (NSSI). However, there has been a dearth of research into the prevalence of ACEs and their associations with NSSI among depressed adolescent populations in China. This study aimed to investigate the prevalence of different types of ACEs and their associations with NSSI in depressed Chinese adolescents. Utilizing Chi-squared tests, latent class analysis (LCA), and multinomial logistic regression, the prevalence of different types of ACEs and their associations with NSSI were determined in a sample of 562 adolescents with depression. Among depressed adolescents. 92.9% of depressed adolescents reported ACEs, and the prevalence of emotional neglect, physical abuse, caregiver treated violently, and bullying was relatively high. ACEs, including sexual abuse (OR = 5.645), physical abuse (OR = 3.603), emotional neglect (OR = 3.096), emotional abuse (OR = 2.701), caregiver divorce/family separation (OR = 2.5), caregiver treated violently (OR = 2.221), and caregiver substance abuser (OR = 2.117), were associated with increased odds of exposure among depressed adolescents with NSSI. The high ACEs class (19%), the moderate ACEs class (40%), and the low ACEs class (41%) were identified as latent classes. NSSI was more prevalent in the high/moderate ACEs class compared to the low ACEs class, particularly in the high ACEs class. The situation of the prevalence of ACEs among adolescents with depression was unsatisfactory, and certain types of ACEs were associated with NSSI. Eliminating potential risk factors for NSSI requires the early prevention and targeted intervention of ACEs. Moreover, additional large-scale longitudinal studies are necessary to assess the different development trajectories associated with ACEs, such as the relationships between the different development periods of ACEs and NSSI, and to ensure the adoption of evidence-based prevention and intervention strategies. [ABSTRACT FROM AUTHOR]

Non-Suicidal Self-Injury (NSSI) is a growing phenomenon on social networks, with an estimated prevalence of 30% among young people in Spain. In light of the aforementioned considerations, we present a methodology designed to identify and analyse the content created by young people on TikTok. On the one hand, a quantitative study was conducted using an API to collect and classify multimedia content through hashtags. In addition, a qualitative analysis was conducted to elaborate a systemic study of the content. The objective is thus to identify the content on TikTok pertaining to NSSI and to comprehend their codes. [ABSTRACT FROM AUTHOR]

Background: The incidence of non-suicidal self-injury (NSSI) is high and often occurs repeatedly. Psychiatric nurses play a vital role in the care and treatment of NSSI patients, as they have the most frequent contact with patients. The experiences and attitudes of nurses has a direct affect on the quality of care they provide to patients. Negative care experiences and attitudes of patient aversion on behalf of nurses may delay the observation and treatment of changes in the patient's condition, leading to irreversible risks. Although cross-sectional studies have investigated the attitudes of medical staff toward NSSI patients, quantitative research results cannot comprehensively reflect the emotional experiences and complex psychological changes of the study subjects. A few studies have focused on the psychiatric nurses' care experiences and attitudes toward patients with repeated NSSI. Objective: This study aimed to explore psychiatric nurses' care experiences and attitudes toward patients during repeated NSSI. Methods: A thematic analysis qualitative study was used. Using purposive sampling, 18 psychiatric nurses were recruited from a mental health center in Chengdu, China. Semi-structured interviews were conducted and audio-recorded. Audio-recordings were transcribed verbatim and analyzed using six-phase thematic analysis. Results: Four themes emerged from the analysis: psychiatric nurses' care experiences, perceptions, care attitudes and coping style toward repeated NSSI patients. Psychiatric nurses have experienced negative care experiences and severe career burnout during the patient's repeated NSSI. Nurses' attitudes toward NSSI patients changed during repeated NSSI, from understanding to indifference to anger and resentment. At the same time, it was found that nurses' coping style with NSSI patients could be divided into three stages, namely, active coping, neglect and perfunctory, and criticism and punishment. Conclusions: The findings have implications for health care systems regarding interventions to improve nurses' care experiences and attitudes toward repeated NSSI patients. These findings suggest that enhancing nurses' understanding of NSSI, establishing standardized emergency response and intervention programs, guiding positive professional values and responsibility, and improving nurses' caring attitudes can promote the early detection and timely intervention of NSSI. [ABSTRACT FROM AUTHOR]

Non‐suicidal self‐injury (NSSI) is an emerging concern in the field of public health. The objective of this study is to develop a conditional process model to investigate the relationship between social anxiety and NSSI, and the role of impulsiveness and self‐esteem in this relationship. A convenience sample of 2717 university students (Mage = 19.81, 22.49% male) from Southern China was recruited. The age range of the participants is between 18 and 25 years. The data were analysed using Spearman correlation analysis, mediation analysis and moderation analysis. The study revealed a positive correlation between social anxiety and NSSI, with impulsiveness serving as a mediating factor in this association. The relationship between social anxiety and NSSI, impulsiveness and social anxiety, impulsiveness and NSSI were all found to be moderated by self‐esteem. The prevalence of NSSI among college students exhibited a strong association with social anxiety and impulsiveness. The present investigation additionally demonstrated that there was no significant association between social anxiety, impulsivity and NSSI when high self‐esteem was included. This finding implies that self‐esteem plays a crucial role in safeguarding against NSSI. [ABSTRACT FROM AUTHOR]

Background: Non-suicidal self-injury (NSSI) is a worldwide mental health problem that deserves thorough investigation. This study aims to explore the effect of parenting styles, attachment to parents, and self-compassion on the occurrence of non-suicidal self-injury (NSSI) behavior in adolescents and whether these factors influence their recovery motivation. Methods: A total of 132 adolescents who had engaged in NSSI within the last year and 72 adolescents who had never engaged in NSSI were recruited from the Shenzhen Kangning Hospital and from primary and secondary schools and communities. Differences in the Hamilton Depression Scale (HAMD), Inventory of Parent and Peer Attachment (IPPA), Egma Minn av. Bardndosnauppforstran (EMBU), and Self-Compassion Scale (SCS) of participants were compared. A binary logistic model was established to measure the odds ratios of these variables on the occurrence of NSSI. In the NSSI adolescent sample, separate binary logistic models were created with NSSI impulse inhibition, NSSI resistance activity, and NSSI recovery motivation as dependent variables and with parenting styles, attachment to parents, and self-compassion as independent variables. Results: Compared with adolescents with no NSSI behavior, those who had engaged in NSSI within the past year had higher scores on the HAMD, as well as higher EMBU-negative father parental behavior (punishment, excessive interference, rejection, and overprotection), EMBU-negative mother parental behavior (excessive interference, rejection, and punishment), and SCS negative self-compassion scores. Moreover, adolescents with NSSI had lower EMBUfather emotional warmth, EMBU-mother emotional warmth, IPPA-attachment to father, IPPA-attachment to mother, and SCS positive self-compassion scores. Current depressive symptoms and maternal punishment are risk factors for NSSI in adolescents, while positive self-compassion was a protective factor. Positive self-compassion can positively predict NSSI impulse inhibition, NSSI resistance activity, and NSSI recovery motivation. However, we unexpectedly found that the father's emotional warmth negatively predicts NSSI resistance activity. Conclusion: This study found that positive self-compassion has a significant impact on the prevention of and recovery from NSSI behavior in adolescents. [ABSTRACT FROM AUTHOR]

