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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]

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]

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]

• This is one of the first studies examined differential pattern and risk factors of NSSI behavior of youth at different developmental stages during the COVID-19 pandemic in China. • The late-adolescent group (age ≥15 - <18) had the highest rate reporting NSSI behavior, while the young-adult group had the lowest rate during the COVID-19 pandemic. • Early-adolescents (age ≥12 - <15) with a poorer help-seeking pattern, lower paternal education level and being female had significantly higher rate of NSSI behavior. • Young adults (age ≥18 - ≤25) with increased smoking, higher maternal education level and lower education level had increased NSSI behaviors. • It is crucial to develop the targeted and personalized intervention strategies on reducing NSSI behavior for youth. [ABSTRACT FROM AUTHOR]

Adolescent non-suicidal self-injury (NSSI) is a major public health issue. Family factors are significantly associated with NSSI in adolescents, while studies on forecasting NSSI at the family level are still limited. In addition to regression methods, machine learning (ML) techniques have been recommended to improve the accuracy of family-level risk prediction for NSSI. Using a dataset of 7967 students and their primary caregivers from a cross-sectional study, logistic regression model and random forest model were used to test the forecasting accuracy of NSSI predictions at the family level. Cross-validation was used to assess model prediction performance, including the area under the receiver operator curve (AUC), precision, Brier score, accuracy, sensitivity, specificity, positive predictive value and negative predictive value. The top three important family-related predictors within the random forest algorithm included family function (importance:42.66), family conflict (importance:42.18), and parental depression (importance:27.21). The most significant family-related risk predictors and protective predictors identified by the logistic regression model were family history of mental illness (OR:2.25) and help-seeking behaviors of mental distress from parents (OR:0.65), respectively. The AUCs of the two models, logistic regression and random forest, were 0.852 and 0.835, respectively. The key limitation is that this cross-sectional survey only enabled the authors to examine predictors that were considered to be proximal rather than distal. These findings highlight the significance of family-related factors in forecasting NSSI in adolescents. Combining both conventional statistical methods and ML methods to improve risk assessment of NSSI at the family level deserves attention. • The most important familial predictor within the random forest algorithm was family function. • The logistic regression model found family history of mental illness as the foremost familial risk predictor for NSSI. • Help-seeking behaviors of mental distress from parents or others in the family were protective predictors of NSSI. • Maternal education less than high school was a protective predictor of NSSI. • Both models resulted in an overall positive ability to predict family-related factors of NSSI. [ABSTRACT FROM AUTHOR]

Suicide is a leading cause of death worldwide. Whereas some studies have suggested that a direct measure of common genetic liability for suicide attempts (SA), captured by a polygenic risk score for SA (SA-PRS), explains risk independent of parental history, further confirmation would be useful. Even more unsettled is the extent to which SA-PRS is associated with lifetime non-suicidal self-injury (NSSI). We used summary statistics from the largest available GWAS study of SA to generate SA-PRS for two non-overlapping cohorts of soldiers of European ancestry. These were tested in multivariable models that included parental major depressive disorder (MDD) and parental SA. In the first cohort, 417 (6.3 %) of 6573 soldiers reported lifetime SA and 1195 (18.2 %) reported lifetime NSSI. In a multivariable model that included parental history of MDD and parental history of SA, SA-PRS remained significantly associated with lifetime SA [aOR = 1.26, 95%CI:1.13–1.39, p < 0.001] per standardized unit SA-PRS]. In the second cohort, 204 (4.2 %) of 4900 soldiers reported lifetime SA, and 299 (6.1 %) reported lifetime NSSI. In a multivariable model that included parental history of MDD and parental history of SA, SA-PRS remained significantly associated with lifetime SA [aOR = 1.20, 95%CI:1.04–1.38, p = 0.014]. A combined analysis of both cohorts yielded similar results. In neither cohort or in the combined analysis was SA-PRS significantly associated with NSSI. PRS for SA conveys information about likelihood of lifetime SA (but not NSSI, demonstrating specificity), independent of self-reported parental history of MDD and parental history of SA. At present, the magnitude of effects is small and would not be immediately useful for clinical decision-making or risk-stratified prevention initiatives, but this may be expected to improve with further iterations. Also critical will be the extension of these findings to more diverse populations. • Polygenic risk for suicide attempt (SA) is associated with history of suicide attempts in US Army soldiers. • This association is seen for suicide attempts but not with non-suicidal self-injury • Polygenic risk indices for SA may contribute in the future to the identification of at-risk individuals. [ABSTRACT FROM AUTHOR]

Non-suicidal self-injury (NSSI) is prevalent and especially among the adolescence population. It has been argued that abnormal brain activations in reward processing could be regarded as objective biomarkers in NSSI, but the evidence is mixed. This study aims to explore the reward processing mechanism of NSSI from the perspective of functional brain circuitry and investigate the role of a cognitive factor (rumination). Seventy-one 17–21 years old participants performed a monetary incentive delay (MID) task during functional magnetic resonance imaging scanning. Psychophysiological interaction (PPI) analysis was used to test the inner-group differences of brain functional connectivity. In addition, a mediation model was established with the mediation effect of rumination on the relationship between functional brain circuitry and NSSI. PPI analysis suggested that functional connectivity of the orbital frontal cortex (OFC) (with precuneus, SMA) was significantly enhanced in NSSI in the gain > loss contrast, but not in the loss > gain contrast. Mediation analysis revealed that rumination mediated the relationship between NSSI and the OFC- precuneus functional connectivity in the gain > loss contrast. Our research revealed that the abnormal OFC functional connectivity in gain (not loss) anticipation can be served as the sensitive biomarkers of NSSI. And there was a chain path for NSSI, that was from functional brain circuitry to negative cognition and then to problem behavior. • PPI seeds of gain and loss anticipation was independently explored by using task-related fMRI with a large sample. • The neural mechanism of NSSIs' reward processing deficits was elaborated from the perspective of functional connectivity. • OFC, as the hub of multi-information integration, has an important influence on NSSI in gain anticipation. • Both rumination and OFC- precuneus functional connectivity were taken into consideration to find a chain path for NSSI. [ABSTRACT FROM AUTHOR]

Although the development and application of mobile phones have changed various aspects of people's lives, excessive use of mobile phones has also raised physical and mental health concerns. However, the relationship between mobile phone addiction (MPA) and non-suicidal self-injury (NSSI) is unclear. A cross-sectional study was conducted (2022) among students from six universities to assess the relationship between MPA and NSSI. A Mobile Phone Addiction Tendency Scale (MPATS) was used to assess MPA, while NSSI was assessed via The Ottawa Self-Injury Inventory. Binary logistic regression models were used to assess the relationship between MPA and NSSI. A total of 18,723 college students (6531 males [34.9 %] and 12,192 females [65.1 %]) were included in the final analyses. The prevalence of NSSI during the past 12 months was 6.5 %. Furthermore, 5553 participants (29.7 %) met the MPA criteria (MPATS score ≥ 48), and the average MPATS score was 39.5 ± 13.0. MPA was associated with increased odds of NSSI after adjusting for socio-demographic characteristics, health-related characteristics, and relevant psychosocial variables (OR , 1.29; 95 % CI , 1.13–1.46). Moreover, gender did not affect the association of MPA and MPATS score with NSSI (P for interaction>0.05). The restricted cubic splines regression showed that a monotonically increasing risk of NSSI was associated with increasing MPATS score (P for non-linearity = 0.474). MPA is associated with increased odds of NSSI among college students, indicating that early examination, prevention, and intervention for MPA may prevent and control NSSI. • MPA was positively associated with increased odds of NSSI among college students. • No gender-specific differences was found in the association of MPA with NSSI. • A significant linear dose-response relationship between MPA and NSSI was observed in this study. [ABSTRACT FROM AUTHOR]

Child maltreatment can increase the risk of lifetime non-suicidal self-injury (NSSI) and suicidal self-injury (SSI), but there is limited knowledge regarding the differences of potentially psychological mechanisms between NSSI with and without SSI. Participants, 3918 community-based Chinese young men aged 18–34 years in Chengdu, were included in this study. We investigated the association between depression, anxiety, psychosis, child maltreatment, adulthood traumatic events, impulsivity, alcohol dependence, drug abuse, and lifetime of NSSI among participants with and without SSI. Parallel mediation analysis was utilized to explore the mediators for the relation between child maltreatment and NSSI. The prevalence of lifetime NSSI was 6.1 % (95 % CI: 5.4 %–6.9 %) among young men. Anxiety and impulsivity partially mediated the effect of child maltreatment on NSSI either with (indirect effect: 51.2 %) or without SSI (indirect effect: 34.3 %). Depression was independently and significantly associated with only NSSI but not with NSSI+SSI. Alcohol dependence and psychosis were independently and significantly associated with NSSI+SSI and mediated the effect of child maltreatment on NSSI+SSI. The cross-sectional survey data limits the robustness of the proof to the causal relationships. Anxiety and impulsivity are associated with NSSI either with or without SSI and partially mediate the effect of child maltreatment on NSSI. Depression is associated with only NSSI, while alcohol dependence and psychosis are only associated with NSSI+SSI. It could be crucial to improve treatment and recovery of alcohol dependence and psychosis for preventing young men engaged in NSSI from attempting SSI. • Anxiety and impulsivity mediated the relation between child maltreatment and NSSI among young men. • Depression was associated with only NSSI, but not associated with NSSI+SSI. • Alcohol dependence and psychosis mediated the relation between child maltreatment and NSSI+SSI among young men. [ABSTRACT FROM AUTHOR]

