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Integrating across motivational models suggests that different self-damaging behaviors (SDBs) are enacted for similar reasons. However, it remains unclear whether some motives are more relevant to certain SDBs than others. To answer this question, the present study compared the salience of 8 potentially shared motives across 3 exemplar SDBs, selected to represent different points along the internalizing and externalizing spectra: binge drinking, disordered eating (binge eating, purging, fasting), and nonsuicidal self-injury (NSSI). Seven hundred and four first-year university students (73% female, Msubage/sub = 17.97) completed monthly surveys assessing their engagement in and motives for SDBs. Motives were conceptualized as either interpersonal (bonding with others, conforming with others, communicating strength, communicating distress, reducing demands) or intrapersonal (reducing negative emotions, enhancing positive emotions, punishing oneself). Multilevel models compared endorsement of each motive across SDBs. Results revealed that SDBs were motivated by similar goals, albeit to different degrees. Although some exceptions emerged, interpersonal motives were most salient to binge drinking, followed by disordered eating, and then NSSI. In contrast, intrapersonal motives were most salient to NSSI, followed by disordered eating, and then binge drinking. Motivational differences were also found within disordered eating. For example, punishing oneself was more relevant to purging and fasting than binge eating, whereas relieving negative emotions was more relevant to binge eating and purging than fasting. Similar to dimensional models that position SDBs on internalizing or externalizing spectra, the salience of motives for binge drinking and NSSI may fall on distinct spectra (i.e., interpersonal and intrapersonal, respectively), with motives for disordered eating exhibiting elements consistent with both spectra. This study supports a common motivational framework for investigating and potentially treating a variety of topographically distinct SDBs.

Behavioral models of nonsuicidal self-injury (NSSI) propose that experiencing desirable consequences following NSSI reinforces the behavior. However, these models do not specify whether experiencing more desirable consequences relative to other people (between-person), an individual's own average (within-person), or both, predicts NSSI severity. To address this gap, this study investigated the prospective, within- and between-person associations of desirable NSSI consequences with NSSI frequency (number of episodes) and versatility (number of methods).Two hundred and ten individuals (93.81% female, MWithin-person increases in desirable emotional consequences were unrelated to NSSI frequency three months later but predicted increases in NSSI versatility. Within-person increases in desirable social consequences predicted decreases in NSSI frequency three months later but were unrelated to NSSI versatility. Between-person variability in desirable consequences was unrelated to NSSI severity.Findings were partially consistent with behavioral models of NSSI. Going forward, we recommend that: (1) behavioral models articulate the salience of within-person fluctuations in consequences; (2) research clarifies the role of social consequences; and (3) clinicians use repeated assessments of emotional consequences to identify periods of elevated NSSI risk.

This study examines the indirect effects of affect dysregulation and suppression on the associations between family stress from confinement, maltreatment, and adolescent mental health during COVID-19. We examined both adolescent and caregiver perspectives to yield a more well-rounded understanding of these associations than afforded in previous research. Using both adolescent (N = 809, Mage = 15.66) and caregiver (N = 578) samples, family stress from confinement, exposure to physical and psychological maltreatment, affect dysregulation and suppression, and youth internalizing and externalizing symptoms were measured in the summer of 2020, following three months of stay-at-home orders due to COVID-19. Affect dysregulation partially accounted for the associations between family stress from confinement and psychological maltreatment on both internalizing and externalizing symptoms for youth and caregiver report. Suppression partially accounted for the associations between family stress and maltreatment on internalizing and externalizing symptoms in the youth sample, but only for internalizing symptoms in the caregiver sample. Understanding family predictors of adolescents’ mental health concerns and their underlying mechanisms, affect dysregulation and suppression, can inform mental health interventions during and following the COVID-19 pandemic.

Objective In light of recent evidence that the coronavirus disease 2019 (COVID-19) pandemic has resulted in marked increases in depression, anxiety, substance use, and other mental health concerns among Canadian adolescents, we investigated the rates of self-harm thoughts and behaviours in this population. Specifically, this study explored: (1) the demographic and geographic distributions of suicidal ideation (SI) and deliberate self-harm (DSH), and (2) the associations of mental health and substance use with SI and DSH. Method A total of 809 Canadian adolescents, aged 12–18 years, completed an online survey between June 17, 2020 and July 31, 2020. Results 44% of adolescents reported experiencing SI since the pandemic began, while 32% reported engaging in DSH. SI and DSH were more common among youth who: identified as transgender, non-binary or gender fluid; who did not reside with both parents; and who reported psychiatric concerns or frequent cannabis use. Conclusion Canadian adolescents appear to be experiencing higher rates of self-harm thoughts and behaviours relative to before the COVID-19 pandemic. It is important for adults who are likely to interact with distressed youth to be aware of potential warning signs that a youth is struggling with self-harm, and to refer youth to specialty mental health services where appropriate.

