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    The relationships between sporadic and repetitive non-suicidal self-injury and mental disorders among first-year college students: results from the World Mental Health International College Student Initiative
    (Cambridge University Press, 2025-09-25) Hasking P; Kiekens G; Petukhova MV; Albor Y; Al-Hadi A; Alonso J; Al-Saud N; Altwaijri Y; Andersson C; Atwoli L; Muaka CA; Báez-Mansur P; Ballester L; Bantjes J; Baumeister H; Bendtsen M; Benjet C; Berman A; Bruffaerts R; Carrasco P; Chan S; Cohut I; Couder MCD; Cristóbal-Narvaez P; Cuijpers P; David O; Dong D; Ebert D; Gaete J; Forero CG; Gutiérrez-García R; Haro J; Hunt X; Hurks P; Husky M; Jaguga F; Jansen L; Jiménez-Pérez A; Kählke F; Klinkenberg E; Langer Á; Lee S; Lima RA; Liu Y; Lochner C; Mac-Ginty S; Martínez V; Mason A; McLafferty M; Mori T; Murray E; Musyoka C; Nedelcea C; Núñez D; O’Neill S; Piqueras J; Popescu C; Rapsey C; Robinson K; Roca M; Rodriguez-Jimenez T; Salemink E; Sampson N; Scarf D; Siu O-L; Stein D; Struijs SY; Tomoiaga C; Valdés-García K; van der Heijde C; Vigo D; Voorspoels W; Wang A; Wong S; Nock M; Kessler R; World Mental Health - International College Student collaborators
    Background. Non-suicidal self-injury (NSSI) is associated with mental disorders, yet work regarding the direction of this association is inconsistent. We examined the prevalence, comorbidity, time–order associations with mental disorders, and sex differences in sporadic and repetitive NSSI among emerging adults. Methods. We used survey data from n = 72,288 first-year college students as part of the World Mental Health-International College Student Survey Initiative (WMH-ICS) to explore time–order associations between onset of NSSI and mental disorders, based on retrospective age-of-onset reports using discrete-time survival models. We distinguished between sporadic (1–5 lifetime episodes) and repetitive (≥6 lifetime episodes) NSSI in relation to DSM-5 mood, anxiety, and externalizing disorders. Results. We estimated a lifetime NSSI rate of 24.5%, with approximately half reporting sporadic NSSI and half repetitive NSSI. The time–order associations between onset of NSSI and mental disorders were bidirectional, but mental disorders were stronger predictors of the onset of NSSI (median RR = 1.94) than vice versa (median RR = 1.58). These associations were stronger among individuals engaging in repetitive rather than sporadic NSSI. While associations between NSSI and mental disorders generally did not differ by sex, repetitive NSSI was a stronger predictor for the onset of subsequent substance use disorders among females compared to males. Most mental disorders marginally increased the risk for persistent repetitive NSSI (median RR = 1.23). Conclusions. Our findings offer unique insights into the temporal order between NSSI and mental disorders. Further work exploring the mechanism underlying these associations will pave the way for early identification and intervention of both NSSI and mental disorders.
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    Emotional responding to overt and subtle social exclusion among young women who engage in non-suicidal self-injury.
    (The Royal Society, 2023-03-08) Robinson K; Boyes ME; Wilson MS; Grimshaw GM
    People who engage in non-suicidal self-injury (NSSI) consistently report greater emotion reactivity and dysregulation than their peers. However, evidence that these self-reports reflect an amplified emotional response under controlled conditions is limited. Here we test the effects of both subtle and overt social exclusion, to determine whether self-reported emotion dysregulation reflects responses to real-time emotional challenge for people who self-injure. We recruited 100 young women with past-year NSSI and 100 without NSSI to an online experiment. Participants took part in a baseline social inclusion ball-tossing game, followed by either an overt or subtle social exclusion ball-tossing game, while we measured negative mood and belongingness. Despite reporting greater emotion reactivity (d = 1.40) and dysregulation (d = 1.63) than controls, women with past-year NSSI showed no differences in negative mood or belongingness ratings in response to either overt or subtle social exclusion. Within the NSSI group, exploratory analyses found greater endorsement of intrapersonal functions predicted greater negative mood following social exclusion (β = 0.19). Given that amplified emotional responding is central to prominent theoretical models of NSSI, findings highlight the need to better understand the divergence in findings between self-reported emotion dysregulation and real-time emotional responding among people who self-injure.
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    Non-suicidal self-injury in New Zealand secondary schools : an investigation of school staff attitudes, beliefs and knowledge of non-suicidal self-injury : a thesis presented in partial fulfilment of the requirements for the degree of MSc Psychology, Massey University, Wellington, New Zealand
    (Massey University, 2019) Wall, Courtney
    Non-Suicidal Self-Injury (NSSI) is a self-destructive, maladaptive behaviour with high prevalence rates among adolescents. In New Zealand, prevalence of NSSI has been identified at high rates among our adolescent populations, which is cause for concern. Increasingly, calls for advocacy and action in supporting adolescents have turned towards schools, as adolescents spend much of their time in education settings and school staff are primed in an optimal position to support students. But how equipped are school staff for this additional job, and how do they feel about students engaging in NSSI? This research aimed to investigate staff’s current attitudes, beliefs and knowledge of NSSI throughout New Zealand Secondary Schools. An online survey-based design was used, which included a mixture of multi-choice, Likert scale and open-ended questions. Participants were 458 Secondary School staff from throughout New Zealand. School staff roles included senior and middle management, guidance teams and school nurses, teaching staff and support staff. Findings provide evidence of a mixtures of attitudes and beliefs towards students engaging in NSSI and reasonable levels of staff knowledge of NSSI as behaviour and how to identify signs of NSSI among students. In total, 77% of participating Secondary School staff had encountered at least one student engaging in NSSI, with results identifying relative levels of self-disclosures to staff and teaching staff as being in a valuable position to notice physical and behavioural signs of NSSI behaviour amongst students. Training was identified to be associated with increases in positive attitudes and beliefs and increases in knowledge across varying professional school staff roles. It was associated with increased competence and confidence in engaging in conversations regarding NSSI with students, and more positive attitudes towards supporting students engaging in NSSI. Results identified low levels of NSSI staff training in New Zealand, and a consequential call for action from staff for training in this area. Just 10.9% of participants had received training in the area of NSSI, with upwards of 85% of staff in most staff categories identifying they would benefit from further training in NSSI.