Recent stressful life events and identity development in emerging adults: An examination of within-person effects.

OBJECTIVE: To examine longitudinal associations among stressful life events and identity processess in emerging adults while accounting for within-person and between-person effects. BACKGROUND: Theoretical perspectives suggest that stressful life events may impact one's identity (i.e., coherent sense of self), but few studies have considered how changes in stressful life events are associated with changes within an individual's identity development over time (within-person effects). METHODS:  Recent stressful life events (i.e., academic problems, friendship problems, romantic problems, and time pressure) and the processes through which identity develops (e.g., exploring in breadth and depth) were examined longitudinally (T1-T3) in a sample of emerging adults (N = 1125, Mage = 17.96 years). RESULTS: Random-intercept cross-lagged modeling demonstrated that at the between-person level, emerging adults with greater academic and friendship problems, as well as more time pressures (relative to their counterparts), tended to engage in greater ruminative exploration. Further, those with more academic problems tended to demonstrate weaker commitment-making and exploration in breadth and depth (relative to their counterparts). Within-person increases in romantic problems predicted lower commitment-making and higher ruminative exploration over time. CONCLUSION: Findings suggest that romantic problems may predict within-person changes in identity processes, whereas academic problems, friendship problems, and time pressure may be more concurrently related to identity development.

Longitudinal Associations among Identity Processes and Mental Health in Young Adulthood: The Mediating Role of Social Support.

Emerging adulthood (ages 18-25) is a period of identity exploration, particularly for young adults navigating the transition to post-secondary school. Little is known about how changes in identity exploration may be related to emerging adults' mental health, or the role of social support plays in identity-related processes. In the present study, associations among identity exploration, internalizing symptoms, and perceived social support were examined. Participants included a diverse group of emerging adults (N = 1,125, Mage = 17.96 years) studying at a Canadian university. Random-intercept cross-lagged modeling demonstrated that within-person increases in exploration in breadth predicted fewer depressive symptoms over time, whereas within-person increases in exploration in depth predicted more depressive and anxious symptoms over time. A mediation effect from perceived support from significant other to depressive symptoms via exploration in breadth was also evident. Findings suggest that identity exploratory processes may be developmentally relevant in emerging adulthood, but their implications for mental health may differ. Perceived social support is also meaningfully related to identity exploration and mental health.

A Daily Diary Study of the Relation between Stress and Nonsuicidal Self-Injury and the Moderating Role of Emotion Dysregulation in Emerging Adulthood.

Research on exposure to stressors and nonsuicidal self-injury (NSSI) in daily life has been lacking, particularly among emerging adults (aged 18-25 years). The aim of this study was to determine whether daily stressors predicted same-day and next-day NSSI thoughts and engagement, and whether emotion dysregulation moderated this relation. Participants included 160 emerging adults (83% female, Mage = 19.75, SD = 1.8, 44% White, 22% East Asian, 11% South Asian, and 23% other) who completed a baseline assessment and 14 days of daily diary entries which resulted in 1982 daily assessments (median compliance = 86%; IQR = 12-14). It was found that daily stressors significantly predicted same-day, but not next-day, NSSI thoughts and engagement and this relation was more pronounced for individuals with greater emotion dysregulation. The present study provides new insight into when individuals may be most at risk for NSSI, as well as which individuals may be most vulnerable.

A Person-Centered Investigation Into the Co-Development of Perceived Stress and Internalizing Symptoms Among Post-Secondary Students.

The early post-secondary years are regarded as a period of heightened vulnerability for stress and internalizing symptoms among emerging adults. However, there is a lack of research examining variability in stress and internalizing symptoms among students, the co-occurrence of stress and internalizing symptoms, or predictors of distinct profiles of stress and internalizing symptoms. To address these gaps in the literature, 1125 ethnically diverse first-year students (71% female; Mage = 17.96 years, SD = 0.69; 55% East or South Asian, 21% Caucasian, 24% other ethnicity) were surveyed three times across the first year of university. Latent growth mixture models revealed four distinct profiles (i.e., high distress, moderate increasing distress, low distress, high decreasing distress), in which patterns of perceived stress and internalizing symptoms co-occurred. Higher levels of exposure to stressful life events, identifying as female and/or LGBQ+ were associated with increasing and high distress profiles. The findings underscore variability in distress among students, as well as the strong associations between stressful experiences, perceived stress, and internalizing symptoms.

A longitudinal examination of predictors of nonsuicidal self-injury disclosures among university students.

