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• People who self-injure experience more negative affective-cognitive states in daily life. • We found higher and more variable negative affect, rumination, and self-criticism. • We observed a negative affect–self-critical cascade in people who self-injure. • Enhancing positive affect may help buffer dysfunctional cognitions. • Baseline variables partially negated observed differences. Although the literature suggests trait-like differences in affective and cognitive vulnerabilities between individuals with and without a history of nonsuicidal self-injury (NSSI), little is known about how these dispositional differences are experienced in the natural environment. The present study compares the intensity, inertia, interaction, and variability of affective (negative and positive affect) and cognitive states (rumination, self-criticism) in the everyday lives of individuals who do and do not engage in NSSI. Using experience sampling methodology (ESM), 60 emerging adults (ages = 18–22 years) with and without past-year NSSI (equally distributed) completed eight questionnaires per day for 12 days (in total, 96 questionnaires per participant), resulting in 4,587 assessments (median compliance = 83.3%; IQR = 71.9–91.7). In a dynamic structural equation modeling framework, dynamic parameters (i.e., mean intensity, carryover effects, spillover effects, and within-person variability) were evaluated using multilevel vector autoregressive models. Emerging adults who engage in NSSI experience higher intensity and greater variability of negative affect, rumination, and self-criticism, whereas those who do not engage in NSSI experience higher intensity and lower variability of positive affect. In addition, past-year NSSI predicted stronger affective-cognitive interactions over time, with stronger spillover effects of negative and positive affect on subsequent rumination and self-criticism in individuals who engage in NSSI. Depressive symptoms and trait levels of emotion dysregulation and self-criticism partially negated these differences. Our findings provide evidence that emerging adults who self-injure experience more negative affective-cognitive states in daily life and point to the potential relevance of boosting positive emotions to buffer negative cognitions. [ABSTRACT FROM AUTHOR]

Background: Suicidal behaviors are prevalent among college students; however, students remain reluctant to seek support. We developed a predictive algorithm to identify students at risk of suicidal behavior and used telehealth to reduce subsequent risk. Methods: Data come from s everal waves of a prospective cohort study (2016–2022) of college students (n = 5454). All first-year students were invited to participate as volunteers. (Response rates range: 16.00–19.93%). A stepped-care approach was implemented: (i) all students received a comprehensive list of services; (ii) those reporting past 12-month suicidal ideation were directed to a safety planning application; (iii) those identified as high risk of suicidal behavior by the algorithm or reporting 12-month suicide attempt were contacted via telephone within 24-h of survey completion. Intervention focused on support/safety-planning, and referral to services for this high-risk group. Results: 5454 students ranging in age from 17–36 (s.d. = 5.346) participated; 65% female. The algorithm identified 77% of students reporting subsequent suicidal behavior in the top 15% of predicted probabilities (Sensitivity = 26.26 [95% CI 17.93–36.07]; Specificity = 97.46 [95% CI 96.21–98.38], PPV = 53.06 [95% CI 40.16–65.56]; AUC range: 0.895 [95% CIs 0.872–0.917] to 0.966 [95% CIs 0.939–0.994]). High-risk students in the Intervention Cohort showed a 41.7% reduction in probability of suicidal behavior at 12-month follow-up compared to high-risk students in the Control Cohort. Conclusions: Predictive risk algorithms embedded into universal screening, coupled with telehealth intervention, offer significant potential as a suicide prevention approach for students. [ABSTRACT FROM AUTHOR]

Objectives: Perfectionism is linked to nonsuicidal self‐injury (NSSI). Individuals with elevated perfectionism tend to avoid undesirable emotions and experience lower self‐esteem, which are associated with NSSI. However, it is unclear if these mechanisms explain the link between clinical perfectionism and NSSI, and if locus of control is involved. We aimed to explore whether experiential avoidance and self‐esteem would mediate the relationship between clinical perfectionism and NSSI, and if locus of control would moderate links between clinical perfectionism and both experiential avoidance and self‐esteem. Method: As part of a larger study, 514 Australian university students (Mage = 21.15 years, SD = 2.40; 73.5% female) completed an online survey of NSSI, clinical perfectionism, experiential avoidance, self‐esteem, and locus of control. Results: Clinical perfectionism was associated with NSSI history, but not with recent NSSI or past year NSSI frequency. Lower self‐esteem, but not experiential avoidance, mediated links between clinical perfectionism and NSSI history, recent NSSI, and NSSI frequency. More external locus of control was associated with NSSI, experiential avoidance, and lower self‐esteem, but locus of control did not moderate pathways between clinical perfectionism and experiential avoidance or self‐esteem. Conclusion: University students reporting elevated clinical perfectionism may have a tendency to experience lower self‐esteem which is associated with NSSI history, recency, and severity. [ABSTRACT FROM AUTHOR]

Background Objectives Implications Non-suicidal self-injury (NSSI) is a behaviour many counselling psychologists encounter in practice, and the way clinician’s respond can have an important impact on the individual’s experience of recovery. The person-centred NSSI recovery framework incorporates the voices of lived experience in understanding the multi-faceted nature of recovery.This paper outlines important considerations for how the recovery framework can guide clinicians with respect to both therapeutic stance and intervention targets in order to support clients in navigating their experience of NSSI and recovery.Clinicians should adopt a strengths-based approach and foster self-efficacy and self-compassion with persons with lived experience. This paper provides specific recommendations for counselling psychologists and their clients, including encouraging clinicians to avoid making assumptions about the causes, meanings, and outcomes of self-injury, and to be cognizant of the non-linear nature of the recovery process. [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 the intentional and deliberate damage to an individual's own body tissue without the intent to suicide. Individuals who have higher self-reported levels of experiential avoidance are more likely to report a history of NSSI. The current study systematically reviewed the literature and meta-analysed studies assessing associations between experiential avoidance and self-injury. An extensive review was conducted of several databases (including ProQuest, Joanna Briggs, Web of Science, PsychArticles, PubMed, Scopus, and Ovid). Nineteen articles (two dissertations) met the inclusion criteria for the systematic review and 14 were analysed in a Robust Bayesian Meta-analysis. This review was registered through PROSPERO (CRD42020198041). There was a small to medium, pooled effect size (d = 0.48, 95 % Credibility Interval 0.00–0.85). There was strong evidence for this effect size (Bayes Factor = 12.16), although there was considerable heterogeneity between studies (τ =0.68, 95 % CI [0.44, 0.1.05]). The analysis testing whether these findings may be due to publication bias was inconclusive (Bayes Factor = 2.45). The majority of studies included were cross-sectional, in English, and most studies were of university students. While some studies reported on recency/frequency of NSSI there was not enough data to conduct meta-analysis. These results suggest there is a robust association between history of NSSI and experiential avoidance. However, as most studies operationalise avoidance as a unidimensional construct, it is not clear which aspects of avoidance differentiate individuals with and without a history of NSSI. • Experiential avoidance is associated with history of NSSI. • Measure of experiential avoidance (AAQ – II) moderated the association. • Research is needed with varied populations and more nuanced measures of experiential avoidance. [ABSTRACT FROM AUTHOR]

