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The relationships between sporadic and repetitive non-suicidal self-injury and mental disorders among first-year college students : results from the World Mental Health International College Student Initiative

Title:	The relationships between sporadic and repetitive non-suicidal self-injury and mental disorders among first-year college students : results from the World Mental Health International College Student Initiative
Authors:	Hasking, Penelope; Kiekens, Glenn; Petukhova, Maria V.; Albor, Yesica; Al-Hadi, Ahmad; Alonso, Jordi; Al-Saud, Nouf; Altwaijri, Yasmin; Andersson, Claes; Atwoli, Lukoye; Ayuya Muaka, Caroline; Baez-Mansur, Patricia; Ballester, Laura; Bantjes, Jason; Baumeister, Harald; Bendtsen, Marcus; Benjet, Corina; Berman, Anne H.; Bruffaerts, Ronny; Carrasco, Paula; Chan, Silver; Cohut, Irina; Covarrubias Diaz Couder, Maria; Cristobal-Narvaez, Paula; Cuijpers, Pim; David, Oana; Dong, Dong; Ebert, David; Gaete, Jorge; Garcia Forero, Carlos; Gutierrez-Garcia, Raul; Haro, Josep; Hunt, Xanthe; Hurks, Petra; Husky, Mathilde; Jaguga, Florence; Jansen, Leontien; Jimenez-Perez, Ana; Kahlke, Fanny; Klinkenberg, Elisabeth; Langer, Alvaro; Lee, Sue; Lima, Rodrigo Antunes; Liu, Yan; Lochner, Christine; Mac-Ginty, Scarlett; Martinez, Vania; Mason, Andre; McLafferty, Margaret; Mori, Tiana; Murray, Elaine; Musyoka, Catherine; Nedelcea, Caitalin; Nunez, Daniel; O'Neill, Siobhan; Piqueras, Jose; Popescu, Codruta; Rapsey, Charlene; Robinson, Kealagh; Roca, Miquel; Rodriguez-Jimenez, Tiscar; Salemink, Elske; Sampson, Nancy; Scarf, Damian; Siu, Oi-ling; Stein, Dan; Struijs, Sascha Y.; Tomoiaga, Cristina; Valdes-Garcia, Karla; van der Heijde, Claudia; Vigo, Daniel; Voorspoels, Wouter; Wang, Angel; Wong, Samuel; Nock, Matthew; Kessler, Ronald
Publisher Information:	Uppsala universitet, Institutionen för psykologi; Curtin Univ, Fac Hlth Sci, Sch Populat Hlth, Perth, WA, Australia.; Katholieke Univ Leuven, Fac Psychol & Educ Sci, Leuven, Belgium.;Katholieke Univ Leuven, Ctr Contextual Psychiat, Leuven, Belgium.;Tilburg Univ, Dept Med & Clin Psychol, Tilburg, Netherlands.; Harvard Med Sch, Dept Hlth Care Policy, Boston, MA USA.; Inst Nacl Psiquiatria Ramon de la Fuente Muniz, Ctr Global Mental Hlth, Mexico City, Mexico.; King Saud Univ, Coll Med, Dept Psychiat, Riyadh, Saudi Arabia.; Hosp del Mar, Res Inst IMIM, Barcelona, Spain.;Pompeu Fabra Univ UPF, Dept Med & Life Sci, Barcelona, Spain.;Inst Salud Carlos III, Ctr Invest Biomed Red Epidemiol & Salud Publ CIBE, Madrid, Spain.; King Faisal Specialist Hosp & Res Ctr, Biostat Epidemiol & Sci Comp Dept, Riyadh, Saudi Arabia.; Malmö Univ, Dept Criminol, Malmö, Sweden.; Aga Khan Univ, Brain & Mind Inst, Nairobi, Kenya.;Aga Khan Univ, Med Coll East Africa, Nairobi, Kenya.; Daystar Univ, Dept Psychol & Counselling, Nairobi, Kenya.; Univ Salle Ciudad Victoria, Coordinac Desarrollo Acad & Serv Educat, Ciudad Victoria, Mexico.; Hosp del Mar, Res Inst IMIM, Barcelona, Spain.;Inst Salud Carlos III, Ctr Invest Biomed Red Epidemiol & Salud Publ CIBE, Madrid, Spain.; South African Med Res Council, Mental Hlth Alcohol Subst Use & Tobacco MAST Res, Cape Town, South Africa.;Univ Cape Town, Dept Psychiat & Mental Hlth, Cape Town, South Africa.; Ulm Univ, Dept Clin Psychol & Psychotherapy, Ulm, Germany.; Linköping Univ, Dept Hlth Med & Caring Sci, Linköping, Sweden.; Katholieke Univ Leuven, Ctr Publ Hlth Psychiat, Leuven, Belgium.;Univ Psychiat Ctr KU Leuven