Nonsuicidal self-injury (NSSI) among adolescents is a health concern. Little is known about the patterns of methods adolescents use, in terms of how many and how often different methods are used.

We used three annual waves of data from 630 Swedish adolescents (T1: age 12-18 years; 56% girls), who reported NSSI use at least once. Latent profile analysis was used to examine profile differences, with supplementary analyses focused on differences and change predicted by gender, internalizing, emotion dysregulation, interpersonal stressors, and severity of NSSI.

Three profiles consistently emerged over time: one very low in NSSI, another with higher frequencies of cutting/scraping skin, and one reporting multiple methods of NSSI, ranging from moderate (T1) to high (T3) frequency. Profile subgroups differed: low subgroups consisted of the fewest girls and reported the lowest levels of intra- and interpersonal issues. Additionally, subgroups differed in severity of NSSI, suggesting damage to the skin may not be the only reason medical attention is needed. Significant change in subgroup membership was also observed.

Although most adolescents engaged in NSSI at very low rates, many used multiple forms, differing in both frequency and versatility. Few differences were found between subgroups characterized by higher frequencies, suggesting that it might be possible to identify adolescents most in need of treatment by attending to the methods most frequently used. Results also suggested that measuring the severity of each method may yield more accurate information than a priori groupings.

Non-suicidal self-injury (NSSI) is highly prevalent in recent years, but the genetic architecture remains unknown. We perform a multitrait analysis of genome-wide association study on NSSI, incorporating self-harm and suicide attempt. Common genetic variants account for 6.03% of NSSI variance. Three risk loci are associated with NSSI at 7q31.2 (rs62474683), DCC (rs4372758), and LCA5L/GET1/GET1-SH3BGR (rs2837022). Increased expression levels of GET1/SH3BGR in hippocampus relates to NSSI risk. Fine-mapping identifies seven likely causal variants, and colocalization with rs4281987 and rs2837022 evidences SH3BGR/GET1 expression in hippocampus to NSSI. In an independent sample, polygenic risk score for NSSI is associated with children's NSSI behavior, suicidal ideation, and suicide attempt (odds ratios [ORs]: 1.14-1.37). Reduction in right temporal pole volume mediates NSSI genetic liability for children's NSSI behavior. Walking for pleasure and exercises like swimming and bowling reduces NSSI risk, whereas smoking increases it. This study elucidates the NSSI genetic basis and its impact on children's emotions, behavior, and brain structure.

Disruptions in melatonin (MT) rhythms have been linked to major depressive disorder (MDD) and may be further associated with non-suicidal self-injury (NSSI). This study investigates whether MDD patients with NSSI exhibit more pronounced MT rhythm disturbances and whether these disruptions correlate with NSSI-related thoughts and the motivation to cease self-injury.

The study included 100 participants aged 14-24 years, including 30 healthy controls (HC) and 70 inpatients diagnosed with MDD. The MDD group was further divided into those with NSSI (NSSI group, n = 35) and those without NSSI (Non-NSSI group, n = 35). Salivary MT levels were measured at six intervals (12 a.m., 8 a.m., 11 a.m., 1 p.m., 4 p.m., and 10 p.m.) using enzyme-linked immunosorbent assay (ELISA). The Ottawa Self-Injury Inventory (OSI) assessed NSSI perception and motivation in the NSSI group.

Melatonin levels were significantly lower across all six time points in the NSSI group compared to both the Non-NSSI and HC groups (P < 0.05), and MT circadian rhythms were notably absent in the NSSI group. Correlational analysis revealed specific associations between MT levels and NSSI behavior, with MT levels at 1 PM positively correlated with invasive self-harm impulses (r = 0.487, P = 0.003, 95% CI: 0.141 to 0.834) and MT levels at 8 a.m. and 11 a.m. inversely correlated with the desire to stop self-injury (r = -0.427, P = 0.010, 95% CI: -0.774 to -0.081; r = 0.348, P = 0.040, 95% CI: 0.002 to 0.695, respectively).

Lower MT levels and disrupted circadian rhythms are associated with NSSI in MDD patients, highlighting a potential link between circadian dysfunction and self-injurious behaviors. Further research is needed to clarify the underlying mechanisms of this association.

Non-suicidal self-injury (NSSI) is a common and serious injury behavior in children and adolescents, however, its treatment remains controversial. Here, using network meta-analysis (NMA), we compared and ranked all available therapeutic treatment interventions to explore the best treatment strategy for NSSI in children and adolescents.

We searched PubMed, Embase, the Cochrane Library and PsycINFO for randomized controlled trials used to reduce the frequency of NSSI in children and adolescents from database inception until Jan. 11, 2025. Primary outcomes were efficacy and acceptability. We estimated summary odds ratios (ORs) with credible intervals (CIs) in random effects models.

We included 28 trials comprising 6496 participants. Dialectical behavior therapy (DBT) was better than other interventions. In subgroup analysis, pharmacotherapy and psychotherapy significantly aggravated the frequency of NSSI in depression (OR = 1.53; 95% CI: 1.10 to 2.14); however, these interventions significantly reduced NSSI in patients with self-harm (OR = 0.53; 95% CI: 0.30 to 0.96). We also found that NSSI was significantly increased in the first 3 months when using SSRIs in treatment but was significantly reduced after 3 months.

Psychotherapy seems to be a better choice than pharmacotherapy, especially DBT. DBT was associated with a better reduction in the frequency of NSSI than treatment as usual, with high confidence of evidence. NSSI is frequently used to combat depression symptoms, suggesting that clinicians should pay greater attention to depression symptoms to reduce NSSI, especially in the first 3 months of treatment with SSRIs.

Trauma exposure (TE) and cognitive flexibility (CF) are risk factors for self-injurious thoughts and behaviors (SITBs). However, it is unknown whether these risk factors contribute to mechanisms associated with distinct categories of SITBs. The current study examined the potential moderating role of TE in the relationships between CF and multiple SITBs, including active suicidal ideation (SI), passive SI, non-suicidal self-injury (NSSI), and history of suicide attempt (SA), among pre-adolescent children.

A total of 11,326 children from the Adolescent Brain Cognitive Development study were included in the present study. SITBs and TE were measured by the Kiddy Schedule for Affective Disorder and Schizophrenia (KSADS). CF was measured using the NIH Cognitive Toolbox.

Cumulative TE moderated the relationship of CF to active SI. Higher CF was associated with lower odds of current SI in children with a single lifetime TE, but not in children without trauma or with two or more TE. As a main effect, two or more TE predicted higher odds of active SI, passive SI, and lifetime SA, but not NSSI. Higher CF was associated with lower odds of passive SI, with effects not moderated by trauma exposure.

The current results clarify previously inconsistent findings about the relationship of CF to SI by identifying cumulative TE as a moderator. CF served as a protective factor against SI, but only in children with a single lifetime trauma. Implications for screening and treatment targets of children at risk for distinct categories of SITBs are discussed.