Objective: This study aimed to explore the impact of the COVID-19 pandemic on non-suicidal self-injury (NSSI) among youth students, and the mediating role of psychological factors in the relationship between the COVID-19 pandemic and NSSI. Method: An online survey was conducted at junior and senior high schools, as well as universities located in Jingzhou, Hubei Province, China between June 2021 and January 2022. The COVID-19 Impact Index was constructed using multiple correspondence analysis (MCA) method. The bootstrapping method was used for mediation analysis. Results: A total of 16025 youth participated in the study and 12507 youth (78.1%) finished the questionnaires. The COVID-19 Impact Index had a significantly positive effect on NSSI (r=0.16, p<0.001). The mediation analysis results showed that the COVID-19 Impact Index had a significant indirect effect on youth' NSSI (b=0.0918, 95% CI [0.0788, 0.1048]), and this indirect effect was mainly achieved through affecting youth' anxiety, depression and post-traumatic stress disorder (PTSD). The mediation effect of anxiety on NSSI was 0.0584, the direct effect was 0.0334, and the mediation proportion was 63.6%. The mediation effect of depression on NSSI was 0.0668, the direct effect was 0.0250, and the mediation proportion was 72.8%. The mediation effect of PTSD on NSSI was 0.0640, the direct effect was 0.0278, and the mediation proportion was 69.7%. All the mediation effects, direct effects and total effects were statistically significant (p<0.001). Conclusion: The higher the impact of the COVID-19 Impact Index, the higher the prevalence of NSSI among youth students. Anxiety, depression and PTSD had mediated the relationship between the COVID-19 Impact Index and NSSI. It is suggested that specific health policies, mental health services and interventions should be developed to reduce the NSSI and improve mental health status among youth students during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Objective: The current study sought to clarify the role of emotion reactivity in non-suicidal self-injury (NSSI) by examining three forms of emotion reactivity (physiological and self-reported trait and state reactivity) among a sample of young adults with or without a history of NSSI. Materials and methods: Seventy-six adults (Mage = 20.97, 73.7% female) participated in a semi-structured clinical interview to determine NSSI history and completed a measure of trait emotion reactivity. Participants then provided state emotion reactivity ratings before and after a social rejection task, recovery period, and positive mood induction while physiological data was continuously recorded. Results: Although individuals with a history of NSSI perceived themselves to be more emotionally reactive, these participants were not more physiologically reactive, nor were their state reactivity ratings significantly different from individuals without a history of NSSI. Discussion: Results suggest increased emotionality in response to a stressor is within normal bounds and not unique to individuals with a history of NSSI, and provide implications for future research on the etiology and treatment of NSSI. [ABSTRACT FROM AUTHOR]

Background: Non-suicidal self-injury (NSSI) is a significant public health concern among adolescents with major depressive disorders (MDD). Although previous research has linked child maltreatment (CM) to NSSI, the precise mechanisms remain unclear. This study aims to investigate the association between CM, cognitive reappraisal (CR), negative coping styles (NC) and NSSI in adolescents with MDD, from the perspectives of both Latent Variable Theory and the Network Theory of Mental Disorder. Methods: A sample of 651 adolescents with MDD was recruited from January to December 2023. Data on CM, CR, NC, and NSSI were collected through paper-based self-reported questionnaires. Data analysis primarily involved structural equation modeling and network analysis. Results: The reporting rate of NSSI among adolescents with MDD was 48.2%. CM showed a significant positive correlation with NSSI. NSSI was affected by CM through three paths: the mediating role of CR, the mediating role of NC, and the chain mediating role of both CR and NC. Emotional abuse (EA) was the central node, while NSSI, EA, and "The urge to cry quietly when faced with troubles"(NC10) were the key bridge nodes. Conclusions: This study is the first to use both structural equation modeling and network analysis to explore the explore the relationship between CM, CR, NC, and NSSI in adolescents with MDD, providing a theoretical basis for future early prevention and targeted interventions for adolescents with MDD. [ABSTRACT FROM AUTHOR]

Purpose: Non-suicidal self-injury (NSSI) is a growing public health concern among college students, with cybervictimization (CV) emerging as a significant contributing factor. Grounded in the experiential avoidance theory, this study investigates the mediating roles of cognitive fusion and negative emotions in the relationship between CV and NSSI, providing new insights into these key variables. Methods: A convenience sample of 457 undergraduate students (29% male; mean age 18.36± 0.66 years) from two universities in Fujian Province participated in this study. Data were collected using the Cyberbullying Victimization Scale, Cognitive Fusion Questionnaire, Positive and Negative Affect Schedule, and Non-Suicidal Self-Injury Scale. Descriptive statistics and Pearson correlation analysis were conducted using SPSS 25.0, while the mediating effects were analyzed using Process 3.5. Results: (1) Significant positive correlations were found among CV, cognitive fusion, negative emotions, and NSSI (p < 0.01). (2) CV was directly associated with NSSI (β = 0.22, p < 0.001) and positively predicted both cognitive fusion (β = 0.17, p < 0.001) and negative emotions (β = 0.15, p < 0.01). Additionally, cognitive fusion (β = 0.16, p < 0.01) and negative emotions (β = 0.11, p < 0.05) significantly predicted NSSI. (3) Mediation analyses revealed that cognitive fusion and negative emotions mediated the CV-NSSI relationship through three pathways: CV→cognitive fusion→NSSI (mediation effect = 0.026), CV→negative emotions→NSSI (mediation effect = 0.02), and CV→cognitive fusion→negative emotions→NSSI (mediation effect = 0.01). Conclusion: The study confirms that CV influences NSSI indirectly through cognitive fusion and negative emotions, supporting the experiential avoidance model. These findings underscore the importance of addressing cognitive and emotional processes in interventions aimed at reducing NSSI among college students. [ABSTRACT FROM AUTHOR]

Suicidal behavior and Non-Suicidal Self-Injuries (NSSIs) are a major health problem in the adolescent population. New technologies can contribute to the development of innovative interventions in suicide prevention. Here, we present the SmartCrisis-Teen study protocol. The study consists of a randomized clinical trial which aims to evaluate the effectiveness of a digital safety plan to prevent suicidal behavior and NSSIs in adolescents. This is a multicentric study which will be conducted among the adolescent population, both in clinical and student settings, with a target sample of 1080 participants. The intervention group will receive an Ecological Momentary Intervention (EMI) consisting of a digital safety plan on their mobile phone. All participants will receive their Treatment As Usual (TAU). Participants will be followed for six months, with weekly and monthly telephone visits and face-to-face visits at three and six months. Participants will be assessed using traditional questionnaires as well as Ecological Momentary Assessment (EMA) and Implicit Association Tests (IATs). With this intervention, we expect a reduction in NSSIs through the acquisition of coping strategies and a decrease in suicidal behavior over the course of follow-up. This study provides a novel, scalable digital intervention for preventing suicidal behavior and NSSIs in adolescents, which could contribute to improving adolescent mental health outcomes globally. [ABSTRACT FROM AUTHOR]

Current research on asexual youth is limited, especially in understanding the impact of their outness and the intersection of sexual orientation with gender minority identities. This study investigates the influence of outness on experiences of harassment, discrimination, violence, and the risk of non-suicidal self-injury (NSSI) among asexual youth, with a focus on those with transgender and non-binary identities. Data for this study were obtained from the 2021 Ace Community Survey, an international online survey designed to assess the needs and health status of the Ace community, targeting respondents aged 13 and older. The analysis involved a subsample of 5574 respondents aged 13 to 24 (mean age = 19.28), including 2361 cisgender (mean age = 19.65), 1,195 transgender (mean age = 18.80), and 2,018 non-binary individuals (mean age = 19.13). The results revealed that experienceds of sexual violence, verbal aggression, and physical harassment and bullying not only correlated with but also completely mediated the relationship between outness and NSSI. Asexual transgender youth experienced heightened levels of discrimination and NSSI but demonstrated notable resilience against the negative effects of identity disclosure, highlighting complex dynamics of vulnerability and protection within these communities. [ABSTRACT FROM AUTHOR]

