Although non-suicidal self-injury (NSSI) is known typically to begin in adolescence, longitudinal information is lacking about patterns, predictors, and clinical outcomes of NSSI persistence among emerging adults. The present study was designed to (1) estimate NSSI persistence during the college period, (2) identify risk factors and high-risk students for NSSI persistence patterns, and (3) evaluate the association with future mental disorders and suicidal thoughts and behaviors (STB).

Using prospective cohorts from the Leuven College Surveys (n = 5915), part of the World Mental Health International College Student Initiative, web-based surveys assessed mental health and psychosocial problems at college entrance and three annual follow-up assessments.

Approximately one in five (20.4%) students reported lifetime NSSI at college entrance. NSSI persistence was estimated at 56.4%, with 15.6% reporting a high-frequency repetitive pattern (≥five times yearly). Many hypothesized risk factors were associated with repetitive NSSI persistence, with the most potent effects observed for pre-college NSSI characteristics. Multivariate models suggest that an intervention focusing on the 10–20% at the highest predicted risk could effectively reach 34.9–56.7% of students with high-frequency repetitive NSSI persistence (PPV = 81.8–93.4, AUC = 0.88–0.91). Repetitive NSSI persistence during the first two college years predicted 12-month mental disorders, role impairment, and STB during the third college year, including suicide attempts.

Most emerging adults with a history of NSSI report persistent self-injury during their college years. Web-based screening may be a promising approach for detecting students at risk for a highly persistent NSSI pattern characterized by subsequent adverse outcomes.

Although non-suicidal self-injury (NSSI) is an issue of major concern to colleges worldwide, we lack detailed information about the epidemiology of NSSI among college students. The objectives of this study were to present the first cross-national data on the prevalence of NSSI and NSSI disorder among first-year college students and its association with mental disorders.

Data come from a survey of the entering class in 24 colleges across nine countries participating in the World Mental Health International College Student (WMH-ICS) initiative assessed in web-based self-report surveys (20 842 first-year students). Using retrospective age-of-onset reports, we investigated time-ordered associations between NSSI and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-IV) mood (major depressive and bipolar disorder), anxiety (generalized anxiety and panic disorder), and substance use disorders (alcohol and drug use disorder).

NSSI lifetime and 12-month prevalence were 17.7% and 8.4%. A positive screen of 12-month DSM-5 NSSI disorder was 2.3%. Of those with lifetime NSSI, 59.6% met the criteria for at least one mental disorder. Temporally primary lifetime mental disorders predicted subsequent onset of NSSI [median odds ratio (OR) 2.4], but these primary lifetime disorders did not consistently predict 12-month NSSI among respondents with lifetime NSSI. Conversely, even after controlling for pre-existing mental disorders, NSSI consistently predicted later onset of mental disorders (median OR 1.8) as well as 12-month persistence of mental disorders among students with a generalized anxiety disorder (OR 1.6) and bipolar disorder (OR 4.6).

NSSI is common among first-year college students and is a behavioral marker of various common mental disorders.

– The family environment is known to be an important contributor to the course of psychiatric disorders. In this study, we examined the family context of eating disordered (ED) patients with and without self-injurious behaviors (SIB).

– A Dutch adaptation of the Family Environment Scale ‘Sci Eng 57(9-B):1997;5927’ was completed by 131 ED patients of whom 47% showed at least one form of SIB (e.g., cutting, burning, hair pulling, etc.).

– Results showed a significant difference in family environment between patients with and without SIB. The family environment of self-injuring ED patients was less cohesive, expressive and socially oriented, and more conflictual and disorganized than the family environment of those without SIB. No significant differences in perceived family environment were found with respect to the number or form of SIB and the subtype of ED. Neither did we find a significant interaction effect between ED subtype and presence/absence of SIB.

Young's Schema Focused Therapy (SFT) is gaining popularity in the treatment of older adults. In the context of this therapy, the Young Schema Questionnaire (YSQ) was developed to assess the early maladaptive schemas (EMS). EMS are considered to be relatively stable over time, but research shows that questionnaires often lack face validity in older adults, which makes it difficult to investigate EMS in older adults and their stability across the lifespan.

In the present cross-sectional study, we investigated the age neutrality of the Young Schema Questionnaire – Long Form in young (aged 18–34 years), middle-aged (aged 35–59 years), and older (aged 60–75 years) adults in a clinical sample of substance use disorders (N = 321) by examining potential differential item functioning (DIF). While investigating the stability of the schemas, we controlled for substance dependency and clinical symptoms by means of, respectively, the Drug Use Screening Inventory – Revised and the Symptom Checklist-90-R.

The Bonferroni-adjusted Liu–Agresti Cumulative Common Log-Odds Ratio confirmed large DIF for six items, divided across five schema scales (Mistrust/Abuse, Subjugation, Entitlement, Enmeshment and Self-sacrifice). Of the six items that presented DIF, only one item showed differential test functioning (Entitlement). Overall results show only 3% DIF, implying age neutrality of the questionnaire.

Current results corroborate that most EMS scales are equally measured across age, and reliable comparisons can be made across the lifespan, allowing for good clinical practice and further research on SFT in older adults. Only for Entitlement, Enmeshment, and Insufficient Self-control, caution is needed when comparing mean scores across the age groups.

Se sabe que el ambiente familiar es un factor importante parcialmente responsable del curso de los trastornos psiquiátricos. En este estudio, examinamos el contexto familiar de pacientes con trastorno de la conducta alimentaria (TCA) con y sin comportamientos autolesivos (CAL).

Ciento treinta y un pacientes con TCA cumplimentaron una adaptación holandesa de la Escala de Ambiente Familiar ‘Sci Eng 57 (9-B): 1997;5927’. El 47% de ellas mostró al menos una forma de CAL (p. ej., cortarse, quemarse, tirarse de los cabellos, etc.).

Los resultados mostraron una diferencia significativa en el ambiente familiar entre las pacientes con y sin CAL. El ambiente familiar de las pacientes con TCA que se autolesionaban era menos cohesivo, expresivo y socialmente orientado, y más conflictivo y desorganizado que el ambiente familiar de las pacientes sin CAL. No se encontraron diferencias significativas en el ambiente familiar percibido con respecto al número o la forma de CAL y el subtipo de TCA. Tampoco hallamos un efecto de interacción significativo entre el subtipo de TCA y la presencia/ausencia de CAL.