Non-suicidal self-injury (NSSI) is an increasingly recognized clinical and public health issue among adolescents. This behavior exhibits certain addictive characteristics, leading it to be classified as a behavioral addiction. Response inhibition is believed to play a role in the occurrence of addictive behaviors and is often impaired in the context of negative emotional states. In this study, we compared the behavioral performance, ERP time-domain and time-frequency characteristics among depressed adolescents with NSSI, depressed adolescents, and healthy controls when exposed to negative emotional stimuli. The aim was to investigate the impact of negative emotional stimuli on the response inhibition in depressed adolescents with NSSI, clarify the role of response inhibition in NSSI behaviors, and provide neurophysiological evidence for its underlying mechanisms.

Seventy-one depressed adolescents with NSSI (MDD+NSSI group: 12 males, 59 females; mean age: 14.37 years), 55 depressed adolescents (MDD group: 24 males, 31 females; mean age: 15.29 years) and 25 healthy subjects (HC group, 13 males, 12 females, mean age: 15.72 years) were recruited to perform a two-choice oddball task related to negative emotional cues. All participants completed a self-administered questionnaire to gather demographic information. A trained psychiatrist administered the Hamilton Depression Scale (HAMD-17) to assess depression severity and used the Ottawa Self-Injury Inventory (OSI) to assess self-injury. Multichannel EEG was recorded continuously from 64 scalp electrodes using the Curry 8 system. EEG signal preprocessing and analysis was performed offline using the EEGLAB toolbox in MATLAB. The ERP time-domain features related to response inhibition were extracted from the difference waves, converted to the time-frequency features using the short-time Fourier transform (STFT), and the time-frequency values of the region of interest (ROI) were extracted and statistically analyzed.

Under exposure to negative emotional stimuli, depressed adolescents with NSSI exhibited significantly larger P300 amplitudes compared to both depressed adolescents and healthy controls. Moreover, depressed adolescents with NSSI showed significant event-related synchronization (ERS) in the Delta and Theta bands of FCz electrode from 0 to 0.6 seconds, and event-related desynchronization (ERD) in the Theta and Alpha bands of Pz electrode from 0.2 to 1.2 seconds, collectively reflecting functional processes associated with response inhibition.

Depressed adolescents with NSSI showed increased P3d amplitudes, enhanced Delta/Theta ERS, and heightened Theta/Alpha ERD when receiving negative emotional stimuli, suggesting that depressed adolescents with NSSI have impaired response inhibition, which may contribute to the development of NSSI.

Interpersonal dysfunction robustly predicts suicide attempts (SA) and non-suicidal self-injury (NSSI) in adolescents. We sought to better elucidate how two interpersonal constructions (interpersonal sensitivity and social problem-solving strategies) may lead to NSSI vs. SA in adolescents.

We compared non-overlapping groups of adolescents engaged in either SA (n = 49, Mage = 15.80, SD = 1.23, 63% female) or NSSI (n = 50, Mage = 15.35, SD = 1.34, 82% female), and healthy controls (HC; n = 43, Mage = 15.46, SD = 1.30, 61% female). We hypothesized: (1) greater interpersonal sensitivity and deficits in social problem-solving strategies would differentiate the three groups and indicate higher risk for being in the NSSI and SA groups, relative to the HC groups, and (2) amongst clinical groups, there would be greater deficits in social problem-solving in the SA group, and greater interpersonal sensitivity in the NSSI group.

NSSI and SA groups demonstrated more interpersonal sensitivity and lower (i.e., worse) social problem-solving skills vs. HCs. Participants were more likely to be in both the SA and NSSI groups based on interpersonal sensitivity (ORSA = 2.61; ORNSSI = 2.75) and social problem-solving (ORSA = 19.11; ORNSSI = 10.89). Significant differences were observed between the NSSI and SA groups on interpersonal sensitivity [t(97) = 4.28, p < .001, d = 0.86; higher levels in the NSSI group], but not on social problem-solving [t(97) = 1.97, p = .052, d = 0.40].

Both greater interpersonal sensitivity and challenges in social problem-solving predict NSSI and suicidal behavior in adolescents, and interpersonal sensitivity may be a particularly salient risk factor for NSSI. Implications for treatment and future research are discussed.

Suicide ideation and attempts are increasing for individuals between the ages of 15 and 24. Emotion dysregulation is a common factor that has been linked to many risky behaviors including NSSI and suicidal ideation. The current study aimed to longitudinally examine how the onset and offset of NSSI associated with changes in emotion regulation domains and suicidal ideation in a community sample of adolescents.

Participants between the ages of 14-17 were asked about NSSI, emotion regulation, and suicide ideation at baseline and 6-month follow-up. Most adolescents reported no NSSI at either timepoint (n = 316; 83 %); 5 % (n = 20) reported NSSI at both time points, 6 % (n = 23) had onset NSSI, and 6 % (n = 23) had offset NSSI. NSSI change groups were compared on emotion regulation domains and suicide ideation across time.

Adolescents who consistently did or did not engage in NSSI across time did not report any changes in emotion dysregulation or suicide ideation. Adolescents who reported an onset of NSSI during the follow-up also reported an increase in lack of impulse control and suicide ideation severity. Adolescents who stopped engaging in NSSI during the follow-up reported significantly better impulse control, better access to emotion regulation strategies, and increased use of reappraisal.

These results hold potential for interventions that help adolescents find alternative coping/emotion regulation strategies outside of NSSI use.

The associations between childhood maltreatment (CM) and mobile phone addiction (MPA), as well as non-suicidal self-injury (NSSI) have been extensively explored. However, the dose-response relationship between CM and NSSI remains inconsistent. Furthermore, there is limited understanding of the potential mediation effect of MPA on the relationship between CM and NSSI. This study aimed to explore the dose-response relationship between CM and NSSI and investigate the potential mediating role of MPA in this relationship.

Cross-sectional study. Cross-sectional study.

In the cross-sectional study, a total of 21481 adolescents were selected using a multi-stage cluster sampling method in China. CM, MPA, and NSSI were obtained via self-reports. Data were analyzed using logistic regression models, restricted cubic spline (RCS) functions, and mediation models.

A total of 38.1 % of adolescents reported engaging in NSSI at least once. Compared with participants without CM, participants with more types of CM (cumulative childhood maltreatment, CCM) had a higher risk of NSSI (P-trend in all models <0.001). RCS further confirmed the dose-response relationships between the continuous change in CM (scores) and the risk of NSSI (P for non-linearity <0.001). Mediation analysis indicated that the relationship between CM (scores) and NSSI was mediated by MPA, and the indirect effect (β = 1.07 × 10-3, 95 % CI: 9.62 × 10-4, 1.19 × 10-3) accounted for 22.23 % of the total effect.

There was a dose-response relationship between CM and the NSSI, and the relationship was mediated by MPA. Interventions targeting MPA may reduce the risk of NSSI among adolescents who have experienced CM, particularly those with CCM.

