Archives of Suicide Research最新文献

{"title":"Typologies of Psychiatric Diagnoses Among Inpatients with Recent Suicide Attempts.","authors":"Kayla A Lord, David F Tolin, Gretchen J Diefenbach","doi":"10.1080/13811118.2024.2405732","DOIUrl":"https://doi.org/10.1080/13811118.2024.2405732","url":null,"abstract":"<p><strong>Objective: </strong>Psychiatric multimorbidity is a well-documented risk factor for suicide. However, diagnostic heterogeneity and patterns of comorbidity likely exists within the population of those who attempt suicide. Person-centered statistical approaches, such as latent class analysis (LCA), extract distinguishable groups differentiated by prevalence and comorbidity of psychiatric disorders.</p><p><strong>Method: </strong>The present study used LCA to identify typologies of psychiatric heterogeneity in a sample of 213 inpatients (<i>M</i> age = 33.04 [<i>SD</i> = 12.67]; 57.3% female; 62.4% White; 23.9% Hispanic/Latino) with a history of suicide attempt who were recruited for a suicide prevention clinical trial. Class differences in suicide history characteristics; demographic characteristics; and cognitive-affective and behavioral risk factors, obtained from an initial evaluation involving the administration of a semi-structured diagnostic interview, suicide risk assessment, and battery of self-report measures, were explored.</p><p><strong>Results: </strong>LCA identified three classes in the best-fitting solution: Depressive-High Comorbidity (<i>n</i> = 68), Depressive-Low Comorbidity (<i>n</i> = 86), and Bipolar (<i>n</i> = 59). The Depressive-Low Comorbidity class reported less severe suicidal ideation (<i>p</i> < .001), anxiety (<i>p</i> < .001), stress (<i>p</i> < .001), unlovability beliefs (<i>p</i> = .006), and impulsivity (<i>p</i> < .001). The Depressive-Low Comorbidity class also reported fewer actual attempts than the Bipolar class (<i>p</i> = .001) and fewer interrupted attempts than the Depressive-High Comorbidity class (<i>p</i> = .004).</p><p><strong>Conclusions: </strong>The Depressive-High Comorbidity and Bipolar classes consistently endorsed higher levels of suicide risk factors. These findings may help to illuminate typologies of suicide attempters with unique clinical needs, which is an essential step toward personalized medicine.</p>","PeriodicalId":8325,"journal":{"name":"Archives of Suicide Research","volume":" ","pages":"1-16"},"PeriodicalIF":2.5,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279806","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Financial Stress Amongst People Who Self-Harm in Sri Lanka.","authors":"Blessing Nyakutsikwa, Peter James Taylor, Keith Hawton, Rob Poole, Manjula Weerasinghe, Kalpani Dissanayake, Sandamali Rajapakshe, Pramila Hashini, Michael Eddleston, Flemming Konradsen, Peter Huxley, Catherine Robinson, Melissa Pearson","doi":"10.1080/13811118.2024.2403499","DOIUrl":"https://doi.org/10.1080/13811118.2024.2403499","url":null,"abstract":"<p><strong>Objective: </strong>Socioeconomic status deprivation is known to be associated with self-harm in Western countries but there is less information about this association in Low and Middle Income Countries (LMIC). One way of investigating this is to assess the prevalence of indicators of financial stress in people who self-harm. We have assessed the prevalence and correlates of day-to-day financial hardships amongst individual presenting with non-fatal self-harm to hospitals in Sri Lanka.</p><p><strong>Methods: </strong>Data on non-fatal self-harm presentations were collected from an ongoing surveillance project in 52 hospitals in Sri Lanka. A questionnaire captured data on two forms of financial stress: unmet need (i.e., costs and bills that cannot be paid) and required support (i.e., steps taken to cover costs, such as selling belongings). Additional data on demographic, economic and clinical characteristics were also collected.</p><p><strong>Results: </strong>The sample included 2516 individuals. Both forms of financial stress were very common, with pawning/selling items (47%) and asking family or friends for money (46%) in order to pay bills or cover costs being commonly reported. Greater financial stress was associated with being aged 26-55 years, limited education, and low socioeconomic position. Financial stress was greater in women than men after adjusting for other factors.</p><p><strong>Conclusion: </strong>The results indicate that financial stress is commonly reported amongst individuals presenting to hospital with non-fatal self-harm in Sri Lanka, especially women. The research highlights a need to attend to financial stress both within self-harm prevention and aftercare.