OBJECTIVE: There is a paucity of longitudinal research on predictors of disclosures of nonsuicidal self-injury (NSSI) among emerging adults. However, understanding the factors that facilitate disclosure is critical, as disclosure may serve as a first step in accessing care. To address this gap, the present study examined predictors of prospective NSSI disclosures in a postsecondary student sample. METHODS: A total of 475 university students with a history of NSSI (Mage = 17.96; 74.9% women) reported on several potential predictors of NSSI disclosure, and their disclosure history at baseline and 4- and 8-month follow-ups. RESULTS: It was found that 22% of students reported disclosing NSSI during the first year of university; students who had previously disclosed, and who reported greater NSSI severity, were more likely to disclose over time. CONCLUSION: Results of the present study suggest that disclosures often occur in the postsecondary context, and students who disclose NSSI may engage in more severe NSSI behaviours.

Impulsivity and nonsuicidal self-injury: A longitudinal examination among emerging adults.

INTRODUCTION: Nonsuicidal self-injury (e.g., self-cutting without lethal intent) is a widely occurring behavior among adolescents and emerging adults. Heightened impulsivity during the adolescent and emerging adult years may contribute to an increased risk for nonsuicidal self-injury onset and engagement during these developmental periods; however, longitudinal research on impulsivity and nonsuicidal self-injury among young persons is lacking. METHOD: To extend previous research, and elucidate the direction of effects between impulsivity and nonsuicidal self-injury, 782 emerging adults (75% female) completed assessments of impulsivity and nonsuicidal self-injury annually for three years. RESULTS: Path analysis revealed a bidirectional relation, such that higher impulsivity predicted greater nonsuicidal self-injury frequency over time, and greater nonsuicidal self-injury frequency predicted higher impulsivity over time, even after taking into account past scores on these variables as well as other participant factors (e.g., age, sex, depressive symptoms, anxiety). Gender did not moderate the pattern of associations. CONCLUSIONS: The present findings indicate that impulsivity may not only lead to nonsuicidal self-injury, but that frequent engagement in nonsuicidal self-injury may undermine regulatory skill development and lead to greater impulsivity over time during the emerging adult years.

Stressful Experiences, Emotion Dysregulation, and Nonsuicidal Self-Injury among University Students.

Developmental theory on nonsuicidal self-injury (NSSI; e.g., self-cutting without lethal intent) underscores that stressful life experiences may lead to heightened risk for NSSI, potentially by undermining individuals' emotion coping capacities. Given that the transition to university is often accompanied by new stressors for emerging adults, it is possible that stressors experienced during the university years may lead to heightened susceptibility for NSSI during this developmental period. Cross-sectional research supports a positive association between stressful experiences and NSSI among students; however, longitudinal research is needed to examine the direction of effects and explore potential mediating factors (i.e., emotion dysregulation). In the present study, university students (N = 1132; 70.5% female; mage = 19.11) reported on their stressful experiences in university, difficulties in emotion regulation, and NSSI each year for three consecutive years. Path analysis revealed a bidirectional association between stressful experiences and NSSI. Increased stressful experiences predicted increased risk for NSSI through emotion dysregulation, and NSSI predicted increased stressful experiences through emotion dysregulation. Overall, these findings provide new insight into the processes through which NSSI may be initiated and maintained, as well as elucidate the impacts of NSSI on emotion regulation and stressful life experiences in university.

An Examination of Correlates for Adolescent Engagement in Nonsuicidal Self-Injury, Suicidal Self-Injury, and Substance Use.

Little research has examined potential risk factors for direct versus indirect self-injury among adolescents. To address this limitation, 541 clinically referred adolescents were assessed using the interRAI Child and Youth Mental Health Assessment. Logistic regression analyses revealed that older females who experienced heightened depressive symptoms and neighborhood violence were at increased risk for direct self-injury, specifically nonsuicidal and suicidal self-injury. Additionally, adolescents who experienced higher levels of caregiver distress were at greater risk of suicidal self-injury. In contrast, older adolescents who experienced heightened aggressive behavior were at increased risk for one form of indirect self-injury, substance use. Findings suggest that nonsuicidal self-injury, suicidal self-injury, and substance use are associated with differential risk factors. Implications for targeted prevention strategies are discussed.

The Child and Youth Mental Health Assessment (ChYMH): An examination of the psychometric properties of an integrated assessment developed for clinically referred children and youth.

