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Item The associations of childhood adversities and mental disorders with suicidal thoughts and behaviors - Results from the World Mental Health International College Student Initiative(Elsevier B V, 2025-08-01) Mortier P; Yang X; Altwaijri YA; Holdcraft JA; Lee S; Sampson NA; Albor Y; Alhadi AN; Alonso J; Al-Saud NK; Andersson C; Atwoli L; Auerbach RP; Muaka CA; Báez-Mansur PM; Ballester L; Bantjes J; Baumeister H; Bendtsen M; Benjet C; Berman AH; Bruffaerts R; Carrasco P; Chan SCN; Cohut I; Covarrubias Díaz Couder MA; Crockett MA; Cuijpers P; David OA; Dong D; Ebert DD; Gaete J; Felez-Nobrega M; García Forero C; Gili M; Gutiérrez-García RA; Haro JM; Hasking P; Hunt X; Husky MM; Jaguga F; Jansen L; Langer ÁI; Liu Y; Mac-Ginty S; Martínez V; Mason A; Mathai M; McLafferty M; Miranda-Mendizabal A; Murray EK; Musyoka CM; O'Neill SM; Papasteri CC; Piqueras JA; Popescu CA; Rapsey C; Robinson K; Rodriguez-Jimenez T; Scarf D; Siu O-L; Stein DJ; Struijs SY; Tomoiaga CT; Valdés-García KP; Vereecke S; Vigo DV; Wang AY; Wong SYS; Kessler RC; World Mental Health International College Student collaboratorsObjective: To investigate the associations of demographic variables, childhood adversities (CAs), and mental disorders (MDx) with onset, transition, and persistence of suicidal thoughts and behaviors (STB) among first-year university students. Method: Poisson regression models within a discrete-time survival framework were constructed using web-based self-report survey data from 72,288 incoming university students across 18 countries (response rate=20.9%; median age=19 years, 57.9% female, 1.4% transgender, 21.0% non-heterosexual). These models examined the associations of four demographic variables, five CAs, and eight MDx with STB outcomes. Results: Lifetime prevalence of suicidal ideation, plans, and attempts was 47.0%, 26.0%, and 9.6%, respectively; 12-month estimates were 30.6%, 14.0%, and 2.3%. In unadjusted analyses, associations were strongest between lifetime onset of suicidal ideation and CAs (RR range 4.4–7.0), particularly parental psychopathology (relative risk [RR]=7.0 [95% CI 6.5–7.7]), followed by MDx (RR range 1.3–3.0). Of the demographic subgroups, transgender students had highest risk of STB (lifetime ideation onset RR=2.4 [2.3–2.6]; ideation-to-attempt transition RR=1.5 [1.3–1.8]). In fully adjusted models, strongest predictors of lifetime ideation onset were emotional abuse (RR=2.1 [1.9–2.2]), major depressive disorder (RR=2.0 [1.9–2.1]), and bipolar disorder (RR=1.8 [1.6–2.0]). Ideation-to-attempt transition remained most strongly associated with panic disorder (RR=1.5 [1.3–1.7]), bipolar disorder (RR=1.4 [1.2–1.7]), and sexual abuse (RR=1.4 [1.2–1.7]). Most predictors were significantly but weakly associated with persistence of ideation and plan, while only physical abuse remained associated with repeated suicide attempts (RR=1.3 [1.0–1.8]). Conclusion: CAs and MDx are strong predictors of both onset of and transition within the STB spectrum, underscoring the importance of implementing early-life prevention interventions.Item Dares in the virtual : the construction of social media challenges : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Clinical Psychology at Massey University, Auckland, New Zealand(Massey University, 2023-12-30) Nazari, VictoriaSocial Media Challenges (SMC), which are structured activities completed by participants with the engagement posted to social media, have resulted in injury and even death. Conceptualised as a social phenomenon, SMC involve a range of stakeholders, including participants, consumers, journalists and researchers. This article-based thesis explores how different stakeholders construct dangerous SMC and what the implications of these constructions are for participants. News reports, academic material, and YouTube comments were analysed using thematic discourse analysis grounded in a social constructionist paradigm. A qualitative systematic review and evidence synthesis was used to critically explore the existing research on dangerous SMC. The review indicates SMC to be a relatively understudied, complex, and dynamic phenomenon. Yet explanations for participation tend to be developmental, psychological, and individualistic, imposing a range of common, acontextual explanations for youth behaviour. The subsequent three analysis chapters consider constructions of risk, participants, reasons for participation, and attributions of responsibility. The referencing of SMC as ‘challenges’ and as forms of fun and entertainment are portrayed as misleading by some stakeholders. Instead, the danger involved in participation is emphasized. Dangerous SMC are constructed by most stakeholders as an undesirable youth activity demanding intervention and prevention. Risk, however, is predominantly understood as involving physical harm with emotional consequences seldom being addressed. Participants are portrayed in diverse ways; as asinine inferior specimens deserving harm, as neurologically immature, as psychologically vulnerable, or as competitive fun-seekers. Self-identified participants, in contrast, speak of forced participation and of participation utilised as a coping strategy. A range of groups are identified as responsible for addressing risk, including social media companies, parents, and participants themselves. Attempts to control participation, such as the use of age restrictions are demonstrated to be by passable. Largely absent from discourse around risky SMC are the larger structural and contextual issues, which draw attention to dynamics specific to social media platforms and the financial investment of companies in SMC proliferation. There is a silence expressed in the form of ineffective and limited interventions that externalise responsibility onto individual participants and their families.Item Non-suicidal self-injury and perfectionism in young adults : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Clinical Psychology at Massey University, Albany, New Zealand(Massey University, 2022) Cory, EmilyNon-suicidal self-injury (NSSI) and perfectionism have each been foci of psychological research, however, the