• Alterations in regional spontaneous activity between depressive patients with and without non-suicidal self-injury (NSSI) were studied by resting-state fMRI. • The NSSI group had characteristic alterations in brain activity and these alterations correlated with clinical features. • This provides help to differentiate subtypes of depression and to predict suicide risk. We conducted this resting-state functional magnetic resonance imaging (rsfMRI) study to characterize changes in regional homogeneity (ReHo) or fractional amplitude of low-frequency fluctuations (fALFF) in young adult patients with major depressive disorder (MDD), with or without non-suicidal self-injury (NSSI). We recruited 54 MDD patients with NSSI (MDD/NSSI), 68 MDD patients without NSSI, which is referred to as simple MDD (sMDD), and 66 matched healthy controls (HCs). A combination of fALFF and ReHo analyses was conducted. The effects of NSSI on the brain and their relationship to clinical variables were examined in this study. MDD/NSSI patients have decreased fALFF in the right superior frontal gyrus (SFG) and the right inferior parietal lobe (IPL), decreased ReHo in the right SFG and the right middle temporal gyrus (MTG) and the left middle occipital gyrus (MOG). fALFF and ReHo values of the right SFG are positively correlated. The ReHo values of the right SFG and the number of recent self-injuries are positively correlated; the fALFF values of the right SFG are negatively correlated with NSSI severity. There is a difference in brain activity between MDD/NSSI and sMDD, which may serve as an important physiological marker to determine the risk of self-injury and suicide. Abnormal brain activity in patients with NSSI may provide new perspectives and significant implications on the severity of MDD patients and the prevention of self-injury and suicide. [ABSTRACT FROM AUTHOR]

COVID-19 has had an enormous impact on the mental health of people around the world, particularly adolescents. Non-suicidal self-injury (NSSI) is one of the most prominent and dangerous behaviors associated with suicide. However, few meta-analyses of the NSSI prevalence have ever been conducted since the COVID-19 outbreak. Here, we conducted a meta-analysis to estimate the pooled prevalence and elucidate the influencing factors for NSSI. We searched PubMed, Web of Science, Embase, APA PsycINFO, CNKI and Wanfang Database for relevant literature published before April 2022. Pooled prevalence and 95 % confidence interval (CI) were used to assess NSSI prevalence. Subgroup and meta-regression analyses were performed to clarify the potential influencing factors. A total of 15 studies with 24,055 participants were eventually included. The results showed that the pooled overall prevalence of NSSI among overall samples during the COVID-19 pandemic was 22.5 % (95 % CI: 17.2 % to 28.9 %). Subgroup and meta-regression analyses revealed that the crucial influencing factors for NSSI included gender, age, regional distribution, and suicidal ideation. Specifically, the NSSI prevalence among adolescents and adults during the pandemic was 32.40 % and 15.70 %, respectively. Most importantly, gender is a significant influencing factor for NSSI among adolescents. The pooled prevalence of NSSI during the COVID-19 outbreak has surged to alarming heights, especially among adolescents. The prevalence of NSSI may be influenced by complex factors such as gender and age. Therefore, it is critical to pay attention to NSSI behaviors in the adolescent population, particularly male adolescents who appear to be susceptible. • This study highlights the shocking prevalence of NSSI for adolescents, adults and overall samples during COVID-19 pandemic. • NSSI is modulated by multifarious factors, such as age, gender, regional distribution, and suicidal ideation. • Influential upon adolescent NSSI, gender emerged as the crucial factor for NSSI (p = 0.006, R 2 = 54%). • Special attention should be given to male adolescents as they are at a high risk of being involved in NSSI. [ABSTRACT FROM AUTHOR]

Despite a surge in research on self-injury in the last decade, a summary of research findings about the development of Non-Suicidal Self-Injury (NSSI) over time in community youth samples is not yet present in the scientific literature. This study aims to summarize the empirical literature on this topic, examining both the occurrence (Study 1) and frequency (Study 2) of NSSI over time, and for this reason, a Systematic Review and Bayesian Meta-Analysis were conducted. Following the PRISMA guidelines, the longitudinal studies included in the systematic review consisted of 41 papers (Study 1 = 16; Study 2 = 25). Only studies with available data were included in the meta-analysis (Study 1 = 12; Study 2 = 11). First, the findings highlight limits related to methodological aspects, the design of the studies, and the availability of data. Meta-analytic results shows that across development, the frequency (i.e., not the occurrence) of NSSI increases for the group of younger adolescents, remains stable in the group of middle adolescents, and it decreases for older adolescents. This study highlights some limitations that can be summarized in three different macro categories: the first refers to methodological aspects (e.g., the lifetime prevalence of NSSI), the second to the design of the studies (e.g., not homogeneous cohort; short-term covered), and the third to the availability of data. The current meta-analysis tries to shed light on the longitudinal research on NSSI behavior and how this behavior develops in terms of both occurrence and frequency, providing practical and methodological indications for future research. • The development of NSSI - occurrence and frequency, in adolescence • A systematic review and a meta-analytic Bayesian approach to synthesize data • Few longitudinal studies with multiple waves and covering long span-time • For younger adolescents, the frequency of NSSI increases over time • For older adolescents, the frequency of NSSI decreases over time [ABSTRACT FROM AUTHOR]

Non-suicidal self-injury (NSSI) and suicide are a serious health concern in young people. Remarkable progress has been made in understanding the correlates and risk factors for suicidality. However, it remains unclear the complex interplay between different factors and which factors are most saliently associated with NSSI and suicide risk and should be targeted for interventions. This study utilized network analysis to examine the interrelationship between NSSI, suicide and a variety of psychological (e.g., depression, psychotic-like experiences) and psychosocial (e.g., childhood maltreatment, family dysfunction, being bullied and social support) correlates in a sample of Chinese first year college students (n = 2328). The severity of depressive symptoms was the only factor connected to both NSSI and suicide. Other psychiatric factors like psychotic experiences could only act in an indirect way via the bridging effect of depression. Emotional abuse, compared with other forms of childhood adversities, was found to be the most influential maltreatment form associated with suicidal ideation and attempts. Finally, social support showed the potential to lower the risk of self-injury and suicide in young people. Only a subset of risk and resilience factors of NSSI and suicide were included. Causal inference was impossible due to the cross-sectional design. Our findings highlighted the importance of identifying risk groups with mental illnesses or negative childhood events, and providing additional support during the key time of transitioning into higher education. • Depression was associated with both non-suicidal-self-injury (NSSI) and suicide in college students. • Depression functioned as a bridging node to connect other psychiatric factors with NSSI and suicide. • Emotional abuse was the most important form of childhood maltreatment correlated with suicidal thoughts and behaviors. • Social support buffered the risk of NSSI and suicide in young people. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the attitudes of adolescents toward NSSI, and to explore their perspectives on barriers to seeking professional treatment for NSSI. A qualitative phenomenological design was used to conduct in-depth interviews with 17 adolescents with NSSI in a psychiatric hospital in Beijing, China. Data from the 17 adolescents were analyzed using Colaizzi's 7-step analysis. Two themes were extracted: (1) attitudes toward NSSI (normal, effective, ignorant, disgraceful); (2) subjective/objective barriers to seeking professional treatment (negative attitudes toward NSSI, fear of being regarded as an attention getter, fear of interfering with personal relationships, fear of aggravating the family burden, fear of being criticized by parents, fear of ongoing hospitalization, fear of the side effects of medication, etc.). It is suggested to strengthen the knowledge of NSSI among adolescents, families and society, formulate interventions suitable for Chinese sociocultural backgrounds, and cultivate the specialty literacy of mental health nurses and their abilities to identify the barriers, which are required for eliminating barriers to seeking professional treatment and establishing a system for seeking full coverage of professional treatment. • The attitudes of 17 adolescents towards NSSI and their perspectives on barriers were obtained by using qualitative research. • 17 adolescents varied in their attitudes to NSSI, including normal, effective, ignorant, disgraceful. • Some subjective and objective barriers were found, including negative attitudes toward NSSI, fear of being regarded as an attention getter, etc. [ABSTRACT FROM AUTHOR]