Non-suicidal self-injury (NSSI) has garnered increasing academic and media attention in society. While more awareness of NSSI is welcomed, inappropriate reporting of NSSI in media could heighten the potential for stigmatization and misunderstanding of NSSI and people who engage in it. Further, certain kinds of content (e.g., graphic imagery) may be harmful to people who self-injure (e.g., provoking urges to self-injure). These concerns notwithstanding, little research has focused on how NSSI has been portrayed in news media. Such knowledge would therefore represent a first step toward illuminating the nature of media depictions of NSSI and highlight potential areas to circumvent any concerns. Using content analysis, we explored how NSSI was portrayed in 568 online news articles about NSSI, published between 2007 and 2018, from top news sources in Australia, Canada, New Zealand, the United Kingdom, and the United States. Codes were developed based on prior research investigating online NSSI content, and the available existing and proposed media guidelines for the reporting of NSSI at the time of the study. While the overall tone of the examined articles was often neutral, areas of concern included: most articles detailing specific NSSI methods, the frequent inclusion of negative imagery, an absence of clear communication about what NSSI is and why people self-injure, the use of sensationalist and stigmatizing language, and a lack of helpful resources. These preliminary findings suggest the utility of a set of newly developed media guidelines on the reporting of NSSI as one component in an effort to address the stigmatization and misunderstanding of NSSI and individuals who self-injure. [ABSTRACT FROM AUTHOR]

Despite significant impacts to mental health and support-seeking, non-suicidal self-injury (NSSI) stigma remains under-studied and poorly understood. Recently, the NSSI Stigma Framework was proposed, conceptualizing NSSI stigma as comprising six constructs (origin, concealability, course, peril, aesthetics, disruptiveness) that manifest across four perspectives (public, self, anticipated, enacted). The present study investigated the extent to which this framework can account for individuals' NSSI stigma experiences using a directed content analysis. Written responses from 99 university undergraduates (Mage =21.5, SD = 3.7; 83.8% female) generated 731 data units for analysis, of which 299 (40.9%) were coded. Results demonstrated support for the public and enacted perspectives, with participants describing stigma experiences within friendships, families, schools, and workplaces. Data pointed to both direct and indirect experiences of public stigma, suggesting a more nuanced understanding of this perspective is required. While there was sufficient support for a majority of elements, more work is needed to verify the applicability of the self and anticipated perspectives. Our findings contribute to a growing body of research investigating NSSI stigma, and provide preliminary support for the utility of the NSSI Stigma Framework in identifying multiple facets of NSSI stigma. Implications for intervention and future research are discussed. [ABSTRACT FROM AUTHOR]

Background: Although non-suicidal self-injury (NSSI) is an issue of major concern to colleges worldwide, we lack detailed information about the epidemiology of NSSI among college students. The objectives of this study were to present the first cross-national data on the prevalence of NSSI and NSSI disorder among first-year college students and its association with mental disorders. Methods: Data come from a survey of the entering class in 24 colleges across nine countries participating in the World Mental Health International College Student (WMH-ICS) initiative assessed in web-based self-report surveys (20 842 first-year students). Using retrospective age-of-onset reports, we investigated time-ordered associations between NSSI and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-IV) mood (major depressive and bipolar disorder), anxiety (generalized anxiety and panic disorder), and substance use disorders (alcohol and drug use disorder). Results: NSSI lifetime and 12-month prevalence were 17.7% and 8.4%. A positive screen of 12-month DSM-5 NSSI disorder was 2.3%. Of those with lifetime NSSI, 59.6% met the criteria for at least one mental disorder. Temporally primary lifetime mental disorders predicted subsequent onset of NSSI [median odds ratio (OR) 2.4], but these primary lifetime disorders did not consistently predict 12-month NSSI among respondents with lifetime NSSI. Conversely, even after controlling for pre-existing mental disorders, NSSI consistently predicted later onset of mental disorders (median OR 1.8) as well as 12-month persistence of mental disorders among students with a generalized anxiety disorder (OR 1.6) and bipolar disorder (OR 4.6). Conclusions: NSSI is common among first-year college students and is a behavioral marker of various common mental disorders. [ABSTRACT FROM AUTHOR]

Gatekeepers play a pivotal role in protecting individuals under their care and are central to keeping people safe and away from harm. In the field of nonsuicidal self-injury (NSSI), a range of gatekeepers exist, including those who protect access to vulnerable research participants, those who protect school children, those charged with making decisions about funding priorities, and those in charge of clinical care for people who self-injure. The aim of this commentary is to outline the roles these different gatekeepers have in protecting access to research participants, access to NSSI knowledge, and access to clinical care for individuals who self-injure. We provide examples in which gatekeepers may present barriers and offer solutions for how to work with gatekeepers for mutual benefit. [ABSTRACT FROM AUTHOR]