</p>","PeriodicalId":8325,"journal":{"name":"Archives of Suicide Research","volume":" ","pages":"1-18"},"PeriodicalIF":2.5,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Qualitative Assessment of Reasons for Living and Dying in the Context of Feeling Trapped Among Adults in the United Kingdom.","authors":"Laura Matheson, Susan Rasmussen, Jessamyn Moxie, Robert J Cramer","doi":"10.1080/13811118.2024.2400915","DOIUrl":"https://doi.org/10.1080/13811118.2024.2400915","url":null,"abstract":"<p><strong>Objective: </strong>Contemporary approaches to suicide assessment and treatment incorporate reasons for living (RFL) and reasons for dying (RFD). This study qualitatively explored individuals' self-described RFL and RFD in the context of suicidal thinking and behaviors.</p><p><strong>Method: </strong>Within a community United Kingdom (UK) sample, adults (<i>N</i> = 331, aged 16+) responded to eight open-ended questions probing their experiences of suicide, defeat, and entrapment. Utilizing these data, which were collected from a larger online survey examining risk and protective factors for suicidal behaviors, this study explored RFL and RFD within these narratives. After the research team established an initial code book, RFL and RFD codes were subsequently analyzed through inductive and deductive thematic analyses.</p><p><strong>Results: </strong>The present study identified five complimentary RFD-RFL themes: (1) Hopelessness-Hopefulness, (2) Stress of Responsibilities-Duty to Responsibilities, (3) Social Disconnection-Social Connection, (4) Death as Sin-Desire for an Afterlife, and (5) Temporary Escapes as Coping-Entrapment (i.e., a lack of escape). Three subthemes within the RFD theme Entrapment were General/Unspecified, By Feelings, and Within Self.</p><p><strong>Conclusions: </strong>Identified themes reflect the existing quantitative RFL and RFD literature. The identified RFL and RFD themes are discussed with reference to their clinical applications in advancing suicide-specific assessments and interventions. We propose a dimensional framework for RFD and RFL which informs future suicidal behaviors research and practice.</p>","PeriodicalId":8325,"journal":{"name":"Archives of Suicide Research","volume":" ","pages":"1-15"},"PeriodicalIF":2.5,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142279804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of Electronic Health Record Measures of Safety Planning Practices as Part of Zero Suicide Implementation.","authors":"Jennifer M Boggs, Bobbi Jo H Yarborough, Gregory Clarke, Erica M Aguirre-Miyamoto, Lee J Barton, Arne Beck, Cambria Bruschke, Stuart Buttlaire, Karen J Coleman, Jean P Flores, Robert Penfold, J David Powers, Julie Angerhofer Richards, Laura Richardson, Arthur Runkle, Jacqueline M Ryan, Gregory E Simon, Stacy Sterling, Christine Stewart, Scott Stumbo, LeeAnn M Quintana, Hsueh-Han Yeh, Brian K Ahmedani","doi":"10.1080/13811118.2024.2394676","DOIUrl":"10.1080/13811118.2024.2394676","url":null,"abstract":"<p><strong>Objective: </strong>Safety planning for suicide prevention is an important quality metric for Zero Suicide implementation. We describe the development, validation, and application of electronic health record (EHR) programs to measure uptake of safety planning practices across six integrated healthcare systems as part of a Zero Suicide evaluation study.</p><p><strong>Methods: </strong>Safety planning was documented in narrative notes and structured EHR templates using the Stanley Brown Safety Planning Intervention (SBSPI) in response to a high-risk cutoff score on the Columbia Suicide Severity Rating Scale (CSSRS). Natural Language Processing (NLP) metrics were developed and validated using chart review to characterize practices documented in narrative notes. We applied NLP to measure frequency of documentation in the narrative text and standard programming methods to examine structured SBSPI templates from 2010-2022.</p><p><strong>Results: </strong>Chart reviews found three safety planning practices documented in narrative notes that were delivered to at least half of patients at risk: professional contacts, lethal means counseling for firearms, and lethal means counseling for medication access/storage. NLP methods were developed to identify these practices in clinical text with high levels of accuracy (Sensitivity, Specificity, & PPV ≥ 82%). Among visits with a high-risk CSSRS, 40% (Range 2-73% by health system) had an SBSPI template within 1 year of implementation.</p><p><strong>Conclusions: </strong>This is one of the first reports describing development of measures that leverage electronic health records to track use of suicide prevention safety plans. There are opportunities to use the methods developed here in future evaluations of safety planning.