Non-suicidal self-harm (NSSH) include deliberate behaviours with the intent to self-injure. NSSH prevalence ranges 15.5%-31.3% in adolescents and young adults<25 years-old.

Our aim is characterizing the psychopathological domains occurring in adolescent and young adults with NSSH during the second COVID-19-related wave (October 2020-August 2021).

A cross-sectional study recruited inpatients aged 15-24 consecutively afferent to psychiatric ward due to NSSH, by investigating anger rumination(ARS), emotional regulation (DERS), dissociation (DES-II), metacognitive capabilities(MCQ-30), perceived stress (PSS), self-criticism (LOSCS), emotional intelligence (Reading the Mind in the Eyes Test-RMET), aggressiveness (AQ), impulsiveness (BIS-11), hopelessness(BHS), alexithymia (TAS-20). NSSH were characterized by using suicide score scale(SSS) and deliberate self-harm interview (DSHI).

A 7-fold increase in young inpatient access was observed from 2019 to 2021. DSHI median was 2 (95%CI=1,17-2,73), SSS-12months median was 5 (95%CI=4.2-6.7), SSS-lifetime median was 5 (95%CI=3.4-5.3) and MINI median was 5 (95%CI=3.4-4.7). Linear regression analysis and Pearson’s correlations revealed strong correlations between DSHI and BHS (r=0.550), TAS-20 (r=0.495), AQ-hostility(r=0.529),AQ-total (r=0.446), PSS(r=0.454), DERS-total (r=0.621), DERS-lack_of_control (r=0.658),MCQ-total(r=0.534),MCQ-perception_danger_not_control (r=0.583); between SSS-12months and AQ-total (r=0.456), AQ-Anger (r=0.443), BIS-total(r=0.457),BIS-Attentional-Impulsiveness (r=0.511),BIS-Complex-Motor-Impulsiveness (r=0.507), PSS (r=0.617), DERS(r=0.571), DES(r=0.559).

COVID-19-related increased perceived stress and depressive symptomatology may have facilitated the onset of severe NSSH in adolescents and young people with trait impulsiveness, hostility and affective dysregulation.

No significant relationships.

Previous studies underline the importance of internalising disorders as risk factors of nonsuicidal self-injury (NSSI), meanwhile only a few research draw the attention to the role of externalising disorders. The possible association between NSSI and pathological internet use (PIU) is also understudied.

The purpose of this study was: 1) to investigate the frequency of NSSI among adolescents with different psychopathology and in different internet user groups of adolescents, 2) to understand the mediator role of psychiatric disorders between NSSI and PIU.

Adolescents were enrolled from a clinical (Vadaskert Child Psychiatric Hospital, Budapest, Hungary) and a school based population (high schools in Budapest, Hungary). The used measurements were: Strengths and Difficulties Questionnaire (SDQ), Deliberate Self-Harm Inventory, Young Diagnostic Questionnaire for Internet Addiction, Mini International Neuropsychiatric Interview Kid.

There was significant difference in the frequencies of NSSI in SDQ subgroups (U=2127.000; z=-6.170; p <0.001). There was also significant difference in NSSI frequency between normal- and pathological internet users (U=2020.000; z=-2,501; p <0.017 p=0.012). According to the mediator model there was no direct association between PIU and NSSI, however it was mediated by different psychiatric disorders (affective disorders, anxiety disorders, attention deficit/hyperactivity disorder, conduct disorder, opposition defiant disorder, psychoactive substance abuse/dependence, psychotic disorders, suicidal behavior).

The results strengthen that both internalising- and externalising psychopathology are associated with NSSI. Moreover this study underlines the importance of careful screening and treating of comorbid disorders with PIU, which can have a role in the prevention of NSSI and suicide as well.

No significant relationships.