Non-suicidal self-injury and suicide attempt represent significant public health concerns. While these outcomes are related, there is prior evidence that their etiology does not entirely overlap. Efforts to directly differentiate risk across outcomes are uncommon, particularly among older, population-based cohorts. This research has been conducted using the UK Biobank. Data on individuals' self-reported history of non-suicidal self-injury only versus suicide attempt (maximum N = 6643) were analyzed. Applying LASSO and standard logistic regression, participants reporting one of these outcomes were assessed for differences across a range of sociodemographic, behavioral, and environmental features. Sociodemographic features most strongly differentiated between the outcomes of non-suicidal self-injury only versus suicide attempt. Specifically, Black individuals were more likely to report a suicide attempt, as were those of mixed race, those endorsing higher levels of depressive symptoms or trauma history, and those who had experienced financial problems (odds ratios 1.02–3.92). Those more likely to engage in non-suicidal self-injury only were younger, female, had higher levels of education, those who resided with a partner, and those who had a recently injured relative. Differences in timing across correlates and outcomes preclude the ability to establish causal pathways. The factors identified in the current study as differentially associated with non-suicidal self-injury only versus suicide attempt provide further evidence of at least partially distinct correlates, and warrant follow-up in independent samples to investigate causality. • In the population-based UK Biobank sample, 4.4 % of respondents reported self-harm. • 51.8 % of those who had self-harmed reported a suicide attempt. • Financial problems and minority racial identity were correlates of suicide attempt. • Correlates of non-suicidal self-injury included younger age and higher education. [ABSTRACT FROM AUTHOR]

Non-suicidal self-injury (NSSI) is a significant public health concern, and its primary formal link to the universe of psychopathology content in DSM diagnoses has been mostly through borderline personality disorder (BPD). Recent research has produced ample evidence of weaknesses of diagnoses relative to transdiagnostic psychopathology dimensions, and found that NSSI-related variables like suicidality are best predicted by transdiagnostic versus diagnosis-based variables. These findings suggest a need to characterize how NSSI may relate to different forms of psychopathology classification constructs. We examined how transdiagnostic dimensions of psychopathology relate to NSSI, focusing on how transdiagnostic (shared) variance of dimensional psychopathology spectra might differentially explained the variance in NSSI relative to traditional DSM diagnoses. In two nationally representative United States samples (N s = 34,653 and 36,309), we modeled the common distress-fear-externalizing transdiagnostic comorbidity model and investigated questions of predictive utility of these dimensional and categorical psychopathology structures. Transdiagnostic dimensions were superior in predicting NSSI compared to common DSM-IV and DSM-5 diagnoses. These dimensions accounted for 33.6–38.7 % of NSSI variance across all analyses in both samples. DSM-IV/DSM-5 diagnoses, however, demonstrated only modest incremental prediction of NSSI over and above the transdiagnostic dimensions. These results support a transdiagnostic reconceptualization of NSSI's links with psychopathology and highlight the importance of transdiagnostic dimensions for predicting clinical outcomes relating to self-injurious behaviors. Implications for research and clinical practice are discussed. • We compared DSM diagnoses vs transdiganostic dimensions in explaining the variance in NSSI. • Transdiagnostic dimensions consistently outperformed categorical DSM diagnoses in accounting for NSSI variance. • Incremental prediction by diagnoses, over and above the transdiagnostic dimensional variables, was modest. • Comparatively few transdiagnostic dimensions outperform DSM diagnoses in linking NSSI to psychopathology. [ABSTRACT FROM AUTHOR]

Non-suicidal self-injury (NSSI) behaviors are a major public health concern among adolescents with depression. Such behaviors may be associated with the reward system. However, the underlying mechanism in patients with depression and NSSI still remains unclear. A total of 56 drug-naïve adolescents with depression, including 23 patients with NSSI (the NSSI group) and 33 patients without NSSI (the nNSSI group), and 25 healthy controls (HCs) were recruited in this study. Seed-based functional connectivity (FC) was used to explore the NSSI-related FC alterations in the reward circuit. Correlation analysis was conducted between the altered FCs and clinical data. Compared with the nNSSI group, the NSSI group showed greater FC between left nucleus accumbens (NAcc) and right lingual gyrus and between right putamen accumbens and right angular gyrus (ANG). The NSSI group also had declined FC between right NAcc and left inferior cerebellum, between left cingulate gyrus (CG) and right ANG, between left CG and left middle temporal gyrus (MTG), and between right CG and bilateral MTG (voxel-wise p < 0.01, cluster-wise p < 0.05, Gaussian random field correction). The FC between right NAcc and left inferior cerebellum was found positively correlated with the score of addictive features of NSSI (r = 0.427, p = 0.042). Our findings indicated that the regions in the reward circuit with NSSI-related FC alterations included bilateral NAcc, right putamen and bilateral CG, which may provide new evidence on the neural mechanisms of NSSI behaviors in adolescents with depression. • The adolescents with depression and NSSI demonstrated altered FCs in the reward system. • The FC between right NAcc and left inferior cerebellum was positively associated with addictive features of NSSI. • This study may provide new evidence on the neural mechanisms of NSSI in adolescents with depression. [ABSTRACT FROM AUTHOR]

Cybervictimization is a risk factor for nonsuicidal self-injury (NSSI). However, there is a lack of evidence on how and under what conditions cybervictimization may influence NSSI. The present study investigated the mediating effect of self-esteem and the moderating effect of peer attachment on the relationship between cybervictimization and NSSI among Chinese adolescents. Using three-wave longitudinal data for one year, a total of 1368 Chinese adolescents (60 % boys; M age at Wave 1 = 15.05 years, SD = 0.85) completed the measurement using a self-report method. The longitudinal moderated mediation model revealed that cybervictimization is associated with NSSI via restraining the protective effect of self-esteem. Moreover, high peer attachment could buffer the negative effects of cybervictimization, and protect their self-esteem from being hurt, consequently reducing the likelihood of NSSI. All variables in this study were self-reported, and the results should be cautiously generalized to other cultures, according to a sample of Chinese adolescents. Results highlight the relation between cybervictimization and NSSI. Recommended intervention and prevention strategies include enhancing the self-esteem of adolescents, breaking the cycle of cybervictimization to NSSI, and providing adolescents with more opportunities to build positive friendships with their peers to buffer the negative effects of cybervictimization. • Self-esteem mediated the association between CV and NSSI. • Peer attachment moderated the mediating effect of self-esteem. • High peer attachment functioned as a protective factor in the indirect effect of CV on NSSI self-injury. [ABSTRACT FROM AUTHOR]

Contemporary models of non-suicidal self-injury (NSSI) suggest that emotional vulnerabilities, negative self-schemas, and beliefs about NSSI work together to differentiate students who self-injure from those who do not. However, it is unclear how these mechanisms are differentially related among students with and without a history of NSSI. Considering this, we used a network analysis approach to explore how students with and without a history of NSSI vary in processing their emotional experiences in relation to their self-concepts and beliefs about NSSI. A sample of 480 university students (M age = 21.18, SD = 2.43; 73.5 % female) completed self-report measures about their perceived emotional experiences (e.g., emotional reactivity, emotion regulation difficulties), self-concepts (e.g., self-esteem, self-efficacy), and NSSI. A network comparison test revealed that students with a history of NSSI perceived themselves to have difficulties regulating particularly intense, unwanted negative emotions. In light of this, students with a history of NSSI expected some benefits of NSSI (e.g., emotion regulation) regardless of potential barriers (e.g., pain). Conversely, for students without a history of NSSI, expecting NSSI to have aversive outcomes was tied to expecting NSSI to have few benefits. The cross-sectional design limits inferences to be made about the network structures. Students with and without a history of NSSI appear to differ in their cognitive processing of negative emotions and strategies used to deal with these emotions. • Individuals with/without NSSI history may process their emotions differently. • We used a network analysis to explore these differences in emotional processing. • Students who self-injured found negative affect more aversive and hard to manage. • Students with NSSI history anticipated NSSI to regulate affect despite negative outcomes. • Conversely, students without NSSI history expected NSSI to be painful and unhelpful. [ABSTRACT FROM AUTHOR]