Objective: This study examined the overlap between considering oneself to have stopped nonsuicidal self‐injury (NSSI) and the actual cessation of the behavior in terms of days self‐injured in the last month and last year, and how these operationalizations are associated with constructs related to NSSI recovery. Methods: A cross‐sectional survey including measures of coping, emotion dysregulation, psychological distress, general self‐efficacy, and self‐efficacy in resisting NSSI was answered by 144 adults aged 17–81 years (Mage [SD] = 21.43 [7.32]). Results: Having self‐injured for ≥5 days in the last year was overly inclusive of individuals who currently considered themselves as having stopped NSSI (39.02%). Considering oneself to have stopped NSSI was associated with better emotion regulation (Cohen's d = 0.45), and higher general self‐efficacy and higher self‐efficacy to resist NSSI (d = 0.59‒0.64) than behavioral cessation. Not actually engaging in NSSI was only associated with self‐efficacy to resist NSSI in risk contexts, such that fewer days self‐injured in the last year increased confidence (partial η2 = 0.085). Conclusion: Accounting for whether an individual considers themselves as having stopped NSSI or not may complement estimates of behavioral cessation, and strengthen outcomes associated with NSSI recovery. [ABSTRACT FROM AUTHOR]

Abstract Background: More than one-third of university students meet diagnostic criteria for a mental disorder, and three quarters experience role impairment in some aspect of their life. One determinant of whether young adults will experience mental health difficulties is their ability to regulate emotion. We conducted two pilot trials of a brief online program designed to teach emotion regulation skills to university students. Methods: In Study 1, we conducted an open-label trial (n = 104). In Study 2, we conducted a waitlist controlled trial (n = 167). In both studies, pre- and post-assessment of emotion regulation, psychological distress, and self-compassion were conducted. Results: In both trials, we observed improvements in emotion regulation, and reductions in symptoms of psychological distress. Acceptability and feasibility were also satisfactory. Conclusion: An online emotion regulation program may offer promise in improving emotion regulation and subsequent mental health concerns among university students. (ACTRN12620000390987; ACTRN12620000839909). [ABSTRACT FROM AUTHOR]

Objective A measure was recently developed which assesses self-efficacy to resist NSSI across differing contexts. The aim of this study was to examine how self-efficacy to resist NSSI across contexts interacts with NSSI-related outcome expectancies when differentiating NSSI history. Participant: 501 Australian college students aged 17–40 years (M = 21.21, SD = 2.36). Method: Participants completed online questionnaires. Results: Self-efficacy to resist NSSI when in contexts considered to be protective or of high risk moderated the relationships between NSSI-related outcome expectancies and recent engagement in NSSI. Participants who expected NSSI to result in communication were more likely to have recently engaged in NSSI if they held weak self-efficacy to resist NSSI in protective contexts. Expecting NSSI to result in diminished self-worth was protective against weak self-efficacy to resist NSSI. Conclusion: Results support the application of Social Cognitive Theory to NSSI and provide future avenues for exploring NSSI-specific cognitions. [ABSTRACT FROM AUTHOR]

Non-suicidal self-injury (NSSI) is the deliberate damage of one's own body tissue in the absence of suicidal intent. Research suggests that individuals engage in NSSI as a means of regulating their emotions and that NSSI is associated with emotion regulation difficulties. There is also evidence supporting the role of outcome expectancies and self-efficacy to resist NSSI. However, it is unclear how these factors work together to explain NSSI. To explore whether the relationships between five NSSI-specific outcome expectancies and NSSI history are moderated by emotion regulation difficulties and self-efficacy to resist NSSI. 1002 participants (Mage = 20.51, 72.5% female, 39.7% lifetime history of NSSI) completed an online survey including measures of NSSI history, outcome expectancies, self-efficacy to resist NSSI, and emotion regulation difficulties. Emotion regulation difficulties were associated with NSSI, as was expecting NSSI to regulate affect. Conversely, expectations of communication and/or pain, as well as self-efficacy to resist NSSI were negatively associated with NSSI. Expectancies also interacted with both difficulties in emotion regulation and self-efficacy to resist NSSI in predicting self-injury. For example, the association between expectations of affect regulation and self-injury was weaker when associated with greater self-efficacy to resist NSSI. These findings provide support for considering NSSI-specific cognitions in concert with emotion regulation when understanding NSSI. Outcome expectancies can differentiate people based on NSSI history. Emotion regulation difficulties and self-efficacy to resist NSSI moderate the relationships between outcome expectancies and NSSI history. Emotion regulation difficulties and low self-efficacy to resist NSSI work together to predict NSSI history. [ABSTRACT FROM AUTHOR]

Abstract: Language is a powerful form of communication that not only conveys ideas and knowledge but also can assign meaning and value to the world around us. As such, language has the power to shape our attitudes toward individuals, behaviors, and ideas, by labeling them (indirectly or not) as "good" or "bad." In this way, language can be used to propagate stigma and other unhelpful attitudes toward individuals who already experience stigma. One behavior that may be particularly prone to the impact of unhelpful language is nonsuicidal self-injury (NSSI). In this article, we draw on Staniland's NSSI stigma framework to demonstrate how an individual with lived experience of NSSI may be exposed to stigmatizing messaging through 30 different channels, and propose that the accumulation of these messages may be particularly damaging. We conclude by offering practical tips for clinicians and researchers wishing to empathically work with individuals who self-injure. [ABSTRACT FROM AUTHOR]

Background: Due to cognitive and emotional differences between individuals who have and have not stopped self‐injuring, we explored these in the context of desire to stop. Method: Australian university students (n = 374) completed cognitive and emotional measures. Comparisons were made between those who had self‐injured in the past 12 months and those who had not, and between individuals who reported wanting to stop self‐injuring and those who did not. Results: Approximately 20% of participants did not want to stop self‐injuring. Cognitive emotional factors (psychological distress, self‐efficacy to resist, difficulties regulating emotion, interpersonal functions, and outcome expectancies) differentiated individuals who had and had not stopped, but could not explain differences in desire to stop. Conclusion: Factors associated with desire to stop are not the same as factors underlying behavioural cessation. Motivational approaches to changes in self‐injurious behaviour would be beneficial for clinicians and their clients. [ABSTRACT FROM AUTHOR]

