Expanding our understanding of the relationship between nonsuicidal self-injury and suicide attempts: The roles of emotion regulation self-efficacy and the acquired capability for suicide

The Effect of Negative Physical Self on Social Anxiety in College Students: The Bidirectional Chain Mediation Roles of Fear of Negative Evaluation and Regulatory Emotional Self-Efficacy

Purpose

The detrimental effects of social anxiety on college students require urgent mitigation. To explore the influencing factors and underlying mechanisms of social anxiety among college students, this study aims to examine the relationship between negative physical self and social anxiety, and the mediating effects of fear of negative evaluation and regulatory emotional self-efficacy.

Methods

The Negative Physical Self Scale, Brief Fear of Negative Evaluation Scale, Regulatory Emotional Self-Efficacy Scale, and Interaction Anxiousness Scale were administered to 924 Chinese college students. SPSS 26.0 was used for analysis, and the Bootstrap method was used to test the significance level of the mediating effect.

Results

Negative physical self was significantly and positively related to social anxiety in college students. Fear of negative evaluation and regulatory negative emotional self-efficacy played independent mediating roles between negative physical self and social anxiety. Fear of negative evaluation and regulatory negative emotional self-efficacy showed a bidirectional chain mediating effect between negative physical self and social anxiety.

Conclusion

This study elucidates the mechanistic pathways between negative physical self and social anxiety. The relationship between negative physical self and social anxiety is influenced by the mediating effects of fear of negative evaluation, regulatory negative emotional self-efficacy, and the bidirectional chain mediating effect of fear of negative evaluation and regulatory negative emotional self-efficacy. This finding provides a reference for policy makers and educators to develop interventions for social anxiety in college students.

The Role of Emotion Dysregulation in Understanding Suicide Risk: A Systematic Review of the Literature

Suicide prevention represents a global imperative, and efforts to identify potential risk factors are intensifying. Among these, emotional regulation abilities represent a transdiagnostic component that may have an impactful influence on suicidal ideation and behavior. Therefore, the present systematic review aimed to investigate the association between emotion dysregulation and suicidal ideation and/or behavior in adult participants. The review followed PRISMA guidelines, and the research was performed through four major electronic databases (PubMed/MEDLINE, Scopus, PsycInfo, and Web of Science) for relevant titles/abstracts published from January 2013 to September 2023. The review included original studies published in peer-reviewed journals and in English that assessed the relationship between emotional regulation, as measured by the Difficulties in Emotional Regulation Scale (DERS), and suicidal ideation and/or behavior. In total, 44 studies were considered eligible, and the results mostly revealed significant positive associations between emotion dysregulation and suicidal ideation, while the findings on suicide attempts were more inconsistent. Furthermore, the findings also confirmed the role of emotion dysregulation as a mediator between suicide and other variables. Given these results, it is important to continue investigating these constructs and conduct accurate assessments to implement effective person-centered interventions.

Childhood emotional dysregulation paths for suicide-related behaviour engagement in adolescence

This study aimed at identifying the heterogeneous trajectories of emotional dysregulation across childhood and to study the relationship between specific trajectories and adolescent suicide-related behaviour (SRB). Data from the Millennium Cohort Study (N = 13,853 children; 49.07% female, M = 3.13 years at baseline, SD = 0.2) were used to identify the emotional dysregulation trajectories from 3 to 8 years old, using growth mixture modelling. Moreover, 1992 participants (52.86% female) from the initial sample were used to study the relationship between childhood emotional dysregulation trajectory and engagement in both self-harm and suicide attempt at age 17, using logistic regression. Some other time-invariant and proximal (adolescent) risk factors were incorporated into this analysis. Six emotional dysregulation trajectories were identified. Self-harm at age 17 was significantly associated with the history of self-harm and other proximal factors, but not with emotional dysregulation trajectory membership. Childhood trajectories featured by earlier emotional dysregulation were associated with higher risk of lifetime suicide attempt, as well as other proximal factors (concurrent self-harm). This study found differential risk profiles involved in both SRB forms. A relationship between early emotional dysregulation and suicide attempt engagement in adolescence was identified. Early interventions should be developed to deal with SRB risk factors from childhood.