UPC KUL, Leuven, Belgium.; Inst Salud Carlos III, Ctr Invest Biomed Red Epidemiol & Salud Publ CIBE, Madrid, Spain.;Univ Jaume 1, Fac Hlth Sci, Unit Med, Castellon de La Plana, Spain.;Univ Jaume 1, FISABIO, Castellon de La Plana, Spain.; Hong Kong Univ Sci & Technol, Hong Kong, Peoples R China.; Tech Univ Cluj Napoca, Career Counseling & Guidance Ctr, Cluj Napoca, Romania.; Univ la Salle Noroeste, Coordinac Invest, Obregon, Mexico.; Parc Sanitari St Joan de Deu, IRSJD, St Boi Llobregat, Spain.; Vrije Univ Amsterdam, Fac Behav & Movement Sci, Dept Clin Neuro & Dev Psychol, Amsterdam, Netherlands.;Babes Bolyai Univ, Int Inst Adv Studies Psychotherapy & Appl Mental, DATA Lab, Cluj Napoca, Romania.; Babes Bolyai Univ, Int Inst Adv Studies Psychotherapy & Appl Mental, DATA Lab, Cluj Napoca, Romania.;Babes Bolyai Univ, Dept Clin Psychol & Psychotherapy, Cluj Napoca, Romania.; Chinese Univ Hong Kong, Fac Med, JC Sch Publ Hlth & Primary Care, Hong Kong, Peoples R China.; Tech Univ Munich, Sch Med & Hlth, Munich, Germany.; Millennium Nucleus Improve Mental Hlth Adolescent, Santiago, Chile.;Univ los Andes, Fac Ciencias Sociales, Ctr Invest Salud Mental Estudiantil ISME, Santiago, Chile.; Univ Int Catalunya, Dept Med, Barcelona, Spain.; Univ La Salle Bajio, Leon, Mexico.; Parc Sanitari St Joan de Deu, IRSJD, St Boi Llobregat, Spain.;Ctr Invest Biomed Red Salud Mental CIBERSAM, Madrid, Spain.; South African Med Res Council, Mental Hlth Alcohol Subst Use & Tobacco MAST Res, Cape Town, South Africa.;Africa Hlth Res Inst, Durban, South Africa.; Maastricht Univ, Fac Psychol & Neurosci, Maastricht, Netherlands.; Univ Bordeaux, Bordeaux Populat Hlth Res Ctr, Bordeaux, France.; Moi Teaching & Referral Hosp, Dept Alcohol & Drug Abuse Rehabil Serv, Eldoret, Kenya.; Katholieke Univ Leuven, Ctr Publ Hlth Psychiat, Leuven, Belgium.; Univ Autonoma Baja California, Fac Ciencias Adm & Sociales, Tijuana, Mexico.; Deggendorf Inst Technol, Fac Appl Hlth Sci, Deggendorf, Germany.; Inholland Univ Appl Sci, Dept Educ & Innovat, Haarlem, Netherlands.; Millennium Nucleus Improve Mental Hlth Adolescent, Santiago, Chile.;Univ San Sebastian, Fac Psicol & Humanidades, Valdivia, Chile.; Inst Recerca St Joan de Deu, St Boi De Llobregat, Spain.; Jining Med Univ, Sch Publ Hlth, Jining, Peoples R China.; Stellenbosch Univ, Dept Psychiat, SAMRC Unit Risk & Resilience Mental Disorders, Stellenbosch, South Africa.; Millennium Nucleus Improve Mental Hlth Adolescent, Santiago, Chile.;Kings Coll London, Inst Psychiat Psychol & Neurosci, Dept Hlth Serv & Populat Res, London, England.; Millennium Nucleus Improve Mental Hlth Adolescent, Santiago, Chile.;Univ Chile, Fac Med, CEMERA, Santiago, Chile.; Univ Otago, Dept Psychol Med, Dunedin, New Zealand.; Univ British Columbia, Fac Med, Dept Psychiat, Vancouver, BC, Canada.; Ulster Univ, Sch Med, Personalised Med Ctr, Derry Londonderry, North Ireland. Atlantic Technol Univ, Donegal, Ireland.; Univ Nairobi, Sch Med, Dept Psychiat, Nairobi, Kenya.; Univ Bucharest, Dept Psychol & Cognit Sci, Bucharest, Romania.; Millennium Nucleus Improve Mental Hlth Adolescent, Santiago, Chile.;Univ Talca, Fac Psicol, Ctr Invest Ciencias Cognit, Talca, Chile.; Ulster Univ, Sch Psychol, Coleraine, North Ireland.; Univ Miguel Hernandez de Elche, Dept Hlth Psychol, Alacant, Spain.; Iuliu Hatieganu Univ Med & Pharm, Dept Human Sci, Cluj Napoca, Romania.; Massey Univ, Sch Psychol, Wellington, New Zealand.; Univ Balearic Isl UIB, Inst Univ Invest Ciencies Salut