Non-suicidal self-injury (NSSI) may be related to serious cognitive impairment in patients with major depressive disorder (MDD), but the specific mechanism is still unclear. This study attempts to identify the neurobiological process alterations of cognitive impairment in MDD patients with NSSI by examining the functional connectivity of the frontotemporal cortex in MDD patients with or without NSSI. Thirty MDD patients with NSSI, 36 MDD patients without NSSI, and 35 healthy controls (HC) were included in the study. The MATRICS Consensus Cognitive Battery (MCCB) was used to comprehensively assess the cognitive function of the subjects and functional near-infrared spectroscopy (fNIRS) was used to detect the functional connectivity of the frontotemporal cortex and its brain regions of interest. MDD patients with or without NSSI had multi-domain cognitive impairments. MDD patients with NSSI showed the lowest score in performance of attention/alertness and the weakest functional connectivity of frontotemporal when compared with the MDD patients without NSSI and the HC. In addition, the functional connectivity of the bilateral frontotemporal cortex was positively correlated with verbal learning and working memory in MDD patients with NSSI. In MDD patients, the appearance of NSSI is often accompanied by further impairment of attention/alertness and a decline in functional connectivity of the frontotemporal cortex. The impairment of verbal learning and working memory was associated with decreased functional connectivity of the frontotemporal cortex in MDD patients with NSSI. [ABSTRACT FROM AUTHOR]

Body dissatisfaction is a global public health concern. Self-injurious thoughts and behaviours (SITB), including suicidal ideation, suicide attempts and non-suicidal self-injury (NSSI), have been documented as potentially significant correlates of body dissatisfaction. However, prior findings regarding associations between body dissatisfaction and SITB have been somewhat inconsistent. Therefore, this meta-analysis was conducted to determine the nature and strength of such associations in both clinical and non-clinical samples. A literature search identified 83 relevant articles and extracted 234 effect sizes. Using a three-level random-effects model, mean effect sizes (r values) for relationships between body dissatisfaction and suicidal ideation, suicide attempts, and NSSI in clinical samples were 0.29 (95% CI, 0.22–0.37), 0.16 (95% CI, 0.13–0.20) and 0.26 (95% CI, 0.19–0.34), respectively. In non-clinical samples, these values were 0.22 (95% CI, 0.16–0.28), 0.24 (95% CI, 0.17–0.30) and 0.22 (95% CI, 0.15–0.29), respectively. Several study features (e.g., participant age, geographic region and instrument validity) emerged as significant moderators. This meta-analysis provides robust support for body dissatisfaction as a significant correlate of SITB across clinical and non-clinical samples in addition to identifying study characteristics that contribute to effect size variability. Implications are discussed for SITB research, prevention and intervention. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Non-suicidal Self-injury (NSSI) has an association with psychological issues, increasing the risk of suicide. Social exclusion is a common and negative phenomenon, arising as a great risk factor for individuals' physical and mental health. College students are in a development period featuring challenges and opportunities, making them vulnerable to social exclusion and NSSI. In this context, this study explored the mechanism of rumination between social exclusion and NSSI among college students and its significance as a mediator. Participants were 674 Chinese college students selected using random cluster sampling. The questionnaires included the Social Exclusion Questionnaire for Undergraduates (SEQU), the Adolescent Self-Injury Scale (ASIS), and the Ruminative Responses Scale (RRS). Additionally, Bootstrap analysis was used to evaluate the mediating role of rumination between social exclusion and NSSI among college students. The results indicate significant positive correlations among social exclusion, NSSI, and rumination (r = 0.171,0.383,0.243, all p < 0.001). This suggests that college students' social exclusion can directly affect the occurrence of NSSI and indirectly influence NSSI through the mediating role of rumination (β = 0.20,t = 4.97,p < 0.001). [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodResultsConclusionsThis study aimed to investigate the emotional experiences and beliefs of individuals who engage in self-harm by analyzing data from an online self-harm forum. Emphasis was placed on understanding how these individuals describe and evaluate their emotions (emotion beliefs) and the role these beliefs play in their emotion regulation and self-harming behaviors.A total of 119 posts from a self-harm discussion board on the forum were analyzed. Thematic analysis, following a critical realist perspective, was employed to identify and interpret recurring patterns in how posters articulated their emotion beliefs.Four themes were created during analysis: "My emotions are too much," "Self-harm as control or controlled by self-harm," "Suppression is better than expression," and "Self-harm helps me escape my emotional pain." Posters described experiencing overwhelming, uncontrollable, and unacceptable emotions, resulting in a desire to suppress or escape them through self-harm.Individuals struggling with self-harm hold negative beliefs about their emotions, which intensify emotional experiences and contribute to feelings of shame and guilt. The findings highlight the necessity of interventions targeting these negative emotion-related beliefs to foster alternative emotional regulation strategies and reduce reliance on self-harm, as well as the importance of increased education on these emotional beliefs for those who support them, in order to reduce stigma. Furthermore, the study emphasizes the potential of online forums in gaining valuable insights into sensitive behaviors. [ABSTRACT FROM AUTHOR]

Childhood trauma was known to increase risks of social isolation, loneliness and self-injurious thoughts and behaviors in adulthood. The aim of this study was to examine the protect and risk factors of social health, self-injurious thoughts and behaviors between adults with or without childhood trauma. This was a cross-sectional study comprising of 145,043 participants enrolled in the UK Biobank. Childhood trauma was determined by the Childhood Trauma Screener. Social health included social isolation, loneliness and emotional support. Outcomes of self-injurious thoughts and behaviors included suicide ideation, suicide attempt and non-suicidal self-injury (NSSI). Demographic data, self-reported morbidities and other confounding variables were covariates. Stata 17.0 and SPSS 27.0 was used to analysis data. Compared with participants without childhood trauma, there was no protective effect of emotional support for NSSI in participants with childhood trauma (β -value difference = 0.334, p = 0.008). The risk effect of loneliness for suicide ideation, suicide attempt and NSSI were also weaker in participants experiencing childhood trauma (p <0.05). Social isolation was no longer a risk factor for NSSI in all participants, while loneliness remained as a threat (p < 0.05). Many variables were measured using core items of the scale in UK Biobank, meanwhile, the childhood trauma data collected in adulthood may have recall bias. Adults reported childhood trauma were less vulnerable to self-injurious thoughts and behaviors when experiencing loneliness, but they could also not be protected from NSSI through emotional support. Emotional dysregulation caused by childhood trauma may contribute to this. • Adults reported childhood trauma were less vulnerable to self-injurious thoughts and behaviors when experiencing loneliness; • Adults reported childhood trauma would not be protected from NSSI through emotional support. • Regardless of childhood trauma, social isolation was not a risk factor for NSSI, while loneliness remained as a threat. [ABSTRACT FROM AUTHOR]