Heterogeneity in Adolescents' Non-Suicidal Self-Injury Behaviour Trajectories Based on the Group-Based Trajectory Model and a Decision Tree Analysis of Family-Related Determinants

Background

Non-suicidal self-injury (NSSI) is a global public health problem. While some studies have noted the importance of behavioural development patterns in NSSI, most NSSI research is based on cross-sectional survey data. Few studies explore the time-series heterogeneity of trajectories of NSSI symptoms and family-related influencing factors of NSSI.

Aim

The purpose of the study was to identify the heterogeneity in trajectories of adolescents' NSSI behaviour and their family-related influencing factors.

Methods

The group-based trajectory model (GBTM) was used to identify the heterogeneity in the NSSI behaviour trajectories of 208 adolescents in China. Next, the decision tree model (DTM) was used to analyse which family related factors influence the trajectory type.

Results

The GBTM revealed two heterogeneous trajectories of NSSI behaviour: the high-risk and low-risk NSSI behaviour groups. Next, DTM's average accuracy was 83.2%. A total of seven independent variables were used for the DTM: gender, number of NSSIs in the past month, and family economic, family structure, family conflict, parental psychological control, parental behavior control and family intimacy risks. Family conflict risk was located at the root node and was the most important factor.

Conclusion

Heterogeneity within the population should be considered in the management of adolescents' NSSI behaviours. Further, from the perspective of family system theory and cumulative risk, focusing on the adverse effect of multiple risk factors on adolescents' NSSI addiction is more meaningful rather than the impact of single risk factors. Studies that use time series data should focus on the trend of dynamic changes in NSSI addiction characteristics over time.

Pathways from childhood trauma to suicidal ideation: mediating through difficulties in emotion regulation and depressive symptoms

OBJECTIVE

Suicidal ideation is a clinical exigency heightening the risk of suicide at different levels of suicidal behavior. This study sought to explore crucial correlates of this phenomenon with a structural equation modeling approach. Accordingly, the mediating role of depressive symptoms and difficulties in emotion regulation between childhood trauma and suicidal ideation were explored.

METHOD

The sample consisted of 372 university students (57.3% females, M = 20.75, SD = 2.25) who completed self-report measures examining experiences of childhood trauma, depressive symptoms, difficulties in emotion regulation, and suicidal ideation. Structural equation modeling was employed, and mediation analysis was conducted. Confirmatory factor analysis was used to test the measurement model of each construct before evaluating the conceptual mediated model.

RESULTS

Findings indicate that depressive symptoms with difficulties in emotion regulation had the strongest association (r = 0.60, P = 0.001), then depressive symptoms and suicidal ideation (r = 0.58, P = 0.001), suicidal ideation with difficulties in emotion regulation (r = 0.45, P = 0.001) then suicidal ideation with childhood trauma (r = 0.39, P = 0.001), difficulties in emotion regulation with childhood trauma (r = 0.36 P = 0.001) and finally depressive symptoms and childhood trauma (r = 0.35, P = 0.001). Regarding indirect paths, difficulties in emotion regulation and depression function together (in a sequential path) to mediate the association between childhood trauma and suicidal ideation ( χ²(68) = 216.86, P < 0.01, CFI = 0.95, TLI = 0.93, RMSE = 0.077, CI [0.066 to 0.089], SRMR = 0.049).

CONCLUSION

Results demonstrate that childhood trauma, depressive symptoms, and difficulties in emotion regulation are linked to suicidal ideation, highlighting the necessity of recognizing and addressing suicidal ideation as well as the factors that contribute to suicidal ideation. Emotion regulation interventions can be effective in reducing the negative effects of childhood trauma and lowering the risk of suicide. These interventions can help in reducing depressive symptoms and improve overall mental well-being, leading to a lower risk of suicide.

