A Comparison of Affective-Cognitive States in Daily Life Between Emerging Adults With and Without Past-Year Nonsuicidal Self-Injury.

Although the literature suggests trait-like differences in affective and cognitive vulnerabilities between individuals with and without a history of nonsuicidal self-injury (NSSI), little is known about how these dispositional differences are experienced in the natural environment. The present study compares the intensity, inertia, interaction, and variability of affective (negative and positive affect) and cognitive states (rumination, self-criticism) in the everyday lives of individuals who do and do not engage in NSSI. Using experience sampling methodology (ESM), 60 emerging adults (ages = 18-22 years) with and without past-year NSSI (equally distributed) completed eight questionnaires per day for 12 days (in total, 96 questionnaires per participant), resulting in 4,587 assessments (median compliance = 83.3%; IQR = 71.9-91.7). In a dynamic structural equation modeling framework, dynamic parameters (i.e., mean intensity, carryover effects, spillover effects, and within-person variability) were evaluated using multilevel vector autoregressive models. Emerging adults who engage in NSSI experience higher intensity and greater variability of negative affect, rumination, and self-criticism, whereas those who do not engage in NSSI experience higher intensity and lower variability of positive affect. In addition, past-year NSSI predicted stronger affective-cognitive interactions over time, with stronger spillover effects of negative and positive affect on subsequent rumination and self-criticism in individuals who engage in NSSI. Depressive symptoms and trait levels of emotion dysregulation and self-criticism partially negated these differences. Our findings provide evidence that emerging adults who self-injure experience more negative affective-cognitive states in daily life and point to the potential relevance of boosting positive emotions to buffer negative cognitions.

Identity Functioning in Patients with an Eating Disorder: Developmental Trajectories throughout Treatment.

Increasing research has indicated a strong association between identity functioning and eating disorder (ED) symptomatology. However, a detailed investigation of identity throughout ED treatment is lacking. The present longitudinal study examined identity in inpatients with an ED and explored its simultaneous change with ED symptomatology throughout treatment. A total of 225 female patients completed questionnaires at admission. From these 225 patients participating at admission (Wave 1), 110 also participated in at least one additional measurement wave, with 43.64% (n = 48) participating at admission and during treatment, 16.36% (n = 18) participating at admission and at discharge, and 40% (n = 44) participating at admission, during treatment and at discharge. Questionnaires on identity synthesis, identity confusion, identity processes, and ED symptomatology were completed. Latent growth curve modeling was used to address the research questions. Throughout treatment, a decrease in identity confusion and an increase in identity synthesis and adaptive identity processes were found. Accordingly, increases in identity synthesis and identification with commitment were related to general decreases in the drive for thinness and body dissatisfaction. Similarly, such decreases in ED symptoms were related to general decreases in identity confusion and ruminative exploration. The present study points to an increase in identity functioning throughout treatment, and longitudinal associations between identity functioning and ED symptomatology were found. Helping patients to decrease their ruminative exploration and to increase their identification with previously made life commitments and treating body/weight concerns could both be helpful in ED treatment.

Personal and illness identity in youth with type 1 diabetes: Developmental trajectories and associations.

OBJECTIVE: Having Type 1 diabetes (T1D) may complicate the normative developmental task of personal identity formation in adolescence and emerging adulthood. Besides exploring and committing to identity choices in different life domains, youth with T1D need to integrate their illness into their identity, a process labeled as illness identity. The present study examined whether youth with T1D belonging to different personal identity trajectory classes developed differently on four illness identity dimensions (acceptance, enrichment, engulfment, rejection). METHOD: This four-wave longitudinal study over a 3-year period used self-report questionnaires to examine how personal identity trajectory classes were related to illness identity over time in youth with T1D (baseline: n = 558; 54% female; age range = 14-25 years). Personal identity trajectory classes were identified using latent class growth analysis. Differential development of the four illness identity dimensions among these personal identity trajectory classes was examined using multigroup latent growth curve modeling. RESULTS: Five personal identity trajectory classes were identified: achievement, foreclosure, moratorium, carefree diffusion, and troubled diffusion. Individuals in achievement and foreclosure displayed highest levels of diabetes integration (i.e., high levels of acceptance and enrichment; low levels of engulfment and rejection), whereas individuals in troubled diffusion displayed lowest levels of illness integration (i.e., low levels of acceptance and enrichment; high levels of engulfment and rejection). CONCLUSIONS: The present study confirms that personal identity development relates to illness identity development over time in youth with T1D. Understanding the intricate link between personal and illness identity may help clinicians to tailor their interventions to patients' individual needs. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Self-regulation profiles in addictive behaviors among adolescents: A transdiagnostic approach.