Non-suicidal self-injury (NSSI) is highly prevalent among adolescents and predicts future psychopathology including suicide. To improve therapeutic decisions and clinical outcome of patients engaging in NSSI, it seems beneficial to determine neurobiological markers associated with treatment response. The present study investigated whether resting-state functional brain connectivity (RSFC) served to predict clinical improvements following treatment in adolescents engaging in NSSI. N = 27 female adolescents with NSSI took part in a baseline MRI exam and clinical outcome was assessed at follow-ups one, two and three years after baseline. During the follow-up period, patients received in- and/or outpatient treatment. Mixed-effects linear regression models were calculated to examine whether RSFC was associated with clinical improvement. Patients' clinical outcome improved across time. Lower baseline RSFC between left paracentral gyrus and right anterior cingulate gyrus was associated with clinical improvement from baseline to one-year and from two-year to three-year follow-up. Lower and higher baseline RSFC in several inter- and intrahemispheric cortico-cortical and cortico-subcortical connections of interest were associated with clinical symptomatology and its severity, independent from time. A relatively small sample size constrains the generalizability of our findings. Further, no control group not receiving treatment was recruited, therefore clinical changes across time cannot solely be attributed to treatment. While there was some evidence that RSFC was associated with clinical improvement following treatment, our findings suggest that functional connectivity is more predictive of severity of psychopathology and global functioning independent of time and treatment. We thereby add to the limited research on neurobiological markers as predictors of clinical outcome after treatment. • Adolescent patients with NSSI underwent MRI and three yearly clinical follow-ups. • Patients' clinical outcome improved following treatment across time. • Baseline brain connectivity (RSFC) associated with clinical outcome • Lower left paracentral-right anterior cingulate RSFC associated with clinical improvement • RSFC was more predictive of clinical outcome independent of time and treatment. [ABSTRACT FROM AUTHOR]

Emerging research has identified sleep disturbance as an important risk factor for predicting self-harming behaviours. However, the temporality of this relationship, particularly in clinical adolescent samples remains poorly understood. This study examines the relationship between sleep disturbance and self-harming behaviours (namely nonsuicidal self-injury and suicide attempts) in clinical adolescents engaging in risk-taking and self-harming behaviours using secondary analyses from a clinical cohort study. Cross-lagged structural equation modelling was used to determine whether baseline sleep disturbance and self-harming behaviours were predictors of each other over a one-year follow-up period in a sample of adolescents (n = 238, 89.5% female) attending and receiving treatment from an outpatient clinic specializing in risk-taking and self-harming behaviours. When controlling for age, sex and depressive symptoms, greater sleep disturbance (p = 0.001) at baseline independently predicted higher numbers of suicide attempts at follow-up. No bidirectional relationship was found when sleep disturbance was modelled with the frequency of nonsuicidal self-injury. This study adds to the growing evidence that sleep disturbance may predict suicidal behaviours. Clinicians should thus regularly assess for sleep disturbances when evaluating suicidal behaviours in high-risk adolescents. Further research and clinical trials should investigate whether sleep-based interventions may be efficacious in reducing the prevalence of suicidal behaviours. [ABSTRACT FROM AUTHOR]

Background: Previous research has found increasing evidence of adverse childhood experiences (ACEs) leading to non-suicidal self-injury (NSSI) and suicidal behaviors. Most studies have focused on a certain type or timing of ACEs or the patterns of multiple types; however, few of them have examined the patterns of ACEs combined types and timing and the gender differences in the association between ACEs and self-harming behaviors.Methods: A cross-sectional survey was conducted in three Chinese cities from November 2020 to May 2021. We asked 16,853 middle school students to anonymously complete a questionnaire to provide the details of their own ACEs and NSSI or suicidal behaviors.Results: Latent class analysis identified four classes: high ACEs (10 %), high abuse/neglect (20.3 %), moderate ACEs (26.7 %) and low ACEs (43 %). Logistic regression models demonstrated that students in the high ACEs, high abuse/neglect and moderate ACEs subgroups were more likely to engage in NSSI and suicidal behaviors than students with low ACEs. Compared with boys, girls had a higher probability of engaging in NSSI and suicidal behaviors when exposed to the same level of ACEs.Conclusion: Co-occurrence of ACEs is associated with high risk of NSSI and suicidal behaviors. Our findings recognized the most dangerous patterns and latent class membership, which supply the evidence for policy makers to adopt preventive measures to protect high-risk individuals. Strategies to relieve the impact of ACEs, especially on girls, need to be considered comprehensively.Limitations: The study was limited by cross-sectional design, as causality could not be confirmed. In addition, because our survey was retrospective, potential recall bias can not be ignored. [ABSTRACT FROM AUTHOR]

Background: Few studies have been conducted focusing on the non-suicidal self-injury (NSSI) incidence rate and influencing factors among left-behind children in northeastern Sichuan, China. In this study, we investigated the incidence rate of the NSSI behaviors, levels of anxiety and depression in left-behind children in northeastern Sichuan, and relevant sociodemographic factors.Methods: The NSSI behaviors were identified using the Ottawa Self-injury Inventory (Chinese version). Its incidence rate and related influencing factors were evaluated by Cluster sampling; the Depression Anxiety Stress Scale-21 Items (DASS-21) was adopted to assess the levels of anxiety, depression, and stress.Results: A total of 9450 adolescents met the inclusion criteria, including 543 with NSSI behaviors, and the prevalence of NSSI was 5.7 %. There were 3596 left-behind children, and 243 of them had NSSI behaviors, the NSSI incidence in left-behind children was 6.8 %. There were 5854 non-left-behind children, and the NSSI incidence in non-left-behind children was 5.1 %. Left-behind children's NSSI behaviors were remarkably correlated with five risk factors: being female (OR = 2.411, 95%CI = 1.773-3.279), parents' divorce (OR = 1.742, 95%CI = 1.262-2.404), elder age (OR = 1.120, 95%CI = 1.028-1.219), severe depression (OR = 1.212, 95%CI = 1.148-1.281), and high anxiety (OR = 1.170, 95%CI = 1.093-1.251).Limitations: This is a cross-sectional study, we cannot probe into the causality between NSSI behaviors and corresponding risk factors. Reporting and recalling biases may be unavoidable as questionnaires are performed by self-rating scales and retrospective reports.Conclusion: The NSSI behaviors are common in left-behind children in northeastern Sichuan. This study proposes that prevention and intervention measures are necessary for the healthy growth of such children. [ABSTRACT FROM AUTHOR]

There is a well-documented epidemiological association between auditory hallucinations and self-harm in the general population. However, there has been limited research examining specific characteristics of auditory hallucinations (e.g., type, source, or context of voices) as correlates of self-harm. We used prospective data from the Tokyo Teen Cohort to explore whether characteristics of voices reported at age 14 were differentially associated with self-harm behaviors at ages 14 and 16. Among respondents with auditory hallucinations, respondents who experienced voices that "said something bad" about them or commented on their thoughts and actions were most likely to report concurrent self-harm, whereas positive or praising voices were protective. Negative voices continued to predict self-harm two years later, at age 16, even with adjustment for self-harm at age 14. The age of the voices, source of the voices, and context (e.g., falling asleep or while sick) was not associated with likelihood of reporting concurrent or subsequent self-harm behaviors. Assessing for negative voices in particular, rather than auditory hallucinations or psychotic experiences more broadly, may provide a more specific indicator of risk for self-harm among adolescents. The real-world utility of these epidemiological findings should be further examined in clinical settings. [ABSTRACT FROM AUTHOR]

Military sexual trauma (MST) is a serious issue among Veterans; it is associated with increased rates of posttraumatic stress disorder (PTSD) and nonsuicidal self-injury (NSSI), both of which are correlated with poorer mental health outcomes, including increased suicide risk. Additional insight into the characteristics associated with NSSI among Veterans with MST can help identify individuals at increased risk for suicide and other negative outcomes and improve care for Veterans with a history of MST. The current study was comprised of 327 Veterans referred for MST-related mental health services at a VHA hospital. Participants completed a semi-structured interview for clinical symptoms, including NSSI behaviors. Results of a retrospective chart review revealed a high endorsement of lifetime NSSI (26.9%) with cutting behaviors identified as the most frequently endorsed method. Logistic regression showed personality features, history of cumulative sexual trauma, and younger age were uniquely related to lifetime NSSI. These results corroborate previous findings that show elevated rates of NSSI among Veterans with exposure to trauma. This study expands upon previous findings by examining risk factors specific to treatment-seeking Veterans with a history of MST, which can aid clinical care and risk management procedures in Veteran healthcare. [ABSTRACT FROM AUTHOR]

Background: Nonsuicidal self-injury (NSSI) is a prevalent health problem among adolescents and commonly associated with psychological stressors such as childhood maltreatment and comorbid psychiatric disorders (e.g., depression). There is evidence that alterations of immunological markers may occur in the context of both environmental stress and psychopathological development.Method: Here, we investigated differences in plasma/serum leukocytes, cortisol, c-reactive protein and interleukin-6 in a large sample of female adolescents with NSSI (n = 155) and healthy controls (HC, n = 42). Further, we assessed correlations between inflammatory markers, depression severity and the severity of childhood maltreatment.Results: The absolute number of leukocytes and the leukocyte/cortisol ratio (adjusted for body mass index and smoking) were significantly higher in NSSI as compared to HC, whereas interleukin-6 and CRP levels did not differ significantly between groups. Childhood maltreatment scores were significantly correlated with the leukocyte/cortisol ratio and depression severity was significantly correlated with both, absolute leukocyte numbers and the leukocyte/cortisol ratio.Conclusions: Our results suggest that an immune activation can be detected in female adolescents with NSSI. Depression and childhood maltreatment, which are commonly reported in NSSI, may potentially underlie immune activation and partially explain group differences. [ABSTRACT FROM AUTHOR]