History of suicide attempts is one of the strongest predictors of adolescent suicide death. Our aim was to improve the comprehension of behavioral and socio-demographical characteristics of adolescent who have attempted suicide which can accelerate preventive and therapeutical measures.

We retrospectively analyzed medical data of 284 psychiatric inpatients aged 13-18. We performed an univariate and multivariate analyses for the whole group and female and male sex separately followed by a logistic regression analysis. The primary outcome measure was history of suicidal attempt (SA).

115 out of 284 analyzed patients (40.5%) - 91 girls (subgroup 1) and 24 boys (subgroup 2) - had a history of SA. In the whole group SA was associated with female gender, cigarette smoking, nonsuicidal self-injury (NSSI) and neglect of emotional or social needs. In the subgroup of girls the most significant association was found between SA and cigarette smoking, followed by neglect of emotional and social needs, NSSI and the older age of receiving psychiatric help. In boys, the history of SA was associated with two factors: cigarette smoking and family victimization.

The only factor that showed significant association with SA consequently throughout all our study was cigarette smoking, which implies that in the high risk adolescents population cigarette smoking might be a more specific characteristic of the history of SA than NSSI and thus should not be neglected during first examination.

This study aimed to elucidate the relationship between cybervictimisation and non-suicidal self-injury (NSSI) behaviours among college students in China, with a particular focus on the mediating roles of emotion dysregulation and social exclusion.

A cross-sectional survey was conducted among a convenience sample of college students.

The study was performed among college students from public universities in Hunan Province, China, between October 26 and November 26, 2023.

A total of 1467 college students aged 19.52±1.16 years participated in the survey.

Data were collected through an online questionnaire that included a general information form, the Ottawa Self-Injury Inventory, the Brief Cyberbullying and Cybervictimisation Scale, the Social Exclusion Questionnaire for Chinese Undergraduates and the Difficulties in Emotion Regulation Scale.

The study sample consisted of 1467 college students, with a mean age of 19.52±1.16 years. Pearson's correlation analysis revealed significant positive correlations between NSSI behaviours and cybervictimisation (r=0.58, p<0.01), social exclusion (r=0.64, p<0.01) and emotion dysregulation (r=0.69, p<0.01). Multivariate regression analysis identified significant predictors of NSSI behaviours, including gender (β=0.06, p<0.05), being a left-behind child (β=-0.20, p<0.05), being the only child (β=0.07, p<0.05), cybervictimisation (β=0.32, p<0.001), emotion dysregulation (β=0.41, p<0.001) and social exclusion (β=0.15, p<0.001). Mediation effect analysis revealed a chain mediation effect where cybervictimisation influenced NSSI behaviours through the mediating roles of emotion dysregulation and subsequent social exclusion (all p<0.001).

This study confirms previous research by highlighting the positive relationship between cybervictimisation and NSSI behaviours, and advances the field by identifying a chain mediation effect involving emotion dysregulation and social exclusion among this relationship. These findings highlight the critical need to incorporate strategies for managing both emotion dysregulation and social exclusion in the prevention and intervention of NSSI behaviours among adolescents exposed to cybervictimisation.

The existing research on the relationship between anxiety and non-suicidal self-injury (NSSI) is inconsistent, and there is no systematic review on this area. This study aims to explore the relationship between anxiety and NSSI, in order to provide evidence-based medicine evidence for the early identification of preventable occurrence factors of NSSI.

The semantic query (i.e. SPARQL) method was used to retrieve the anxiety- related literature on the Knowledge graph of NSSI, which consist of the metadata and semantic annotation data of English literature related to non-suicidal self-injury in PubMed by June 2023. Two researchers strictly followed the inclusion and exclusion criteria for independent literature screening. After evaluating the quality of the included studies, the selected data was subjected to meta-analysis using RevMan5.3 software.

A total of 14 studies met the inclusion criteria of the meta-analysis, including 44064 subjects. The results showed that the proportion of anxiety in the NSSI group was significantly higher than that in the non-NSSI group, and the difference between the groups was statistically significant (OR=3.60, 95% Cl=2.08-6.22, p<0.01).

There is a significant correlation between anxiety and NSSI, which is a possible risk factor for NSSI. However, due to limitations of the design type, quantity, and quality of the included study, further research is needed on the causal relationship between anxiety and NSSI. Furthermore, we show that using knowledge graphs is an effective approach to retrieve literature for meta-analysis.

Non-suicidal self-injury (NSSI) is common among adolescents and frequently co-occurs with depression. Understanding the distinct patterns of NSSI behaviors, along with their associated risk and protective factors, is crucial for developing effective interventions.

To classify NSSI behaviors and examine interactions between risk and resilience factors in Chinese adolescents.

A cross-sectional study involving 3967 Chinese students (51.7% female, mean age 13.58 ± 2.24 years) who completed questionnaires on parenting styles, bullying, childhood maltreatment, depression, resilience, and NSSI. Latent profile analysis (LPA) was used to identify NSSI subtypes, and network analysis explored interactions between risk and resilience factors.

Three NSSI subtypes were identified: NSSI with depression (18.8%), NSSI without depression (12.3%), and neither (68.9%). Bullying was the central risk factor across subtypes, while emotional control and family support were key protective factors. Statistical analyses showed significant differences between groups (P < 0.001).

This study identified three NSSI subtypes among Chinese adolescents. Bullying emerged as a central risk factor, while emotional control and family support were key protective factors. Targeting these areas may help reduce NSSI behaviors in this population.

Non-suicidal self-injury (NSSI) emerged as an escalating health concern in youths worldwide, particularly in the vulnerable. In China, a burgeoning internal migration in human history has been tearing families apart, generating a surging number of left-behind children (LBC) with a lack of parental supervision. Despite the empirical acknowledgment of parental migration as a risk predictor of the NSSI among LBC, there remains a lack of understanding of the specific role of the maternal migration experience.

This study sought to determine the association of maternal migration experience and its characteristics in terms of age at initiation and length with 12-month NSSI among school-aged children.

Data were collected by a self-administrated questionnaire survey conducted among a school-based sample of students in the Anhui province, China.

A total of 2476 participants were analyzed, and the Chi-squared tests and binary logistic regression analysis were employed.

Compared with children whose father is currently migrating and the mother never migrated for work (FM-MN), children whose father never migrated but the mother previously migrated for work (FN-MP, OR = 2.21, 95% CI [1.27-3.84], p < 0.01) and children whose father is currently migrating and the mother previously migrated for work (FM-MP, OR = 1.46, 95% CI [1.00-2.13], p < 0.05) evidenced greater odds of the prevalence of 12-month NSSI. And also, a significantly higher risk for 12-month NSSI was found among FN-MP and FM-MP compared with children whose parents lived in the household and neither had ever migrated for work (FN-MN). For those children with maternal migration experience, while controlling for the paternal migration characteristics, there was no difference between before and after school age at initiation of migration in the risk of NSSI, nor were there any differences across 1-3, 4-6, and more than 6 years of maternal migration length CONCLUSIONS: Findings suggested the potential long-term effect of the experience of maternal migration on children and provided implications for the early identification and prevention of school-aged children at risk for NSSI, particularly within the maternal migrant family context.