Dual-pathway models suggest that poor self-regulation (immature regulatory combined with strong reactive processes) is an important factor underlying addictive behaviors among adolescents. This study examined whether there are different self-regulation profiles among community adolescents, and how these profiles are related to the presence, severity and comorbidity of different addictive behaviors. A community sample of 341 adolescents (54.5% female; 13-17 years) was recruited. Participants self-reported on regulatory (inhibitory control) and reactive (reward and punishment sensitivity) processes, as well as on different addictive behaviors (binge eating, tobacco-, cannabis- and alcohol use, gaming, gambling and pathological buying). A model-based clustering analysis found evidence for three meaningful profiles: 'impulsive/under-controlled', 'anxious' and 'protective'. The 'impulsive/under-controlled' profile was characterized by the highest prevalence and severity of cannabis use and the most severe alcohol use. The 'impulsive/under-controlled' and 'protective' profiles demonstrated the highest prevalence and severity of tobacco use, whereas the 'impulsive/under-controlled' and 'anxious' profiles showed the highest binge eating scores. Adolescents who reported more than three types of addictive behaviors generally belonged to the 'impulsive/under-controlled' profile. The profiles did not differ for gaming, gambling and pathological buying. The 'impulsive/under-controlled' profile emerged as the most vulnerable profile in the context of addictive behaviors (especially for binge eating and substance use).

DSM-5 non-suicidal self-injury disorder in a community sample: comparing NSSI engagement, recency and severity among emerging adults.

Up to one in five emerging adults engage in non-suicidal self-injury (NSSI). Providing a better understanding of factors that differentiate between who engages in lifetime NSSI and who is more likely to engage in recent and clinically severe NSSI can provide meaningful information for prevention and intervention of NSSI. The present study (n = 669) considered NSSI lifetime engagement (no prior history of NSSI vs. lifetime NSSI), recency [past NSSI (>12 months ago) vs. recent (≤12-month) NSSI], and clinical severity among those with recent NSSI (subthreshold vs. DSM-5 NSSI disorder). The prevalence of NSSI disorder was 8.4% in emerging adults aged 18 to 26 years old. Higher anxiety levels were related to NSSI engagement, but only depressive symptoms and NSSI versatility were consistently associated with more recent NSSI and NSSI disorder. A stepped-care approach may be required in addressing NSSI among emerging adults.

Psychometric Properties of the Dutch Version of the Eating Competence Satter Inventory (ecSI 2.0TM) in Community Adolescents.

Eating competence can help adolescents navigate their food choices and attitudes toward eating in a healthy and balanced way. In the present study, we investigated the psychometric properties of the Dutch translation of the Eating Competence Satter Inventory 2.0TM (ecSI 2.0TM), which was developed to assess eating attitudes and behaviors. A sample of 900 Flemish adolescents completed the ecSI 2.0TM DUTCH and two self-report measures on eating disorder symptoms and identity functioning (i.e., confusion and synthesis). Confirmatory factor analysis confirmed the four-factor structure of the ecSI 2.0TM DUTCH, and the resulting four subscales (i.e., Eating Attitudes, Food Acceptance, Internal Regulation, and Contextual Skills) showed acceptable-to-excellent reliability (αs ranging from 0.69 to 0.91). The ecSI 2.0TM DUTCH also demonstrated scalar invariance across sex and age (<17 years, ≥17 years). Males reported significantly higher ecSI 2.0TM DUTCH scores than females on the four subscales and the total scale. The two age groups did not significantly differ on the ecSI 2.0TM DUTCH scales. Finally, scores on the ecSI 2.0TM DUTCH subscales showed non-significant or small negative correlations with adolescents' Body Mass Index (BMI), large negative correlations with eating disorder symptoms and identity confusion, and large positive associations with identity synthesis. The Dutch translation of the ecSI 2.0TM is a valid and reliable instrument to assess eating competence skills in male and female adolescents.

Inhabiting the body: Exploring the link between embodiment and identity in community adolescents.

