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
Year: 2025
Type: article
Study design: Observational Study
Abstract: 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.
Source: Psychological Medicine
Authors: Penelope Hasking, Glenn Kiekens, Maria V. Petukhova, Yesica Albor, Ahmad Al-Hadi, Jordi Alonso, Nouf Al-Saud, Yasmin Altwaijri, Claes Andersson, Lukoye Atwoli, Caroline Ayuya Muaka, Patricia Báez-Mansur, Laura Ballester, Jason Bantjes, Harald Baumeister, Marcus Bendtsen, Corina Benjet, Anne Berman, Ronny Bruffaerts, Paula Carrasco, Silver Chan, Irina Cohut, Maria Covarrubias Díaz Couder, Paula Cristóbal-Narvaez, Pim Cuijpers, Oana David, Dong Dong, David Ebert, Jorge Gaete, Carlos García Forero, Raúl Gutiérrez-García, Josep Haro, Xanthe Hunt, Petra Hurks, Mathilde Husky, Florence Jaguga, Leontien Jansen, Ana Jiménez-Pérez, Fanny Kählke, Elisabeth Klinkenberg, Álvaro Langer, Sue Lee, Rodrigo Antunes Lima, Yan Liu, Christine Lochner, Scarlett Mac-Ginty, Vania Martínez, Andre Mason, Margaret McLafferty, Tiana Mori, Elaine Murray, Catherine Musyoka, Caitalin Nedelcea, Daniel Núñez, Siobhan O’Neill, José Piqueras, Codruta Popescu, Charlene Rapsey, Kealagh Robinson, Miquel Roca, Tiscar Rodriguez-Jimenez, Elske Salemink, Nancy Sampson, Damian Scarf, Oi-ling Siu, Dan Stein, Sascha Y. Struijs, Cristina Tomoiaga, Karla Valdés-García, Claudia van der Heijde, Daniel Vigo, Wouter Voorspoels, Angel Wang, Samuel Wong, Matthew Nock, Ronald Kessler
Institutions: Curtin University, Tilburg University, KU Leuven, Harvard University, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, King Saud University, Universitat Pompeu Fabra, Instituto de Salud Carlos III, Municipal Institute for Medical Research, Hospital del Mar Research Institute, King Faisal Specialist Hospital & Research Centre, Malmö University, Aga Khan University, Aga Khan University, Daystar University, Universidad La Salle Victoria, South African Medical Research Council, Universität Ulm, Linköping University, Uppsala University, Universitat Jaume I, Hong Kong University of Science and Technology, Technical University of Cluj-Napoca, Universidad La Salle Noroeste, Institut de Recerca Sant Joan de Déu, Babeș-Bolyai University, Vrije Universiteit Amsterdam, Chinese University of Hong Kong, Technical University of Munich, Universidad de Los Andes, Universitat Internacional de Catalunya, Universidad La Salle Bajío, Africa Health Research Institute, Maastricht University, Université de Bordeaux, Universidad Autónoma de Baja California, Deggendorf Institute of Technology, Inholland University of Applied Sciences, Universidad San Sebastián, Jining Medical University, Stellenbosch University, King's College London, University of Chile, University of Otago, University of Ulster, Atlantic Technological University, University of British Columbia, University of Nairobi, University of Bucharest, Universidad de Talca, Universitat de Miguel Hernández d'Elx, Iuliu Hațieganu University of Medicine and Pharmacy, Massey University, Universitat de les Illes Balears, Universidad de Zaragoza, Utrecht University, Lingnan University, University of Cape Town, Universidad Autónoma de Coahuila, University of Amsterdam
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: hybrid
Estimated APC paid: $3,550
Funders: John D. and Catherine T. MacArthur Foundation, Bristol-Myers Squibb, Eli Lilly and Company, Pfizer, GlaxoSmithKline, University of Otago, Ministry of Health – Kingdom of Saudi Arabia, European Commission, South African Medical Research Council, Public Health Agency, ZonMw, King Faisal Specialist Hospital and Research Centre, King Saud University, Generalitat de Catalunya, Consejo Nacional de Ciencia y Tecnología, Vetenskapsrådet, Institut Universitaire de France, Ministerio de Ciencia e Innovación, King Abdulaziz City for Science and Technology, University of British Columbia, Autoritatea Natională pentru Cercetare Stiintifică, Koning Boudewijnstichting, Unitatea Executiva pentru Finantarea Invatamantului Superior, a Cercetarii, Dezvoltarii si Inovarii, Saudi Basic Industries Corporation, Vlaamse regering, King Salman Center for Disability Research, Suicide Prevention Australia, Agencia Nacional de Investigación y Desarrollo, National Institutes of Health, U.S. Public Health Service, Pfizer Foundation, Pan American Health Organization, Health Canada, Medical Research Council, National Health and Medical Research Council, Agència de Gestió d'Ajuts Universitaris i de Recerca, Instituto de Salud Carlos III, Division of Research Capacity Development, National Institute of Mental Health, National Institute on Drug Abuse, Fogarty International Center, Interreg, EU Aid Volunteers, Feilman Foundation, Ortho-McNeil Pharmaceutical
Awards: G1037158725, G106448529, World Mental Health Consortium Annual Meeting 2003-07, G1226586044, G1383203395, G1480764736, G1550703150, G2237026874, Social Role Disability and Mental-Physical Co-Morbidity, G2355135450, G2586284485, G2613077195, G2901801384, G2909711470, COMPAS-S: Checking on mental health - Providing alternatives to suicide for students, Predicting Internet-Based Treatment Response for Major Depressive Disorder, G328221351, G3351693910, CROSS-NATIONAL STUDIES OF DRUG INVOLVEMENT: WMH2000, G3658001182, PROMHES-U: Promoción de la salud mental entre estudiantes universitarios: tecnologías E-health para la predicción personalizada y la prevención de la salud mental adversa., G4054495390, G4076321871, EFICACIA DE UNA APLICACION PARA TELEFONOS MOVILES PARA INTERVENCION TEMPRANA DE DEPRESION Y ANSIEDAD EN JOVENES UNIVERSITARIOS/AS, G4259029317, G45505900, G4826352796, G4860032371, G5103078189, Risk Factors for Psychopathology in the WHO WMH Surveys, G5523569254, G6081243323, G6667095330, G6703262589, G6749568058, G7284921876, G7433974870, G7711221855, National assessment and e-health interventions for mental health problems among university students: Swedish partnership in the WHO-World Mental Health International College Student (WHM-ICS) study, G8239453862, G8309976149, G832398967, G851565850, Lebanon-Epidemiology: The NCS Replication Study, G8808417261
OpenAlex ID: W4414516487