Non-suicidal self-injury (NSSI) behavior is a common issue in youth with depression while lacks a prognostic prediction model. This study aims to develop a nomogram for NSSI in youth with depression. A total of 701 patients were included in the analysis based a youth depression cohort. They were further divided into a training set and a validation set. The Lasso regression and binary logistic regression were used to select variables for the nomogram. The nomogram's discrimination, calibration, accuracy, clinical applicability, and generalization involved the use of metrics such as the area under the receiver operating characteristic curve (ROC), Hosmer-Lemeshow (HL) test, Brier score, calibration curve, decision curve analysis (DCA), and internal validation. The Delong test was employed to compare the ROC performance between the two models. These patients had an average age of 19.3+/-3.3 years, and 101 (20.6%) individuals reported NSSI. Five risk factors for NSSI were identified: age, age at first medication, previous instances of NSSI, academic stress score in the Adolescent Self-rating Life Events Check List (ASLEC), and somatic anxiety of the 14 item Hamilton Anxiety Rating Scale (HAMA-14). The training set and validation set of binary logistic regression-based model showed good discrimination (area under the curve (AUC) 0.781, 95% CI: 0.735 ~ 0.827; and 0.757, 95% CI: 0.682 ~ 0.831, respectively), calibration (P = 0.421 and 0.175, respectively), and accuracy (Brier score 0.119 to 0.155 and 0.109 to 0.168, respectively). A prognostic nomogram was developed and validated to assist clinicians in predicting NSSI of youth with depression.

Borderline personality disorder (BPD) is a debilitating condition characterized by pervasive instability across multiple major domains of functioning. The majority of persons with BPD engage in self-injury and up to 10% die by suicide - rendering persons with this condition at exceptionally elevated risk of comorbidity and premature mortality. Better characterization of clinical risk factors among persons with BPD who die by suicide is urgently needed.

We examined patterns of medical and psychiatric diagnoses (1580 to 1700 Phecodes) among persons with BPD who died by suicide (n = 379) via a large suicide death data resource and biobank. In phenotype-based phenome-wide association tests, we compared these individuals to three other groups: (1) persons who died by suicide without a history of BPD (n = 9468), (2) persons still living with a history of BPD diagnosis (n = 280), and (3) persons who died by suicide with a different personality disorder (other PD n = 589).

Multivariable logistic regression models revealed that persons with BPD who died by suicide were more likely to present with co-occurring psychiatric diagnoses, and have a documented history of self-harm in the medical system prior to death, relative to suicides without BPD. Posttraumatic stress disorder was more elevated among those with BPD who died by suicide relative to the other PD group.

We found significant differences among persons with BPD who died by suicide and all other comparison groups. Such differences may be clinically informative for identifying high-risk subtypes and providing targeted intervention approaches.

It is challenging to predict the occurrence of non-suicidal self-injury (NSSI) among adolescents over short periods. Moreover, the predictive value of indices for NSSI remains elusive. Thus, this study aimed to identify predictors of NSSI within 6 months among adolescents after psychiatric hospitalization by establishing a risk assessment model.

A total of 632 high-risk participants were included in this study. The distribution characteristics of adolescent NSSI were initially assessed through a cross-sectional survey, following which risk factors were identified using logistic regression analysis. The risk score method was then used to construct a 6-month risk assessment model for NSSI. Lastly, the predictive effect of the model was evaluated by indicators such as the area under the receiver operating characteristic (ROC) curve and the positive predictive value.

After 6 months, 412 cases of NSSI were identified. According to the logistic regression model, the frequency of relapses, medication status, and NSSI history were identified as influencing factors. Higher scores on the Impulsive Behavior Scale and Pittsburgh Sleep Quality Index were associated with a higher risk of NSSI. Conversely, higher scores on the Pain and Belief Perception Scale were correlated with a lower risk of NSSI. Moreover, the area under the ROC curve for the predictive model was 0.9989, with a 95% confidence interval of (0.9979, 0.9999), highlighting its high predictive ability and accuracy. The predictive model was validated using 78 patients, yielding an area under the ROC curve of 0.9703 and a 95% confidence interval of (0.9167, 0.9999), demonstrating outstanding predictability.

These results collectively showed that the predictive model could accurately predict adolescent NSSI. Thus, the model's primary variables may be applied to predict the risk of NSSI in the clinical setting.

Non-suicidal self-injury (NSSI) involves repetitive self-harm without suicidal intent and is common among adolescents, often linked to major depressive disorder (MDD). NSSI can lead to physical harm, cognitive impairments, interpersonal issues, violent behavior, and increased risks of psychological disorders and suicide attempts later in life.

Voxel-based morphometry (VBM) and surface-based morphometry (SBM) were performed on 44 NSSI patients and 44 healthy controls (HCs). Differences in GMV, CT, and cortical complexity were compared using the two-sample t-tests and correlated with neuropsychological scales.

NSSI patients exhibited significant GMV atrophy in multiple regions, including the left insula, left anterior cingulate cortex, left putamen, left middle frontal gyrus, and right superior frontal gyrus showing increased GMV in the cerebellum posterior lobe. NSSI patients had increased CT in multiple left hemisphere regions and decreased CT in the right middle frontal gyrus. Additionally, they exhibited reduced cortical complexity, including decreased SD in the right frontal gyrus, and lower GI in the left insula. There were no significant differences between the two groups in terms of fractal dimension (FD). NSSI patients showed negative correlation between the CT of the right middle frontal gyrus and the anger dimension of the BPAQ, as well as the SD of the right superior frontal gyrus and the hostility dimension of the BPAQ.

NSSI patients have significant structural changes in the insular cortex, prefrontal cortex, precentral and postcentral gyrus, temporal lobe, putamen, and anterior cingulate cortex, offering a morphological perspective on the pathophysiology of NSSI in MDD.

The outbreak of the coronavirus disease 2019 (COVID-19) pandemic threatened adolescents' mental health and livelihoods, which can worsen their non-suicidal self-injury (NSSI) behaviors. With the significant increase of total online time use, adolescents become more prone to problematic internet use (PIU). This study examined whether depression mediated the relationship between PIU and NSSI among adolescence during the COVID-19 outbreak. Constructed with a cross-sectional design during the COVID-19 outbreak in Taiwan, 1060 participants were drawn from junior high schools through stratified and cluster sampling, and completed a set of comprehensive surveys. The mediation model demonstrated a good fit to the data, GFI = .96, CFI = .97, NFI = .97, NNFI = .95, IFI = .97, and SRMR = .02. The overall fit of the mediational model was adequate. The path from PIU to depression, β = .41, p < .001, and the path from depression to NSSI, β = .40, p < .001, were both significant. Moreover, the effect of PIU to NSSI decreased from .23 (p < .001) to .05 (p = .099) when depression was incorporated into the analysis. Moreover, results in bootstrapping analysis displayed that the indirect effect (PIU on NSSI via depression) was statistically significant (p < .001) and the direct effect (PIU on NSSI) was statistically non-significant (p = .134). The full mediation model was confirmed. The findings of the structure equation modeling and bootstrap analysis showed that PIU significantly and positively predicted NSSI, and that depression fully mediated this relationship.