Background: Non-Suicidal Self-Injury (NSSI) has continued to be a major issue for public health worldwide, especially among teenagers. Studies have found a certain correlation between NSSI and Problematic Internet Use (PIU). However, this relationship is still unclear among Chinese adolescents, a specific population. Hence, a meta-analysis was carried out on observational studies to explore the connection between NSSI and PIU in Chinese teenagers, aiming to provide more clarity on the correlation. Methods: To identify the link between NSSI and PIU, we scoured seven digital repositories until November 16, 2023. Employing a random-effects meta-analysis framework, we delved into the association between NSSI and PIU. Additionally, we carried out subgroup evaluations to scrutinize variables including geographical location, age demographics, research methodology, diagnostic instruments, gender, and variables controlled for confounding, like symptoms of depression. For amalgamating data, STATA software (version 16) was deployed. Results: In this analysis, we included 15 research papers encompassing a collective sample of 137,166 individuals. Our findings revealed a significant positive association between NSSI and PIU within the adolescent population in China, with an Odds Ratio (OR) of 2.02 and a 95% Confidence Interval (CI) ranging from 1.73 to 2.37. Notably, this correlation was markedly stronger in specific subgroups: adolescents from China's Western regions exhibited an OR of 4.22 (95% CI: 3.44, 5.18); middle school attendees had an OR of 2.09 (95% CI: 1.92, 2.28); those diagnosed with concurrent depression disorders showed an OR of 2.32 (95% CI: 1.98, 2.73); and female adolescents demonstrated an OR of 2.49 (95% CI: 2.26, 2.75), highlighting the nuanced dynamics of this relationship. Conclusion: This meta-analysis indicates that PIU among adolescents is associated with an increased risk of NSSI. Our findings underscore the importance of targeting specific populations, including those in the western region of China, middle school students, adolescents with comorbid depression disorders, and female adolescents, who may be at higher risk of PIU and subsequently NSSI. These results emphasize the need for tailored interventions and preventive strategies to address these intertwined issues effectively. Systematic review registration: PROSPERO, identifier CRD42024496579. [ABSTRACT FROM AUTHOR]

The multilevel psychosocial stressors associated with COVID-19 pandemic set the stage to investigate risk factors and groups susceptible for non-suicidal self-injury (NSSI). A national sample of 9,929 Brazilian adults aged 36.1  years on average participated in the study. Cross-sectional data were collected in 2020, 2021, 2022, and 2023. NSSI levels were considered high in the total sample (13.2%) when compared to other studies in this context. The variables with the highest explanatory power in the regression models were age, anxiety, and depression. The main risk factors were being younger, living in the South or Southeast regions of Brazil, having lower educational attainment, and having higher rates of anxiety and depression. Respondents had the highest probability of NSSI in 2022. The sustained higher rates of NSSI in 2023 compared to the beginning of the pandemic underscores the need for continuous monitoring and the development of preventive actions for self-injurious behaviors. [ABSTRACT FROM AUTHOR]

To investigate the association between single nucleotide polymorphisms (SNPs) of tryptophan hydroxylase 2 (TPH2) (rs11178997, rs11178998, and rs120074175) and negative life events in adolescent depression with Non-suicidal self-injury (NSSI). Methods: Genomic DNA was extracted from 197 adolescents with depression (participants group, including NSSI group and non-NSSI group), as well as from 100 healthy controls (control group), in northern China. PCR technology was utilized to amplify DNA fragments and detect genotypes in both groups. The Adolescent Life Event Scale (ASLEC) was employed to conduct a questionnaire survey among the participants and control groups. Differences in allele and genotype frequency distribution between the two groups were analyzed using the X^2 test, while generalized multifactor dimensionality reduction (GMDR) was used to analyze gene-environment interactions. Results: Significant differences were observed in ASLEC scores between the control group and both the NSSI group and non-NSSI group (P< 0.05). Additionally, significant differences were found in the interpersonal relationship factor and punishment factor between the NSSI group and non-NSSI group (P < 0.05). Moreover, a significant difference was identified in SNP genotype of rs11178997 between the depression group (NSSI group + non-NSSI group) and control group (P< 0.05). GMDR analysis revealed an interaction among rs11178997, rs11178998, and ASLEC. Conclusion: Adolescents with depression, particularly females, may exhibit a tendency to employ NSSI as an emotional coping mechanism when confronted with greater family and interpersonal challenges. The AT genotype of TPH2 gene locus rs11178997 is more prevalent among adolescents with depression. Furthermore, the occurrence of NSSI may be associated with an interaction involving polymorphic sites rs11178997 and rs11178998 along with life events. [ABSTRACT FROM AUTHOR]

Background: Non-suicidal self-injury (NSSI) is a significant social issue, especially among adolescents with major depressive disorder (MDD). This study aimed to construct a risk prediction model using machine learning (ML) algorithms, such as XGBoost and random forest, to identify interventions for healthcare professionals working with adolescents with MDD. Methods: This study investigated 488 adolescents with MDD. Adolescents was randomly divided into 75% training set and 25% test set to testify the predictive value of risk prediction model. The prediction model was constructed using XGBoost and random forest algorithms. We evaluated the area under the receiver operating characteristic curve (AUC), sensitivity, specificity, accuracy, recall, F Score of the two models for comparing the performance of the two models. Results: There were 161 (33.00%) participants having NSSI. Compared without NSSI, there were statistically significant differences in gender (P=0.035), age (P=0.036), depressive symptoms (P=0.042), sleep quality (P=0.030), dysfunctional attitudes (P=0.048), childhood trauma (P=0.046), interpersonal problems (P=0.047), psychoticism (P) (P=0.049), neuroticism (N) (P=0.044), punishing and Severe (F2) (P=0.045) and Overly-intervening and Protecting (M2) (P=0.047) with NSSI. The AUC values for random forest and XGBoost were 0.780 and 0.807, respectively. The top five most important risk predictors identified by both machine learning methods were dysfunctional attitude, childhood trauma, depressive symptoms, F2 and M2. Conclusion: The study demonstrates the suitability of prediction models for predicting NSSI behavior in Chinese adolescents with MDD based on ML. This model improves the assessment of NSSI in adolescents with MDD by health care professionals working. This provides a foundation for focused prevention and interventions by health care professionals working with these adolescents. [ABSTRACT FROM AUTHOR]

Objective To investigate the mediating role of sleep quality in the relationship between adverse childhood experiences (ACEs) and non-suicidal self-injury (NSSI) among middle school students, as well as the moderating effect of psychological resilience, to provide reference for promoting the mental health of adolescents. Methods A total of 4 767 middle and high school students in Guiyang city, Guizhou Province, were selected by a stratified random cluster sampling method and surveyed using multiple questionnaires including the General Information Questionnaire, Adolescent Non 一 Suicidal Self-Injury Behavior Assessment Questionnaire, Adverse Childhood Experiences International Survey Questionnaire, Pittsburgh Sleep Quality Index, and Self-Rating Scale for Psychological Resilience. The mediating effect of sleep quality in the relationship between ACEs and NSSI, as well as the moderating effect of psychological resilience, were analyzed using a mediation model. Results The prevalence of NSSI among middle school students was 343%. Sleep quality partially mediated the relationship between ACEs and NSSI (j8 =0.282, t =19.115, P <0.001), accounting for 32.89% of the total effect. Psychological resilience negatively moderated the mediating pathway ACEs -sleep quality-NSSI, indicating that higher levels of psychological resilience weakened the impact of low sleep quality on NSSI 俗二一0.091, £=-6.805, P<0,001) and the impact of high ACEs on NSSI 俗=-0.074, £=-5.349, P<0,001). Conclusion There is a moderated mediating effect between ACEs and NSSI among middle school students, with sleep quality serving as a mediating variable in this relationship. Additionally, psychological resilience can weaken the impact of high ACEs and low sleep quality on NSSL [ABSTRACT FROM AUTHOR]

