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

Introduction: The outbreak of COVID-19 has heightened mental health challenges among adolescents worldwide, while also hindering the development of effective emotion regulation strategies. Nevertheless, there exists a pertinent requirement to further investigate the psychological ramifications of COVID-19 on adolescents, as well as to discern disparities in these impacts across various nations. In order to address this gap in research, this study compares the prevalence of NSSI (characterized by purposefully injuring one's own body tissues without suicidal intention or engaging in behaviors that are not socially approved or sanctioned.), emotion regulation strategies, and psychopathology (internalization and externalization) among Belgian and Iranian adolescents pre- and during the COVID-19 pandemic. Method: Adolescents between the ages of 13-21 from Iran and Belgium participated in a two-wave longitudinal design. In Iran, the sample consisted of 117 adolescents in wave 1 (April 2019) and 142 adolescents in wave 2 (Nov 2020). The Belgian sample consisted of 376 participants in wave 1 and 356 adolescents in wave 2. NSSI was assessed using the Self-Harm Inventory (SHI). Emotion Regulation was examined via the Emotion Regulation Inventory (ERI). The S trengths and Difficulties Questionnaire for Youth (SDQ) was used to assess psychological symptoms. Result: Across the whole sample, lifetime NSSI prevalence was 35% in the first wave and 43.8% in the second wave. Longitudinal analysis across waves and counties did not show an increase in the prevalence of NSSI but did find that emotion dysregulation and internalizing symptoms are important risk factors for NSSI across countries. Emotional suppression and emotional dysregulation were the most prevalent emotion regulation strategies in Iran, whereas emotional integration was most prevalent in the Belgian sample. Conclusion: Our study highlights cultural differences on the impact of COVID-19 on adolescent mental health. But it also indicates the importance of certain universal risk factors, for example, emotional dysregulation. These findings can inform developers to tailor programs for (early) intervention culturally. [ABSTRACT FROM AUTHOR]

Non-suicidal self-injury (NSSI) is prevalent in adolescence and is associated with increased risk for a variety of subsequent negative mental health outcomes, necessitating an evidence-based preventive approach. This pilot study examines the potential iatrogenic effects and feasibility of an evidence-based school program for the prevention of NSSI. Differences are examined between a general in-classroom prevention program (Happyles) and this program combined with a 1-h in-classroom psychoeducation module on NSSI (HappylesPLUS) in terms of primary (e.g., delay in NSSI onset and decrease in NSSI frequency, urges, probability of future engagement) and secondary outcomes (e.g., psychological distress, emotion regulation, help-seeking, and stigma) using a mixed-method design. A total of 651 secundary school pupils (Mage = 12.85 years; 49.8% female versus 50.2% male) were assigned to the Happyles program and HappylesPLUS. Participants filled out validated self-report questionnaires pre (T0) and post (T1, 6 weeks after T0) the school prevention program, including the Youth Outcome Questionnaire (YOQ), the Brief Non-Suicidal Self-Injury Assessment Test (BNSSI-AT), the Difficulties in Emotion Regulation Scale (DERS), the Attitudes Toward Seeking Professional Psychological Help Scale—Short Form (ATSPPH-SF), and the Peer Mental Health Stigmatization Scale (PMHSS). Qualitative semi-structured interviews (at T2,6 weeks after T1) were conducted with participants with and without a history of NSSI. Overall, results show no iatrogenic effects of the NSSI-focused psychoeducation module. In terms of our primary outcome, both groups reported a reduced likelihood of future NSSI engagement from T0 to T1. Regarding secondary outcome measures, we also observed increased emotional awareness in both groups. The qualitative data suggest that the addition of the NSSI-specific module to the Happyles program may have direct benefits to some students with lived experience, such as increased help-seeking behavior for NSSI. Findings of this pilot study show that incorporating NSSI-specific modules into evidence-based school prevention programs is feasible and does not lead to iatrogenic effects. Future work is needed to evaluate the potential (longer-term) benefits of incorporating NSSI-focused modules to evidence-based mental health programs in the prevention of NSSI. [ABSTRACT FROM AUTHOR]