Suicide is the second leading cause of death in young people worldwide and is responsible for about 52,000 deaths annually in children and adolescents aged 5-19 years. Familial, social, psychological, and behavioral factors play important roles in suicide risk. As traumatic events such as the COVID-19 pandemic may contribute to suicidal behaviors in young people, there is a need to understand the current status of suicide in adolescents, including its epidemiology, associated factors, the influence of the pandemic, and management initiatives.

We investigated global and regional suicide mortality rates among children and adolescents aged 5-19 years using data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. The suicide mortality rates from 1990 to 2019 were examined in 204 countries and territories across six World Health Organization (WHO) regions. Additionally, we utilized electronic databases, including PubMed/MEDLINE and Scopus, and employed various combinations of terms such as "suicide", "adolescents", "youth", "children", "risk factors", "COVID-19 pandemic", "prevention", and "intervention" to provide a narrative review on suicide within the pediatric population in the post-pandemic era.

Despite the decreasing trend in the global suicide mortality rate from 1990 to 2019, it remains high. The mortality rates from suicide by firearms or any other specified means were both greater in males. Additionally, Southeast Asia had the highest suicide rate among the six WHO regions. The COVID-19 pandemic seems to contribute to suicide risk in young people; thus, there is still a strong need to revisit appropriate management for suicidal children and adolescents during the pandemic.

The current narrative review integrates up-to-date knowledge on suicide epidemiology and the effects of the COVID-19 pandemic, risk factors, and intervention strategies. Although numerous studies have characterized trends in suicide among young people during the pre-pandemic era, further studies are required to investigate suicide during the pandemic and new strategies for suicide prevention in the post-pandemic era. It is necessary to identify effective prevention strategies targeting young people, particularly those at high risk, and successful treatment for individuals already manifesting suicidal behaviors. Care for suicidal children and adolescents should be improved with parental, school, community, and clinical involvement.

Adolescent suicidal ideation (SI) and non-suicidal self-injury (NSSI) are crucial public health issues, yet their co-developmental trajectories during early adolescence and their associations with predictors and outcomes are unclear. This study aimed to (a) identify heterogeneous co-developmental trajectories of SI and NSSI, (b) explore associations between transdiagnostic predictors and trajectories, and (c) assess suicide attempt risk across trajectories.

Four hundred fifty-three adolescents (Mage = 12.35 years, 48.3% boys) completed surveys at 6-month intervals across 2 years. At Time 1 (Nov 2020), participants completed surveys encompassing SI, and NSSI, along with family, peer, and individual predictors. Subsequent surveys (Times 2-4) measured SI and NSSI, with suicide attempts queried at Time 4.

Parallel process latent class growth models revealed three co-developmental groups (i.e., Stable low NSSI and SI; Moderate-NSSI and high-SI, parallel decreasing; High-NSSI and moderate-SI, parallel increasing). Multivariate logistic regression indicated that group membership was predicted by parental rejection, parental warmth, bullying victimization, depressive and anxiety symptoms, thwarted belongingness, and perceived burdensomeness. Adolescents in the "High-NSSI and moderate-SI, parallel increasing" group reported the highest suicide attempt frequency.

These findings underscore subgroup distinctions and transdiagnostic predictors in comprehending SI and NSSI progression, emphasizing the necessity of dynamic monitoring and tailored interventions for distinct subgroup characteristics.

Suicidal ideation (SI) is increasingly prevalent among adolescents, often arising from depression and linked with non-suicidal self-injury (NSSI). Previous studies have noted significant sex differences in the manifestation and predictors of SI, depression, and NSSI.

This study aims to analyze and compare the relationships between SI, depression, and NSSI among male and female adolescents, examining whether these associations differ based on sex.

A total of 368 adolescents (M = 15.43, SD = 1.22, about 56.2% female participants), both from clinical and school settings, were assessed for SI, depression, NSSI, and other related variables. Network analysis was utilized to explore the interconnections among these variables, focusing on identifying sex-specific patterns. Logistic regression was used to confirm the findings from the network analysis.

The network analysis revealed significant sex differences in the relationships between SI, depression, and NSSI. In the female network, the edge weights between SI and NSSI (0.93) and between SI and depression (0.31) were much higher compared to the male network (0.29 and 0, respectively). Centrality indices (strength, betweenness, closeness, and expected influence) for SI, NSSI, and depression were also higher in the female network. Logistic regression confirmed these findings, with depression being a potential predictor of SI only in females (OR = 1.349, p = 0.001) and NSSI having a stronger influence on SI in females (OR = 13.673, p < 0.001) than in males (OR = 2.752, p = 0.037).

The findings underscore the necessity of considering sex differences when predicting suicidal ideation from depression and NSSI in adolescents. Intervention and prevention strategies should be tailored to address these distinct patterns in male and female adolescents.

Non-suicidal self-injury (NSSI) can both precede and co-occur with suicidal attempts (SA). Underlying mechanisms/factors leading to the transition to SA in NSSI youths have been proposed (including the role of social cognition), despite they should be yet confirmed. Therefore, the study aims at exploring the role of the Theory of Mind in the differentiation of a sample of NSSI youngsters (aged 15-24) according to the presence of SA. We divided the sample into 4 groups using the Deliberate Self Harm Inventory (DSHI) and Columbia Suicide Severity Rating Scale (C-SSRS): control group (notNSSInotSA), NSSI without SA (NSSInotSA), NSSI with SA (NSSIplusSA), and SA without NSSI (SAonly). NSSIplusSA patients displayed higher Reading the Mind in the Eyes Test (RMET) scores (indicative of ToM abilities) than both the NSSInotSA (p=0.0016) and SAonly groups (p=0.0198), while SAonly patients showed lower RMET scores compared to the control group (p=0.0214). Multiple regression models used to differentiate NSSInotSA and NSSIplusSA found a significant association between RMET and LOSCS-CSC (Level Of Self-Criticism Scale-Comparative Self-Criticism) (pC=0.0802, pD=0.0016, pG=0.0053). Our findings supported the hypothesis that a hypertrophic affective ToM may possibly be associated with the occurrence of SA in youth NSSI. Further larger and longitudinal studies should confirm these preliminary findings, by exploring all social cognition dimensions.

Confidentiality is a foundational element of high-quality, accessible, and equitable health care. Despite strong grounding in federal and state laws, professional guidelines, and ethical standards, health care professionals and adolescent patients face a range of complexities and barriers to seeking and providing confidential care to adolescents across different settings and circumstances. The dynamic needs of adolescents, the oftentimes competing interests of key stakeholders, the rapidly evolving technological context of care, and variable health care billing and claims requirements are all important considerations in understanding how to optimize care to focus on and meet the needs of the adolescent patient. The following assessment of the evolving evidence base offers a view of the current state and best practices while pointing to numerous unmet needs and opportunities for improvement in the care experiences of youth as well as their health outcomes.

