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Objective: To examine the prevalence of ADHD and the association of comorbid disorders, and multivariate disorder classes with role impairment in college students.Method: About 15,991 freshmen (24 colleges, 9 countries, WMH-ICS) (response rate = 45.6%) completed online WMH-CIDI-SC surveys for 6-month ADHD and six 12-month DSM-IV disorders. We examined multivariate disorder classes using latent class analysis (LCA) and simulated a population attributable risk proportions (PARPs) of ADHD-related impairment.Results: About 15.9% had ADHD, of which 58.4% had comorbidities. LCA classified ADHD respondents to pure (42.9%), internalizing (36.0%), bipolar comorbidities (11.3%), and externalizing disorder classes (9.8%). ADHD, comorbidities, and multivariate disorder classes independently predicted severe impairment. PARPs: eliminating ADHD hypothetically reduced severe impairment by 19.2%, 10.1% adjusted for comorbidities, 9.5% for multivariate disorder classes.Conclusions: ADHD and comorbid disorders are common and impairing in college students. Personalized transdiagnostic interventions guided by multivariate disorder classes should be explored. [ABSTRACT FROM AUTHOR]

According to Social Cognitive Theory, the anticipated consequences of a behaviour (outcome expectancies), influence the likelihood of engaging in a behaviour. Results from self-report studies suggest that people who have self-injured expect self-injury will regulate emotions while people who have never self-injured expect self-injury to result in pain. In this study we trialled three experimental tasks measuring implicit self-injury related outcome expectancies. 150 Australian university students aged 18–45 (M = 21.45, SD = 3.84) completed the experimental tasks (Sentence Completion Task, Implicit Association Tests, Covariation Bias Task) within a laboratory setting. Results revealed that implicit associations with affect regulation, pain, and communication differentiated people according to self-injury history in the sentence completion task. The strength of implicit associations with affect regulation also predicted the recency of self-injury. People who had self-injured, but not in the past 12 months appeared to have a bias towards associating images of self-injury and neutral words when compared to people who had recently self-injured. Implicit associations, as measured by the Implicit Association Tests did not significantly differentiate participants by self-injury history. Results suggest that the sentence completion task could further research and theoretical understanding of the role of implicit outcome expectancies in facilitating self-injury. [ABSTRACT FROM AUTHOR]

The Emotional Image Tolerance (EIT) task assesses tolerance of negative emotion induced by negatively valenced images. We made several minor modifications to the task (Study 1) and adapted the task to include positive and neutral images in order to assess whether individuals respond to the valence or the intensity of the image content (Study 2). In both studies, we assessed subjective distress, gender differences in task responses, and associations between behavioral and self-reported distress tolerance, and related constructs. Across both studies, the EIT successfully induced distress and gender differences were observed, with females generally indicating more distress than males. In Study 2, responses on the adapted EIT task were correlated with self-reported distress tolerance, rumination, and emotion reactivity. The EIT successfully induces distress and the correlations in Study 2 provide promising evidence of validity. [ABSTRACT FROM AUTHOR]

Non-suicidal self-injury (NSSI), which involves deliberate damage to body tissue without suicidal intent, has long been a concern for schools and school staff. Secondary schools are an ideal setting in which to identify, and appropriately refer, students who self-injure as well as implement evidence-based prevention and early intervention programs. However, in the context of the global COVID-19 pandemic, schools have been closed and students sent home to learn online. This may result in the exacerbation of existing anxieties and pose several new stressors that cumulatively may increase risk of NSSI. In this article, we draw on recent research and our collective experience working with schools, as well as digital mental health, to outline some of these potential stressors and offer resources for school staff to help students who are engaging in or at risk of NSSI. [ABSTRACT FROM AUTHOR]

Nonsuicidal self-injury (NSSI) is defined as the deliberate, self-inflicted damage of body tissue without suicidal intent and for purposes not socially or culturally sanctioned. School nurses are often a first point of contact for young people experiencing mental health challenges, and yet they often report they lack knowledge and training to provide care for persons who engage in NSSI. In the second of two parts, this article offers a strategy for brief assessment of NSSI, as well as reflection on two case studies and how to offer support, ongoing care, and referral for treatment to youth who engage in self-injury. [ABSTRACT FROM AUTHOR]

Nonsuicidal self-injury (NSSI) is defined as the deliberate, self-inflicted damage of body tissue without suicidal intent and for purposes not socially or culturally sanctioned. School nurses are often a first point of contact for young people experiencing mental health challenges, and yet they often report they lack knowledge and training to provide care for persons who engage in NSSI. In the first of two parts, this article provides school nurses with a better understanding of NSSI and the distinctions between NSSI and suicidal behaviors, discusses the role of nurses' knowledge and attitudes on their ability to care for their patients' mental health needs, and discusses approaches for developing a respectful, empathic manner for working with and supporting youth who engage in self-injury. Part 2 will offer a strategy for brief assessment of NSSI and reflect on two case studies and their implications for school nursing practice. [ABSTRACT FROM AUTHOR]

