Different profiles with multiple risk factors of nonsuicidal self-injury and their transitions during adolescence: A person-centered analysis

Examining trajectories of nonsuicidal self-injury across the first year of university

BACKGROUND

Nonsuicidal self-injury (NSSI) is prevalent among emerging adults in post-secondary school, but little is known about change and stability in NSSI during the transition to university. Moreover, there has been limited person-centered work focusing on heterogeneity in NSSI engagement among students over time. The present study aimed to investigate the development and maintenance of NSSI across the first year of university and explore predictors of potential variability in trajectories of NSSI.

METHODS

The present sample consisted of 1125 first-year university students at a large post-secondary institution (Mage = 17.96, 71 % female, 28 % male, 1 % gender diverse) who participated in a larger longitudinal study. Participants completed an online survey three times over their first year of university. Latent growth curve modeling (LGCM) in Mplus was utilized to explore different NSSI group trajectories across first year university.

RESULTS

NSSI was prevalent among first year students (35 %). LGCM revealed one developmental trajectory; NSSI engagement decreased across the first year of university. Students who engaged in NSSI had increased difficulties with emotion regulation, lower self-compassion, and lower levels of social support compared to students who did not engage in NSSI.

LIMITATIONS

The present study may be subject to recall errors and future studies should include more gender diverse samples to increase generalization of findings.

CONCLUSIONS

Findings highlight the transition to university as a peak period of vulnerability for NSSI engagement and emphasize the need for proactive university intervention efforts to mitigate risk and improve student well-being.

Self-Compassion as a Mediator Linking Sleep Disturbances with Non-Suicidal Self-Injury: A Four-Wave, Cross-Lagged Study

Objective

This longitudinal study examined the reciprocal relationship between sleep disturbances with non-suicidal self-injury and whether self-compassion mediates these associations.

Methods

A total of 5785 freshmen were sampled from a large-scale health-related cohort among Chinese college students at the baseline. This study spanned six waves with a six-month interval between each wave. Data from the last four waves were used because self-compassion or non-suicidal self-injury was not measured in the first two waves. The cross-lagged panel models were used to examine the longitudinal dynamic relationships between sleep disturbances, self-compassion, and non-suicidal self-injury.

Results

The results showed that all the auto-regressive paths were significant. For the cross-lagged paths, there was a reciprocal relation between sleep disturbances and self-compassion. Importantly, self-compassion played a longitudinal mediating role in the prediction from sleep disturbances to non-suicidal self-injury (indirect effect = 0.007 to 0.009, all p values < 0.001).

Conclusion

Psychological interventions targeting improved sleep quality and self-compassion may hold great promise for reducing the incidence of non-suicidal self-injury.

Gender-Specific Trajectories of Non-Suicidal Self-Injury among Adolescents: Predictive Roles of Distal and Proximal Risk Factors

Non-suicidal self-injury (NSSI) is considered a strong risk factor for suicide. Although NSSI is prevalent among adolescents and varies by gender, few studies have examined the gender-specific trajectory of NSSI and its predictors. This study examined the trajectory of NSSI among Chinese adolescent boys and girls separately, and the roles of distal (i.e., childhood maltreatment and its specific subtypes) and proximal risk factors (i.e., emotional dysregulation, peer victimization) on their trajectories. A total of 3290 Chinese adolescents (Mage = 13.08; SD = 0.84; 57.6% boys) participated in assessments at three time points. Latent class growth models identified three trajectories for boys: Low stable (92.5%), moderate increasing (5.0%) and high decreasing (2.5%). Four trajectories were identified for girls: Low stable (87.9%), moderate increasing (7.6%), high decreasing (3.0%) and high stable (1.5%). Multinomial logistic regression analyses revealed that both emotional dysregulation and emotional abuse predicted the trajectories of moderate increasing, high decreasing and high stable for girls, as well as predicted moderate increasing and high decreasing trajectories for boys. Peer victimization served as a significant risk factor predicting the moderate increasing and high decreasing trajectories only for girls, while overall childhood maltreatment was a remarkable predictor for the moderate increasing and high decreasing trajectories of boys. The findings highlighted the importance of gender differences in understanding the progression of NSSI and the key predictors, informing effective strategies for prevention and intervention.

Identifying high-risk subgroups for self-harm in adolescents and young adults: A longitudinal latent class analysis of risk factors

BACKGROUND

Self-harm is a major public health concern in young people and is governed by a complex interaction of different risk factors. While many studies have identified these risk factors, less is known about how they tend to co-occur together.

METHODS

A latent class analysis was conducted using risk factors for self-harm from two waves at ages 13 and 17 from the Growing Up in Ireland (GUI) study their associations with self-harm were examined longitudinally at ages 17 and 20, respectively.