Research into nonsuicidal self-injury (NSSI) has primarily focussed on the experience and regulation of emotion. Recently, NSSI-specific cognitions, including self-efficacy to resist self-injury, have been explored to further understand the behaviour. However, within these studies self-efficacy to resist NSSI has been assessed broadly using an adapted measure of self-efficacy to avoid suicide. There is a need for a NSSI-specific measure of self-efficacy, which considers specific contexts that may influence confidence in the ability to resist self-injuring. This paper reports the development of such a measure. An initial item pool (125 items) was generated from interviews with people with lived experience of NSSI and experts in the field of self-injury. These items were then administered to 650 participants aged 18–40 years (M = 21.14, SD = 2.32, 45.69% with a history of NSSI). Analyses revealed a three-factor structure representing: contexts in which it would be difficult to resist NSSI (risk contexts); contexts which make it easier to resist NSSI (protective contexts); and contexts in which people are reminded of self-injury (reminders of NSSI). To reduce the number of items, eight items with the highest loadings on each factor were retained. The final 24 item (three subscales) scale fit the data well and demonstrated invariance across individuals with and without a history of self-injury. Correlations with related but distinct constructs (e.g., self-esteem, locus of control) supported convergent and discriminative validity. This measure could be used to further theoretical understanding of NSSI and may be useful in clinical settings. [ABSTRACT FROM AUTHOR]

Non-suicidal self-injury (NSSI), the deliberate and self-inflicted damage of body tissue, typically serves an emotion regulation function. Both negative and positive affectivity have been associated with NSSI, as has low distress tolerance. In the current study, we tested whether relationships between both negative and positive affectivity and NSSI are moderated by the four facets of distress tolerance (tolerance, absorption, appraisal, regulation) captured by the Distress Tolerance Scale. A sample of 531 university students completed well-validated measures of NSSI, negative affectivity, positive affectivity, and distress tolerance. Findings indicate that negative and positive affectivity, as well as the appraisal (i.e. negative perceptions of distress) and absorption (i.e. allocation of attention to distress) facets of distress tolerance, were directly associated with NSSI. Positive affectivity and appraisal also interacted in differentiating participants with recent, lifetime and no history of NSSI. Specifically, the association between negative perceptions of distress and self-injury was weaker at high levels of positive affectivity. Positive affectivity and absorption also interacted to differentiate between individuals with no history of NSSI and individuals who recently engaged in NSSI. Specifically, positive affectivity was negatively associated with self-injury, but only among individuals who allocate less attention to their distress. Considering the independent roles of negative and positive affectivity alongside specific facets of distress tolerance and their interactions with emotional experience, may enhance understanding of NSSI. Prevention and intervention initiatives that assist regulation of negative affectivity, increase positive affectivity, and improve distress tolerance, may reduce the likelihood of engaging in self-injury. Negative and positive affectivity are independently associated with NSSI Appraisal and absorption facets of distress tolerance are associated with NSSI Positive affectivity moderates associations between appraisal and absorption and NSSI [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]

Many dysregulated behaviours, used to cope with intense or unwanted emotion, can be learned in an interpersonal context. Nonsuicidal self-injury (NSSI) is potentially one such behaviour. In this study we explored whether knowing a parent self-injured was related to NSSI among young adults, and whether such an association was associated with thoughts and beliefs about NSSI. Specifically we tested the roles of anticipated outcomes of NSSI, and belief in the ability to resist urges to self-injure, in this relationship. A sample of 669 university students, aged between 17 and 30 years (M = 20.77, SD = 2.31), completed self-report measures of the constructs of interest. Of the sample 43 (6.4%) were aware of a parent self-injuring; this was associated with a threefold increase in history of NSSI reported by participants. This relationship was mediated by expectations that NSSI would relieve negative affect, and weaker expectations of resulting physical pain. The relationship between pain expectancies and NSSI was moderated by self-efficacy to resist NSSI. The results suggest that knowledge of parental NSSI may be a risk factor for NSSI among their children, and that cognitions about NSSI could be a potential mechanism explaining this relationship. [ABSTRACT FROM AUTHOR]

Nonsuicidal self-injury (NSSI) is a complex behavior that serves many functions and may be motivated by several factors. Although previously limited to the context of personality disorders, consideration of how general personality traits might be related to NSSI warrants examination. Our aims were to investigate whether clusters based upon the Big Five personality traits exist among people who have engaged in NSSI, and explore systematic differences with regard to gender, age, key indicators of NSSI severity, functions of NSSI, emotional avoidance, alexithymia, psychological distress, and emotion regulation strategies. A sample of 236 university students (83% female, M age = 21.59, SD = 5.43) who had engaged in NSSI completed an anonymous online questionnaire. Cluster analysis yielded three subgroups who were characterized by tendencies for resilience, dysregulation, and disagreeableness. Resilient and dyregulated profiles fell within opposite ends of a continuum with regard to severity of NSSI, psychological distress and alexithymia, and adaptive vs less adaptive emotion regulation strategies. Dysregulated characteristics were also associated with affect regulation and self-punishment functions of NSSI. Disagreeable characteristics were associated with high alexithymia and psychological distress. Implications of these findings for theory and tailored treatment approaches to NSSI are discussed. [ABSTRACT FROM AUTHOR]

Non‐suicidal self‐injury (NSSI) is a major public health concern and is also associated with increased risk of suicide. The type of care people with NSSI receive at the hospital impacts their health outcomes. This study explored emergency department (ED) and mental health nurses' (MHNs) understanding, attitudes, empathy and confidence to work with people presenting with NSSI. ED and MHNs who belonged to either the College of Emergency Nursing Australasia (CENA) or the Australian College of Mental Health Nurses (ACMHN) were invited to complete an online survey through a group email from their college. One hundred and one nurses (56 ED and 45 MHNs) completed the survey. The results revealed that nurses from both groups had an accurate understanding of NSSI and had positive attitudes about patients who self‐injure. However, confidence was higher among MHNs. Greater knowledge of NSSI was correlated with increased confidence, positive attitudes and empathy. For mental health nurses, but not ED nurses, years of clinical practice was associated with nurses' confidence. In contrast, ED nurses with more than 10 years' experience were less confident in addressing NSSI than ED nurses with less experience. Issues that affect both ED and MHNs' knowledge, attitude, empathy and confidence to care for patients who self‐injure are multifactorial. Future education and training should focus on therapeutic interactions with people at risk of repeat NSSI. Further, more research is recommended to explore patients' perspectives of nurses' attitudes in care for people who self‐injure. [ABSTRACT FROM AUTHOR]