Association between psychological pain and suicidal ideation among men with substance use disorder: a moderated mediation model

Previous studies have found that people with substance use disorder are associated with significantly higher odds of suicidal ideation than the general population. Psychological pain and emotional regulation are considered protective factors for suicidal ideation, but the interaction process is not clear. In this study, we investigated the effects of psychological pain on suicidal ideation and constructed a moderated mediation model. 445 men with substance use disorder in China were recruited to complete the Chinese version of the Psychological Pain Scale, Regulatory Emotional Self-efficacy Scale, Suicidal Ideation Scale, and Intolerance of Uncertainty Scale. The results demonstrated that psychological pain significantly and positively predicted suicidal ideation among people with substance use disorder, and that regulatory emotional self-efficacy played a mediating role between psychological pain and suicidal ideation. Intolerance of uncertainty moderated the top and bottom halves of the intermediate process paths. This study suggests that intolerance of uncertainty and regulatory emotional self-efficacy can be improved by interventions among people with substance use disorder, which in turn can reduce their suicidal ideation and improve quality of life.

Patterns of psychological pain and self-harm behaviors in adolescents

BACKGROUND

The study examined the role of campus stressors and psychological pain on non-suicidal self-injury (NSSI) and suicide attempt (SA).

METHODS

Specific patterns of co-occurring psychological pain, campus stressors, and self-harm behaviors were identified by latent profile analysis, and their odds ratios (ORs) on NSSI and SA were analyzed in cross-sectional study and 2-year follow-up study. Structural Equation Model was used to explore indirect effect of campus stressors on SA and NSSI via different components of psychological pain.

RESULTS

Three classes were identified as low-risk class (68.58%) with low endorsements on the three measures, moderate-risk class (26.52%) with the elevated academic stressors, high levels of painful feelings, and high probabilities on NSSI; and high-risk class (4.90%) with the elevated combined stressors, high levels of pain avoidance, and high probabilities on SA. Compared to the moderate-risk class, adolescents in the high-risk class had a 4.97 OR of reporting NSSI, 17.98 OR of reporting SA. Pain avoidance class at baseline reported a higher probability in SA class (OR = 224.00) in a 2-year study.

CONCLUSIONS

Painful feelings might be shared psychosocial correlates for NSSI and SA. However, pain avoidance may play a role in distinguishing SA from NSSI, which shed light on the intervention of adolescents who engage in self-harm behaviors.

The prospective relation between borderline personality disorder symptoms and suicide risk: The mediating roles of emotion regulation difficulties and perceived burdensomeness

BACKGROUND

Despite the strong link between borderline personality disorder (BPD) symptoms and suicide risk, little is known about the mechanisms underlying this association. Theory-driven research clarifying the pathways through which BPD symptoms increase suicide risk over time is needed and may highlight relevant treatment targets for decreasing suicide risk among individuals with heightened BPD symptoms. This study examined the prospective relations among BPD symptoms, emotion regulation (ER) difficulties, perceived burdensomeness, thwarted belongingness, and suicide risk across five assessments over a 7-month period. Consistent with the interpersonal theory of suicide, we hypothesized that greater BPD symptoms would predict greater suicide risk over time via greater ER difficulties and, subsequently, greater perceived burdensomeness.

METHODS

A U.S. nationwide sample of 500 adults (47 % women; mean age = 40.0 ± 11.64) completed a prospective online study, including an initial assessment and four follow-up assessments over the next seven months.

RESULTS

Results revealed a significant indirect relation between BPD symptoms and greater suicide risk over time through greater ER difficulties and later perceived burdensomeness. Results also provided evidence for transactional relations between BPD symptoms and ER difficulties and suicide risk over time.

LIMITATIONS

All constructs were assessed via self-report questionnaire data. Our measure of suicide risk focuses on only suicidal ideation, plans, and impulses, and not suicide attempts or preparatory behaviors.

CONCLUSIONS

Results highlight both ER- and interpersonal-related factors as key mechanisms underlying suicide risk among community adults with BPD symptoms.

The relationship between negative peer relationship and non-suicidal self-injury in Chinese adolescents: A moderated-mediation model

Objective

The objective of the study was to investigate the mediating effect of regulatory emotional self-efficacy (RESE) between negative peer relationship and non-suicidal self-injury (NSSI), as well as the moderating effect of gender difference.

Methods

A study of 578 Chinese adolescents (46.9% males, mean age = 16.32 years, SD =0.54) was conducted using the Child and Adolescent Peer Relationship Inventory, Regulatory Emotional Self-Efficacy Scale, and the Adolescent Self-Injury Questionnaire.