OBJECTIVE To test a diathesis-stress model whereby self-criticism interacts with monthly perceived stress to predict same-month or next-month internalizing problems, including depression, anxiety, nonsuicidal self-injury (NSSI), and suicidal ideation, in students transitioning to university. Participants: 704 students (73% female, Mage = 17.97) were recruited during their first month of university in 2017 and 2018. Methods: Students completed surveys assessing self-criticism, perceived stress, and internalizing problems from September to April. Results: Self-criticism predicted higher depression and anxiety, as well as odds of NSSI and suicidal ideation, in students' first month on campus. Consistent with a diathesis-stress model, self-criticism strengthened the associations between stress and same-month depression and anxiety. Conclusions: Self-critical students are at elevated risk of internalizing problems during the transition to university, particularly when they feel more stressed than usual. These findings elucidate which students should be targeted in interventions and when interventions should be delivered to curtail internalizing problems.

Transactional developmental theories propose that poor parenting behaviors contribute to youth substance use, and youth substance use contributes to poor parenting behaviors. However, research aimed at testing these theories has not distinguished: (1) between- and within-person sources of variance; (2) maternal and paternal parenting behaviors; and (3) alcohol, marijuana, and other illicit drug use. This study addressed these limitations by investigating the reciprocal associations between maternal and paternal warmth and hostility with alcohol, marijuana, and other illicit drug use among justice-involved adolescents, an at-risk population for substance use. 1354 justice-involved adolescents (86.4% male; M

The objective of this study was to conduct an ecologically valid test of etiological models of deliberate self-harm (DSH) during the COVID-19 pandemic. Using a sample of Canadian adolescents, we investigated: (1) the association between COVID-19-related stress and DSH; (2) whether emotion regulation (ER) difficulties mediated/moderated this association, including whether these effects differed by age; and (3) whether the mediating/moderating effects of ER difficulties were stronger among socially distanced youth. Canadian adolescents (N = 809) aged 12-18 were recruited on social media and completed an online survey. COVID-19-related stress was associated with recent DSH. Nonacceptance of emotional responses and limited access to ER strategies fully mediated this association. The indirect effect through nonacceptance of emotional responses was stronger among more socially distanced youth, whereas the indirect effect through limited access to ER strategies was stronger among older and more socially distanced youth. COVID-19-related stress and ER difficulties did not interact to predict DSH, nor did age or social distancing moderate these interactions. These results align with etiological models proposing central roles for stress and ER difficulties in DSH. Furthermore, this study underscores a need to support adolescents, particularly older teens with reduced in-person interactions, in adaptively coping with pandemic-related stress.

Research examining the prevalence, impact, and course of personality disorders in sexual and gender minority populations is sparse; however, the available literature suggests that personality pathology is more prevalent in sexual and gender minorities compared to those who identify as heterosexual and/or cisgender. Although research is limited, several competing hypotheses have attempted to explain this disparity, including environmental, developmental, minority stress, and dual marginalization theories, as well as critical theories that point to possible roles of diagnostic, clinician, and cultural biases. This chapter highlights three critical future directions. First, rigorous longitudinal research needs to be conducted to evaluate competing etiological hypotheses of personality disorders in sexual and gender minorities. Second, future personality research should examine through an intersectional lens how additional aspects of one’s identity (e.g., ethnicity, class) interact with sexual orientation and gender to influence the experiences of these groups. Finally, clinicians and researchers must be sensitive to both the need to accurately document personality pathology, and the need to avoid unnecessarily pathologizing the experiences of sexual and gender minorities. Ultimately, addressing these future directions would enhance clinicians’ and researchers’ understanding of and ability to respond to the mental health needs of sexual and gender minority populations.

Chronic medical conditions are a risk factor for the onset of suicidal thoughts and behaviors in adults. However, few studies have examined this association in adolescents. The present study explored the association between chronic medical conditions and the emergence of suicidal thoughts and behaviors in an adolescent sample representative of the U.S.A. population. Using data from the National Comorbidity Survey—Adolescent Supplement (10,148 Americans between ages 13–17), discrete-time survival analyses were performed to examine the odds of developing suicidal ideation, planning, and attempts, given prior presence of a chronic medical condition. Multivariate models controlled for sociodemographic factors and the presence of comorbid mental health conditions. Post-hoc sensitivity analyses examined associations between timing of chronic medical condition onset and later suicidal thoughts and behaviors. Multivariate analyses showed that dermatological conditions, asthma, allergies, headache, and back/neck pain were associated with elevated odds of suicidal ideation, while cardiovascular conditions were associated with increased odds of suicide attempts. Additionally, cardiovascular conditions were associated with increased risk of suicide planning and attempts among adolescents with suicidal ideation. Chronic medical conditions that began in adolescence were associated with the greatest risk of later suicidal thoughts and behaviors, compared to chronic medical conditions that began in early or middle childhood. Consistent with research in middle and older adults, physical health conditions are associated with increased risk for the onset of suicidal thoughts and behaviors in adolescents. Mental health screening for adolescents with chronic medical conditions may help parents and physicians identify suicidality early.