BACKGROUND: The Child and Youth Mental Health (ChYMH) assessment system was developed by interRAI (i.e., an international collective of researchers and clinicians from over thirty countries) in response to the unprecedented need for a coordinated approach to delivery of children's mental health care. Many interRAI instruments are used across Canada and internationally, but the ChYMH represents the first assessment specifically for children and youth. In the present paper, a short overview of the development process of the ChYMH is provided, and then the psychometric properties of several embedded scales on the ChYMH are examined. METHODS: Participants included 1297 children and youth and their families who completed the ChYMH after being referred to mental health agencies within Ontario, Canada. In addition, smaller subsets of participants (N = 48-53) completed additional criterion measures, including the Social Skills Improvement System (SSIS), the Child and Adolescent Functional Assessment Scale (CAFAS), the Child Behavior Checklist (CBCL), and the Brief Child and Family Phone Interview (BCFPI). RESULTS: Results demonstrated that the ChYMH subscales had strong internal-consistency (Cronbach's higher than .70), and correlated well with the criterion measures. CONCLUSIONS: Findings support the clinical utility of the ChYMH for use among clinically referred children and youth. Implications for children's mental health assessment and practice are discussed.

Nonsuicidal self-injury and affect regulation: recent findings from experimental and ecological momentary assessment studies and future directions.

CONTEXT: Although research indicates that nonsuicidal self-injury (NSSI) may be used as a form of emotion regulation, studies have largely relied on the use of retrospective self-report data, which limits inferences about directionality of effects. Recently, researchers have started to employ lab-based experimental (e.g., guided imagery, acute pain) and moment sampling approaches to the study of NSSI. METHODS: In the present study, we conducted a review of this recent literature, using several electronic databases (e.g., PsychINFO, ERIC, CINAHL). RESULTS: We identified 18 studies that met our inclusion criteria. Findings indicated that the administration of pain was associated with decreases in negative affect among both self-injurers and noninjurers, although these declines were more pronounced for self-injurers in some studies. CONCLUSIONS: We discuss findings within the context of two central theories (i.e., opponent-process theory and distraction theory) and offer several recommendations for future research in this area.

The triadic systems model perspective and adolescent risk taking.

In this special issue, Ernst (2014) outlines the triadic systems model, which focuses on the balanced interaction among three functional neural systems: the prefrontal cortex (regulation/control), striatum (motivation/approach), and amygdala (emotion/avoidance). Asynchrony in maturation timelines, coupled with less mature connectivity across brain regions, is thought to result in unique vulnerabilities for risk taking during the adolescent age period. Yet, the research evidence linking the triadic systems model to differences in risk taking across adolescence and adulthood is equivocal, and few studies have examined how neural development is associated with real-world behavior. In this commentary, we outline research on adolescent risk taking which highlights the importance of considering trait level and situational conditions when examining associations between neural systems and behavior, as well as the need to adopt a lifespan perspective.

Examining the link between adolescent brain development and risk taking from a social-developmental perspective (reprinted).

The adolescent age period is often characterized as a health paradox because it is a time of extensive increases in physical and mental capabilities, yet overall mortality/morbidity rates increase significantly from childhood to adolescence, often due to preventable causes such as risk taking. Asynchrony in developmental time courses between the affective/approach and cognitive control brain systems, as well as the ongoing maturation of neural connectivity are thought to lead to increased vulnerability for risk taking in adolescence. A critical analysis of the frequency of risk taking behaviors, as well as mortality and morbidity rates across the lifespan, however, challenges the hypothesis that the peak of risk taking occurs in middle adolescence when the asynchrony between the different developmental time courses of the affective/approach and cognitive control systems is the largest. In fact, the highest levels of risk taking behaviors, such as alcohol and drug use, often occur among emerging adults (e.g., university/college students), and highlight the role of the social context in predicting risk taking behavior. Moreover, risk taking is not always unregulated or impulsive. Future research should broaden the scope of risk taking to include risks that are relevant to older adults, such as risky financial investing, gambling, and marital infidelity. In addition, a lifespan perspective, with a focus on how associations between neural systems and behavior are moderated by context and trait-level characteristics, and which includes diverse samples (e.g., divorced individuals), will help to address some important limitations in the adolescent brain development and risk taking literature.

A longitudinal person-centered examination of nonsuicidal self-injury among university students.