</p>","PeriodicalId":8325,"journal":{"name":"Archives of Suicide Research","volume":" ","pages":"1-14"},"PeriodicalIF":2.5,"publicationDate":"2024-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11868447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142078941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acceptability and Feasibility of an Ecological Momentary Intervention for Managing Emotional Distress Among Psychiatric Inpatients at Risk for Suicide.","authors":"Evan M Kleiman, Kate H Bentley, Adam C Jaroszewski, Joseph S Maimone, Rebecca G Fortgang, Kelly L Zuromski, Erin N Kilbury, Michelle B Stein, Stuart Beck, Jeff C Huffman, Matthew K Nock","doi":"10.1080/13811118.2024.2391293","DOIUrl":"10.1080/13811118.2024.2391293","url":null,"abstract":"<p><p>The weeks following an inpatient psychiatric hospitalization are known to be the highest-risk time for suicide. Interventions are needed that are well-matched to the dynamic nature of suicidal thoughts and easily implementable during this high-risk time. We sought to determine the feasibility and acceptability of a novel registered clinical trial that combined three brief in-person sessions to teach core cognitive-behavioral therapy (CBT) skills during hospitalization followed by smartphone-based ecological momentary intervention (EMI) to facilitate real-time practice of the emotion management skills during the 28 days after hospital discharge. Results from this pilot study (<i>N</i> = 26) supported some aspects of feasibility and acceptability. Regarding feasibility, 14.7% of all screened inpatients met study eligibility criteria. Half (50.3%) of those who were ineligible were ineligible because they were not part of the population for whom this treatment was designed (e.g., symptoms such as psychosis rendered them ineligible for the current study). Those who were otherwise eligible based on symptoms were primarily ineligible due to inpatient stays that were too short. Nearly half (48%) of study participants did not receive all three in-person sessions during their hospitalization. Among enrolled participants, rates of engagement with the smartphone-based assessment and EMI prompts were 51.47%. Regarding acceptability, quantitative and qualitative data supported the perceived acceptability of the intervention, and provided recommendations for future iterations. Well-powered effectiveness (and effectiveness-implementation) studies are needed to determine the effects of this promising and highly scalable intervention approach.</p>","PeriodicalId":8325,"journal":{"name":"Archives of Suicide Research","volume":" ","pages":"1-18"},"PeriodicalIF":2.5,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11861377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Progression of Lethality Across Multiple Suicide Attempts: A Systematic Review.","authors":"Gamal Wafy, Lin Ajayi, Sara Siddiqi, Taylor Saravanamuttoo, Risa Shorr, Marco Solmi, Ian Colman, Jess G Fiedorowicz","doi":"10.1080/13811118.2024.2394671","DOIUrl":"10.1080/13811118.2024.2394671","url":null,"abstract":"<p><strong>Objective: </strong>Suicide is a major global public health concern. While some progress has been made in understanding risk factors for suicidal behavior, other relevant questions have received less attention. One such question relates to the longitudinal course of suicidal behavior amongst individuals with multiple suicide attempts. This systematic review investigated whether there is an increase in the lethality across multiple suicide attempts.</p><p><strong>Method: </strong>This systematic review followed PRISMA 2020 reporting guidelines. A literature search was conducted in MEDLINE, Embase and PsycINFO electronic databases from inception to August 2023 to identify studies with key terms related to multiple suicide attempts and lethality. The review included longitudinal studies with data on multiple suicide attempts, and any rating of their lethality. Covidence was used to guide the screening and extraction process. A narrative synthesis approach was used to descriptively summarize included studies.</p><p><strong>Results: </strong>After identifying 828 unique abstracts for screening, 11 studies were included for narrative synthesis. Suicide attempt assessment methods and definitions were heterogenous, often indirectly inferring lethality based on suicide attempt method. Individuals with repeat attempts may be more likely to continue using the same method.</p><p><strong>Conclusions: </strong>There was no evidence to support increasing lethality across repeat suicide attempts. However, this should be interpreted along with the fact that the evidence base is scarce, heterogenous, and methodologically limited.