According to Social Cognitive Theory, the anticipated consequences of a behavior (outcome expectancies), coupled with our belief in our ability to successfully perform the behavior (self-efficacy), determine the likelihood of engagement in a behavior. We explored whether the relationship between nonsuicidal self-injury outcome expectancies and self-injury was moderated by self-efficacy to resist nonsuicidal self-injury. Participants: Five hundred and sixteen college students aged 18–26 years (M = 20.60, SD = 1.86). Methods: Self-report measures were completed online. Results: The relationship between expecting self-injury would result in pain or emotion regulation and engaging in self-injury was moderated by a belief in the ability to resist self-injury. People who had never self-injured were more likely to believe that self-injury would cause physical pain and believe they could resist self-injury. A belief in the ability to resist self-injury countered expectations that self-injury would result in emotion regulation. Conclusion: Results may inform college-based prevention and intervention efforts. [ABSTRACT FROM AUTHOR]

Abstract: Nonsuicidal self-injury (NSSI) is a behavior that can be perplexing to many people. Usually engaged as a means of regulating intense or unwanted emotions, it seems to counter the human instinct to avoid pain and harm to the self. The language people use to talk about NSSI, and individuals who engage in the behavior, can contribute to the significant stigma that is associated with NSSI. In this data-driven commentary, we report on the language clinicians and researchers typically use when talking about NSSI, and the language they consider appropriate to use. We observed some disparity in the language people use and what they deemed appropriate. Notably, researchers and clinicians report underusing terms that people with lived experience find most appropriate (someone with a history of self-injury; someone with lived experience of self-injury). We call on all researchers and clinicians to be mindful of the language they use to discuss NSSI and adopt person-centered and respectful language at all times. [ABSTRACT FROM AUTHOR]

Growing interest has been paid to the concept of non‐suicidal self‐injury (NSSI) recovery. In research, and sometimes clinical practice, the focus has been on NSSI cessation, with recovery operationalised with reference to the time since someone last self‐injured. Yet, perspectives from people with lived experience of NSSI indicate that recovery is much more complex. Drawing on recent empirical work, and the voices of people with lived experience of NSSI, we outline a new framework for conceptualizing NSSI recovery. We argue that recovery is nonlinear and multifaceted, comprising: Realistic Expectations and Setbacks; Normalizing Thoughts and Urges; Fostering Self‐efficacy; Identifying Strengths; Finding Alternatives; Addressing Underlying Adversities; Addressing and Accepting Scarring; Navigating Disclosures; and Self‐acceptance. In presenting research and clinical implications of this new framework, we propose that this framing offers a more complete understanding of NSSI recovery—one conducive to optimizing wellbeing and promoting resilience among individuals with lived experience. [ABSTRACT FROM AUTHOR]

Both non‐suicidal self‐injury (NSSI) and risky drinking are positively associated with alexithymia, a personality trait characterized by difficulties appraising feelings and an externally orientated thinking style. Although researchers have studied the associations between alexithymia and both NSSI and risky drinking, the underlying factors of both associations are rarely compared. Using path analysis, we compared the mediating effects of behaviour‐specific outcome expectancies and self‐efficacy beliefs on the associations between alexithymia and both NSSI and risky drinking. A sample of 627 university students (76.10% female, Mage = 20.75, SD = 1.88) completed a battery of questionnaires. Alexithymia exhibited indirect effects on NSSI via affect regulation expectancies, pain expectancies, communication expectancies, and low self‐efficacy to resist NSSI. Alexithymia exhibited indirect effects on risky drinking via expectations of increased confidence and negative consequences. However, the indirect effects differed depending on the valance of the emotion the individual had difficulties appraising. Our findings indicate that the underlying factors in the associations between alexithymia and both NSSI and risky drinking could differ. Where individuals who have difficulties appraising negative emotions may engage in NSSI to help regulate negative feelings, they may consume alcohol to gain more confidence in expressing their feelings. Clinical implications are discussed. [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]

Non-Suicidal Self-Injury (NSSI) and risky drinking have a shared emotion regulatory function. Alexithymia is an important risk factor for both behaviors. However, it is conceivable that the emotional processing difficulties thought to underlie both behaviors may contribute to differences between people who self-injure or drink in a risky fashion, and those who do not, when interpreting alexithymia items on self-report questionnaires. Therefore, measurement invariance should be established before attributing scale score differences between groups to true differences in alexithymia. We examined the validity, factor structure, and measurement invariance of the Toronto Alexithymia Scale (TAS-20) and the Perth Alexithymia Questionnaire (PAQ) among 640 university students (Mage = 20.39, SD = 1.86) with and without histories of NSSI and risky drinking. The original factor structure of the TAS-20 was not supported; however, the addition of a reverse-scored item method factor improved fit. The intended five-factor model of the PAQ was supported. We found configural, full metric, and full scalar invariance for the PAQ and a revised-TAS-20. Both the PAQ and TAS-20 demonstrated good concurrent, convergent, and discriminate validity. Our results suggest that all subscales of the PAQ and the difficulties identifying feelings and difficulties describing feelings subscales of the TAS-20 can be used confidently to discern differences in alexithymia in the context of NSSI and risky drinking. However, the externally orientated thinking subscale of the TAS-20 had poor internal consistency and several inadequate factor loadings. We discuss the utility of the externally orientated thinking subscale (TAS-20). [ABSTRACT FROM AUTHOR]

Alexithymia is a vulnerability factor for physical and mental illness that can significantly influence the daily function of alcohol-dependent patients. The aim of this study was to examine the indirect effect of obsessive thoughts and compulsive behaviors involving alcohol craving on the relationship between alexithymia, quality of life (QoL) of psychological well-being and health status. Three hundred and eighty-one outpatients (263 males and 118 females) in treatment for alcohol dependence completed self-report measures of alexithymia, alcohol craving, GHQ-28 (QoL-psychological well-being) and SF-36 (QoL-health status). Males scored significantly higher than females on aspects of alexithymia, and females reported significantly higher levels of alcohol craving. Path analysis showed an indirect effect of alcohol craving on the relationship between alexithymia, QoL-psychological well-being and self-reported QoL-health status for males only. The current study provides important new information about impaired self-reported health status and well-being among male alcohol-dependent treatment seekers with alexithymia. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to explore common and differential relationships between nonsuicidal self-injury (NSSI), risky drinking, and disordered eating attitudes and impulsivity, emotion dysregulation, and alexithymia. Methods: We investigated these associations in a sample of 951 college students (79.4% female, Mage = 21.86 years) by means of self-report questionnaires assessing the constructs of interest. Results: Overall, 28% of the students reported a history of NSSI, one third engaged in risky drinking, and less than 5% reported disordered eating symptoms. Negative urgency and difficulties in emotion regulation were both related to each of the three behaviors and can be considered as common transdiagnostic mechanisms. Conclusions: We discuss the implications of transdiagnostic mechanisms involved in these three dysregulated behaviors with respect to their assessment and treatment in college counseling settings. [ABSTRACT FROM AUTHOR]