RESULTS

At age 13, there was a 'peer problems' group with higher probabilities of bullying, being unpopular and internalising problems and a 'school and substance use problems' group with higher probabilities of substance use, truancy or excessive absence from school and violence. Both of these two groups had over a two-fold risk of self-harm at age 17 in comparison to the low risk factor group. At age 17, there was a group with depression that was diagnosed by a medical professional with the highest relative risk (RR:13.9 (95 % CI 10.2-19.0)) of self-harm at age 20. Two other groups with undiagnosed depression had high probabilities of being bullied, and either high or low probabilities of substance use that had a 9.4 (95 % CI 6.8-13.1) and 7.4 (95 % CI 5.5-10.0) relative risk of self-harm at age 20, respectively.

CONCLUSIONS

Identifying hidden sub-groups using risk factors for self-harm in young people can inform potential public health interventions by clinicians and other professionals who work with young people.

The impacts of latent profiles and transitions of stresses on adolescent mental health: A person-centred analysis

Research has demonstrated robust links between adolescent stress and serious psychological problems. The current study aimed to identify latent stress profiles of 1510 adolescents (59.7% females; Mage  = 16.77 years, SD = 0.86) based on five stresses (parental stresses, family environment stresses, academic stresses, teacher stresses, and peer stresses) at three time points (T1/2/3). Moreover, this study would investigate the transition patterns of these profiles over time and examine the associations between the profiles and adverse psychological symptoms (e.g., anxiety, depression, nonsuicidal self-injury [NSSI], and suicidal ideation). Three latent stress profiles were identified, including High-stress profile, Medium-stress profile, and Low-stress profile. The three profiles were significantly different on the levels of T1/2/3 anxiety, depression, NSSI, and suicidal ideation. The profile memberships remained relatively stable across three time points. Notably, the present study found gender differences, with boys were more likely to be in the High-stress profile and to transition from the Medium- to the High-stress profile, compared to girls. Furthermore, left-behind adolescents were more likely to be in the High-stress profile than non-left-behind adolescents. The findings highlight the importance of adopting 'this-approach-fits-this-profile' interventions for adolescents. Parents and teachers are advised to adopt different strategies for girls and boys.

Longitudinal relationship between child maltreatment, bullying victimization, depression, and nonsuicidal self-injury among left-behind children in China: 2-year follow-up

BACKGROUND

Left-behind childre (LBC) in China are deeply concerned by society because of their high risk of emotional and behavioral problems. Depression and nonsuicidal self-injury are the most harmful and worrying negative emotional and behavioral problems in LBC. Unfortunately, LBCs are in unfavorable environments for a long time and are prone to negative interpersonal interactions. Child maltreatment and bullying victimization, as the two most typical negative interpersonal interactions in family and school environments, maybe the key risk factors for depression and nonsuicidal self-injury among LBCs. However, we are less known of the longitudinal effects of child maltreatment and bullying victimization on LBC's depression and nonsuicidal self-injury and their underlying mechanisms.

AIMS

This study used a two-year longitudinal design with three-time points to investigate the longitudinal effects of child maltreatment and bullying victimization on depression, nonsuicidal self-injury, and the mediating role of negative thoughts and self-compassion.

MATERIALS & METHODS

A sample of 592 LBC (390 were males, Mage at time 1 = 9.56, SDage = 0.65; 202 were females, Mage at time 1 = 9.43, SDage = 0.63) completed a set of questionnaires at three-time points. This study used SPSS software (version 25.0) and MPLUS software (version 8.3) for all analyses.

RESULTS

(1) Child maltreatment not only affects depression and nonsuicidal self-injury but also affects depression and nonsuicidal self-injury through negative thoughts. Child maltreatment affects depression through self-compassion and does not affect nonsuicidal self-injury. (2) Bullying victimization affects depression and nonsuicidal self-injury through negative thoughts and bullying victimization further affects depression through self-compassion but does not affect nonsuicidal self-injury.

CONCLUSION

This study revealed the effects of negative interpersonal interactions (child maltreatment, bullying victimization) on LBC's adverse emotions and behaviors, and their underlying mechanisms, which helps to provide parents, schools, and psychoeducational workers with a new perspective on intervention.

Profiles, Transitions, and Resilience Factors of Suicide Risk in Early Chinese Adolescents

As a severe public health concern directly endangering life safety, adolescent suicide has been extensively investigated in variable-centered studies. However, gaps remain in the knowledge of heterogeneous suicide risk patterns and their developmental nature. Additionally, little is known about protective factors associated with suicide risk patterns and changes. This study applied person-centered approaches to explore suicide risk profiles and transitions over time in early Chinese adolescents, along with their protective factors. A total of 1518 junior high school students (49.6% girls, Mage = 13.57, SD = 0.75) participated in two surveys within a 12-month interval. Latent Profile Analysis and Latent Transition Analysis were used to model the profiles and transitions of suicide risk. Three risk profiles were identified at both time points: low risk profile (73.9, 78.3%), medium risk-high threat profile (16.2, 10.2%), and high risk profile (9.9, 10.2%). Low risk profile was stable, while medium risk-high threat and high risk profiles showed great transitions over 12 months. Sense of control, meaning in life, and regulatory emotional self-efficacy served as protective factors against suicide risk profiles and transitions. Findings underscore the importance of comprehensively illustrating suicide risk states from multiple aspects, as well as understanding the fluid nature of transitions between different risk states. Prevention and intervention strategies aimed at enhancing resilience, such as increasing sense of control, perceived meaningfulness, and belief in emotional regulation, may contribute to reducing the risk of suicide among adolescents.