</p>","PeriodicalId":8325,"journal":{"name":"Archives of Suicide Research","volume":" ","pages":"1-22"},"PeriodicalIF":2.5,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11861381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142054785","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Transtheoretical Model of Change and Recovery from a Suicidal Episode.","authors":"Yosef Sokol, Yaakov Wahl, Sofie Glatt, Chynna Levin, Patricia Tran, Marianne Goodman","doi":"10.1080/13811118.2024.2394674","DOIUrl":"https://doi.org/10.1080/13811118.2024.2394674","url":null,"abstract":"<p><strong>Objective: </strong>The Transtheoretical Model of Change (TTM) is an established model outlining five stages of change within a psychotherapeutic context: pre-contemplation, contemplation, preparation, action, and maintenance. Research shows that these models benefit patients and clinicians by enhancing their understanding of complex processes and identifying optimal therapeutic support for individuals at specific times. This study aimed to apply the TTM to personal recovery following a suicidal episode.</p><p><strong>Method: </strong>A meta-synthesis was conducted on qualitative studies that outlined distinct phases or stages of recovery from a suicidal episode. The identified recovery stages were mapped onto corresponding TTM stages.</p><p><strong>Results: </strong>Recovery processes followed a pattern aligning with TTM stages, but the action, maintenance, and termination stages were not clearly distinguished in the context of personal recovery. A three-stage model was proposed instead: (1) precontemplation, where recovery is not seen as possible or meaningful; (2) contemplation, during which there is growing awareness and consideration of the possibility of recovery and change; and (3) active growth, which is characterized by ongoing progress and engagement in at least one personal recovery process.</p><p><strong>Conclusions: </strong>The proposed three-stage model condenses the later TTM stages and may better reflect personal recovery from a suicidal episode. Applying the model in clinical settings could help with case conceptualization and inform recovery approaches to an individual's current stage. Future research should evaluate the benefits of incorporating stages of change into suicide-focused recovery interventions to develop more effective interventions.</p>","PeriodicalId":8325,"journal":{"name":"Archives of Suicide Research","volume":" ","pages":"1-17"},"PeriodicalIF":2.5,"publicationDate":"2024-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142046200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing a Suicide Prevention Helpline's Impact on Caller Crisis Level and Suicidality.","authors":"Kirsten Pauwels, Eva De Jaegere, Patrick Vanderreydt, Silke Aerts, Eva Vande Gaer, Gwendolyn Portzky","doi":"10.1080/13811118.2024.2394666","DOIUrl":"https://doi.org/10.1080/13811118.2024.2394666","url":null,"abstract":"<p><strong>Objective: </strong>Worldwide helplines are considered an important part of suicide prevention strategies. Nevertheless, evidence regarding the impact of suicide prevention helplines on the suicidality of its users remains limited and is frequently confronted with methodological issues. This study aimed to assess the impact of crisis calls on callers' levels of crisis and suicidality both immediately after the call and at follow-up compared to before the call. After the call, the satisfaction of the callers with the intervention was also assessed.</p><p><strong>Methods: </strong>A pre-post study, generated automatically by a telephone system, was conducted in order to compare the level of crisis and suicidality (operationalized by five indicators: hopelessness, entrapment, controllability, suicidal intent, and social support) experienced by callers before and immediately after the call and at follow-up (one to two weeks after the call).</p><p><strong>Results: </strong>Callers (n = 487) showed significant improvement in their level of crisis (<i>p</i> < .001, <i>d</i> = -0.31), hopelessness (<i>p</i> < .001, <i>d</i> = -0.22), entrapment (<i>p</i> < .001, <i>d</i> = -0.25), suicide intent (<i>p</i> < .001, <i>d</i> = -0.37), and social support (<i>p</i> < .001, <i>d</i> = 0.33) after the call compared to before the call. Improvements were also found at follow-up compared to pretest. The satisfaction of callers with the helpline was high.</p><p><strong>Conclusions: </strong>This study adds to the growing evidence on suicide prevention helplines and addresses some important methodological issues in helpline research. Furthermore, it shows promising results regarding the potential supportive impact of helplines on callers who feel suicidal.