Results

Negative peer relationship was positively correlated with NSSI, and RESE was negatively correlated with negative peer relationship and NSSI. RESE mediated the association between negative peer relationship and NSSI. The first stage(predicting the effect of negative peer relationship on RESE) and the second stage (predicting the effect of RESE on NSSI) of the mediation effect of RESE were both moderated by gender. Specifically, compared with boys, the effect of negative peer relationship on RESE was stronger for girls, and the effect of RESE on NSSI was stronger for girls than boys.

Conclusion

Negative peer relationships may influence NSSI of adolescents through the mediating effect of RESE and the moderating role of gender.

Resilience to suicidal behavior in young adults: a cross-sectional study

Despite decades of research on suicide risk factors in young people, there has been no significant improvement in our understanding of this phenomenon. This study adopts a positive deviance approach to identify individuals with suicide resilience and to describe their associated psychological and sociodemographic profiles. Australian young adults aged 18–25 years with suicidal thoughts (N = 557) completed an online survey covering sociodemographic, mental health status, emotion regulatory and suicide-related domains. Latent class analysis was used to identify the individuals with suicide resilience. The predictors of suicide resilience were assessed using logistic regression models. The results suggested that one in ten (n = 55) met the criteria for suicide resilience. Factors that had a significant association with suicide resilience included greater cognitive flexibility, greater self-efficacy in expressing positive affect, reduced use of digital technology and less self-harm and substance use as a response to emotional distress. This study identified the factors that may protect young adults with suicidal thoughts from progressing to suicide attempts. Suicide prevention programs might be optimised by shifting from a deficit-based to a strength-based approach through promoting cognitive flexibility, self-efficacy and reducing maladaptive coping.

Suicidal behavior in Mexican adolescents: A test of a latent class model using two independent probability samples

Suicidal behavior is a serious health issue that affects the adolescent population and that may be prevented through evidence-based approaches. There are many risk factors involved in suicidal behavior, but there are few studies encompassing the complex relationships between them. This study tested the similarity between two latent class models from two different epidemiological samples of middle-school students and evaluated if the multinomial regression model replicated the associations between the classes and the psychosocial variables. Data of 4013 adolescents from the Mexican states of Campeche and Querétaro were included in LCA to characterize suicide behavior and associated factors. The most likely latent class membership was used as the outcome in multinomial regression models. The model with data from Querétaro was consistent with the previous LC model from Campeche. The four latent classes were nearly identical for both populations and can be defined as follows: 1) "No Problems," included 73% of the adolescents; 2) "Drug Use Only," comprised 7% of the adolescents; 3) "Suicidal Behavior, No Depression," captured 8% of the adolescents (25% reported binge drinking in the past month, 50% self-inflicted injuries, and 43% low-lethality suicide attempt); 4) "Depression and Suicidal Behavior," comprised 12% of the sample (66% met criteria for Major Depressive Episode, 28% reported binge drinking in the past month, and 11% had a high-lethality suicide attempt). The congruence between the models and the consistency with identified factors highlight the need for appropriate and effective prevention strategies to minimize risk factors and reinforce protective factors in the adolescent population.

Emotion Regulation as a Risk Factor for Suicide Ideation among Adolescents and Young Adults: The Mediating Role of Belongingness

Thwarted belongingness is an established predictor of suicide ideation. Emerging theory suggests belongingness may be a crucial pathway through which risk factors such as dysfunctional emotion regulation influence suicide ideation. This study examined whether belongingness mediated the relationship between emotion regulation and suicide ideation in young people (16-25 years). Participants (n = 1699; 63.6% females, M = 20.24 years, SD = 2.45 years) completed measures of these constructs, including the emotion regulation domains of internal-functional, internal-dysfunctional, external-functional, and external-dysfunctional. Belongingness mediated over half of the association between three emotion regulation domains and suicide ideation (internal-functional: 55.6%, internal-dysfunctional: 54.1%, and external-functional: 64.8%). Consistent with current etiological suicidality models, results suggest low belongingness is an important precursor to suicide ideation in young people, and that there is an inter-relationship between emotional regulation styles and belongingness.