Different self-damaging behaviours, similar motives? Testing measurement invariance of motives for nonsuicidal self-injury, disordered eating and substance misuse.

OBJECTIVES: Theory and research suggest that distinct self-damaging behaviours (SDBs; e.g., nonsuicidal self-injury [NSSI], restrictive eating, binge eating, drug misuse, alcohol misuse) share similar motives. However, few studies have used a common self-report inventory to investigate the shared relevance and relative salience of motives for SDBs. Accordingly, the present study: (1) examined whether self-report scales assessing intrapersonal motives (i.e., relieving negative emotions, enhancing positive emotions, punishing oneself) and interpersonal motives (i.e., bonding with others, conforming with others, communicating distress, communicating strength, reducing demands) have invariant factor structures across SDBs; and (2) compared the salience of these motives across SDBs. METHODS: 1018 adults (54.6% men, Mage = 35.41 years) with a history of SDBs were allocated to the following groups: NSSI (n = 213), restrictive eating (n = 200), binge eating (n = 200), drug misuse (n = 200) or alcohol misuse (n = 205). Participants reported on their motives for engaging in their allocated SDB. Measurement invariance analyses compared the factor structures and latent means of the motive scales across SDBs. RESULTS: The motive scales had comparable factor structures across SDBs. Intrapersonal motives were most strongly endorsed for NSSI and drug misuse. Interpersonal motives were most strongly endorsed for drug and alcohol misuse. All motives were least salient to restrictive eating. CONCLUSIONS: Results suggest that common motives underlie distinct SDBs and that they can be adequately assessed using a single self-report inventory. However, certain motives are more relevant to some SDBs than others, with restrictive eating being the most motivationally distinct SDB. This knowledge can inform transdiagnostic models and interventions for SDBs.

Influence of perceived peer behavior on engagement in self-damaging behaviors during the transition to university.

As students transition to university, they experience significant social changes that can affect their behaviors, including self-damaging behaviors like disordered eating, problematic alcohol/drug use, suicidal thoughts, and non-suicidal self-injury (NSSI). Building on prior work, we examined the associations between (1) perceptions of peers' engagement in self-damaging behaviors predicting one's own subsequent engagement in such behaviors (i.e., socialization) and (2) one's own engagement in self-damaging behaviors predicting perceptions of peers' subsequent engagement in such behaviors (i.e., selection). We also examined whether these associations were moderated by the source of influence (close peer/acquaintance) and degree of social disconnection experienced by the student. First-year university students (N = 704) were asked to complete seven monthly surveys. Multilevel models indicated that when students perceived their close peers had engaged in NSSI or suicidal thinking, they had seven times greater odds of future engagement in the same behavior, implying that socialization increases the risk of these behaviors among university students. Perception of acquaintances' NSSI also predicted greater odds of a student's own NSSI the following month. Social disconnection increased the likelihood of matching own behaviors to perceptions of acquaintances' alcohol abuse, highlighting the importance of fostering connections/mentors to reduce self-damaging behaviors on college campuses. Furthermore, when students engaged in alcohol abuse, they had almost four times greater odds of reporting that their acquaintances abused alcohol the following month, emphasizing the importance of the wider social network in alcohol use behaviors.

Examining the components and stability of negative affect in disordered eating frequency.

OBJECTIVE: There is a limited understanding of the unique components of negative affect that are most important to disordered eating. Our study tested the contributions and stabilities of unique components of negative affect in the frequency of both binge eating and restricted eating. We examined if: (1) symptoms of depression, anxiety and stress share unique, concurrent associations with binge eating and restricted eating, respectively, and if (2) instability of depression, anxiety, and stress predict binge eating and restricted eating, respectively. METHOD: 627 first year undergraduate students completed 7 assessments of these constructs across their first academic year. Generalised multilevel modelling was employed. RESULTS: Higher than average anxiety, but not depression or stress, was concurrently associated with restricted eating. No concurrent associations between negative affect and binge eating were found. Instability of depression, but not anxiety or stress, predicted both binge and restricted eating. CONCLUSION: Anxiety may be a more salient predictor of restricted eating than depression or stress. However, larger monthly changes in depression may confer risk for more frequent binge eating and restricted eating.

Personality correlates of eating pathology severity and subtypes in The National Comorbidity Survey Adolescent Supplement.