Sleep problems are a significant risk factor for identifying and preventing suicidal involvement among adolescents. However, there is limited evidence to assess the underlying mechanisms between them. This study investigated the longitudinal relationship between sleep problems and suicidal behavior and examined whether this relationship was moderated by negative emotions, low self-control, and nonsuicidal self-injury (NSSI).

From December 2020 onward, we assessed 1214 Chinese secondary school adolescents (60.7% were boys, aged 13-19 years) three times, 6 months apart.

In the direct effects model, sleep problems were found to have a positive impact on adolescent suicidal behavior. In the indirect effects model, we observed that sleep problems were associated with an elevated risk of suicidal behavior through several pathways: one-mediator path of negative emotions, low self-control, and NSSI, respectively; two-mediator path of negative emotions via low self-control, negative emotions via NSSI, and low self-control via NSSI, and three-mediator path from negative emotions to NSSI via low self-control.

This longitudinal study provides evidence that sleep problems in adolescents may increase suicidal behavior by exacerbating negative emotions, weakening self-control, and promoting NSSI. The findings suggest sleep problems should be addressed in suicide prevention and intervention efforts for adolescents.

The contribution of specific childhood trauma subtypes to suicidal thoughts and the associated mechanisms remains unclear, particularly in psychiatric patients.

Face-to-face interviews were conducted with 449 psychiatric patients aged 18-73. Childhood trauma, self-esteem, nonsuicidal self-injury (NSSI), and suicidality were assessed retrospectively. Regression and moderated mediation model were employed to examine these relationships.

Emotional and sexual abuse were independently associated with suicidality. Female patients reported higher levels of emotional and sexual abuse, lower self-esteem, and a heightened risk of suicide. Self-esteem moderated the links between childhood trauma and NSSI, as well as between NSSI and suicidality. NSSI served as a mediator between childhood trauma and suicidality.

Suicide prevention in mentally ill patients should involve targeted programs addressing specific childhood trauma. Additionally, psychological interventions to enhance self-esteem and assist individuals engaging in NSSI behavior are crucial.

Non-suicidal self-injury (NSSI), defined as a deliberate destruction of one's own body without a suicidal intent, is a global public health issue. Adverse childhood events (ACEs) have been shown to be associated with various mental illnesses; however, to date the impact of such events on NSSI in youth has not been reviewed.

We conducted a systematic review, searched 5 databases for published articles evaluating ACE and NSSI in youth less than or equal to 21 years of age. After screening 247 articles, we included 21 unique articles in this systematic review.

Increasing ACE score, physical, sexual or emotional abuse, parental neglect and substance use, parental separation or dysfunctional family, and death of a close family member had statistically significant correlation with NSSI.

Non-suicidal self-injury is an impairing diagnosis with far reaching psychiatric manifestations and repercussions. Practitioners having high clinical suspicion for ACEs in youth with NSSI must intervene early by administering the ACEs questionnaire. Effective treatment of NSSI in those with ACEs with psychotherapy significantly improves outcomes and prevents suicide in youth.

Nonsuicidal self-injury (NSSI) combined with suicide ideation increases the risk of suicidal behaviors. Depression and posttraumatic stress disorder (PTSD) are comorbidities of NSSI compounding this relationship. The present study compared diagnostic subgroups of NSSI based on current depression and PTSD on psychological correlates (i.e., vulnerabilities and impairment) and suicidal presentations (i.e., suicidal cognitions and behaviors) in a psychiatric sample of adolescents.

Eighty-seven adolescents meeting DSM-5 criteria for NSSI and 104 age-range-matched nonclinical controls (NC) participated. Participants completed self-report measures on psychological vulnerabilities and impairment (e.g., emotion regulation difficulties, negative cognitions). Adolescents with NSSI also completed clinical interviews on psychiatric diagnoses and a recent self-injurious behavior (SIB). Scores on the psychological correlates of NSSI were compared between adolescents with NSSI and NC, and across three diagnostic subgroups of NSSI (A: NSSI+/depression-/PTSD-, n = 14; B: NSSI+/depression+/PTSD-, n = 57; C: NSSI+/depression+/PTSD+, n = 14). Differences between NSSI diagnostic subgroups were tested on the motives for SIB and accompanying suicidal presentations (e.g., desire, intent, motive, lethality).

Common comorbidities of NSSI included depression, panic disorder, generalized anxiety disorder, and PTSD. The NSSI subgroup classification was significantly associated with panic disorder, which was controlled for in the subsequent group comparisons. Overall, adolescents who engage in NSSI with vs. without depression reported more psychological vulnerabilities and impairment and a greater degree of suicidal thoughts/desire in SIB (i.e., groups B, C >A), which remained significant after controlling for panic disorder. An increased odds of the suicidal motive for SIB was found in adolescents with all three conditions (i.e., group C: NSSI+/depression+/PTSD+) compared to those with NSSI but neither depression nor PTSD (i.e., group A: NSSI+/depression-/PTSD-); however, this was not significant after controlling for panic disorder.

Psychological underpinnings of adolescent NSSI in clinical contexts may be largely associated with concurrent depression. Suicidal motives in adolescents who engage in NSSI in the presence of depression and PTSD may be confounded by the co-occurrence of panic disorder. This study warrants the importance of attending to the comorbid depression with NSSI in adolescents as it is related to an increase in suicidal desire accompanying SIB.

Suicide is the second leading cause of death for 10- to 24-year-olds in the United States and is a global public health issue, with a recent declaration of a National State of Emergency in Children's Mental Health by the American Academy of Pediatrics, American Academy of Child and Adolescent Psychiatry, and Children's Hospital Association. This clinical report is an update to the previous American Academy of Pediatrics clinical report, "Suicide and Suicide Attempts in Adolescents." Because pediatricians and pediatric health care providers are at the front line of care for adolescents amid a child and adolescent mental health crisis, and because of the chronic and severe shortage of mental health specialists, it is important that pediatric health care providers become facile with recognizing risk factors associated with suicidality and at-risk populations, screening and further assessment of suicidality as indicated, and evidence-based interventions for patients with suicidal ideation and associated behaviors. Suicide risk can be mitigated by appropriate screening, bolstering of protective factors, indicated treatment, community resources, and referrals to mental health providers when available.

Nonsuicidal self-injury (NSSI) by proxy is the intentional destruction of one's own body tissue through the elicitation of another being's actions. Despite its clinical relevance, research on NSSI by proxy is limited and there are no available measures of this behavior. This research aimed to characterize NSSI by proxy among young adults and provide preliminary data on the validity of a new self-report measure, the NSSI by Proxy Questionnaire (NSSIBPQ). Two nationwide community samples of young adults (one general community sample and one with a history of traditional NSSI and suicidality) completed online studies. NSSI by proxy was reported by 18% of the general community sample and 45% of the self-injuring sample. Findings support the clinical relevance of NSSI by proxy and its potential to meet criteria for an NSSI disorder diagnosis. Results also provide preliminary support for the internal consistency and convergent, discriminant, and concurrent validity of the NSSIBPQ.