DSM-5 defines non-suicidal self-injury (NSSI) as socially unaccepted, direct, repeated and deliberate harm done to one’s own body. It is estimated that in a general population approximately 13-29% of adolescents present NSSI, and 70-80% among hospitalized youth. It seems that emotional dysregulation is the core characteristic of NSSI manifesting by self-harm behaviors, impulsiveness, lack of emotional awareness and experiencing high intensity of negative emotion. Emotional dysregulation is a pivotal characteristic of NSSI. Rationale of this theory is provided by the results of psychological and psychophysiological studies as well as those presenting brain activity. Neuroimaging data point to a variant pattern of brain activity of adolescents with NSSI during perception of emotionally negative stimuli i.e. hyperactivity in amygdala – a structure responsible for fear and automatic reaction to exciting stimuli and low activity of inferior frontal gyrus area – a structure responsible for inhibition and interpretation of social interactions. This activity pattern suggests a disorder of cortico-subcortical neuronal connections.

The aim was to verify tDCS as a therapeutic aid for patients who exhibit NSSI despite implementation of pharmacotherapy and psychotherapy.

We investigated the modulation effect of tDCS treatment at the right inferior frontal gyrus (rIFG) in hospitalized adolescents with NSSI.

Preliminary tDCS stimulation results indicate potential usefulness of this method in regulating emotions and improving executive functions.

Prefrontal cortex stimulation may restore balance in aforementioned connections and, as a result, positively influence an emotional regulation i.e. lower the impulsiveness, agitation and, by doing so, decrease NSSI frequency.

No significant relationships.

Transsexual adolescents frequently present psychiatric comorbidities and psychopathology among which self-injurious behaviours are prominent (Modrego Pardo et al., 2021). GAHT seems to decrease the rate of mental health problems especially in terms of anxiety, depression and hostility (Heylens et al., 2014). However the impact of exogenous cross-sex hormones on non-suicidal and suicidal self-injurious behaviours is not thoroughly understood (Claes et al., 2015).

We present the case of a transsexual boy who was first diagnosed with depression and benign self-injurious behaviours and subsequently - transsexualism.

He was prescribed a treatment with testosterone depot injections in fortnight intervals. The initiation of testosterone injections co-occurred with the switching of antidepressant drug. Self-injurious behaviours, substance abuse and suicidal attempts were observed regularly after GAHT onset – 10-14 days after a testosterone injection. The lethality and intensity of self-harm was greater than that observed before GAHT. After admission to the psychiatry unit pharmacotherapy was adjusted accordingly to presented symptoms. Remission of self-injurious behaviours followed.

The incidence of self-injury 10-14 days after the injection of depot testosterone overlaps the peak of serum testosterone levels in treated patients (O’Connor et al., 2004). Moreover, a relative serotonin deficiency in a depressed patient may be insufficient to counteract testosterone believed to be driving aggressive tendencies (Batrinos, 2012).

Since psychiatric comorbidity and psychopharmacotherapy in transsexual young population is the rule rather than the exception, careful monitoring and therapy adjustment is crucial for maintaining safety and obtaining best results (Kaltiala et al., 2020).

No significant relationships.

Tobacco smoking (TS) is a major public health concern worldwide because of its association with a number of unfavorable health-related outcomes. According to recent studies TS negatively affects both physical and mental health. Suicidal ideation (SI) is more prevalent in people with mental disorders than in the general population. Factors associated with the transition from SI to suicide attempt (SA) should be detected to prevent suicide in this high-risk population.

The aim of the study is to evaluate the influence of tobacco smoking on risk of lifetime suicide plan (SP), SA and nonsuicidal self-injury (NSSI) in patients with nonpsychotic mental disorders (NPMD) and SI.

Four hundred and 78 consecutive patients with NPMD and SI were included into the study. All patients were evaluated by a psychiatrist, underwent Self-Injurious Thoughts and Behavior Interview as well as semi-structured interview designed to gather information on demographic and biographical features. Mann-Whitney, Fishers exact test, chi-square test and stepwise logistic regression were used as statistical methods.

Three hundred and 24 (67.8%) patients have smoked at least 100 cigarettes in their entire life. No differences were found between smokers and non-smokers in terms of age, gender, educational and occupational statuses as well as age at onset of self-injurious thoughts and behavior, and total number of SP, SA and NSSI (all: p>0.05). The lifetime smokers were at higher risk of SA (OR=2.379; 95% CI 1.58-3.581: p<0.001) and NSSI (OR=1.591; 95% CI 1.064-2.38: p=0.024).