relationship between them has only recently begun to be examined. Further study is needed to understand if and how these concepts relate and the possible causal mechanisms underpinning this relationship. Discussion of the lived experiences of those who are perfectionistic and engage in NSSI also appears to be underrepresented in the literature. The current research, therefore, aims to examine the relationship between NSSI and perfectionism in young adults in New Zealand. The research also aims to examine the interpersonal theory of suicide (Joiner, 2005; Van Orden et al., 2010) to achieve a deeper understanding of the mechanisms of the relationship between NSSI and perfectionism. Using a two-stage data collection and analysis approach, New Zealand participants aged 18 to 35 years old first completed an online, self-report questionnaire to measure their engagement in NSSI, relative levels of perfectionism, and relative levels of thwarted belongingness and perceived burdensomeness. Secondly, a smaller subset of participants with a history of NSSI and experiences of perfectionism engaged in a semi-structured interview to discuss these experiences. Statistical analyses of the survey data supported overall perfectionism as positively related to NSSI. When perfectionism was broken down into two dimensions, both perfectionistic strivings and perfectionistic concerns were found to be positively related to NSSI. Overall perfectionism and perfectionistic concerns were both positively related to thwarted belongingness and perceived burdensomeness, while perfectionistic strivings was not. Thwarted belongingness and perceived burdensomeness were also positively related to NSSI. Finally, the relationship between both overall perfectionism and NSSI and perfectionistic concerns and NSSI were found to be partially mediated by perceived burdensomeness. The use of thematic analysis abstracted five main themes from the semi-structured interviews. These themes were: functions of NSSI; perfectionism and academic grades; perfectionism affected by others; NSSI scars and perfectionism; and failing to meet perfectionistic standards and engaging in NSSI. Overall, the current study found a positive relationship between perfectionism and NSSI and demonstrated that perceived burdensomeness may partially mediate this relationship. These findings may have important implications for clinicians working with individuals with perfectionism that engage in, or are at risk of engaging in, NSSI. Having an awareness of the above relationship may improve the implementation of targeted prevention, intervention and treatment methods resulting in better client outcomes. The current findings may also contribute to the future development of targeted prevention and intervention methods in this, and related areas.Item Non-suicidal self-injury and suicide risk among young adults : an examination of the role of perceived burdensomeness : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Clinical Psychology at Massey University, Wellington, New Zealand(Massey University, 2019) Edwards, LouiseBackground: Non-suicidal self-injury (NSSI) is defined as direct, self-inflicted damage of body tissue in the absence of the intent to die, and outside of that which is socially sanctioned (Nock, 2009). The Interpersonal-Psychological Theory of Suicide (IPTS; Joiner, 2005; Van Orden et al., 2010) posits that serious suicide attempts occur when an individual experiences both thwarted belongingness and perceived burdensomeness (leading to the desire to die) and the capability to act upon that desire (acquired capability). Current Study: The current research suggests the possibility that in addition to the role played in suicidal behaviours, perceived burdensomeness (PB) also plays a role in NSSI and conceivably in the transition between NSSI and a suicide attempts. The aims of the current study were to gain further insight into the role of PB and its relationship with NSSI and to explore themes, narratives and meaning making of PB amongst those who have engaged in NSSI. The study hypothesised that higher levels of PB will be present amongst individuals who have engaged in NSSI compared with those who have not. Methods: A mixed methods approach was utilised, consisting of an anonymous online survey completed by 159 young New Zealanders (18 – 24 years of age). Results: A total of 36.9% of participants endorsed perceiving some degree of burdensomeness towards significant others in their lives, while over half of participants (51.6%) endorsed having engaged in NSSI. Question responses were combined to produce an overall PB score to be used for comparison between groups. An interpretative phenomenological analysis (IPA) was conducted consisting of six in-depth semi-structured interviews with individuals who had engaged in NSSI and made at least one suicide attempt. Study findings include the following, in a sample of individuals who engaged in self- injurious behaviours, scores on a measure of PB increased as self-injurious behaviour moved from NSSI to suicidal behaviour. Findings: Findings suggested that emotional regulation or reducing internal distress was a major driver for engaging in NSSI. Regression analysis suggested that scores on a screening measure for Major Depressive Disorder, scores on a screening measure for Borderline Personality Disorder, frequency of NSSI and number of NSSI methods used were independently predictive of PB score, accounting for 39.8% of the variation in PB scores. However Major Depression scores were most significantly predictive, accounting for 34.2% of the variation in PB scores. A model of the interaction of PB, guilt and shame has been proposed from the IPA findings. Major conclusions were that higher levels of PB are present in individuals who have engaged in NSSI compared to those who have not engaged in any self-injurious behaviours; that there is evidence to suggest that a continuum of PB may exist moving from NSSI behaviours to suicidal behaviours and finally that PB is an important construct both clinically and for research into NSSI and suicide prevention. Study limitations are discussed and suggestions for future research made.