Little is known about the development and maintenance of nonsuicidal self-injury (NSSI) over time; however, identifying individuals at risk for NSSI onset or its recurrent engagement is of critical importance for developing effective prevention and intervention strategies. To address this important gap in the literature, we used a person-centered approach to study patterns of change among self-injurers (i.e., new beginners, recovered injurers, relapsers, desisters, and persistent injurers). Undergraduate students (N = 666, 71.1 % female, M age = 19.15) from a mid-sized Canadian university participated in the two-wave study (assessments were 1 year apart). Participants completed the Inventory of Statements about Self-Injury (ISAS, Klonsky and Glenn in J Psychopathol Behav Assess 31:215-219, 2009) at Time 1, and a measure of past year NSSI frequency 1 year later. Participants also completed several measures of psychosocial risk (e.g., problem behaviors, problems with parents) at both time points. Consistent with Nock's (Ann Rev Clin Psychol 6:339-363, 2010) model on the development of NSSI over time, individuals who continued to engage in NSSI across the university years (i.e., persistent injurers) reported greater levels of psychosocial risk as compared to those in the other groups. Moreover, a discriminant function analysis revealed that new beginners, relapsed injurers, and persistent injurers were differentiated from recovered injurers and desisters by increases over time in problem behaviors, problems with parents, internalizing behaviors, and suicidal ideation. Our findings provide new insight into the course of NSSI engagement across the university years, and offer clinicians ways to discriminate among individuals with varying longitudinal patterns of NSSI (i.e., on measures of psychosocial risk, and motivations to stop self-injuring).

Pain tolerance as a 'barrier' to nonsuicidal self-injury: A longitudinal study.

Theoretical perspectives underscore that low pain tolerance may be a relevant 'barrier' to non-suicidal self-injury (NSSI). However, there is limited longitudinal work on the link between pain tolerance and NSSI, which is needed to assess if pain tolerance precedes NSSI engagement, and/or if NSSI precedes altered pain tolerance. Further, assessing both NSSI frequency and versatility (or number of NSSI methods), in addition to engagement, can provide a more nuanced understanding of the influence of pain on NSSI severity. In the present study, 1125 undergraduate students at a large university (72 % female, Mage = 17.96) reported on their NSSI frequency, NSSI versatility, and perceived pain tolerance. Four individual regressions were run to examine the potential bidirectional nature of the association between NSSI frequency and pain tolerance, and NSSI versatility and pain tolerance. Pain tolerance predicted both NSSI frequency and versatility over time. Neither NSSI frequency nor versatility predicted pain tolerance. Results suggest that high pain tolerance may be a risk factor for severe NSSI engagement.

Examining trajectories of nonsuicidal self-injury across the first year of university.

BACKGROUND: Nonsuicidal self-injury (NSSI) is prevalent among emerging adults in post-secondary school, but little is known about change and stability in NSSI during the transition to university. Moreover, there has been limited person-centered work focusing on heterogeneity in NSSI engagement among students over time. The present study aimed to investigate the development and maintenance of NSSI across the first year of university and explore predictors of potential variability in trajectories of NSSI. METHODS: The present sample consisted of 1125 first-year university students at a large post-secondary institution (Mage = 17.96, 71 % female, 28 % male, 1 % gender diverse) who participated in a larger longitudinal study. Participants completed an online survey three times over their first year of university. Latent growth curve modeling (LGCM) in Mplus was utilized to explore different NSSI group trajectories across first year university. RESULTS: NSSI was prevalent among first year students (35 %). LGCM revealed one developmental trajectory; NSSI engagement decreased across the first year of university. Students who engaged in NSSI had increased difficulties with emotion regulation, lower self-compassion, and lower levels of social support compared to students who did not engage in NSSI. LIMITATIONS: The present study may be subject to recall errors and future studies should include more gender diverse samples to increase generalization of findings. CONCLUSIONS: Findings highlight the transition to university as a peak period of vulnerability for NSSI engagement and emphasize the need for proactive university intervention efforts to mitigate risk and improve student well-being.

Examining the link between adolescent brain development and risk taking from a social-developmental perspective.

The adolescent age period is often characterized as a health paradox because it is a time of extensive increases in physical and mental capabilities, yet overall mortality/morbidity rates increase significantly from childhood to adolescence, often due to preventable causes such as risk taking. Asynchrony in developmental time courses between the affective/approach and cognitive control brain systems, as well as the ongoing maturation of neural connectivity are thought to lead to increased vulnerability for risk taking in adolescence. A critical analysis of the frequency of risk taking behaviors, as well as mortality and morbidity rates across the lifespan, however, challenges the hypothesis that the peak of risk taking occurs in middle adolescence when the asynchrony between the different developmental time courses of the affective/approach and cognitive control systems is the largest. In fact, the highest levels of risk taking behaviors, such as alcohol and drug use, often occur among emerging adults (e.g., university/college students), and highlight the role of the social context in predicting risk taking behavior. Moreover, risk taking is not always unregulated or impulsive. Future research should broaden the scope of risk taking to include risks that are relevant to older adults, such as risky financial investing, gambling, and marital infidelity. In addition, a lifespan perspective, with a focus on how associations between neural systems and behavior are moderated by context and trait-level characteristics, and which includes diverse samples (e.g., divorced individuals), will help to address some important limitations in the adolescent brain development and risk taking literature.