IUNICS IDISBA, Palma De Mallorca, Spain.;Univ Balearic Isl UIB, Dept Med, Palma De Mallorca, Spain.; Univ Zaragoza UNIZAR, Dept Psychol & Sociol, Zaragoza, Spain.; Univ Utrecht, Dept Clin Psychol, Utrecht, Netherlands.; Univ Otago, Dept Psychol, Dunedin, New Zealand.; Lingnan Univ, Dept Psychol, Hong Kong, Peoples R China.; Univ Cape Town, Dept Psychiat & Mental Hlth, Cape Town, South Africa.;Univ Cape Town, SA MRC Unit Risk Resilience Mental Disorders, Cape Town, South Africa.;Neurosci Inst, Cape Town, South Africa.; Vrije Univ Amsterdam, Fac Behav & Movement Sci, Dept Clin Neuro & Dev Psychol, Amsterdam, Netherlands.; Babes Bolyai Univ, Int Inst Adv Studies Psychotherapy & Appl Mental, DATA Lab, Cluj Napoca, Romania.; Univ Autonoma Coahuila, Fac Psicol, Saltillo, Mexico.; Univ Amsterdam, Student Hlth Serv, Amsterdam, Netherlands.; Univ British Columbia, Fac Med, Dept Psychiat, Vancouver, BC, Canada.;Univ British Columbia, Fac Med, Sch Populat & Publ Hlth, Vancouver, BC, Canada.; Harvard Univ, Dept Psychol, Cambridge, MA USA.
Publication Year:	2025
Collection:	Uppsala University: Publications (DiVA)
Subject Terms:	college students; non-suicidal self-injury; NSSI; mental disorders; Psychiatry; Psykiatri
Description:	Background: Non-suicidal self-injury (NSSI) is associated with mental disorders, yet work regarding the direction of this association is inconsistent. We examined the prevalence, comorbidity, time-order associations with mental disorders, and sex differences in sporadic and repetitive NSSI among emerging adults. Methods: We used survey data from n = 72,288 first-year college students as part of the World Mental Health-International College Student Survey Initiative (WMH-ICS) to explore time-order associations between onset of NSSI and mental disorders, based on retrospective age-of-onset reports using discrete-time survival models. We distinguished between sporadic (1-5 lifetime episodes) and repetitive (≥ 6 lifetime episodes) NSSI in relation to DSM-5 mood, anxiety, and externalizing disorders. Results: We estimated a lifetime NSSI rate of 24.5%, with approximately half reporting sporadic NSSI and half repetitive NSSI. The time-order associations between onset of NSSI and mental disorders were bidirectional, but mental disorders were stronger predictors of the onset of NSSI (median RR = 1.94) than vice versa (median RR = 1.58). These associations were stronger among individuals engaging in repetitive rather than sporadic NSSI. While associations between NSSI and mental disorders generally did not differ by sex, repetitive NSSI was a stronger predictor for the onset of subsequent substance use disorders among females compared to males. Most mental disorders marginally increased the risk for persistent repetitive NSSI (median RR = 1.23). Conclusions: Our findings offer unique insights into the temporal order between NSSI and mental disorders. Further work exploring the mechanism underlying these associations will pave the way for early identification and intervention of both NSSI and mental disorders.
Document Type:	article in journal/newspaper
File Description:	application/pdf
Language:	English
Relation:	Psychological Medicine, 0033-2917, 2025, 55; PMID 40995649; ISI:001577968300001
DOI:	10.1017/S0033291725100688
Availability:	http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-569212; https://doi.org/10.1017/S0033291725100688
Rights:	info:eu-repo/semantics/openAccess
Accession Number:	edsbas.16EAC419
Database:	BASE