Research on nonsuicidal self-injury (NSSI) has grown significantly over the last 15 years, with much of this work focused on factors that initiate and maintain NSSI among school-aged youth. Although this work is important, it does raise several ethical concerns. In this article we outline key ethical issues underlying NSSI research in schools and offer recommendations for conducting ethically sound and productive research in this area. Ethical concerns addressed include: 1) recruitment of minors to research; 2) disclosure and confidentiality; 3) the risk of iatrogenic effects; 4) duty of care; 5) engaging schools in research; and 6) safety of the researchers. In each area, we offer recommendations to assist researchers, ethics committees, and schools in working together to conduct ethical NSSI research, further our understanding of NSSI, and address and respond to these behaviors in schools. [ABSTRACT FROM AUTHOR]

We examined how family functioning and emotion regulation strategies relate to both a history of nonsuicidal self-injury (NSSI) and recovery from NSSI. Participants were 272 adolescents aged between 12 and 18 years (M = 14.50 years, SD = 1.46 years), of whom 17.6% reported a history of NSSI. As expected, poor family functioning was associated with engagement in NSSI. Among the emotion regulation variables, higher use of self-blame and lower use of refocus on planning was associated with NSSI. Self-blame and refocus on planning also mediated the relationship between family functioning and NSSI. Similarly, better family functioning and adaptive emotion regulation were related to recovery, while maladaptive emotion regulation was negatively related to recovery. Adaptive emotion regulation moderated the relationship between family functioning and NSSI recovery. We discuss how family-based interventions combined with emotion regulation education may help deter NSSI engagement. [ABSTRACT FROM AUTHOR]

Phenomenological and cultural understandings of recovery from the perspective of individuals who engage in nonsuicidal self-injury (NSSI) are rare. The primary study objective was to understand similarities across three samples in (a) how young people define recovery from NSSI and (b) what they consider helpful approaches taken by parents and professionals to assist their recovery. Using a cross-national sample of young people (n = 98) from Australia (n = 48), Belgium (n = 25) and the United States (n = 25), we assessed their perspectives on NSSI. Consistent across all samples, young people defined recovery as no longer having the urge to self-injure when distressed, often displayed ambivalence about recovery, and reported it was helpful when parents and professionals were calm and understanding. Acceptance of recovery as a process involving relapses may need to be emphasized in NSSI treatment, to ease the pressure young people often place on themselves to stop the behavior outright. [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]

Non-suicidal self-injury (NSSI) is of increasing concern, yet many adolescents who self-injure are reluctant to seek professional help. Instead, they turn to friends for support, although it is unclear what these friends can offer. This study aimed to identify adolescents’ views of how peers and online friends can help young people who self-injure, and examine differences according to age, gender, and exposure to NSSI. Students (n = 2,637; aged 12-18 years) from 41 schools completed questions asking them to describe what peers and online friends could do to help young people who self-injure. Thematic analysis identified seven strategies, including communication about NSSI with peers and online friends, referral to adults and health professionals, greater public awareness of NSSI, and reduced peer stigma and bullying. Endorsement of themes varied by age, gender, and experience with NSSI. Findings have implications for school prevention of NSSI. [ABSTRACT FROM AUTHOR]

Around the world, school staff are increasingly expressing concern about nonsuicidal self-injury (NSSI) and how best to address this behavior in the school setting. However, there is a notable lack of informed guidance for schools, and clear inconsistencies in the practices school staff adopt. In this position paper we draw on our collective research and clinical expertise to provide best-practice guidelines for addressing NSSI in school settings. We outline the importance of a school protocol, and the key features all school protocols should contain. We also focus on how schools can minimize contagion of NSSI within their school environment. We believe these guidelines will be an important starting point for schools interested in developing an evidence-based approach to addressing NSSI. [ABSTRACT FROM AUTHOR]

A total of 371 university students were asked to estimate the amount of alcohol contained in a standard drink and to estimate the number of standard drinks contained in popular alcoholic beverages. In addition, students completed questionnaires assessing their perception of short and long term harm related to the consumption of beer, wine, spirits and pre-mixed alcopops. Results revealed that students were generally inaccurate in their estimate of alcoholic content of beverages, and national guidelines for low risk drinking. Students were also found to hold different perceptions regarding how harmful different alcoholic beverages were. While both male and female students considered spirits to be more harmful than beer, wine and pre-mixed drinks, males also believed beer to be more harmful than wine when considering the short term consequences. The pattern of beliefs reported by this sample suggest a high-risk population who are not aware of the risks they are exposing themselves to through their drinking behavior. [ABSTRACT FROM AUTHOR]