Background: 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. Methods: 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. Results: 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. Limitations: Future studies should investigate the separate effects of fathers' and mothers' suicide and NSSI histories on familial transmission patterns. Conclusion: The familial transmissions of suicide and NSSI exhibited distinct patterns across different income levels. [ABSTRACT FROM AUTHOR]

Little is known about trajectories of NSSI. We aimed to identify NSSI trajectories in adolescent psychiatric inpatients and emotional processes that differentiate between trajectories. Participants were 180 adolescents (71.7 % female; mean age of 14.89 years, SD = 1.35) from a psychiatric inpatient facility. NSSI was assessed at their index hospitalization, as well as 6, and 12 months after discharge. Emotion recognition, emotion reactivity, and emotion dysregulation were assessed at baseline. Latent class mixture modeling was used to identify different NSSI trajectories and ANOVAs were used to evaluate predictors of the trajectories. Analyses yielded three NSSI trajectories. These included a stable low-frequency class (90.53 % of sample), a stable moderate-frequency class, and a class characterized by high-frequency NSSI at baseline but that largely resolves by 6-month follow-up. After adjustments for multiple comparisons were made, only emotion regulation at baseline differentiated between the trajectories, with greater overall emotion dysregulation and greater emotional non-acceptance (a facet of emotion dysregulation) characterizing the initially high-frequency class and the stable moderate-frequency class more than the stable low-frequency class (ps <.05). Difficulties engaging in goal-directed behavior when distressed characterized the stable moderate-frequency NSSI class more than the stable low-frequency class (p <.05). Limitations The study sample consists predominantly of female and White adolescents and thus may not generalize to other demographic groups. The current findings suggest that interventions involving emotion regulation with adolescents who engage in NSSI would particularly benefit from a focus on increasing acceptance of emotional experiences. • We identified three non-suicidal self-injury trajectories in a youth sample. • We evaluated emotional processes in relation to these trajectories. • Emotion dysregulation was associated with worse trajectories. • Emotion recognition and emotion reactivity did not predict trajectories. [ABSTRACT FROM AUTHOR]

Objectives: Non‐suicidal self‐injury (NSSI) is theorized to be reinforced by its emotional consequences. Mental images of NSSI are commonly reported as occurring prior to NSSI. Based on the known functional properties of anticipatory mental imagery as an emotional and motivational amplifier, this study investigated whether NSSI mental imagery constitutes a proximal and dynamic mechanism underpinning NSSI risk. Method: An intensive ecological momentary assessment (EMA) study was conducted to track the occurrence and characteristics of NSSI mental imagery alongside NSSI urge and behavior in naturalistic settings. A sample of N = 43 individuals aged 17 to 24 with a history of repetitive NSSI completed EMA surveys seven times a day for 14 days. Results: Mental preoccupation in the form of NSSI mental imagery‐based flash‐forwards to the actions, bodily sensations, and emotional benefits of NSSI was found to occur when NSSI urge was high but not when urge was low. Critically, objective cross‐panel analyses showed that higher frequencies of NSSI imagery occurrence predicted greater future NSSI urge and increased likelihood of acting on urge, over and above current urge. Conclusions: Mental imagery of NSSI is not simply an epiphenomenal by‐product of NSSI urge and may constitute a dynamic and proximal novel intervention target. [ABSTRACT FROM AUTHOR]

Introduction: Adolescent suicidal ideation (SI) and non‐suicidal self‐injury (NSSI) are crucial public health issues, yet their co‐developmental trajectories during early adolescence and their associations with predictors and outcomes are unclear. This study aimed to (a) identify heterogeneous co‐developmental trajectories of SI and NSSI, (b) explore associations between transdiagnostic predictors and trajectories, and (c) assess suicide attempt risk across trajectories. Methods: Four hundred fifty‐three adolescents (Mage = 12.35 years, 48.3% boys) completed surveys at 6‐month intervals across 2 years. At Time 1 (Nov 2020), participants completed surveys encompassing SI, and NSSI, along with family, peer, and individual predictors. Subsequent surveys (Times 2–4) measured SI and NSSI, with suicide attempts queried at Time 4. Results: Parallel process latent class growth models revealed three co‐developmental groups (i.e., Stable low NSSI and SI; Moderate‐NSSI and high‐SI, parallel decreasing; High‐NSSI and moderate‐SI, parallel increasing). Multivariate logistic regression indicated that group membership was predicted by parental rejection, parental warmth, bullying victimization, depressive and anxiety symptoms, thwarted belongingness, and perceived burdensomeness. Adolescents in the "High‐NSSI and moderate‐SI, parallel increasing" group reported the highest suicide attempt frequency. Conclusion: These findings underscore subgroup distinctions and transdiagnostic predictors in comprehending SI and NSSI progression, emphasizing the necessity of dynamic monitoring and tailored interventions for distinct subgroup characteristics. [ABSTRACT FROM AUTHOR]

This study identified typologies of specific non-suicidal self-injury (NSSI) functions among youth admitted for psychiatric hospitalization and investigated clinically relevant correlates. Inpatient youth (n = 68) aged 10–17 years reported on their reasons to engage in NSSI, frequency and severity of NSSI, and symptoms of borderline personality disorder (BPD). A latent class analysis using youth's specific NSSI functions as indicators found two NSSI function typologies, which were differentially associated with clinical correlates. The Multiple Functions class (n = 28) endorsed to "feel something," "punish self," "escape feelings," "relieve anxiety," "stop feeling self-hatred," "stop feeling angry," "show much they are hurting," and "create a hurt that can be soothed." Conversely, the Single/Avoidant Function class (n = 40) endorsed one primary function—i.e., to "escape feelings." Youth in the Multiple Functions class reported significantly more frequent self-injury and greater BPD symptomology. The present study illustrates the importance of examining constellations of specific NSSI functions in inpatient care settings, given their unique associations with NSSI frequency and features of BPD. These findings could inform targeted psychological screening and, in turn, guide the implementation of interventions for elevated NSSI frequency and BPD symptomology among inpatient youth, based on NSSI functions endorsed. [ABSTRACT FROM AUTHOR]

Background: Non-suicidal self-injury (NSSI) and Feeding or Eating Disorders (FEDs) often coexist during adolescence with reciprocal influences on their clinical picture. The present study aimed to identify differences and similarities in the clinical presentation of young patients with both conditions compared to those with the two non-comorbid disorders. Methods: We consecutively recruited forty-five female patients aged between 11 and 18 at our third-level hospital and subdivided them into three groups (NSSI: n = 15; FED: n = 15; NSSI + FED: n = 15). Patients underwent a full clinical assessment. Results: Based on our results, the NSSI + FED group was characterized by higher rates of binging/purging behaviors, greater prevalence of Cyclothymic Disorder, and a more severe clinical presentation compared to the non-comorbid groups. Moreover, higher levels of suicidal ideation were found in the NSSI + FED group. Pharmacological treatment patterns also differed, with SSRI being prescribed more frequently to NSSI + FED patients while mood stabilizers were prescribed more frequently to NSSI ones. A Principal Component Analysis identified four main dimensions: "Body Image" impairment was more pronounced in NSSI + FED patients, indicating negative attitudes towards their own body; "Metacognition" deficits were higher in NSSI than FED. Conclusions: The present study underscores distinctive clinical features in patients with comorbid NSSI and FED, emphasizing the urgent need for tailored intervention strategies focusing on specific symptom domains. [ABSTRACT FROM AUTHOR]