People who engage in dysregulated behaviours, such as nonsuicidal self-injury (NSSI) and risky drinking, commonly report adverse family environments. We investigated the association between family functioning and NSSI and/or risky drinking, with a focus on the roles of emotional reactivity and dysregulation. A sample of 733 university students (age: 18–33 years; M = 21.54; 76.6% female) completed self-report measures. Of the sample, 35% reported self-injury and 31% risky drinking. NSSI was associated with all variables (family functioning, emotional reactivity, emotional dysregulation) but few predicted risky drinking. Family functioning was indirectly associated with NSSI through emotional reactivity and dysregulation. Additionally, difficulties in emotion regulation moderated the association between family function and NSSI. While people with difficulties regulating emotion are more likely to self-injure, poor family functioning increases risk even among those with no such difficulties. While family context may increase risk of dysregulated behaviours, intervention may also benefit from focusing on emotional reactivity and regulation of emotions. Highlights: We tested the association between family functioning and NSSI and/or risky drinking. Poor family functioning increases risk of NSSI. Family functioning was indirectly associated with NSSI, via emotion regulation. Intervention could focus on the experience and regulation of emotions. [ABSTRACT FROM AUTHOR]

Alexithymia and experiential avoidance are personality traits regularly identified as correlates of behaviours that serve an emotion regulatory function, including, non‐suicidal self‐injury (NSSI) and risky drinking. In the current study, we examined whether the relationships between alexithymia, NSSI, and risky drinking are moderated by experiential avoidance and sex. A sample of 778 university students (77.1% female, Mage = 22.27, SD = 6.71) completed online questionnaires. For men, a combination of high levels of externally orientated thinking and experiential avoidance was associated with NSSI. Conversely, for women, a combination of high levels of externally orientated thinking but low levels of experiential avoidance was associated with risky drinking. Findings suggest that associations between alexithymia and experiential avoidance with NSSI and risky drinking may differ between men and women. [ABSTRACT FROM AUTHOR]

Non-suicidal self-injury (NSSI) is particularly prevalent during adolescence and emerging adulthood. The salience of shame during these developmental periods suggests that shame may be inherently linked to NSSI, and at least partially explain the high rates of NSSI observed among youth. In this article, a theoretical developmental model relating shame and NSSI is proposed, and results from a preliminary test of a sub-set of cross-sectional relationships in this model is presented. In the model tested, it was hypothesized that adverse caregiving experiences in prior development (i.e., childhood to late adolescence) like parental invalidation and child maltreatment, established predictors of NSSI, would be linked to proximal episodes of NSSI (i.e., past year) through current shame-proneness (i.e., experiencing shame in a trait-like manner) and internalizing shame-coping (i.e., responding to shame through attacking one's self and withdrawing). It was also hypothesized that some key proximal predictors of NSSI during youth development, such as low body esteem, increased loneliness and heightened psychological distress, would be linked to proximal NSSI via shame-proneness and internalizing shame-coping. Using structural equation modelling, it was observed that data, obtained via self-reports completed by 573 emerging adults (age in years: M = 20.7, SD= 2.20, 69.1% female, NSSI history: n = 220, where most recent NSSI episode was within a year of study participation) recruited throughout Australia between June 2013 and June 2014, fit the hypothesized model well. Tests of indirect effects indicated that current shame-proneness and internalizing shame-coping significantly linked perceived parental invalidation and prior experiences of child maltreatment to proximal NSSI, though this relationship was, unexpectedly, an inverse one in relation to child maltreatment. Current shame-proneness was also linked to proximal NSSI via internalizing shame-coping, current loneliness, and current psychological distress, but not through current body esteem. Finally, proximal self-evaluations of body esteem, loneliness and increased psychological distress were linked to recent NSSI through internalizing shame-coping. The theory and findings presented in this article contribute to a deeper developmental understanding of NSSI among youth, highlight crucial pathways between adverse caregiving experiences and NSSI, and illuminate important shame-based mechanisms that potentially warrant clinical attention for at-risk individuals. Future research directions and clinical recommendations are discussed. [ABSTRACT FROM AUTHOR]

We investigated whether rumination and self-compassion moderate and/or mediate the relationships between negative affect and both non-suicidal self-injury (NSSI) and suicide ideation. Undergraduate university students (n = 415) completed well-validated measures of negative affect, rumination, self-compassion, NSSI, and suicide ideation. Neither rumination nor self-compassion moderated associations between negative affect and NSSI and suicide ideation. However, both rumination and self-compassion mediated associations between negative affect and lifetime history of NSSI and suicide ideation. Self-compassion additionally mediated the association between negative affect and both 12-month NSSI and suicide ideation. The salience of self-compassion, particularly in predicting recent NSSI and suicide ideation, offers promise for early intervention initiatives focusing on less judgmental or self-critical means of self-relation. [ABSTRACT FROM AUTHOR]

The recently proposed cognitive‐emotional model of nonsuicidal self‐injury (NSSI) draws on emotion regulation models and social cognitive theory to understand the onset, maintenance, and cessation of NSSI. We tested the prediction of the model that the relationship between emotional reactivity and NSSI is moderated by specific cognitions about self‐injury (i.e., self‐efficacy to resist NSSI, NSSI outcome expectancies), emotion regulation, and rumination. A sample of 647 university students aged 17–25 years (M = 19.92, SD = 1.78) completed self‐report measures of the constructs of interest. As expected, we found that emotional reactivity was positively related to NSSI, particularly for people who had weak self‐efficacy to resist NSSI. However, emotional reactivity was negatively related to NSSI for people who were more likely to use expressive suppression to regulate emotion. Implications for the theoretical understanding of NSSI are discussed. [ABSTRACT FROM AUTHOR]