Lifetime smoking in patients with NPMD and SI is associated with SA and NSSI.

Non-suicidal self-injury (NSSI) is a clinical condition defined as intentional, self-inflicted act causing pain or superficial damage without suicidal intents (12-35% of the adolescent community). Several findings show a high correlation between NSSI and impairments in the impulsivity control.

The goal of our study is to evaluate the role of impulsivity in NSSI adolescents, relatively to the inhibitory control, in order to investigate if it can represent a neurocognitive risk factor underlying maladaptive behaviours and which psychopathological dimensions can be associated with this neurobiological process.

30 NNSI inpatients (age range: 12 to 18 years), drug-free, were compared with an age-matched control group, using two behavioural paradigms for the study of inhibitory control: the Stop Signal task and the emotive go/Nogo. Psychopathological traits were evaluated by self-report questionnaires for impulsivity dimensions, suicidality and self-injurious acts. Statistical analyses were performed with SPSS program (p =0.05).

NSSI patients did not present impairments in the global inhibitory control but they had longer movement times in both paradigms and faster reaction times in the Go/no-go behavioural paradigm. Therefore, NSSI patients tended to be impulsive at an early stage of movement (rapid TR) and have to slow down in a second phase (TM slow) in order to have time to rework the cognitive processes underlying movement.

The impulsivity dimension is a complex construct that involves multiple interconnected factors. The study of neuro-cognitive and psychopathological aspects and how they are interconnected is necessary to draw new perspectives on the etiopathogenesis of NNSI.

Lower quality of life (QoL) scores are associated with suicidal behavior, both in the general population and in psychiatric patients. Nonsuicidal self-injury (NSSI) behavior is a public health concern because of its increasing prevalence and high risk of lifetime suicide attempt. Despite its significance QoL in patients with NSSI is underinvestigated. There is a gap in knowledge on the influence of suicidal ideation (SI) on certain domains and facets of QoL in patients with NSSI.

The study aimed to assess the impact of SI on QoL of patients with NSSI.

We conducted a case-control study (1:3): 13 consecutive patients (11 female) with non-psychotic mental disorders and NSSI without lifetime SI were compared to 39 age and gender matched patients with NSSI and SI. All patients were evaluated by a psychiatrist, underwent Self-Injurious Thoughts and Behaviors Interview (Nock MK et al., 2007) and filled out the World Health Organization Quality of Life Assessment 100 (WHOQOL-100). Mann-Whitney and Fishers exact test were used as statistical methods.

The overall QoL (p=0.001) and the perception of life (p=0.005) were significantly higher in patients without SI. Patients with SI had a lower scores in psychological (p=0.002), social (p=0.036) and spiritual (p=0.005) domains as well as lower rates in energy (p<0.02); positive emotions (p<0.001); thinking, learning, memory and concentration (p=0.007); self-esteem (p=0.013); negative emotions (p=0.035); activities of daily living and participation (p=0.014) and opportunities for recreation/leisure facets (p=0.007).

SI in patients with NSSI was found to be associated with worse QoL

People with mental disorders who had same-sex experience (SSE) are at increased risk of self-injurious behavior probably due to the double stigma phenomenon, which severity varies in different societies. So far, there is a knowledge gap on factors associated with SSE in Russian psychiatric patients.

We aimed to investigate variables associated with homosexual experience in Russian patients with non-psychotic mental disorders (NPMD) and suicidal ideation (SI).

In a case-control study (1:1.5): 92 female patients with NPMD and SI with lifetime SSE were compared with 138 patients without homosexual experience. All patients underwent a psychiatric examination, Self-Injurious Thoughts and Behaviors Interview (Nock MK, 2007) and semi-structured interview to assess demographic, clinical, and behavioral features. Mann-Whitney, Fishers exact test and Pearson’s chi-squared were used as statistical methods.

Groups did not differ in education level, marital status, family history of suicidal behavior, traumatic events exposure and lifetime eating disorders (all:p>0.05). More patients with SSE had family history of non-suicidal self-injuries (NSSI), were dissatisfied with their parenting style, had a higher number of unprotected sexual contacts with unfamiliar persons, practiced group sex, had a history of sexual abuse, illicit drug use experience, were smokers, had piercing and severe body modifications. Lifetime history of suicide plan, attempts and NSSI were significantly more common in people with SSE (all:<0.05).