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Abstract Background The incidence of non-suicidal self-injury (NSSI) is high and often occurs repeatedly. Psychiatric nurses play a vital role in the care and treatment of NSSI patients, as they have the most frequent contact with patients. The experiences and attitudes of nurses has a direct affect on the quality of care they provide to patients. Negative care experiences and attitudes of patient aversion on behalf of nurses may delay the observation and treatment of changes in the patient’s condition, leading to irreversible risks. Although cross-sectional studies have investigated the attitudes of medical staff toward NSSI patients, quantitative research results cannot comprehensively reflect the emotional experiences and complex psychological changes of the study subjects. A few studies have focused on the psychiatric nurses’ care experiences and attitudes toward patients with repeated NSSI. Objective This study aimed to explore psychiatric nurses’ care experiences and attitudes toward patients during repeated NSSI. Methods A thematic analysis qualitative study was used. Using purposive sampling, 18 psychiatric nurses were recruited from a mental health center in Chengdu, China. Semi-structured interviews were conducted and audio-recorded. Audio-recordings were transcribed verbatim and analyzed using six-phase thematic analysis. Results Four themes emerged from the analysis: psychiatric nurses’ care experiences, perceptions, care attitudes and coping style toward repeated NSSI patients. Psychiatric nurses have experienced negative care experiences and severe career burnout during the patient’s repeated NSSI. Nurses’ attitudes toward NSSI patients changed during repeated NSSI, from understanding to indifference to anger and resentment. At the same time, it was found that nurses’ coping style with NSSI patients could be divided into three stages, namely, active coping, neglect and perfunctory, and criticism and punishment. Conclusions The findings have implications for health care systems regarding interventions to improve nurses’ care experiences and attitudes toward repeated NSSI patients. These findings suggest that enhancing nurses’ understanding of NSSI, establishing standardized emergency response and intervention programs, guiding positive professional values and responsibility, and improving nurses’ caring attitudes can promote the early detection and timely intervention of NSSI.

Abstract Background Non-suicidal self-injury (NSSI) is a significant public health concern among adolescents with major depressive disorders (MDD). Although previous research has linked child maltreatment (CM) to NSSI, the precise mechanisms remain unclear. This study aims to investigate the association between CM, cognitive reappraisal (CR), negative coping styles (NC) and NSSI in adolescents with MDD, from the perspectives of both Latent Variable Theory and the Network Theory of Mental Disorder. Methods A sample of 651 adolescents with MDD was recruited from January to December 2023. Data on CM, CR, NC, and NSSI were collected through paper-based self-reported questionnaires. Data analysis primarily involved structural equation modeling and network analysis. Results The reporting rate of NSSI among adolescents with MDD was 48.2%. CM showed a significant positive correlation with NSSI. NSSI was affected by CM through three paths: the mediating role of CR, the mediating role of NC, and the chain mediating role of both CR and NC. Emotional abuse (EA) was the central node, while NSSI, EA, and “The urge to cry quietly when faced with troubles“(NC10) were the key bridge nodes. Conclusions This study is the first to use both structural equation modeling and network analysis to explore the explore the relationship between CM, CR, NC, and NSSI in adolescents with MDD, providing a theoretical basis for future early prevention and targeted interventions for adolescents with MDD.

BackgroundSuicidal ideation serves as a sensitive predictive indicator for non-suicidal self-injury （NSSI） behavior， and NSSI behavior brings profound effects to both mental and physical health of senior high school students. Existing studies have made exploration on the relationship among insomnia， anxiety and NSSI behavior in the general population， but the internal mechanism of NSSI behavior in senior high school students with suicidal ideation requires further study.ObjectiveTo explore the pathway of anxiety between insomnia and NSSI behavior in senior high school students， so as to provide references for the intervention on NSSI behavior in such demographic.MethodsFrom December 10 to 15， 2021， cluster sampling was adopted to select 2 572 senior high school students across three senior high schools in Hubei Province as the research objects. Assessment was conducted by using Insomnia Severity Index （ISI）， Generalized Anxiety Disorder Scale-7 item （GAD-7） and Adolescents Self-Harm Scale. Spearman correlation analysis was conducted to examine the correlation among scores of scales finished by senior high school students with suicidal ideation. Model 4 from the SPSS 20.0 Process 4.2 was employed to test the mediating path of anxiety between insomnia and NSSI behavior.ResultsA total of 2 421 valid questionnaires （94.13%） were recovered， which revealed 554 cases （22.88%） with suicidal ideation and 408 cases （16.85%） with NSSI behavior. The scores of ISI， GAD-7 and Adolescents Self-Harm Scale of senior high school students with suicidal ideation were higher than those of students without suicidal ideation （Z=17.124， 20.611， 21.314， P

Abstract This study delves into the correlation between childhood trauma and non-suicidal self-injury (NSSI) behaviors among high school students. Additionally, it examines the mediating role of stress perception and the moderating role of the teacher-student relationship in this association. A questionnaire survey was administered to 1,329 high school students in Yunnan Province to assess childhood trauma, NSSI behaviors, and stress perception. Firstly, the survey revealed a 12% prevalence of NSSI, with girls exhibiting a higher occurrence compared to boys (OR = 0.413, 95% CI: 0.280–0.609). Secondly, childhood trauma emerged as a significant predictor of NSSI behavior, irrespective of gender or whether the individual was an only child (r = 0.17, P

Abstract Background Non-suicidal self-injury (NSSI) has exhibited an increasing trend in recent years and is now globally recognized as a major public health problem among adolescents and young adults. Negative life events (NLEs) are positively associated with NSSI. We sought to explore (1) whether sex plays a role in the risk of NLEs leading to NSSI and (2) the role played by mental health (MH). Methods We adopted a multi-stage cluster sampling method to select college students across four grades from May to June 2022. Generalized linear models were used to evaluate the relationships between NLEs, sex, MH and NSSI, presented as incidence-rate ratios (RRs) with 95% confidence intervals (CIs). We examined the complex relationship between these variables using the PROCESS method for moderation analysis. Results Following the exclusion of data that did not meet the study requirements, data from 3,578 students (mean age: 20.53 [± 1.65] years) were included. Poisson regression results indicate that high-level NLEs (RR = 0.110, 95%CI: 0.047–0.173) are associated with increased NSSI. Furthermore, interaction effects were observed among sex, NLEs and NSSI. MH and sex moderated the relationship between NLEs and NSSI. Conclusion Identifying risk factors for NSSI is also important when exploring the interaction between NLEs and MH given the potential for NSSI to significantly increase the risk of later psychopathological symptoms and substance abuse problems. In addition, the significance of sex differences in risk factors for NSSI should be determined. This study evaluated how the impact of NLEs on NSSI can be reduced among adolescents from multiple perspectives.