Highlights • Nonsuicidal self-injury, risky drinking and disordered eating are common among university students. • These behaviours are often used to regulate negative emotions. • Behaviour-specific self-efficacy mediated the relationships between emotion regulation self-injury and behavioural outcomes. • Our findings offer new insights into targets for prevention and intervention in university settings. • Perceived ability to resist these behaviours could be a target in treatment and early intervention. Abstract We examined the relationship between self-efficacy and three behaviours that can serve similar affect-regulatory functions (self-injury, risky alcohol use, disordered eating). We proposed that general self-efficacy would be indirectly related to each outcome, operating via emotion regulatory self-efficacy and behaviour-specific self-efficacy. A path analysis confirmed this proposal in a sample of 490 university students, who completed questionnaires assessing the constructs of interest. Emotion regulatory self-efficacy was a salient predictor of self-injury and disordered eating, evidencing both direct and indirect relationships. Self-efficacy to resist each of the behaviours was uniquely related to its target behaviour. We discuss these findings, outlining the implications for a theoretical understanding of emotion-regulatory behaviours, and offer suggestions for prevention and early intervention initiatives. [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]

Non-suicidal self-injury (NSSI) is commonly used by young adults to regulate emotional responses. Yet, experimental examination of how people who self-injure appraise and respond to emotional stimuli is limited. We examined appraisals of, and responses to, emotive images in young adults who did and did not self-injure, and assessed whether these were impacted by exposure to a stressor. Study 1 (N = 51) examined whether participants differed in their appraisals of emotional images. Study 2 (N = 78) assessed whether appraisals of images changed after exposure to the Trier Social Stress Test. Ratings of emotional valence and arousal were collected in both studies; skin conductance was measured as an indicator of physiological arousal in Study 2. In Study 1 participants reporting NSSI rated positively valenced images as less pleasant than participants not reporting NSSI. In Study 2, after acute stress, participants reporting NSSI displayed dampened physiological reactions to positive images whereas participants who did not self-injure displayed heightened physiological reactions to these and rated them as more pleasant. Individuals who self-injure seem less able to engage in strategic mood repair after exposure to stress compared to people who do not self-injure. [ABSTRACT FROM AUTHOR]

Grounded in Emotional Cascade Theory, we explored whether rumination and multisensory imagery-based cognitions moderated the relationships between affect and both odds of non-suicidal self-injury (NSSI), and frequency of the behaviour. A sample of 393 university students completed self-report questionnaires assessing the constructs of interest. Contrary to expectations, rumination did not emerge as a significant moderator of the affect-NSSI relationship. However, the relationship between affect and frequency of NSSI was moderated by the use of imagery. Further, the relationship between negative affect and NSSI was moderated by positive affect, underscoring the need to consider both negative and positive affect in models of NSSI. Most youth who self-injured reported thinking in images while the urge to self-injure was strong, with 53% thinking in images at least half the time. Future work is needed to explore how positive and negative affect work in concert to govern NSSI, and how imagery might either exacerbate or reduce risk of NSSI. [ABSTRACT FROM AUTHOR]

Background: Approximately one in five college students report a history of nonsuicidal self-injury. However, it is unclear how many students meet criteria for the recently proposed DSM-5 nonsuicidal self-injury disorder (NSSI-D). In this study, we used full NSSI-D criteria to identify those students most in need of clinical care.Methods: Using data from the Leuven College Surveys (n = 4,565), we examined the 12-month prevalence of DSM-5 NSSI-D in a large and representative sample of incoming college students. We also explored the optimal frequency threshold as a function of interference in functioning due to NSSI, and examined comorbidity patterns with other 12-month mental disorders (i.e., major depressive disorder, broad mania, generalized anxiety disorder, panic disorder, and alcohol dependence) and suicidal thoughts and behaviors (STB).Results: Twelve-month NSSI-D prevalence was 0.8% and more common among females (1.1%) than males (0.4%). The proposed 5+ diagnostic threshold was confirmed as yielding highest discrimination between threshold and subthreshold cases in terms of distress or disability due to NSSI. A dose-response relationship was observed for NSSI recency-severity (i.e., 12-month NSSI-D, subthreshold 12-month NSSI-D, past NSSI, no history of NSSI) with number of 12-month mental disorders and STB. NSSI-D occurred without comorbid disorders for one in five individuals, and remained associated with severe role impairment when controlling for the number of comorbid disorders.Conclusions: These findings offer preliminary evidence that DSM-5 NSSI-D is uncommon among incoming college students, but may help to improve the deployment of targeted resource allocation to those most in need of services. More work examining the validity of NSSI-D is required. [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]

Background: Although non-suicidal self-injury (NSSI) is known typically to begin in adolescence, longitudinal information is lacking about patterns, predictors, and clinical outcomes of NSSI persistence among emerging adults. The present study was designed to (1) estimate NSSI persistence during the college period, (2) identify risk factors and high-risk students for NSSI persistence patterns, and (3) evaluate the association with future mental disorders and suicidal thoughts and behaviors (STB). Methods: Using prospective cohorts from the Leuven College Surveys (n = 5915), part of the World Mental Health International College Student Initiative, web-based surveys assessed mental health and psychosocial problems at college entrance and three annual follow-up assessments. Results: Approximately one in five (20.4%) students reported lifetime NSSI at college entrance. NSSI persistence was estimated at 56.4%, with 15.6% reporting a high-frequency repetitive pattern (≥five times yearly). Many hypothesized risk factors were associated with repetitive NSSI persistence, with the most potent effects observed for pre-college NSSI characteristics. Multivariate models suggest that an intervention focusing on the 10–20% at the highest predicted risk could effectively reach 34.9–56.7% of students with high-frequency repetitive NSSI persistence (PPV = 81.8–93.4, AUC = 0.88–0.91). Repetitive NSSI persistence during the first two college years predicted 12-month mental disorders, role impairment, and STB during the third college year, including suicide attempts. Conclusions: Most emerging adults with a history of NSSI report persistent self-injury during their college years. Web-based screening may be a promising approach for detecting students at risk for a highly persistent NSSI pattern characterized by subsequent adverse outcomes. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Non‐suicidal self‐injury (NSSI) is physically harmful behaviour, primarily used to regulate emotions. Emotion regulatory ability is theorised to develop in the context of primary attachment relationships and to be impacted by the quality of these relationships. We propose a developmental perspective for why some people engage in NSSI. Method: A questionnaire assessing aspects of attachment, emotion regulation, and NSSI was completed by 237 young adults. Results: Participants reporting NSSI were more likely to report difficulties in attachment relationships and emotion relation. Using multiple mediation modelling, anxiety related to mothers, and a fearful attachment model predicted NSSI through non‐acceptance of emotional responses and lack of regulatory strategies; the fearful model also predicted NSSI through difficulties in engaging in goal‐directed behaviour and impulse control. Conclusions: Risk of NSSI may increase as a result of attachment difficulties and associated emotional development; early prevention measures may be useful. Treatment of NSSI should target attachment constructs as well as understanding, expression, and regulation of emotion. [ABSTRACT FROM AUTHOR]