A number of suicide risk factors were found to be more prevalent in people with SSE. Homosexual experience in people with mental disorders is associated with an increased risk of NSSI, suicide plan development and suicide attempts.

No significant relationships.

Nonsuicidal self-injury (NSSI) is prevalent among adolescents and research is needed to clarify the mechanisms which contribute to the behavior. Here, the authors relate behavioral neurocognitive measures of impulsivity and compulsivity to repetitive and sporadic NSSI in a community sample of adolescents.

Computerized laboratory tasks (Affective Go/No-Go, Cambridge Gambling Task, and Probabilistic Reversal Task) were used to evaluate cognitive performance. Participants were adolescents aged 15 to 17 with (n = 50) and without (n = 190) NSSI history, sampled from the ROOTS project which recruited adolescents from secondary schools in Cambridgeshire, UK. NSSI was categorized as sporadic (1-3 instances per year) or repetitive (4 or more instances per year). Analyses were carried out in a series of linear and negative binomial regressions, controlling for age, gender, intelligence, and recent depressive symptoms.

Adolescents with lifetime NSSI, and repetitive NSSI specifically, made significantly more perseverative errors on the Probabilistic Reversal Task and exhibited significantly lower quality of decision making on the Cambridge Gambling Task compared to no-NSSI controls. Those with sporadic NSSI did not significantly differ from no-NSSI controls on task performance. NSSI was not associated with behavioral measures of impulsivity.

Repetitive NSSI is associated with increased behavioral compulsivity and disadvantageous decision making, but not with behavioral impulsivity. Future research should continue to investigate how neurocognitive phenotypes contribute to the onset and maintenance of NSSI, and determine whether compulsivity and addictive features of NSSI are potential targets for treatment.

Little is known about the clinical characteristics and motivations for engaging in non-suicide self-injury (NSSI) behaviors in adolescence. The aim of this study was to examine the prevalence, characteristics and functions of NSSI among adolescents in community settings, and to explore risk factors related to this behavior.

Two hundred and seventy-five adolescents aged 12 to 17 were recruited randomly from different High Schools in Israel. They completed self-report questionnaires assessing NSSI (Ottawa Self-Injury Inventory), depression (Children's Depression Inventory – CDI) and impulsivity (Barratt Impulsiveness Scale – BIS-II).

In the past year, 20.7% of the participants reported engaging NSSI at least once. Among them, 42.1% declared they are still engaging in NSSI at the present. Motives for NSSI were internal emotion regulation reasons, external emotion regulation reasons for social influences. In addition, the NSSI group reported significantly higher levels of depressive, impulsivity and suicidal ideations. Depressive symptoms were found as significant predictors of NSSI in the future.

High rates of NSSI among community adolescents were found. Depression, impulsivity and suicidal ideation were found significantly related to NSSI. Mental health professionals in schools and in primary care should routinely assess NSSI among adolescents.

Despite increased awareness that non-suicidal self-injury (NSSI) poses a significant public health concern on college campuses worldwide, few studies have prospectively investigated the incidence of NSSI in college and considered targeting college entrants at high risk for onset of NSSI.

Using data from the Leuven College Surveys (n = 4,565; 56.8%female, Mage = 18.3, SD = 1.1), students provided data on NSSI, sociodemographics, traumatic experiences, stressful events, perceived social support, and mental disorders. A total of 2,163 baseline responders provided data at a two-year annual follow-up assessment (63.2% conditional response rate).

One-year incidence of first onset NSSI was 10.3% in year 1 and 6.0% in year 2, with a total of 8.6% reporting sporadic NSSI (1–4 times per year) and 7.0% reporting repetitive NSSI (≥ 5 times per year) during the first two years of college. Many hypothesized proximal and distal risk factors were associated with the subsequent onset of NSSI (ORs = 1.5–18.2). Dating violence prior to age 17 and severe role impairment in daily life were the strongest predictors. Multivariate prediction suggests that an intervention focused on the 10% at highest risk would reach 23.9% of students who report sporadic, and 36.1% of students who report repetitive NSSI during college (cross-validated AUCs =.70–.75).