Adolescents involved in juvenile legal system are at increased risk for self-cutting behavior, however, correlates associated with elevated risk remain underresearched, particularly among youth with first involvement with the court. This study utilized an epidemiological two-year longitudinal study involving 401 adolescents at first contact with the court (Mage = 14.47; SDage = 1.94 years; 43% female; 42% Latinx/Hispanic) and an involved caregiver. Study aims examined key prospective psychosocial correlates of self-cutting behavior. Baseline assessments captured individual and family level risk and protective factors; self-cutting behavior was assessed longitudinally every four months post-baseline for 24 months. Psychosocial correlates of self-cutting behavior included adolescent affect dysregulation, post-traumatic stress disorder symptoms, impulsive decision making, anxiety and depression symptoms. Significant protective factors included positive communication with caregiver and family, higher self-esteem, and having a caring and supportive family. These findings suggest that internalizing symptoms as well as difficulties with emotion regulation and impulsive decision making are correlated with heightened risk for self-cutting behavior among adolescents involved in the juvenile legal system. The findings also suggest that individual and family level protective factors, like positive communication and a supportive family, are associated with decreased risk for self-cutting behavior among adolescents at first contact with the court.

The structural neural correlates underlying youth nonsuicidal self-injury (NSSI) warrant further exploration. Few studies have explored the association between NSSI and brain structure in adolescence, and no studies have investigated differences in the relation between age and brain structure in youth with NSSI. This preliminary investigation examined associations between NSSI history, age, and cortical structure using magnetic resonance imaging in adolescent girls (N=100, Mage=13.4 years) at increased risk for psychopathology. We conducted whole-brain analyses to investigate the associations between age and cortical structure, NSSI history and cortical structure, and NSSI history as a moderator of the association between age and cortical structure. Results suggested that age was associated with less cortical thickness and surface area in the left and right prefrontal, temporal, and parietal cortex. NSSI history was associated with less left insula and left inferior parietal cortex cortical surface area. Among adolescents with NSSI history, older age predicted greater left inferior parietal cortex surface area and was not associated with left precentral cortex surface area. Among adolescents without NSSI history, older age predicted smaller surface areas as expected with the typical trajectory of neurodevelopment. Overall, our results suggest differences in cortical surface area development in adolescents with NSSI history.

Both self-harm and suicidal behaviors have been targeted through school-based prevention programs, many of which have been developed in the United States. The aims of this systematic review were to assess effects of school-based prevention programs on suicide and self-harm and to evaluate whether they are fit to the exporting culture. The review followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Our inclusion criteria, structured according to population/problem, intervention, control/comparison, outome, were: children and youth up to 19 years of age, school-based programs at universal, selective or indicated levels compared with teaching as usual or with other programs, and outcomes of suicide or self-harm measured at least 10 weeks after intervention. Studies without a control group or using non-behavioral outcomes were excluded. A comprehensive and systematic literature search was conducted from the 1990s to March 2022. Risk for bias was assessed with checklists adapted from the Cochrane Risk of Bias (ROB) tool. A total of 1,801 abstracts were retrieved. Five studies fulfilled our inclusion criteria, but one had high risk for bias. Confidence in the evidence for effect was assessed with Grading of Recommendations Assessment, Development and Evaluation (GRADE). Studies included in this review were evaluated with respect to applicability in the context of international export. Only two school-based programs demonstrated efficacy in preventing suicidal behaviors. Although implementation of evidence-based interventions is a crucial next step, further replication with simultaneous attention to dissemination and implementation issues are called for. Funding and registration: conducted on assignment by the Swedish government. The protocol is available at the SBU website in Swedish.

To explore the relationship between family cohesion and adaptability and non-suicidal self-injury behavior among ethnic minority adolescents, as well as the mediating effect of depression and the moderating effect of school connectedness, this study adopts the Family Adaptability and Cohesion Scale, the Non-Suicidal Self-Injury Behavior Questionnaire, the Center for Epidemiological Studies Depression Scale, and the School Connectedness Scale to collect behavioral data from 949 ethnic minority middle-school students. Descriptive statistical analysis and correlation analysis, as well as the mediating and moderating effects, were performed using SPSS 25.0 and the PROCESS macro program. We found that family cohesion and adaptability significantly and negatively predicted non-suicidal self-injury in ethnic minority adolescents (β = -0.28, p < 0.001); depression mediated the relationship between family cohesion and adaptability and non-suicidal self-injury in minority adolescents, with a confidence interval (mediating effect size -0.15, and a Bootstrap 95% CI) of [-0.19, -0.12]. School connectedness moderated the second half of the mediating effect (β = -0.08, p < 0.01).

A growing body of empirical literature connects anxiety symptoms and high-risk suicidal and self-harming behaviors in youth. Emotion regulation (ER) processes and deficits have been identified as important factors in the etiology, maintenance, and treatment of both youth anxiety and high-risk behaviors. The present study assessed the association between these variables using an acute, socio-demographically diverse clinical sample of youth presenting to an outpatient mental health clinic. Ninety-nine youth aged 12-20 years old completed measures of anxiety symptoms, ER difficulties, and lifetime history of high-risk behaviors including non-suicidal self-injury (NSSI) and suicide attempts. Unadjusted analyses show that more severe anxiety symptoms were associated with more ER difficulties and history of risk behavior. Multivariate linear regression models considering age, sex, race/ethnicity, and risk history show that more severe anxiety symptoms remained significantly associated with more ER difficulties (p < 0.0001) and positive suicide attempt history (p < 0.01). Findings highlight the importance of integrating considerations of ER into the case conceptualization and treatment planning of high-risk, anxious youth to inform evidenced-based care with this population. The need for targeted, ongoing risk assessment with anxious youth to identify and mitigate risk is also demonstrated.

To explore the relationship between non-suicidal self-injury and suicidal ideation in adolescents and examine the roles of rumination and decentering in that relationship.

By means of a questionnaire, 175 adolescent patients in a psychiatric hospital in Fujian Province were given the Functional Assessment of Self-Mutilation: Chinese Version, Positive and Negative Suicide Ideation, Ruminative Response Scale: Chinese Version, and Experiences Questionnaire: Decentering Scale.

(1) Adolescent non-suicidal self-injury was significantly positively related to suicidal ideation and rumination and significantly negatively related to decentering. Suicidal ideation was significantly positively related to rumination and significantly negatively related to decentering. Rumination was significantly negatively related to decentering. (2) Rumination and decentering played a complete chain-mediating role between non-suicidal self-injury and suicidal ideation. Non-suicidal self-injury was found to indirectly affect suicidal ideation along three pathways: the independent mediating role of rumination (the mediating effect accounted for 40.166%), independent mediating role of decentering (the mediating effect accounted for 41.274%), and chain-mediating role of rumination and decentering (the mediating effect accounted for 14.958%).