Associations between insomnia symptom trajectories with depression and self-harm behaviors in Chinese college students before and during the COVID-19 pandemic: A five-wave longitudinal investigation

BACKGROUND

Sleep problems are highly prevalent during COVID-19 pandemic. However, only very limited studies have examined the changing patterns of insomnia symptom before and during the COVID-19 pandemic, and most of these studies were limited to two-wave designs and the variable-centered approach.

METHODS

The data was taken from a large-scale health-related cohort among Chinese college students. This cohort was a five-wave design and 3834 participants who completed at least two waves were included in the present study. Growth mixture modeling (GMM) was used to estimate trajectory classes for insomnia symptoms, followed by binary logistic regression to explore the association between trajectory classes and subsequent mental health problems.

RESULTS

GMM analyses extracted four distinct trajectories of insomnia symptoms: stable-low pattern (n = 2897, 75.6 %), increasing pattern (n = 405, 10.6 %), decreasing pattern (n = 182, 4.7 %), and stable-high pattern (n = 350, 9.1 %). Additionally, we found that individuals in stable-high and increasing patterns were more likely to experience mental health problems after the COVID-19 pandemic even after adjusting significant covariates and outcomes at baseline.

CONCLUSIONS

Appreciable heterogeneity in insomnia symptoms among college students was revealed before and during the COVID-19 pandemic. About 20 % of college students were classified as high-risk patterns of insomnia symptoms. Psychological interventions should target such vulnerable groups to reduce the rates of mental health problems.

Profiles and Transitions of Non-Suicidal Self-Injury and Depressive Symptoms among Adolescent Boys and Girls: Predictive Role of Bullying Victimization

Although non-suicidal self-injury (NSSI) and depressive symptoms often co-occur, as well as display distinct profiles in different genders, few studies examined the gender-specific profiles and transitions of NSSI and depressive symptoms among adolescents and the role of bullying victimization on their profiles and transitions. This study examined the profiles and transitions of NSSI and depressive symptoms for Chinese adolescent boys and girls separately, along with the predictive role of bullying victimization in subgroup memberships and transitions. A total of 3510 adolescents (52.9% boy, M age = 13.36, SD = 0.50) participated in two waves of the study over six months. The results indicated that four and three profiles identified for girls and boys separately. Adolescents in at-risk profiles showed varying degrees of transition. Adolescents with more bullying victimization were more likely to belong or transition to at-risk profiles for both genders, and bullying victimization exacerbated girls transitioning into co-occurring high profile but not in boys. The findings indicate distinct profile and transition patterns of NSSI and depressive symptoms, as well as different risk role of bullying victimization on their profiles and transitions in boys and girls, highlighting the importance of gender differences in understanding co-occurring and transitional nature of NSSI and depressive symptoms and the risk role of bullying victimization, informing effective strategies for prevention and intervention.

Sexual Minority Stigma and Nonsuicidal Self-Injury Among Sexual Minorities: the Mediating Roles of Sexual Orientation Concealment, Self-Criticism, and Depression

Introduction

Nonsuicidal self-injury (NSSI), a significant predictor of suicide, is more frequent in sexual minorities (e.g., lesbian, gay, and bisexual) than in heterosexuals. The Minority Stress Model proposed that sexual minority stigma (SMS) may lead to maladaptive behaviors, including NSSI. However, the potential mechanism underlying the relationship between SMS and NSSI remains unclear. Therefore, the current study will examine the relationship between SMS and NSSI, and explore the serial mediating roles of sexual orientation concealment (SOC), self-criticism, and depression.

Methods

A total of 666 individuals who self-identified as sexual minorities (64.0% male, M age = 24.49 years, SD = 6.50) completed questionnaires of SMS, SOC, self-criticism, depression, and NSSI, in 2020.

Results

The findings indicated that (1) SMS, SOC, self-criticism, depression, and NSSI were positively correlated; (2) SOC, self-criticism, and depression independently played partial mediating roles between SMS and NSSI; and (3) SOC, self-criticism, and depression played serial mediating roles between SMS and NSSI.

Conclusions

The current study supported the relation between SMS and NSSI among Chinese sexual minorities, and also implied a potential mechanism underlying the relation. Specifically, SMS was related to increased NSSI by higher SOC, self-criticism, and depression. SOC had dual-edged effects on NSSI.

Policy Implications

To reduce NSSI and other psychological problems among sexual minorities, policy makers should take more measures to eliminate SMS. Specifically, policy makers are encouraged to provide more support for changing sexual minorities' living environment, such as repealing bills that could cause SMS and popularizing the knowledge about sexual orientation.