Background: Non-suicidal self-injury (NSSI) is a highly prevalent transdiagnostic psychiatric symptom in adolescents. Research in adults has begun to investigate neurocognitive processes associated with NSSI as potential underlying phenotypes. However, research on neurocognitive function in adolescent patients with NSSI is scarce.Methods: In this study, we examined neurocognitive functioning in the domains of processing speed, attention, learning, working memory, and executive function in a relatively large sample of n = 240 adolescent patients engaging in NSSI and n = 49 healthy controls. Further, associations between neurocognitive performance and clinical characteristics in the patient group were examined.Results: While conventional regression analyses showed somewhat weaker neurocognition in the NSSI group in several domains, propensity score matching for IQ showed little evidence that patients engaging in NSSI showed worse neurocognition when general intelligence was considered. Further, a random forest machine learning algorithm was not able to classify NSSI vs. control groups based on neurocognitive features. Within the patient group, linear regression and latent class analyses yielded little evidence that neurocognitive performance was related with clinical characteristics or phenotypes.Limitations: As the study did not include a clinical control group, findings might not be specific to NSSI.Conclusions: Our findings challenge the importance of specific neurocognitive measures related to the presence or severity of NSSI in adolescents. Future studies should consider general intelligence as an important confounding factor and should focus on domains of affective cognition. Finally, longitudinal studies are needed to determine whether low neurocognitive performance serves to inform prognosis of NSSI or psychopathology in general. [ABSTRACT FROM AUTHOR]

Background: Previous research has suggested that depressive symptoms, emotional competence, and posttraumatic stress symptoms (PTSS) may mediate the association between family functioning and non-suicidal self-injury (NSSI). Therefore, this study aimed to evaluate the mediation effects of depressive symptoms, emotional competence, and COVID-related PTSS on the relationship between family functioning and NSSI in adolescents.Method: A sample of 5854 adolescents was recruited from June 16 to July 8, 2020. The data for family functioning, depressive symptoms, emotional competence, COVID-related PTSS, and NSSI behavior of adolescents were collected via self-reported questionnaires. A structural equation model was constructed to examine the relationship, and a bootstrap analysis was conducted to evaluate the mediation effects.Results: The reporting rate of adolescent NSSI was 30.2%. The poor family functioning was positively associated with adolescent NSSI (β = 0.130, 95% CI = 0.093-0.182), which was mediated by depression with effect size of 0.231 (95% CI = 0.201-0.257). The pathway coefficients between emotional competence and NSSI, and depression, COVID-related PTSS and NSSI, though statistically significant were unlikely to be clinically meaning with values of 0.057 and 0.015. There was no mediating effect by COVID-related PTSS. The pathways initially constructed between family functioning and COVID-related PTSS, emotional capacity and COVID-related PTSS were not been verified.Limitations: It was unclear whether this mediational effect would be supported in a longitudinal design. The application and extension of this model toward other regions and countries, and different ages need to be further explored.Conclusion: The interventions of adolescent NSSI should focus on both the family level and individual levels. Improving family environment, screening depressive symptoms, enhancing emotional competence and lessening COVID-related PTSS may reduce NSSI. [ABSTRACT FROM AUTHOR]

Introduction: NSSI (non-suicidal self-injury) is an important public health issue, with high prevalence and associations with future mental illness and suicide. To date, no large single study has tested age and gender effects on NSSI and their interplay with psychological distress.Method: NSSI and psychological distress were ascertained by questionnaire in a community study of 2368 young people aged 14-25; proportions at each age and of each gender were approximately equal.Results: There was a significant quadratic interaction between age and gender on last month NSSI prevalence (p = 0.025): NSSI was more common in females ages 16-19, but there were no significant gender differences at younger/older ages. General distress partially mediated the effects of age and gender on NSSI. The association between general distress and NSSI was not significantly moderated by age, gender nor their interactions.Conclusions: Gender difference in NSSI is not a static gap, but evolves across time, widening in mid-adolescence and disappearing by early adulthood. Part of the reason for that gender gap being present at those ages is the increase levels of distress in young women at those ages. There was no evidence that the effects of general distress on NSSI differed by age/gender. [ABSTRACT FROM AUTHOR]

Background: Non-suicidal self-injury (NSSI) is a significant public health concern. Authoritarian parenting is a common parenting style in China. Authoritarian parenting is associated with NSSI in adolescents. Little is known about the mechanism underlying this association. This study was to investigate the mediating effect of depressive symptoms on the association between maternal authoritarian parenting and NSSI among Chinese adolescents.Methods: A total of 7072 adolescents who participated in the 1-year follow-up of Shandong Adolescent Behavior & Health Cohort (SABHC) were included for the analysis. A self-administered questionnaire was used to assess authoritarian parenting, depressive symptoms, non-suicidal self-injury, and family demographics in November-December in 2015. One year later, a follow-up survey was carried out to assess participants' depressive symptoms and NSSI.Results: Of the sample, mean age was 14.58 (SD = 1.46) and 3536 (50%) were female at baseline. 19.4% adolescents reported having ever NSSI over the past 12 months at baseline, and 8.8% reported having ever NSSI at 1-year follow-up. The association of maternal authoritarian parenting with subsequent NSSI was at least partially mediated by depressive symptoms. Mediation analyses showed that effect size was 0.194 in the entire sample, 0.192 in females and 0.193 in males, respectively.Limitation: All variables were measured based on self-report.Conclusions: Maternal authoritarian parenting style is a significant predictor of NSSI and its association with NSSI is partially mediated by depressive symptoms among Chinese adolescents. It may be important to intervene poor parenting styles and depression to reduce the risk of NSSI in Chinese adolescents. [ABSTRACT FROM AUTHOR]

• Brain activity and connectivity was measured in young adults with MDD/NSSI. • Activation patterns in the right lingual gyrus, right middle occipital gyrus, and right superior frontal gyrus distinguished resilient from depressed with NSSI and without NSSI. • Activation in right superior frontal gyrus predicted NSSI frequency. • Activation in right lingual gyrus predicted NSSI severity. Major depressive disorder (MDD) with non-suicidal self-injury (NSSI)(MDD/NSSI) has been found to differ from simple MDD without NSSI (sMDD). This study analyzes the amplitude of low-frequency fluctuations (ALFF) to explore the NSSI-relevant local neural activity, and uses functional connectivity (FC) analysis to explore the NSSI-relevant circuits corresponding to alterations in local regions in young adult patients with MDD/NSSI. A total of 54 patients with MDD/NSSI, 68 patients with sMDD, and 66 matched healthy controls (HCs) were recruited. ALFF and seed-based FC analyses were employed. The NSSI-relevant brain alteration and its associations with clinical variables were examined. Compared with the sMDD group, the MDD/NSSI group showed higher ALFF in the right lingual gyrus and right middle occipital gyrus; lower ALFF in the right superior frontal gyrus; higher FC values between the right lingual gyrus and left precentral gyrus; and lower FC values between the right middle occipital gyrus and right paracentral gyrus. Within the MDD/NSSI group, ALFF values of the right superior frontal gyrus and right lingual gyrus were positively correlated with the frequency and severity of NSSI. The sample size was small, and the potential influence of medicine on brain activity was not excluded. Our preliminary findings indicate that NSSI-relevant ALFF in the right lingual gyrus, right middle occipital gyrus, and right superior frontal gyrus, as well as the alteration FCs in corresponding brain circuits, may play an important role in the neural basis of MDD/NSSI. [ABSTRACT FROM AUTHOR]

• First review to evaluate brief specific psychotherapies interventions (SPI) specifically designed for NSSI in adolescents. • SPI should include psychotherapeutic components from or adapted cognitive behavioral and dialectical behavior Therapy, and psychoeducation. • The interventions specifically developed for adolescents with NSSI agree applying individual and brief treatments manualized (8–19 sessions). • Only 13 studies have evaluated the effectiveness of 6 different SPI. • In general, all interventions are demonstrative of the general effectiveness, but CDP and T-SIB therapies presented more effect for decreases in NSSI behaviors. Non-suicidal self-injury (NSSI) is a clinically significant behavior with high relevance and prevalence, especially affecting approximately 17–18% of the adolescent population worldwide. The aim of this study is to perform a systematic review to evaluate the effectiveness of the available Specific Psychotherapeutic Interventions (SPI) focused on the reduction of NSSI behaviors. A systematic review was performed analyzing PsychINFO, MEDLINE, Web of Science, PubMed and Cochrane CentralRegister of Controlled Trials to identify studies of interest from January 2010 to December 2020. According to PRISMA guidelines, only 13 studies were included in the review. Six SPI were found to specifically and significantly reduce NSSI in adolescents: Developmental Group Psychotherapy (DGP), Therapeutic Assessment (TA), Cutting Down Program (CDP), Emotional Regulation Individual Therapy for Adolescents (ERITA), Treatment for Self-Injurious Behaviors (T-SIB) and Intensive Contextual Treatment (ICT). Furthermore, relevant improvements in anxiety and depression symptoms were observed. The results of this review demonstrate the effectiveness of these interventions, mainly the CPD and T-SIB, which are the only SPI that have been studied using Randomized Controlled Trial (RCT). Considering the clinical relevance and associated functional impairment of NSSI, more research is needed to replicate the results and to increase knowledge about SPIs. [ABSTRACT FROM AUTHOR]