Adolescent non-suicidal self-injury can indirectly affect suicidal ideation through rumination and decentering. In the future, mindfulness and other methods should be used to improve individuals' levels of decentering and cultivate emotional regulation abilities, so as to reduce the incidence of non-suicidal self-injury and suicide in adolescents.

Non-suicidal self-injury (NSSI) is a highly prevalent clinical concern in adolescents and is associated with impaired functioning and suicide risk. The BRIDGES (BRain Imaging Development of Girls' Emotion and Self) study was designed to collect longitudinal clinical and neurobiological data to advance our understanding of NSSI in adolescents. The purpose of this paper is to describe the clinical data collected as part of this study, including psychiatric diagnoses, depression symptoms, episodes of non-suicidal self-injury, suicidal thoughts and behaviors, childhood trauma, and personality domains.

The baseline sample included 164 adolescents aged 12-16 assigned female at birth (Mean age = 14.97, SD = 1.20) with NSSI histories ranging from none to severe. Participants and their parent/guardian were invited to provide data at three time points spaced approximately one year apart. Descriptive analyses were conducted to provide estimates of rates and trajectories of clinical data.

Of the 164 study participants, 75.61% and 57.93% completed the second and third time points, respectively. Visual inspection of the data suggests an overall trend of decreasing severity of psychopathology over time, and adolescents with a history of NSSI appeared to have higher rates of psychopathology than those without.

This paper describes longitudinal clinical trajectories in adolescents with a range of NSSI histories and presents readers with an overview of the rich, publicly available dataset that we hope will inspire future research to advance the understanding of the neurodevelopmental trajectories associated with NSSI, depression, and suicide risk.

Nonsuicidal self-injury (NSSI) is prevalent and concerning among adolescents and adults. Although prior meta-analytic work has considered the efficacy of individual psychotherapy for reducing NSSI, the efficacy of group psychotherapy remains unclear. We conducted a systematic meta-analysis of group psychotherapy studies with NSSI measures. We identified a total of eight studies, including published articles (n = 6) or dissertations (n = 2) with 10 total effect sizes for group interventions. Overall, random-effects meta-analysis suggests that group psychotherapies have a significant small effect on NSSI. However, when corrected for publication bias, the effect is no longer significant. This meta-analysis cautiously suggests that group psychotherapies, which are cost-effective and efficient, hold promise for attenuating NSSI. The field would benefit from further study and treatment refinement, including consideration of what works for whom.

This study aimed to objectively evaluate the severity of impulsivity [behavior inhibitory control (BIC) impairment] among adolescents with depression. In particular, those involved in non-suicidal self-injury (NSSI) behaviors, compared with those engaged in suicidal behaviors and adolescents without any self-injury behavior, using event-related potentials (ERPs) and event-related spectral perturbation (ERSP) within the two-choice oddball paradigm.

Participants with a current diagnosis of major depressive disorder (MDD) engaged in repetitive NSSI for five or more days in the past year (n = 53) or having a history of at least one prior complete suicidal behavior (n = 31) were recruited in the self-injury group. Those without self-injury behavior were recruited in the MDD group (n = 40). They completed self-report scales and a computer-based two-choice oddball paradigm during which a continuous electroencephalogram was recorded. The difference waves in P3d were derived from the deviant minus standard wave, and the target index was the difference between the two conditions. We focused on latency and amplitude, and time-frequency analyses were conducted in addition to the conventional index.

Participants with self-injury, compared to those with depression but without self-injury, exhibited specific deficits in BIC impairment, showing a significantly larger amplitude. Specifically, the NSSI group showed the highest value in amplitude and theta power, and suicidal behavior showed a high value in amplitude but the lowest value in theta power. These results may potentially predict the onset of suicide following repetitive NSSI.

These findings contribute to substantial progress in exploring neuro-electrophysiological evidence of self-injury behaviors. Furthermore, the difference between the NSSI and suicide groups might be the direction of prediction of suicidality.

Individuals with non-suicidal self-injury (NSSI) behavior are usually prone to repeated, intentional, direct harm to their own bodies that is not allowed by society without suicidal ideation. Under this behavior guidance, childhood traumatic experience may easily cause a series of psychological comorbidity symptoms, such as anxiety and depression, finally leading to a suicidal tendency.

A total of 311 adolescent NSSI behavioral patients were recruited at the Ningbo Kangning hospital, Zhejiang Province according to the DSM-5 diagnostic criteria. Demographic data, childhood abuse and neglect, internet addiction, self-esteem, anxiety, and suicidal tendency were evaluated. A structural equation model with a path induction mechanism was constructed to evaluate the relationship between distal and proximal factors related to suicidal tendencies due to childhood traumatic experiences in NSSI behavioral individuals.

Among the 311 subjects included in the survey, 250 (80.39%) suffered traumatic experiences, such as emotional abuse/physical abuse/sexual abuse/emotional neglect or physical neglect in their childhood, 303 (97.43%) had suicidal ideation, 271 (87.14%) showed the total score of self-esteem, 148 (47.59%) had different degrees of Internet addiction tendency, and 286 (91.96%) showed obvious anxiety. The established path model fit well (GFI = 0.996, RMSEA = 0.03), and the model showed that self-esteem, anxiety, and childhood traumatic experience had standardized coefficients of -0.235 (z = -4.742, p < 0.01), 0.322 (z = 6.296, p < 0.01), 0.205 (z = 4.047, p < 0.01), respectively, with suicidal ideation path, suggesting that self-esteem, Internet addiction, and anxiety showed significant mediating effects in the process of childhood traumatic experience affecting suicidal ideation.

In the context of childhood traumatic experience, it is often accompanied by a series of regulatory behaviors such as Internet addiction, self-esteem, and so on, which finally leads to anxiety, mental symptoms, and even suicidal tendencies. The results provide effective support for the structural equation modeling to evaluate the multi-level influence of NSSI behavior individuals and emphasize that childhood familial factors may lead to psychiatric comorbidity symptoms and suicidal behavior.

A traumatic brain injury (TBI) is a significant factor in injury-related deaths in the United States and may lead to complex psychological disorders. Auto-cannibalism as a sequela of a TBI has yet to be reported in the literature. The current literature regarding such behavior is often associated with psychosis, intellectual disability, or substance use. A 35-year-old male had a past medical history significant for a TBI a decade ago. He was transferred to the emergency department due to a self-inflicted wound. The patient had been scratching his arms and legs for the last few months and displayed an intense new pattern of self-destructive behavior in the past week. He went through surgical wound debridement and psychiatric evaluation before he was discharged home. This case depicts the importance of regular, long-term psychiatric, and neurological follow-up for patients sustaining TBIs, regardless of whether or not they were previously deemed stable. A greater understanding of many factors leading to self-destructive behavior following TBIs is needed to improve patient outcomes.