A Longitudinal Examination of Recent Posttraumatic Stress Symptoms and Nonsuicidal Self-Injury among University Students.

Nonsuicidal self-injury is a burgeoning mental health concern amongst post-secondary students. In the present study, the link between posttraumatic stress symptoms (PTSS) and nonsuicidal self-injury (NSSI) was examined among post-secondary students over time, while accounting for the role of co-occurring depressive symptoms. Participants were 841 first-year university students with self-reported lifetime histories of trauma who reported on traumatic experiences, PTSS, depressive symptoms, and NSSI at three time points over the course of their first year of university. This study also included exploratory correlational analyses of the relation among PTSS and motivations for NSSI engagement. As expected, PTSS predicted NSSI engagement among students within and across time, though effects were small. The strongest correlations were among PTSS and engaging in NSSI for the purposes of fulfilling self-punishment desires and anti-dissociation (e.g., to reduce feelings of numbness). This study provides further support for theories underscoring NSSI as a means of coping with intra- and interpersonal distress among post-secondary students experiencing stressful life events, such as trauma.

An examination of nonsuicidal self-injury disclosures in a high-risk university sample.

Objective: There is a lack of research examining factors that promote the disclosure of nonsuicidal self-injury (NSSI) among post-secondary students. However, elucidating which factors facilitate disclosures among students - particularly students with high risk NSSI - is important given that disclosure may facilitate access to care. Methods: Participants included 149 post-secondary students with recent NSSI (81% women, Mage = 19.96) who reported on their disclosures, as well as several potential correlates of disclosure. Results: Eighty-seven percent of respondents had disclosed NSSI, often to several informal sources. Students with higher willingness to disclose personally distressing information, perceived levels of social support, stressful experiences, and frequency of NSSI engagement were more likely to disclose NSSI to more types of sources and more unique individuals. Conclusion: Results suggest that disclosure is an ongoing process rather than a single event, and underscore the importance of teaching effective NSSI disclosure responses to campus community members.

Surprise and delight: Response to informal versus formal mindfulness among university students with self-injury.

Nonsuicidal self-injury (NSSI) is defined as the deliberate destruction of one's bodily tissue without suicidal intent. Mindfulness practice is commonly incorporated into universities' stress management programming and may benefit students with a history of NSSI. However, recent findings suggest that these students may respond differentially to specific types of mindfulness practice (i.e., formal vs. informal practice). The present study qualitatively explored the acceptability of different types of mindfulness practice among university students with a history of NSSI. University students with a recent history of NSSI (n = 36) completed a semistructured interview following a brief mindfulness practice (i.e., either a formal body scan, formal sitting meditation, or informal practice). Reflexive thematic analysis of interview transcripts revealed five key themes. First, there appeared to be general misconceptions regarding what constitutes mindfulness practice (Theme 1). Nevertheless, within the present study, all mindfulness practices were carried out with relative ease (Theme 2). Notably, favorable physical and psychological experiences were predominant in response to informal practice (Theme 3). Preferences regarding level of guidance were more mixed in response to formal versus informal practice (Theme 4). Finally, only informal practice inspired feelings of delight and surprise following practice (Theme 5). Informal mindfulness practice is deemed highly acceptable by university students with a history of NSSI and clinicians should strongly consider emphasizing it in mindfulness-based interventions offered to these students, to provide them with the best opportunity to build a regular mindfulness practice and develop their emotion regulation abilities. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The mental health impact of the COVID-19 pandemic on post-secondary students: A longitudinal study.

This prospective longitudinal study measured sex-specific changes in depression, anxiety, and stress scores using, validated Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and the Perceived Stress Scale (PSS) in a cohort of 1445 post-secondary students (500 males, 945 females) assessed at three time points from December 2020 to January 2022. Participants were ascertained from a population of 15,585 students with in-person activities on campus at baseline and recruited from December 2020 to January 2021. We also assessed how sociodemographic characteristics influenced students' mental health outcomes. Inverse probability weighting was used to account for missing data and attrition. Linear mixed effects models were used to analyze the relationship between the mental health scores in each questionnaire, demographic and academic data, and public health stringency measured by the local stringency index. No change was observed in questionnaire scores over time for males and females, but the stringency index was significantly associated with increased stress. Being in a non-health-related-field or being white affected males and females differently for stress and anxiety, but not depression. Demographics tended to be more influential on females' mental health than males. In conclusion, mental health resource allocation in time of emerging pandemic could benefit from targeted interventions.