</p>","PeriodicalId":8325,"journal":{"name":"Archives of Suicide Research","volume":" ","pages":"1-16"},"PeriodicalIF":2.5,"publicationDate":"2024-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142035095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does Psychological Flourishing Have the Potential to Mitigate Self-Injurious Thoughts and Behaviors? A Preliminary Analysis of the Protective Influence of Flourishing.","authors":"Benjamin E Canter, Joshua Hart, Matthew G Clayton, Mitchell J Prinstein, Rachel Mann-Rosan, Sheldon Solomon","doi":"10.1080/13811118.2023.2265418","DOIUrl":"10.1080/13811118.2023.2265418","url":null,"abstract":"<p><strong>Aim: </strong>The purpose of this article was to examine whether psychological flourishing, a multi-dimensional construct of well-being, has the potential to play a preventative role in suicidal and nonsuicidal thoughts and actions.</p><p><strong>Methods: </strong>This two-part study utilized cross-sectional survey data from college students across the United States, assessing levels of psychological distress, loneliness, and psychological flourishing. Frequencies of suicidal ideation, intent, previous suicidal attempts, and nonsuicidal self-injury (NSSI) were also assessed. Data collected in 2019 were used for Study 1 (<i>n</i> = 38,679) and data collected in 2020 were used for Study 2 (<i>n</i> = 50,307).</p><p><strong>Results: </strong>Psychological flourishing is significantly inversely related to suicide and NSSI risk when controlling for loneliness and psychological distress. There were two-way interactions between flourishing and distress, whereby under conditions of high distress, the inverse effect of flourishing on suicidal ideation, intent, and attempts and NSSI was more pronounced. These results were consistent across both studies. Subgroup analyses revealed similar results regardless of participants' race, sexual orientation, and gender identity.</p><p><strong>Conclusion: </strong>Inverse associations between flourishing and self-injurious thoughts and behaviors suggest that flourishing may buffer risk of suicide and NSSI, and these findings may have important implications for developing evidence-based therapeutic interventions. Additional research, including longitudinal and clinical work, is warranted.</p>","PeriodicalId":8325,"journal":{"name":"Archives of Suicide Research","volume":" ","pages":"964-978"},"PeriodicalIF":2.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41189512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Investigation of the Mediating Roles of Emotion Regulation Difficulties, Distress Tolerance, Self-Compassion, and Self-Disgust in the Association Between Childhood Trauma and Nonsuicidal Self-Injury.","authors":"Yasemin Erol, Mujgan Inozu","doi":"10.1080/13811118.2023.2237083","DOIUrl":"10.1080/13811118.2023.2237083","url":null,"abstract":"<p><strong>Objective: </strong>Childhood maltreatment has been associated as a risk factor with the development of nonsuicidal self-injury (NSSI), with difficulty in emotion regulation explaining the association. However, little is known about the potential factors that make some individuals with maltreatment history more vulnerable to difficulties in emotion regulation and, in turn, engage in NSSI. The current study aimed to examine the roles of distress tolerance, self-compassion, and self-disgust in the association between childhood maltreatment types and emotion regulation difficulty, which was expected to predict NSSI.</p><p><strong>Method: </strong>The sample included 397 university students between the ages of 18 and 30. Participants completed self-report scales assessing childhood maltreatment, emotion regulation difficulty, distress tolerance, self-compassion, self-disgust, and NSSI using the paper-pencil and online methods. The mediation model suggested for the association between childhood maltreatment types and NSSI was tested using path analysis.</p><p><strong>Results: </strong>Low distress tolerance, low self-compassion, high self-disgust, and resulting high emotion regulation difficulty mediated the indirect effect of emotional neglect on NSSI.</p><p><strong>Conclusion: </strong>The current study sheds light on various factors in the development and maintenance of NSSI and reveals three developmental pathways from emotional neglect in childhood to engaging in NSSI.HIGHLIGHTSEmotional neglect may be a distal risk factor for nonsuicidal self-injury (NSSI).Low distress tolerance and self-compassion and high self-disgust may increase the risk of NSSI.Emotion regulation difficulty may make people engage in NSSI to regulate emotions.</p>","PeriodicalId":8325,"journal":{"name":"Archives of Suicide Research","volume":" ","pages":"815-829"},"PeriodicalIF":2.5,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9892689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}