Huan Wang,1,&ast; Xing Xie,2,&ast; Zuowei Li,3 Lian Xue,4 Qiaoling Liao5 1The First Department of Psychosomatic Diseases, the Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, 621000, People’s Republic of China; 2Mental Health Center of West China Hospital, Sichuan University, Chengdu, 610041, People’s Republic of China; 3Nursing Department, the Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, 621000, People’s Republic of China; 4The Second Department of Psychosomatic Diseases, the Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, 621000, People’s Republic of China; 5The Second Department of Severe Psychiatric, the Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, 621000, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Qiaoling Liao, The second department of severe Psychiatric, the Third Hospital of Mianyang, Sichuan Mental Health Center, No. 190, Jiannan Road, Youxian District, Mianyang, Sichuan Province, 621000, People’s Republic of China, Email qqliao2009@163.comPurpose: This study aims to investigate the status of family functioning and dissatisfaction of family function from the perception of adolescents with affective disorders and explore associated factors.Methods: This was a multicentric cross-sectional study conducted from April 2022 to February 2023. Adolescents with affective disorders were surveyed in representative samples drawn from three hospitals in Sichuan province, China. Data were obtained from 235 participants regarding their demographic characteristics, family characteristics, disease-related characteristics, and family functioning.Results: The study found family functioning and its’ dissatisfaction both lower than national norms from the perspectives of adolescents. Younger age, single-parent family, and reconstituted family were predictors of not close of cohesion. Younger age, lower educational level of father, and reconstituted family were associated with less change of flexibility. Less times of hospitalizations, higher educational level of father, stem family were more satisfy with cohesion. Higher educational level of father, and stem family were also associated with greater satisfaction with flexibility.Conclusion: The study demonstrated that the family function of adolescents of affective disorders was poor, more attention should be paid to it. Age, family structure, number of hospitalizations and the educational level of father were influencing factors of family functioning. Therefore, it is important for medical worker to assess demographic and family characteristics of adolescents with affective disorders. Younger children, children of reconstituted family and single-parent family, children with repeated hospitalizations and fathers of lower level of education should be given emphasized in implementation of interventions. Based on the evaluation results, personalized family therapy has been proved to be an affective measure and could be used in clinical work.Keywords: affective disorders, adolescent, family functioning

Chenyu Zhang,1,2,&ast; Yalan Li,1,&ast; Wo Wang,1 Zhenghao Jiang,1 Chuan Liu,1 Yiting Kong,2 Daqi Li,1 Liuyi Ran,1 Li Kuang1,2 1Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, 401331, People’s Republic of China; 2Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Liuyi Ran; Li Kuang, Mental Health Center, University-Town Hospital of Chongqing Medical University, Shapingba District, Chongqing, 401331, People’s Republic of China, Tel/Fax +86-023-65714061, Email ranliuyi@163.com; kuangli0308@163.comPurpose: The aim of our study was to explore the relation between serum levels of non-enzymatic antioxidants, thyroid function with the risk of non-suicidal self-injury (NSSI) in depressed adolescents.Patients and Methods: We retrospected the electronic records of 454 hospitalized patients aged 13– 17 years old with a diagnosis of major depressive disorder (239 patients with NSSI and 215 subjects without NSSI), and collected their demographic and clinical information, including serum levels of total bilirubin (Tbil), uric acid (UA), free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH).Results: The incidence of NSSI was 52.6% among depressed adolescents aged 13– 17, 57.1% in female and 38.5% in male. After using the propensity scoring method to exclude the influence of age between the two groups, it was found that patients with NSSI showed lower levels of Tbil (P=0.046) and UA (P=0.015) compared with those without NSSI. Logistic regression results showed that serum UA was associated with NSSI behavior in female patients (OR=0.995, 95% CI: 0.991– 0.999, P=0.014), and TSH was associated with NSSI in male participants (OR=0.499, 95% CI: 0.267– 0.932, P=0.029).Conclusion: Female and male may have different pathological mechanisms of NSSI. NSSI is more likely to be related to antioxidant reaction in female adolescent patients, while more likely to be related to thyroid function in male depressed adolescent patients.Keywords: antioxidant system, depressed adolescents, incidence, non-suicidal self-injury, thyroid function

Abstract Background Suicidal ideation (SI) is increasingly prevalent among adolescents, often arising from depression and linked with non-suicidal self-injury (NSSI). Previous studies have noted significant sex differences in the manifestation and predictors of SI, depression, and NSSI. Aim This study aims to analyze and compare the relationships between SI, depression, and NSSI among male and female adolescents, examining whether these associations differ based on sex. Methods A total of 368 adolescents (M = 15.43, SD = 1.22, about 56.2% female participants), both from clinical and school settings, were assessed for SI, depression, NSSI, and other related variables. Network analysis was utilized to explore the interconnections among these variables, focusing on identifying sex-specific patterns. Logistic regression was used to confirm the findings from the network analysis. Results The network analysis revealed significant sex differences in the relationships between SI, depression, and NSSI. In the female network, the edge weights between SI and NSSI (0.93) and between SI and depression (0.31) were much higher compared to the male network (0.29 and 0, respectively). Centrality indices (strength, betweenness, closeness, and expected influence) for SI, NSSI, and depression were also higher in the female network. Logistic regression confirmed these findings, with depression being a potential predictor of SI only in females (OR = 1.349, p = 0.001) and NSSI having a stronger influence on SI in females (OR = 13.673, p

Abstract Background Unhealthy lifestyle behaviors among adolescents have emerged as a significant public health concern worldwide, however, there is little investigation on the impact of unhealthy behaviors on non-suicidal self-injury (NSSI), suicidal ideation (SI) and suicide attempt (SA). This study aimed to investigate the prevalence of seven unhealthy behaviors as well as their associations with NSSI, SI and SA, and to explore whether the aforementioned associations differ across sex. Methods A total of 74,152 adolescents were included in this study via a multi-stage, stratified cluster, random sampling method in 2021. Information about unhealthy behaviors (insufficient physical activity, current smoking, current drinking, excessive screen time, long homework time, insufficient sleep and unhealthy BMI), NSSI, SI, SA and other demographics was collected. Sampling weights were used to estimate the prevalence, and the weighted logistic regression models were performed. Stratified analyses by sex and sensitive analyses were conducted. Results Overview, the weighted prevalence of adolescents had more than five unhealthy behaviors were 5.2%, with boys showing a higher prevalence than girls (6.5% vs.3.8%). Current smoking, current drinking, excessive screen use, long homework time, insufficient sleep, and unhealthy BMI were significantly associated with NSSI, SI and SA. Moreover, adolescents with high lifestyle risk scores were associated with an increased risk of NSSI (5–7 vs. 0: OR 6.38, 95% CI 5.24–7.77), SI (5–7 vs. 0: OR 7.67, 95% CI 6.35–9.25), and SA (5–7 vs. 0: OR 9.57, 95% CI 6.95–13.17). Significant sex differences were found in the associations of unhealthy behaviors with NSSI, SI and SA. Conclusion Unhealthy behaviors are quite common among Chinese adolescents. Adolescents with multiple unhealthy behaviors are associated with increased risks of NSSI, SI, and SA. The implementation of school and family-based interventions to promote healthy lifestyles is recommended as a preventive measure against self-injurious behavior and suicidality in adolescents.