OBJECTIVE: We examined how personality traits are associated with eating pathology (EP) across a range of severities and symptom subtypes. METHOD: The National Comorbidity Survey Adolescent Supplement (N = 10,148) was used to compare personality across severities (i.e., clinical Eating Disorders [EDs], subclinical disordered eating, preclinical weight concerns, or no weight/EP [no W/EP]), subclinical subtypes (i.e., Binge Eating Only, Binge-Purge, Binge-Restrict, Restrict-Purge, or no W/EP), and clinical subtypes (i.e., Anorexia Nervosa [AN]), Bulimia Nervosa [BN], Binge Eating Disorder [BED], internalizing disorders, or no ED or internalizing disorder) of EP. RESULTS: More severe EP was associated with more extreme personality trait endorsements. Impulsivity-related traits did not consistently distinguish binge eating/purging from restricting subtypes, although behavioral disinhibition differentiated adolescents with BN or BED from AN. CONCLUSION: Personality traits related to affectivity and impulsivity were more consistently associated with severity rather than subtype of EP.

From facts to feelings: Navigating the complexities of COVID-19 restrictions, perceptions, and mental well-being.

Objectives of the present study were to 1) examine accuracy of COVID-19 public health restriction knowledge and the impact of information source, 2) assess the effect of perceived level of restriction on perceived infection risk of COVID-19 infection and level of compliance with restrictions, and 3) investigate the relationship between mental health outcomes and perceived as well as actual level of restriction. Canadians (n = 5,051) completed an online survey between December 2020 and March 2021 assessing public health restriction knowledge, accuracy of this knowledge, information sources about COVID-19, perceived infection risk, compliance with restrictions, loneliness, anxiety, and depressive symptoms. Approximately half of our sample had accurate knowledge of the restrictions in their region/province, which significantly differed by province. Individuals who perceived restriction levels to be higher than they were, reported significantly greater perceived infection risk, more compliance with restrictions, worse mental health, and greater loneliness. Individuals living under moderate restrictions had better mental health and experienced less loneliness compared to minor, significant and extreme restriction levels. Findings suggest that while restrictions are beneficial for compliance, stronger and clearer restrictions should be coupled with mental health supports to remediate the negative effects of restrictions and uncertainty on mental health and loneliness.

Between- and Within-Person Correlates of Alcohol-Impaired Driving in First-Year University Students: The Roles of Impulsivity, Binge Drinking, Depression, and Anxiety.

OBJECTIVE: University students are a high-risk demographic for alcohol-impaired driving (AID), a leading contributor to death and injury on Canadian roads. Although between-person correlates of AID are well established, little research has identified within-person correlates that elucidate when AID occurs. Accordingly, this study investigated whether between- and within-person variability in impulsivity, binge drinking, depression, and anxiety are associated with AID in university students. METHOD: Participants were 633 first-year students (75% female, mean age = 17.97 [SD = 0.76]) from a Canadian university who completed seven monthly surveys. Multilevel models disaggregated between- and within-person associations. RESULTS: Between-person elevations in negative and positive urgency, sensation seeking, lack of premeditation, binge drinking, and depression were associated with greater odds of AID. Within-person elevations in negative urgency, sensation seeking, and binge drinking were associated with greater odds of AID, whereas within-person elevations in depression were associated with lower odds of AID. CONCLUSIONS: These results support existing research regarding who is most likely to engage in AID (students with elevated impulsivity, binge drinking, and depression) and extend this research by identifying under what conditions AID is likeliest to occur (when impulsivity and binge drinking are higher than usual, and depression is lower than usual). The opposing between- and within-person associations of depression with AID highlight the need for careful specification of hypotheses, as findings at the between-person level may not generalize to the within-person level. Moving forward, research that elucidates not only for whom but also when AID occurs may be best positioned to inform intervention and prevention efforts among university students.

Psychological mediators of the associations between pandemic-related stressors and suicidal ideation across three periods of the COVID-19 pandemic in Canada.