The college period carries high risk for the onset of NSSI. Individualized web-based screening may be a promising approach for detecting young adults at high risk for self-injury and offering timely intervention.

Social media presents an important means for social interaction, especially among adolescents, with Instagram being the most popular platform in this age-group. Pictures and communication about non-suicidal self-injury (NSSI) can frequently be found on the internet.

During 4 weeks in April 2016, n = 2826 (from n = 1154 accounts) pictures which directly depicted wounds on Instagram were investigated. Those pictures, associated comments, and user accounts were independently rated for content. Associations between characteristics of pictures and comments as well as weekly and daily trends of posting behavior were analyzed.

Most commonly, pictures depicted wounds caused by cutting on arms or legs and were rated as mild or moderate injuries. Pictures with increasing wound grades and those depicting multiple methods of NSSI generated elevated amounts of comments. While most comments were neutral or empathic with some offering help, few comments were hostile. Pictures were mainly posted in the evening hours, with a small peak in the early morning. While there was a slight peak of pictures being posted on Sundays, postings were rather evenly spread across the week.

Pictures of NSSI are frequently posted on Instagram. Social reinforcement might play a role in the posting of more severe NSSI pictures. Social media platforms need to take appropriate measures for preventing online social contagion.

Recent studies regarding non-suicidal self-injury (NSSI) among adolescents have focused primarily on individual characteristics (e.g., depressive symptoms) and background factors (e.g., parental relationship), whereas less emphasis has been given to the role of school-related factors in NSSI. Therefore, the purpose of the current study was to explore the relationships between teachers’ support, peer climate, and NSSI within the school context.

The sample consisted of 594 high school students nested within 27 regular classes (54.4% boys; mean age 14.96, SD = 1.33 years). The students were evaluated for NSSI behaviors, perception of teacher support, peer climate, relationships with mothers, and depressive symptoms using validated scales.

The primary analysis used hierarchical linear modeling (HLM), controlling for gender and age. The main findings indicated that teacher support was positively associated with NSSI at the classroom-level (OR = 6.15, 95% CI = 2.05–18.5) but negatively associated at the student-level (OR = 0.66, 95% CI = 0.49–0.89). There was a trend toward an association between positive peer climate and NSSI at the classroom-level (OR = 0.43, 95% CI = 0.18–1.05), while negative peer climate was associated with NSSI at the student-level (OR = 1.37, 95% CI = 1.00–1.87).

School-related factors are associated with NSSI behaviors among students. Teachers and educators should focus on both individual-level and classroom-level perceptions of school context. Students who feel supported by their teachers and who are exposed to a positive peer climate are less likely to engage in NSSI.

Non-suicidal self-injury (NSSI) is the deliberate and direct injuring of body tissue without suicidal intent for purposes not socially sanctioned. Few studies have examined the correlates of NSSI among young adults. This study aimed to identify predictors of lifetime and past-year NSSI, and describe motives for NSSI and disclosure of NSSI to others.

Interviews were conducted annually with 1081 students enrolled in the College Life Study, a prospective longitudinal study conducted at a large public mid-Atlantic university. NSSI characteristics were assessed at Year 4. Demographic and predictor variables were assessed during Years 1 to 4. Multivariate logistic regression models were used to identify correlates of lifetime NSSI and predictors of past-year NSSI.

The prevalence of past-year and lifetime NSSI was 2% and 7% respectively (>70% were female for both lifetime and past-year NSSI). Seven percent of NSSI cases self-injured once, whereas almost half self-injured six or more times. Independent predictors of past-year NSSI were maternal depression, non-heterosexual orientation, affective dysregulation and depression. Independent predictors of lifetime NSSI were depression, non-heterosexual orientation, paternal depression and female sex. One in six participants with NSSI had attempted suicide by young adulthood. The three most commonly reported motives for NSSI were mental distress, coping and situational stressors. Most (89%) told someone about their NSSI, most commonly a friend (68%).

This study identified unique predictors of NSSI, which should help to elucidate its etiology and has implications for early identification and interventions.