Non-suicidal self-injury (NSSI) is a significant international mental health concern, with consequences for not only youth who self-injure, but for their entire family system. Helping caregivers respond productively to their child’s self-injury is a vital part of effectively addressing NSSI. This paper will assist school-based mental health practitioners and other personnel support caregivers of youth who self-injure by reviewing current literature, highlighting common challenges faced by school-based professionals, and providing evidenced-informed recommendations for supporting caregivers of youth who self-injure. We posit that schools can best support caregivers by having clear and well-articulated self-injury protocols and by engaging caregivers early. Once engaged, helping caregivers to navigate first conversations, keep doors open, know what to expect, seek support for themselves and understand and address safety concerns will ultimately benefit youth who self-injure and the school systems that support them. We also review recommendations for working with youth whose caretakers are unwilling or unable to be engaged. [ABSTRACT FROM AUTHOR]

This study investigated the caregiving experiences of mothers and fathers of restrictive and binge-eating/purging eating disordered (ED) inpatients with and without non-suicidal self-injury (NSSI). Sixty-five mothers and 65 fathers completed the Experience of Caregiving Inventory. All inpatients completed the Self-Injury Questionnaire-Treatment Related to assess NSSI and the Eating Disorder Evaluation Scale to assess eating disorder symptoms. Mothers reported significant more negative and more positive caregiving experiences compared with fathers. Mothers (but not fathers) of restrictive ED patients reported more positive caregiving experiences compared with mothers of binge-eating/purging patients. The presence of NSSI in ED patients was associated with more negative caregiving experiences of both parents. Mothers and fathers of ED inpatients differ in caregiving experiences, and both binge-eating behaviours and NSSI negatively affect their caregiving experience. Therefore, supportive interventions for parents of ED patients are necessary, especially of those patients who engage in NSSI. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

This study aimed to investigate family functioning of restrictive and binge-eating/purging eating disordered adolescents with or without non-suicidal self-injury (NSSI), as perceived by the patients and their parents (mothers and fathers). In total, 123 patients (between 14 and 24 years), 98 mothers and 79 fathers completed the Family Assessment Device. Patients completed the Self-Injury Questionnaire-Treatment Related and the Symptom Checklist 90-Revised. No main effects were found of restrictive versus binge-eating/purging behaviour nor of presence/absence of NSSI. For the parents, a significant interaction between binge-eating/purging behaviour and NSSI emerged: Mothers and fathers reported worse family functioning in the binge-eating/purging group in presence of NSSI, whereas mothers reported worse family functioning in the restrictive group without NSSI. Parental perception of family functioning is affected by the combined presence of binge-eating/purging behaviour and NSSI. This finding should be taken into account when treating families living with eating disorders. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

Objective The present study investigates whether either adolescents' psychological distress and/or perceived parenting predicted the occurrence of NSSI. Furthermore, the consequences of NSSI are examined in a three-wave longitudinal study. Design The sample at time 1 (age 12) consisted of 1396 adolescent reports and 1438 parent reports. At time 2 (age 13), 827 adolescent reports and 936 parent reports were obtained. Time 3 (age 14) included 754 adolescent reports and 790 parent reports. Psychological distress of adolescents was measured using the Strengths and Difficulties Questionnaire. Perceived parenting behaviors were examined by the Parental Behavior Scale and the Psychological Control Scale. Results A total of 10% of the adolescents engaged in NSSI at least once before age 15. Higher psychological distress of adolescents at time 1 was associated with the presence of NSSI at time 2 or 3. The association between psychological distress at time 1 and perception of decreased parental rule setting at time 3 was mediated by the presence of NSSI at time 2. Conclusions The present study showed that psychological distress at age 12 predicts NSSI over time and that parental awareness of NSSI changes the perception of parenting behaviors. [ABSTRACT FROM AUTHOR]

Abstract: This study investigates differences in temperament dimensions between community adolescents with and without non-suicidal self-injury (NSSI). Data were collected from 251 adolescents (62.9% females). NSSI was assessed by means of the Self-Harm Inventory (SHI; ) and temperament by means of the Early Adolescent Temperament Questionnaire-Revised (EATQ-R; ) filled out by the adolescent and his/her parent(s). Almost 27% of the adolescents showed at least one type of NSSI and there were no significant gender differences in the overall frequency of NSSI. However, considering specific NSSI methods, females showed significantly more cutting and scratching compared to males. Self-injurious adolescents showed significant higher scores on Negative Affectivity and lower scores on Effortful Control than adolescents without NSSI. Finally, Lack of Effortful Control and Negative Affectivity were the strongest predictors of NSSI in adolescents. Implications of these findings for the treatment of NSSI in community adolescents are discussed. [ABSTRACT FROM AUTHOR]