• Non-suicidal self-injury (NSSI) has become a serious public health concern. • Social factors play a role in the onset and maintenance of NSSI in adolescents. • Low perceived social support (PSS) predicted NSSI engagement. • Borderline personality traits best predicted NSSI in multivariate analysis. • Borderline personality traits mediate the association between PSS and NSSI. Non-suicidal self-injury (NSSI) is a serious public health concern among adolescents, especially in clinical settings. Social support plays a critical role in the onset and maintenance of NSSI in adolescence. NSSI is closely associated with borderline personality disorder (BPD), yet no previous work has analyzed the mediating role of borderline traits in the relationship between perceived social support (PSS) and NSSI. This study aimed to address this gap. Participants were 228 adolescent patients (12 to 18 years old), who completed a clinical interview and self-report measures of BPD-traits, current psychological distress, emotion dysregulation and PSS. They were grouped based on the presence (vs. absence) of NSSI. Univariate and multivariate logistic regression analyses were used to identify risk factors of NSSI, and a mediation analysis was conducted to examine the intermediary role of borderline traits in the relationship between PSS and NSSI. NSSI was highly prevalent in our sample (58%) and was associated with higher clinical severity. Low PSS predicted NSSI in univariate, but not multivariate regression. Mediation analyses showed that borderline traits fully accounted for the relationship between low PSS and NSSI, even when controlling for current psychological distress and gender. Cross-sectional design through self-report assessment. Findings suggest that adolescents with low PSS are especially vulnerable for developing NSSI due to elevated BPD traits. In clinical settings, interventions aimed to reduce borderline symptoms may be a promising treatment option for adolescents with NSSI and low PSS. [ABSTRACT FROM AUTHOR]

The study aimed to examine the relationship on attitudes toward suicide, frustrated interpersonal needs, and non-suicidal self-injury (NSSI) of the university students. The participants included 175 university students. Data were analyzed using the SPSS PROCESS macro (Model 4). Depression showed a fully mediating effect on the relationship between one's attitude toward suicide and NSSI behaviors. Furthermore, depression showed a full mediating impact on the relationship between frustrated interpersonal needs and NSSI behaviors. These findings indicate that suicidal attitudes and frustrated interpersonal needs should be considered significant factors for developing NSSI preventions and intervention among university students. • Depression mediated on frustrated interpersonal needs-NSSI relationship. • Attitude toward suicide is a positive correlation with NSSI. • Depression has a mediating effect on attitude toward suicide–NSSI relationship. [ABSTRACT FROM AUTHOR]

This study aimed to utilize machine learning to explore the psychological similarities and differences between suicide attempt (SA) and non-suicidal self-injury (NSSI), with a particular focus on the role of psychological pain. A total of 2385 middle school students were recruited using cluster sampling. The random forest algorithm was used with 25 predictors to develop classification models of SA and NSSI, respectively, and to estimate the importance scores of each predictor. Based on these scores and related theories, shared risk factors (control feature set) and distinct risk factors (distinction feature set) were selected and tested to distinguish between NSSI and SA. The machine learning algorithm exhibited fair to good performance in classifying SA history [Area Under Curves (AUCs): 0.65–0.87] and poor performance in classifying NSSI history (AUC: 0.61–0.68). The distinction feature set comprised pain avoidance, family togetherness, and deviant peer affiliation, while the control feature set included pain arousal, painful feelings, and crisis events. The distinction feature set slightly but stably outperformed the control feature set in classifying SA from NSSI. The three-dimensional psychological pain model, especially pain avoidance, might play a dominant role in understanding the similarities and differences between SA and NSSI. • Pain avoidance as a distinct pre-existing factor can distinguish SA from NSSI in adolescents. • Pain avoidance ranks the top three in classifying SA within different time windows, but not in classifying NSSI. • Deviant peer affiliation played a more important role in classifying NSSI. • Family togetherness was an important factor in classifying SA. [ABSTRACT FROM AUTHOR]

• Parental emotional warmth is negatively related to adolescent NSSI. • Bullying perpetration and bullying victimization mediate the relationship between parental emotional warmth and NSSI, respectively. • The dark triad moderates the second half of the mediating role of bullying perpetration. That is, a higher dark triad exacerbates the association. • The dark triad moderates the second half of the mediating role of bullying victimization. That is, a higher dark triad exacerbates the association. Previous studies have mostly explored the relationship between negative parenting styles and non-suicidal self-injury (NSSI), while little research has investigated the role of parental emotional warmth in NSSI. The present study constructed two moderated mediation models and explored the effects of multiple factors, involving family, peer, and individual aspects, on NSSI. A random cluster sampling of 955 adolescents (490 boys, M age = 13.33 years, SD = 1.29) was surveyed using questionnaires to measure parental emotional warmth, bullying perpetration and victimization, the dark triad, and NSSI. The results showed that parental emotional warmth was negatively associated with NSSI. Bullying perpetration and bullying victimization mediated the relationship between these two, respectively. Moreover, the dark triad moderated the relationships between bullying perpetration and NSSI, as well as bullying victimization and NSSI, and further moderated both mediating pathways. That is, for adolescents with lower levels of the dark triad, parental emotional warmth is more conducive to reducing the risk of NSSI by decreasing bullying involvement. Accordingly, there is a need for educators to provide youth with as much emotional support as possible and create a warm and healthy environment for growing up, which might help to prevent and mitigate their NSSI. [ABSTRACT FROM AUTHOR]

• Data-driven methods were used in many prior study to address NSSI heterogeneity. • This review included 21 studies that identified from 2 to 5 potential NSSI subtypes. • A new conceptual framework was proposed to describe NSSI subtypes in this review. • The framework emphasizes psychological pain and NSSI function as critical dimensions. • The paper introduces suggestions for validating and enriching NSSI subtype research. Non-suicidal self-injury (NSSI) is a significant public health problem, but there is no consistent evidence of its risk factors. One possibility is that there are subtypes NSSI that have different risk factors and clinical symptoms. In this review we evaluated the evidence of subtypes to determine if there were consistent subtypes of NSSI that emerged across studies. Four databases (Medline; Embase; PsycINFO; Web of Science) were searched to identify studies that used data-driven approaches and were published before November 9, 2022. There were 21 studies with 23 unique samples for review. Most of the included studies used NSSI symptoms or personal characteristics as the subtyping indicators, revealing 2–5 subtypes of NSSI. Variations in subtyping indicators, sample characteristics, and statistical methods may have contributed to the inconsistent number and characteristics of subtypes across studies. A new conceptual framework is proposed to integrate these diverse findings, highlighting the important roles of NSSI function and psychological pain in differentiating NSSI subtypes. This framework sheds light on the differences among self-injurers and offers insights for future endeavors to address the complexities of NSSI. [ABSTRACT FROM AUTHOR]

Background: Identifying the risk factors of suicide attempts(SA) in adolescents with mood disorders(MD) who engage in non-suicidal self-injury(NSSI) is of great significance for suicide prevention. The aim of the present study was to explore the psychological characteristics and risk factors of SA among MD adolescents engaged in NSSI.Methods: We recruited MD outpatients accompany with NSSI aged 12-18 years. SA, NSSI methods and function, suicidal ideation(SI), psychological distress(PD), self-esteem, stress mindset and perceived social support were assessed by valid scales. Classification and regression tree analysis (CART) was employed to explore the characteristics and risk factors of SA among MD adolescent with NSSI.Results: We included 658 participants in this study. Of 58.1% participants reported SA during the past 12 months. Compared with the adolescents without SA, the attempters used more different NSSI methods and reported more frequent NSSI. SA, SI, PD, self-esteem and amount of thinking time before engaging in self-injury were risk factors of SA among MD adolescents. Interactions between the four risk factors resulted in varying degrees of risk of SA. Compared to adolescents with the characteristics of low level of SI - little consideration before self-injury, adolescents who having multiple characteristics of the high level of SI -high level of PD - low self-esteem were associated with a 15.1-fold increased risk of SA(P < 0.001), and those with the characteristics of high SI - deliberated before engaging in self-injury were associated with a 28.1-fold increased risk of attempted suicide(P < 0.001).Conclusions: Our findings identify multiple correlates for SA in MD adolescents accompany with NSSI, including SI, PD, self-esteem and deliberate time they thought before self-injury, which may contribute to the development of suicidal behaviors in an interactive manner. [ABSTRACT FROM AUTHOR]

