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Non-suicidal self-injury among first-year college students and its association with mental disorders: results from the World Mental Health International College Student (WMH-ICS) initiative

Published online by Cambridge University Press:  18 June 2021

Glenn Kiekens Open the ORCID record for Glenn Kiekens [Opens in a new window] ,
Penelope Hasking Open the ORCID record for Penelope Hasking [Opens in a new window] ,
Ronny Bruffaerts Open the ORCID record for Ronny Bruffaerts [Opens in a new window] ,
Jordi Alonso Open the ORCID record for Jordi Alonso [Opens in a new window] ,
Randy P. Auerbach Open the ORCID record for Randy P. Auerbach [Opens in a new window] ,
Jason Bantjes Open the ORCID record for Jason Bantjes [Opens in a new window] ,
Corina Benjet Open the ORCID record for Corina Benjet [Opens in a new window] ,
Mark Boyes Open the ORCID record for Mark Boyes [Opens in a new window] ,
Wai Tat Chiu  and
Laurence Claes Open the ORCID record for Laurence Claes [Opens in a new window]
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Glenn Kiekens*
Affiliation:
Center for Public Health Psychiatry, KU Leuven, Leuven, Belgium Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
Penelope Hasking
Affiliation:
School of Population Health, Curtin University, Perth, Australia
Ronny Bruffaerts
Affiliation:
Center for Public Health Psychiatry, KU Leuven, Leuven, Belgium Institute for Social Research, Population Studies Center, University of Michigan, Ann Arbor, Michigan, USA
Jordi Alonso
Affiliation:
Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain CIBER en Epidemiología y Salud Pública, Madrid, Spain Pompeu Fabra University, Barcelona, Spain
Randy P. Auerbach
Affiliation:
Department of Psychiatry, Columbia University, New York, USA
Jason Bantjes
Affiliation:
Department of Global Health, Institute for Life Course Health Research, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
Corina Benjet
Affiliation:
Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
Mark Boyes
Affiliation:
School of Population Health, Curtin University, Perth, Australia
Wai Tat Chiu
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
Laurence Claes
Affiliation:
Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Antwerp, Belgium
Pim Cuijpers
Affiliation:
Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
David D. Ebert
Affiliation:
Department for Sport and Health Sciences, Chair for Psychology & Digital Mental Health Care, Technical University Munich, Munich, Germany
Arthur Mak
Affiliation:
Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR
Philippe Mortier
Affiliation:
Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain CIBER en Epidemiología y Salud Pública, Madrid, Spain
Siobhan O'Neill
Affiliation:
School of Biomedical Sciences, Ulster University, Derry-Londonderry, Northern Ireland
Nancy A. Sampson
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
Dan J. Stein
Affiliation:
Department of Psychiatry and Mental Health and South African Medical Council Research Unit on Risk and Resilience in Mental Disorders, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
Gemma Vilagut
Affiliation:
Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain CIBER en Epidemiología y Salud Pública, Madrid, Spain
Matthew K. Nock
Affiliation:
Department of Psychology, Harvard University, Cambridge, MA, USA
Ronald C. Kessler
Affiliation:
Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
*
Author for correspondence: Glenn Kiekens, E-mail: Glenn.Kiekens@kuleuven.be
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Abstract

Background

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.

Methods

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).

Results

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).

Conclusions

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

Keywords

Adolescencecollege studentsemerging adulthoodmental disordersnon-suicidal self-injury
Type
Original Article
Information
Psychological Medicine , Volume 53 , Issue 3 , February 2023 , pp. 875 - 886
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Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

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