BACKGROUND: The COVID-19 pandemic's mental health impact is well-established. While early evidence suggested suicide deaths remained stable or declined, suicidal ideation (SI) became more prevalent than before the pandemic. Our study: (1) examined the prevalence and distribution of SI among Canadian adults, (2) compared SI among those with and without pre-existing mental illnesses, and (3) evaluated associations between pandemic-related stressors (i.e., unemployment, insecure employment, loss of income, medical vulnerability, COVID-19 exposure) with SI, and whether such associations were mediated by depression, thwarted belongingness, perceived burdensomeness, or perceived discrimination. METHODS: The sample was comprised of data gathered at three timepoints (Wave 1 08/18/2020-10/01/2020, n = 6629; Wave 2 12/21/2020-03/31/2021, n = 5920; Wave 3 09/07/2021-12/07/2021, n = 7354). Quota-based responses from survey research panels which matched the geographic, age, and sex distribution of the Canadian population were supplemented with convenience-sampled responses. RESULTS: The prevalence of SI was 4.1 % (Wave 1), 5.3 % (Wave 2), and 5.8 % (Wave 3). Odds of SI were higher for respondents under the age of 35 years and with pre-existing mental illnesses. SI was associated with quarantining due to suspected or confirmed COVID-19 exposure, potential COVID-19 exposure at work, medical vulnerability toward COVID-19, insecure employment or unemployment, and income loss. These associations were mediated by psychological experiences, particularly depression and thwarted belongingness. LIMITATIONS: This cross-sectional, observational study cannot establish temporality or causality. CONCLUSION: Results highlight groups who may benefit from enhanced screening for depression and suicide risk. Reducing depression and increasing sense of belonging should be prioritized.

Psychological Impacts of the COVID-19 Pandemic on Canadian Healthcare Workers: A Case Control Comparison From Three Cross Sectional Surveys.

OBJECTIVE: The aim of the study is to describe mental health impacts of the COVID-19 pandemic and identify roles that predict distress among Canadian healthcare workers (HCWs). METHODS: Using data from three cross-sectional Canadian surveys, we compared 799 HCWs to demographically matched controls and compared HCWs with and without COVID-19 patient contact. Participants completed validated measures of depression, anxiety, trauma-related stress, alcohol problems, coping self-efficacy, and sleep quality. RESULTS: Non-HCWs reported more depression and anxiety in Fall 2020 and more alcohol problems in Fall/Winter 2021 than HCWs. In Winter 2020-2021, HCWs reported more trauma-related stress than non-HCWs. As of early 2021, HCWs with direct patient contact reported worse symptoms across nearly all measures than HCWs without. CONCLUSIONS: Although Canadian HCWs did not report worse mental health than demographically similar peers, mental health supports are needed for HCWs providing direct patient care.

Support for a Transdiagnostic Motivational Model of Self-Damaging Behaviors: Comparing the Salience of Motives for Binge Drinking, Disordered Eating, and Nonsuicidal Self-Injury.

Integrating across motivational models suggests that different self-damaging behaviors (SDBs) are enacted for similar reasons. However, it remains unclear whether some motives are more relevant to certain SDBs than others. To answer this question, the present study compared the salience of 8 potentially shared motives across 3 exemplar SDBs, selected to represent different points along the internalizing and externalizing spectra: binge drinking, disordered eating (binge eating, purging, fasting), and nonsuicidal self-injury (NSSI). Seven hundred and four first-year university students (73% female, Mage = 17.97) completed monthly surveys assessing their engagement in and motives for SDBs. Motives were conceptualized as either interpersonal (bonding with others, conforming with others, communicating strength, communicating distress, reducing demands) or intrapersonal (reducing negative emotions, enhancing positive emotions, punishing oneself). Multilevel models compared endorsement of each motive across SDBs. Results revealed that SDBs were motivated by similar goals, albeit to different degrees. Although some exceptions emerged, interpersonal motives were most salient to binge drinking, followed by disordered eating, and then NSSI. In contrast, intrapersonal motives were most salient to NSSI, followed by disordered eating, and then binge drinking. Motivational differences were also found within disordered eating. For example, punishing oneself was more relevant to purging and fasting than binge eating, whereas relieving negative emotions was more relevant to binge eating and purging than fasting. Similar to dimensional models that position SDBs on internalizing or externalizing spectra, the salience of motives for binge drinking and NSSI may fall on distinct spectra (i.e., interpersonal and intrapersonal, respectively), with motives for disordered eating exhibiting elements consistent with both spectra. This study supports a common motivational framework for investigating and potentially treating a variety of topographically distinct SDBs.