This study examined the prevalence and cross-sectional correlates of past-month suicidal thoughts, suicide attempts, interrupted attempts, aborted attempts, and non-suicidal self-injury (NSSI) among patients seeking treatment at a partial hospitalization program (PHP). 1063 patients (54% female, 87% white, mean age = 33.6 years) receiving treatment at a PHP completed self-report questionnaires and the Columbia-Suicide Severity Rating Scale as part of routine clinical monitoring upon admission to the program. We examined demographic and clinical cross-sectional correlates of self-injurious thoughts and behaviors (SITBs) using descriptive statistics, ordinal regression, and logistic regression analyses. In the past month, 44.6% of patients reported active suicidal thoughts, 5.6% reported a suicide attempt, 1.8% reported an interrupted attempt, 5.5% reported an aborted attempt, and 16.6% reported NSSI. Inpatient referral source (ORs = 2.45–5.28), minority sexual orientation (ORs = 1.43–6.94), and more Borderline Personality Disorder (BPD) symptoms (ORs = 1.09–1.23) were each associated with at least three of the five SITBs examined. This study highlights elevated rates of suicidal thoughts, suicide attempts, and NSSI in a partial hospital sample. Given that past attempts predict future attempts and death by suicide, support during the transition from inpatient to outpatient care via programs such as PHPs is needed. Patients referred from inpatient treatment, who identity as a sexual minority, and with more BPD symptoms may require additional support and safety monitoring. Further work is indicated to better understand how PHP patients' SITBs change during and after partial hospitalization. [ABSTRACT FROM AUTHOR]

Prompt access to appropriate professional care for adolescents with self-harm thoughts and respective behaviors (suicidal behavior and non-suicidal self-injury [NSSI]) is crucial as both are associated with an increased risk of suicide in later life. The present study aimed to describe the duration from initial onset of thoughts and incidents of self-harm until first clinical presentation in children and adolescents and to identify factors affecting help-seeking duration. Onset of self-harm thoughts and behaviors, time of first clinical presentation, and psychiatric and demographic variables were obtained from n = 672 adolescents (11–19 years) from the Germany-based AtR!Sk (Ambulanz für Risikoverhalten & Selbstschädigung) cohort-study at an outpatient clinic for risk-taking and self-harm behaviors. In 22% of overall cases, the first self-harm thoughts and behaviors occurred after contact to professional care was already established. Focusing on actual help-seeking delay only, it took between M = 0.99 years (after first suicide attempt) and M = 1.98 years (after first thoughts of NSSI) until participants sought professional help. Overall, help-seeking duration and help-seeking delay were longer for participants with more severe psychopathology (i.e., BPD, depressive symptoms, general symptom severity). The findings revealed a substantial delay of receiving appropriate professional care in adolescents with self-harm thoughts and behavior. The correlation between treatment latency and higher psychopathology may emphasize the need of prompt treatment. A better understanding of barriers and facilitators to professional help will contribute to enhance measures of tailored support for young patients in their help-seeking process. • In a quarter of adolescents, new symptoms arose after first clinical presentation. • Help-seeking delay for self-harm thoughts and behaviors was between 1 and 2 years. • Help-seeking duration and severity of psychopathology are positively correlated. • Results indicate the need for prompt professional help-seeking. [ABSTRACT FROM AUTHOR]

Purpose: This population-based study explored the associations between childhood adversity and admission to emergency departments (EDs) with non-suicidal self-injury (NSSI) and with a suicide attempt.Methods: A nationally representative cross-sectional sample of 5-17-year-olds admitted to EDs (N = 143,113,677) from 2006 to 2015 was utilized to assess the associations between childhood adversities, NSSIs, and suicide attempts.Results: ED admissions with NSSI and admissions with a suicide attempt were associated with greater odds of exposure to individual childhood adversities (aORs: 1.34 to 5.86; aORs: 2.37 to 15.69, respectively). ED admissions with a suicide attempt were associated with greater odds of exposure to childhood adversities that might be perceived as less extreme or harmful (separation or divorce aOR: 15.69) than other adversities (death of a family member aOR: 13.38; history of physical abuse aOR: 9.56) as well as greater odds of exposure to three or more childhood adversities (aOR: 20.98).Conclusion: Early detection of childhood adversities is important for identifying potential risk factors for self-harm. ED admission data can provide population-level surveillance to aid in these efforts and lead to more targeted and effective interventions aimed at reducing the negative effects of toxic stress that can result from exposure to childhood adversities. [ABSTRACT FROM AUTHOR]

Background: Non-suicidal self-injury (NSSI) has received increased attention as a major public health problem among adolescents. However, there is a lack of evidence testing the longitudinal association between cybervictimization and NSSI as well as its underlying mediating and moderating mechanisms. The current study investigated the potential mediator (i.e., anxiety symptoms) and moderator (i.e., self-control) of the relation between cybervictimization and NSSI over a 12-month period.Methods: Three waves of data (called T1, T2 and T3) were collected 6 months apart, between November 2018 and 2019. 1987 Chinese adolescents completed self-report measures in their classrooms. SEM was used to test a moderated mediation model, with gender, age and childhood trauma and baseline measures as covariates.Results: The results found a longitudinal association between cybervictimization and NSSI as well as the mediating role of anxiety symptoms in explaining this association. Moderated mediation analyses revealed that greater cybervictimization contributed to anxiety symptoms, which in turn predicted increased levels of NSSI only among adolescents with lower self-control.Limitations: Measures of study variables were self-reported, and generalizability may be limited by a sample of adolescents from school in China.Conclusions: The present study demonstrated that the indirect effect of anxiety symptoms in the association between cybervictimization and NSSI was conditioned by self-control. These results have implications for preventative interventions aimed toward reducing NSSI for at-risk adolescents. [ABSTRACT FROM AUTHOR]

Bipolar disorder (BD) is a chronic mental disorder characterized by alternating or mixed episodes of mania or hypomania and depression. Cognitive function impairment is a frequent associated feature of the disease. While many BD patients also engage in non-suicidal self-injury (NSSI), there is a lack of studies on the cognitive function of BD patients with NSSI. This study aimed to evaluate cognitive functioning of BD patients with NSSI and provide a clinical basis for the differential diagnosis and treatment of BD and NSSI. A total of 60 BD patients with NSSI, 60 BD patients without NSSI, and 60 healthy controls (HC) were selected for the study. All participants met the inclusion criteria and were not taking any medications, excluding the potential effects of medication on cognitive functions. The following neurocognitive tests were used to measure the cognitive functions in areas such as speed of processing, reasoning and problem solving, attention/vigilance, working memory, visual learning, and verbal learning: The Trail Making Test (TMT), Category Fluency, Digit Symbol Coding Test (DSCT), Brief Visuospatial Memory Test-Revised (BVMT-R), The Neuropsychological Assessment Battery Mazes (NABM), Wechsler Memory Scale Third Edition Spatial Span Test (WMS III-SST), Hopkins Verbal Learning Test-Revised (HVLTR) and Continuous Performance Test and Identical Prs (CPT-IP). The findings indicated that BD patients with NSSI exhibited cognitive impairment in all measured cognitive domains. On the other hand, BD patients without NSSI showed less pronounced impairment in terms of speed of processing, but exhibited significant cognitive impairment in the remaining five areas compared to the HC group. The study underscores the presence of cognitive impairment in BD, and the cognitive impairment is more severe in BD patients with NSSI compared to those without NSSI. In conclusion, both individuals with NSSI and those without NSSI in BD exhibit cognitive impairment, which provides ideas and strategies for using cognitive-behavioral therapy to treat BD and NSSI. [ABSTRACT FROM AUTHOR]

• Physical activity exhibits a double-edged effect on NSSI in depressed adolescents. • Perceived stress mediates the negative impact of physical activity on NSSI. • Excessive physical activity leads to increase in NSSI in depressed adolescents. • Social support weakens the risk caused by perceived stress for NSSI. Non-suicidal self-injury (NSSI) is an emerging health concern is adolescents. The current research investigated the relationship between physical activity (PA) and NSSI frequency in depressed adolescents and analyzed the mediating role of perceived stress (PS), as well as the moderating role of perceived social support (PSS). 1675 depressed adolescents aged 12 to 18 years across 9 provinces in mainland China were recruited from December 2020 to December 2021. We employed the SPSS PROESS models to test the mediating effects and moderating effects. The age, gender, depression, peer bullying and rumination factors were controlled in the analysis. PA was negatively associated with PS, and PS was positively associated with NSSI frequency. However, PA exerted positive direct impacts on NSSI frequency. The total effect of PA on NSSI was positive and significant. PA exhibits a double-edged effect on NSSI frequency. Notably, for different physical activity levels, the positive impact of PA on NSSI only existed in high PA group. PSS effectively moderated and attenuated the effect of PS on NSSI. An appropriate level of PA should be maintained and the disadvantages of excessive activity should be avoided. [ABSTRACT FROM AUTHOR]