Non-suicidal self-injury (NSSI) is a complex behaviour, routinely engaged for emotion regulatory purposes. As such, a number of theoretical accounts regarding the aetiology and maintenance of NSSI are grounded in models of emotion regulation; the role that cognition plays in the behaviour is less well known. In this paper, we summarise four models of emotion regulation that have repeatedly been related to NSSI and identify the core components across them. We then draw on social cognitive theory to unite models of cognition and models of emotion in developing a new cognitive-emotional model of NSSI. Our model articulates how emotion regulation and cognition can work in concert to govern NSSI, and offers several new research questions that can be addressed within this framework. [ABSTRACT FROM AUTHOR]

Although nonsuicidal self-injury (NSSI) peaks in adolescence, a significant proportion of young people continue to self-injure into emerging adulthood. Yet, little is known about factors prospectively associated with persistent NSSI. Using data from a 3-year longitudinal study (n = 1466), we compared 51 emerging adults (67.3% female; average age, 20.0 years) who continued to self-injure from adolescence and 50 emerging adults (83.7% female; average age, 20.3 years) who had ceased NSSI, on a broad range of psychosocial factors. More frequent NSSI, use of a greater number of methods, specific NSSI functions, academic and emotional distress, and lack of perceived emotion regulatory capability differentiated emerging adults who continued with NSSI and those who had ceased the behavior. Further, the relationships between social support, life satisfaction, and NSSI were mediated by perceived ability to regulate emotion. Findings from this study point to the role of personal belief in the ability to effectively regulate emotion in the cessation of NSSI. Future research directions and clinical implications are discussed. [ABSTRACT FROM AUTHOR]

In this study we examined the relative risk of Non-Suicidal Self-Injury (NSSI) associated with a history of physical and sexual abuse/assault, poor attachment relationships, and poor emotion regulation among adolescents. A total of 2,637 adolescents (aged 12–15 years) completed questionnaires at 3 time-points: baseline, 12, and 24 months later. Across the study, 9.4% reported a history of NSSI. Each of past or recent abuse/assault, poor attachment relationships, and poor emotion regulation was associated with NSSI. We also observed a potential “high-risk” group among those reporting recent sexual abuse or assault. Knowledge of abuse history, recent sexual assault, attachment, and emotion regulatory ability will enable clinicians to assist adolescents in avoiding some of the more negative outcomes of these, including NSSI. [ABSTRACT FROM PUBLISHER]

Social cognitive theory articulates a role for two key thought processes in governing volitional behaviour: outcome expectancies and self-efficacy expectancies. These cognitions are behaviour-specific, and should thus differentiate people who engage in one behaviour over another. This paper presents the results of a study applying social cognitive theory to explore how outcome expectancies and self-efficacy expectancies differentially relate to non-suicidal self-injury (NSSI) and risky alcohol use amongst a sample of young adults. A sample of 389 undergraduate students completed self-report questionnaires assessing their engagement in NSSI, alcohol consumption, their beliefs about the anticipated consequences of self-injury and alcohol consumption (outcome expectancies), and their belief in their ability to resist self-injury or risky drinking (resistance self-efficacy). Generally, people who self-injure rather than drink are characterised by a belief in the ability to resist drinking, coupled with stronger positive, and weaker negative, NSSI expectancies. People who self-injure are less likely to think alcohol reduces tension than people who do not self-injure. People who engaged in both NSSI and risky drinking report more anxiety than participants who engaged only in risky drinking and lowered ability to resist self-injury. Overall, the findings suggest that a unique combination of beliefs differentially predict NSSI and drinking. The pattern of results suggests potential avenues for future research to delineate why people engage in one behaviour rather than another and to inform future prevention and early intervention initiatives. [ABSTRACT FROM AUTHOR]

Objective: Disclosure of nonsuicidal self‐injury (NSSI) is associated with a range of both positive (e.g., help‐seeking) and negative (e.g., discrimination) outcomes. The aim of this study was to assess the importance of a range of factors concerned with: NSSI experiences, self‐efficacy to disclose self‐injury, interpersonal factors, and reasons for or expectations of disclosure, to the decision to disclose self‐injury to friends, family members, significant others, and health professionals. Methods: Three hundred seventy‐one participants with lived experience of NSSI completed a survey in which they rated the importance of the aforementioned factors to the decision of whether to disclose NSSI to different people. A mixed‐model analysis of variance was conducted to investigate whether the factors differed in importance and if this importance differed across relationship types. Results: All factors held importance, though to differing degrees, with those related to relationship quality being most important overall. Generally, factors relating to tangible aid were considered more important when considering disclosure to health professionals than to other people. Conversely, interpersonal factors, particularly trust, were more important when disclosing to individuals in social or personal relationships. Conclusion: The findings provide preliminary insight into how different considerations may be prioritized when navigating NSSI disclosure, in a way that may be tailored to different contexts. For clinicians, the findings highlight that clients may expect tangible forms of support and nonjudgment in the event that they disclose their self‐injury in this formal setting. [ABSTRACT FROM AUTHOR]