Abstract Background Nurses face disproportionately high rates of suicidal ideation and non-suicidal self-injury (NSSI). The role of workplace violence, loneliness, and depressive symptoms in exacerbating these issues is poorly understood. This study aims to explore these relationships to inform interventions for improving nurses’ mental health. Methods A cross-sectional study involving 1,774 Chinese nurse staff selected through convenient sampling methods was conducted. Workplace violence, depressive symptoms, and loneliness were assessed using the Chinese versions of the Workplace Violence Scale (WVS), the 9-item Patient Health Questionnaire (PHQ-9), and a three-item loneliness scale, respectively. Participants completed self-report questionnaires anonymously to ensure adherence to ethical standards. Statistical analysis utilized structural equation modeling (SEM) to examine the intricate relationships among variables, thereby elucidating the impact of workplace violence, loneliness, and depressive symptoms on nurses’ suicidal ideation/NSSI outcomes. Results Nurse staff 165 (7.8%) were reported different level of suicidal ideation and 139 (7.8%) participants were reported different level of NSSI. And the final model of workplace violence on suicidal ideation shown a good model fit index (CMIN/DF = 3.482 NFI = 0.969 CFI = 0.977 TLI = 0.955 RFI = 0.938, RMSEA = 0.037 SRMR = 0.035). The pathway of workplace violence to loneliness (β = 0.163, P

Abstract Background Individuals may be more likely to engage in NSSI due to negative cognitive bias, while the use of negative emotional regulation mechanisms may further contribute to NSSI. Currently, there is a dearth of studies regarding the correlation among the three variables. Method The study employed convenience sampling to collect data via online platforms from a total of 572 college students in Harbin, Heilongjiang Province, China, over the period of January 2024 to February 2024. The questionnaires comprise the Non-Adaptive Cognitive Emotion Srategy Regulation Subscale, the Negative Cognitive Processing Bias Questionnaire, and the NSSI Questionnaire. Outcome Negative cognitive bias significantly and directly influences NSSI, as indicated by a beta coefficient of 0.3788 and a confidence interval of [0.2878, 0.4698]. The existence of negative cognitive bias significantly enhances the impact of non-adaptive cognitive emotion control approaches (β = 0.5613, CI [0.4808, 0.6418]). Non-adaptive cognitive emotion regulation strategies showed a significant effect on NSSI, as indicated by a beta coefficient of 0.2033 and a confidence interval of [0.0942, 0.3125]. The non-adaptive cognitive emotion control strategy serves as an intermediary between negative cognitive bias and NSSI, explaining 30.12% of the overall impact. In conclusion The results demonstrate that non-adaptive cognitive emotion regulation strategies play a partially moderating role in the relationship between negative cognitive bias and NSSI among nursing students. We emphasize the importance of non-adaptive cognitive emotion regulation strategies, negative cognitive biases, and NSSI among nursing students. In order to reduce the occurrence of NSSI, it is important for schools, families, and teachers to work together closely and implement a well-organized and efficient intervention to protect the mental well-being of nursing students.

Abstract Background The prevalence of non-suicidal self-injury among South Korean adolescents has increased significantly, requiring academic attention. This methodological study aims to develop a non-suicidal self-injury motivation scale for adolescents and evaluate its validity and reliability. Methods In the first phase of scale development, the factors constituting self-injury motivation were identified through a literature review and analysis of online counseling data from self-injuring adolescents. In the second phase, 45 initial preliminary items were derived based on the identified factors, and 38 preliminary items were selected through content validation by experts. In the scale validation phase, the survey was conducted using 38 items. Data were collected from adolescents with a history of self-injury, using exploratory factor analysis (EFA) involving 715 participants and confirmatory factor analysis (CFA) involving 537 participants. The EFA involved 27.0% male and 73.0% female participants, with a mean age of 16.83 years, and the CFA involved 20.7% male and 79.3% female participants, with a mean age of 16.15 years. The data collected were tested for validity and reliability using SPSS 28.0 and M-plus. Results The EFA yielded four factors and 24 items. The factors were named interpersonal influence, emotion regulation, sensation seeking, and anti-suicide, and the scale had an explanatory power of 55.8%. In the CFA, the fit of the 23-item model after deleting one item with low standardized factor loadings was x 2 = 1081.52 (p

Abstract Background Suicide among male construction workers are reported to be disproportionally high compared to the working age population. However, there is minimal understanding of the prevalence and associated factors for suicidal ideation, non-suicidal self-injury, and suicide attempt among this occupational group globally. Methods A cross-sectional study was conducted on a large sample of male construction workers in Ireland (n = 1,585). We investigated the prevalence of suicidal ideation, non-suicidal self-injury and suicide attempts and sociodemographic, occupational, and mental health factors associated with these three outcomes. Multivariable Poisson regression was performed to estimate the prevalence rate ratio of suicidal ideation (model 1 primary outcome), while multivariable logistic regression was used to estimate the odds ratio of non-suicidal self-injury (model 2 primary outcome), and suicide attempt (model 3 primary outcome). Results The lifetime prevalence rate for suicidal ideation was 22%, 6% for non-suicidal self-injury, and 6% for suicide attempt. In univariate modelling, socio-demographic and occupation-specific factors associated with the three outcomes included younger age (suicidal ideation and non-suicidal self-injury), not being in a relationship (suicide attempt) and working 35–44 h per week (suicidal ideation and suicide attempt). The mental health factors generalized anxiety disorder, depression, and suicide bereavement were significantly associated with increased risk of the three outcomes. In fully adjusted multivariable models, increasing severity of generalized anxiety disorder and depression were associated with an increased prevalence rate ratio of suicidal ideation, and a higher odds ratio of non-suicidal self-injury and suicide attempt. Conclusion Suicidal ideation, non-suicidal self-injury and suicide attempt are significant issues for male construction workers that require specific attention. Findings highlight a need to support younger male construction workers and those bereaved by suicide. They also highlight the need for the early detection and treatment of generalized anxiety disorder and depression in order to intervene in, and potentially prevent, suicidality among male construction workers.

Lihua Zhou,1,&ast; Kun Zhang,2,3,&ast; Juanjuan Guo,4 Jianbo Liu,5 Suhong Wang,6 Jingbo Gong7 1College of Education Science, Hengyang Normal University, Hengyang, People’s Republic of China; 2Suzhou Guangji Hospital, Suzhou, People’s Republic of China; 3Affiliated Guangji Hospital of Soochow University, Suzhou, People’s Republic of China; 4School of Education, Hunan University of Science and Technology, Xiangtan, Hunan, People’s Republic of China; 5Department of Child Psychiatry of Shenzhen Kangning Hospital, Shenzhen Mental Health Center, School of Mental Health, Shenzhen University, Shenzhen, People’s Republic of China; 6Department of Clinical Psychology, The Third Affiliated Hospital, Soochow University, Changzhou, People’s Republic of China; 7Shanghai Changning Mental Health Centre, Shanghai, People’s Republic of China&ast;These authors contributed equally to this workCorrespondence: Jingbo Gong, Shanghai Changning Mental Health Center, Shanghai, 200335, People’s Republic of China, Email yefenhua@126.com Suhong Wang, Department of Clinical Psychology, The Third Affiliated Hospital, Soochow University, Changzhou, People’s Republic of China, Email yarmine@gmail.comBackground: The present study aimed to investigate the potential role of perceived stress, impulsivity trait, executive dysfunction in non-suicidal self-injury (NSSI) thoughts among college students, as well as the gender differences.Methods: A sample of 890 university students completed self-report measures of NSSI thoughts in the past month, the level of perceived stress, impulsivity traits, and executive dysfunction.Results: Compared to those with low level of perceived stress, participants with high level of perceived stress reported significant higher levels of impulsivity trait and executive dysfunction, and higher frequency of NSSI thoughts, and there were no gender differences. Male participants with NSSI thoughts, compared to males without NSSI thoughts, reported significant higher levels of perceived stress and executive dysfunction. Female participants with NSSI thoughts, compared to females without NSSI thoughts, reported significant higher levels of perceived stress, impulsivity trait, and executive dysfunction. Hierarchical regression analysis revealed only executive dysfunction was associated with NSSI thoughts in males, while only perceived stress was associated with NSSI thoughts in females.Conclusion: This study revealed different influence factors for NSSI thoughts in male and female college students. NSSI thoughts in males were more likely associated with executive dysfunction while in females were due to recently perceived stress.Keywords: perceived stress, impulsivity, executive dysfunction, non-suicidal self-injury, gender difference