Studies on Emotionally Dysregulated Behavior (EDB) demonstrated that the conduct thereof is associated with emotion dysregulation and preceded by mental imagery of EDB, which can direct future behavior. These findings are specifically important within the context of Borderline Personality Disorder (BPD), where emotion dysregulation and EDB are at the core of the disorder. The present study aims to evaluate the efficacy of imagery rescripting (IR) in treating emotion dysregulation associated with EDB in patients diagnosed with BPD. Forty-eight females diagnosed with BPD were randomly allocated to the IR intervention or treatment-as-usual group. Assessment took place one week before the first treatment session, as well as one week, and twelve weeks after the last treatment session evaluating emotion regulation strategies, borderline-symptomatology, EDB, depressiveness, impulsivity, mental imagery, and illness severity. Within-, and between subject, intention-to-treat-, and per-protocol analysis were conducted. Results showed decreased maladaptive emotion regulation strategies and increased adaptive emotion regulation strategies within the intervention group. Borderline-symptomatology improved immediately after treatment for the intervention group. Additionally, BPD patients within the intervention group improved regarding their impulsivity, depressiveness, and EDB symptomatology in comparison to patients in the TAU group. The presented intervention has proven to be effective in improving BPD-related symptomatology, such as emotion regulation, EDB, depressiveness, and impulsivity. Imagery rescripting could be routinely applied when EDB related images are present. German Clinical Trials Registry (DRKS) ID: DRKS00010620. • RCT using a short-intervention of two sessions imagery rescripting (IR) to treat emotion dysregulation in BPD. • Two sessions of IR can improve adaptive emotion regulation and decrease maladaptive emotion regulation in BPD. • Emotionally dysregulated behaviors can be improved. • BPD symptomatology, depressiveness, impulsivity decreased post-intervention. [ABSTRACT FROM AUTHOR]

Background: Although previous studies have shown that childhood sexual abuse (CSA) experiences might be related to suicide-related thoughts and behaviours in later life, the effects of alexithymia and experiential avoidance (EA) on this relationship have remained unclear. The present study aimed to expand prior findings among Chinese college students with a history of CSA in order to further test the effects of alexithymia on the relationship between CSA and non-suicidal self-injury (NSSI) and suicidal ideation (SI), and its indirect effects on NSSI and SI through EA.Methods: The Childhood Sexual Abuse Questionnaire, the Toronto Alexithymia Scale-20, the Acceptance and Action Questionnaire-II, the Non-Suicidal Self-Injury Questionnaire, and the Symptom Checklist were completed by 6,834 college students (3,829 female).Results: Overall, 1404 (20.76%) Chinese college students reported experiences of CSA; students with CSA experiences reported higher rates of SI and NSSI than those without CSA (12.82% vs. 4.50%, 35.11% vs. 20.82%). CSA, alexithymia, and EA were positively related to NSSI and SI. The effect of alexithymia on the relationship between CSA and NSSI and SI were significant. The effects of EA on the relationship between alexithymia and NSSI and SI were significant, too.Limitations: The major limitations of this study are its cross-sectional design and the use of self-report scales, especially retrospective self-reports (e.g., the Childhood Sexual Abuse Questionnaire).Conclusions: This study cast light on the effects of alexithymia, EA, and CSA on NSSI and SI in Chinese college students with a history of CSA. These findings can contribute to the prevention and treatment of suicide-related thoughts and behaviours. [ABSTRACT FROM AUTHOR]

Background: Persistent psychotic experiences (PEs) may increase risk for mental disorders, non-suicidal self-injury (NSSI), and suicide attempts, relative to PEs that are more transient and remitting in nature. Most investigations of PE persistence have incorporated only two waves of data, and have not investigated the persistence of different PE subtypes and their association with future NSSI and suicide attempts. This study aimed to investigate the association between PE persistence, NSSI, and suicide attempts using three waves of prospective data. A secondary aim was to investigate potential reverse pathways where self-injurious behaviour (and its persistence) instead precedes subsequent PE occurrence.Method: Participants were 1100 adolescents (12-17 years) from an Australian prospective cohort study; with three time points over two years. The Self-Harm Behaviour Questionnaire was used to assess NSSI and suicide attempts. Four PE subtypes (auditory hallucinatory experiences [HEs], and three delusional experiences) were assessed using the Diagnostic Interview Schedule for Children. Logistic regression analyses were conducted where PEs was grouped into five categories according to their persistence across the three waves of data. Analyses were adjusted for sociodemographics and substance use.Results: Overall, persistence of PEs (with endorsement of PE across two or three waves) was associated with the highest risk of incident NSSI and suicide attempts at 1- and 2-year follow-up (OR range: 2.57-12.25), whereas remitted PEs (with endorsement of PE at baseline only) were not associated with increased risk of future NSSI or suicide attempts. This pattern of association was evident for auditory HEs but not for most other PE subtypes; although some estimates had wide confidence intervals. There was no support for reverse temporality.Conclusion: Our findings support and extend the two-wave cohort literature demonstrating that PEs which persist over time are more robust predictors of future NSSI and suicidal behaviour. Auditory HEs that are persisting in nature are an important but under-recognised risk factor for NSSI and suicide attempts during adolescence, and current findings should inform clinical guidelines into the predictors of self-harm and suicide risk at this life stage. [ABSTRACT FROM AUTHOR]

Background: Frequent nightmares and depression are associated with non-suicidal self-injury (NSSI) in adolescents. Little is known about the mediating role of depression in the nightmare-NSSI link. This study explores the longitudinal mediating effect of depression on the relationship between frequent nightmares and NSSI as well as the moderating effect of gender using a three-wave longitudinal design.Methods: Participants were adolescents from the Shandong Adolescent Behavior and Health Cohort who were surveyed at baseline, 1 year later, and 2 years later. A self-administered questionnaire was used to measure nightmare frequency, depression, and NSSI. Structural equation modeling and multiple-group analysis were used to test the mediating effect of depression and the moderating effect of gender. Covariates included demographics and earlier measures of depression and NSSI.Results: Among 6995 participants, 3399 (48.6%) were females, mean age was 14.86 (SD = 1.50) years at baseline. Frequent nightmares had a significant mediation effect on NSSI through depression (Bab = 0.06, 95% CI = 0.02-0.10) after controlling for demographics and earlier measures of depression and NSSI. Gender had no significant moderating effect on the nightmare-NSSI association.Limitations: All data were collected by self-report.Conclusions: The association between frequent nightmares and NSSI in adolescents was partially mediated by depression. Frequent nightmares and depression should be assessed and treated to prevent self-harm in adolescents. [ABSTRACT FROM AUTHOR]

Background: Beta-endorphin (BE) has been suggested to play a central role as to why people engage in NSSI. To our knowledge, no study has systematically assessed this potential relationship in adolescents with NSSI.Methods: 94 adolescents with NSSI (according to DSM-5 criteria) and 35 healthy controls (HC) were enrolled. All participants received heat pain stimulation, with pain threshold and tolerance measured in °C. Plasma BE levels were assessed. Sociodemographic and clinical characteristics were obtained via semi-structured interviews and self-report questionnaires.Results: Adolescents with NSSI showed increased pain thresholds (t(127)=2.071, p=.040), lower pain intensity (t(114)==2.122, p=.036) and lower plasma BE levels (t127==3.182, p=.002) compared to HC. Groups did not differ on pain tolerance (t(127)=0.911, p=.364). Greater pain threshold correlated positively with borderline personality disorder (BPD) symptoms (r=0.182, p=.039), while pain intensity (r=-0.206, p=.033) and BE levels (r=-0.246, p=.007) correlated negatively with depression severity. No significant relationship was found between pain threshold and plasma BE (r=-0.013, p=.882).Limitations: Future studies should implement repeated plasma BE measures to assess BE release in association with pain in NSSI. Validity of plasma BE measures compared to central measures should be considered. Assessing the association between pain sensitivity (PS) and BE in a naturalistic setting presents a promising avenue for future research in NSSI.Conclusions: Findings support both reduced PS and basal opioid deficiency as independent biological correlates and potential risk-factors for NSSI. Further longitudinal and experimental studies are needed to investigate the role of BE levels and PS as well as their potential association. [ABSTRACT FROM AUTHOR]