The intricate relationship between the body and identity has been highlighted in previous studies. However, a holistic approach to the body that focuses on embodiment is lacking in research examining body - identity linkages. The current study (N = 917 adolescents; 58% female; Mage = 16.17, range = 14-19 years) examined the psychometric properties of a Dutch translation of the Experience of Embodiment Scale (EES) and explored the link between embodiment and personal identity. First, confirmatory factor analysis revealed a second-order factor structure for the EES and adequate reliability coefficients were obtained. Metric invariance across gender was demonstrated for the first- and second-order factors. Second, path analysis demonstrated that experiencing embodiment was positively associated with adaptive identity work. Third, five identity statuses emerged using cluster analysis. Adolescents in statuses reflecting less adaptive identity functioning displayed lower levels of embodiment. The EES shows promising indications of reliability and factor structure for assessing adolescents' Experience of Embodiment, and the present study demonstrates that embodiment is meaningfully related to identity functioning. These findings support the call for the adoption of a positive psychology framework within this research field, with attention given to more broadly defined body-related concepts such as embodiment.

Longitudinal development of non-suicidal self-injury disorder in adolescence: Prospective prediction of stability and change by identity development, depression, trauma, and resilience.

BACKGROUND: With the introduction of non-suicidal self-injury disorder (NSSI-D) in DSM-5, the field obtained a standardised set of criteria to study those engaging in more severe and chronic NSSI. To date, no previous research has studied the development of NSSI-D longitudinally, leaving questions on its stability and potential prospective predictors unanswered. METHODS: 2162 community adolescents (M = 15.00 years, SD = 1.88, 53.9 % girls at T1) completed a set of self-report questionnaires for three consecutive years and were classified into three severity-based NSSI subgroups (no-NSSI, subthreshold-NSSI, NSSI-D). Multinomial logistic regression analyses were used to prospectively predict subgroup membership by age, gender, identity development, depressive symptoms, traumatic experiences, and resilience. RESULTS: At baseline, the sample was distributed over the no-NSSI group (88 %), the subthreshold-NSSI (6 %) and NSSI-D (6 %) groups. These groups respectively showed high (93.5 %), low (25 %) and moderate (47.5 %) stability over one-year intervals. Longitudinally, higher levels of identity confusion and trauma significantly increased the likelihood of transitioning to subthreshold-NSSI. Moreover, boys had a higher likelihood of transitioning from NSSI-D to no-NSSI over the course of one year. CONCLUSIONS: This three-year study provides the first indication of the longitudinal course of NSSI-D with the current set of DSM-5 criteria. Clinically, the results suggest the particular potential of identity confusion and trauma as prevention targets in community adolescents.

Personal identity, somatic symptoms, and symptom-related thoughts, feelings, and behaviors in adolescence: Examining between- and within-person associations and the role of depressive symptoms.

Recent literature highlights the complex relationship between personal identity and body-related pathology, yet there is a lack of integrative longitudinal research on the relationship between identity and somatic symptoms. The present study investigated the longitudinal associations between identity functioning and (psychological characteristics of) somatic symptoms, and examined the role of depressive symptoms in this relationship. A total of 599 community adolescents (Time 1: 41.3% female; Mage = 14.93, SD = 1.77, range = 12-18 years) participated in three annual assessments. Using cross-lagged panel models, a bidirectional relationship between identity and (psychological characteristics of) somatic symptoms, mediated by depressive symptoms, emerged at the between-person level; whereas only a unidirectional relationship from psychological characteristics of somatic symptoms to identity functioning, mediated by depressive symptoms, emerged at the within-person level. Identity and depressive symptoms were bidirectionally related at both levels. The present study suggests that adolescent identity development is closely related to somatic and emotional distress.

The Detection of Acute Risk of Self-injury Project: Protocol for an Ecological Momentary Assessment Study Among Individuals Seeking Treatment.

BACKGROUND: Nonsuicidal self-injury (NSSI) is a major mental health concern. Despite increased research efforts on establishing the prevalence and correlates of the presence and severity of NSSI, we still lack basic knowledge of the course, predictors, and relationship of NSSI with other self-damaging behaviors in daily life. Such information will be helpful for better informing mental health professionals and allocating treatment resources. The DAILY (Detection of Acute rIsk of seLf-injurY) project will address these gaps among individuals seeking treatment. OBJECTIVE: This protocol paper presents the DAILY project's aims, design, and materials used. The primary objectives are to advance understanding of (1) the short-term course and contexts of elevated risk for NSSI thoughts, urges, and behavior; (2) the transition from NSSI thoughts and urges to NSSI behavior; and (3) the association of NSSI with disordered eating, substance use, and suicidal thoughts and behaviors. A secondary aim is to evaluate the perspectives of individuals seeking treatment and mental health professionals regarding the feasibility, scope, and utility of digital self-monitoring and interventions that target NSSI in daily life. METHODS: The DAILY project is funded by the Research Foundation Flanders (Belgium). Data collection involves 3 phases: a baseline assessment (phase 1), 28 days of ecological momentary assessment (EMA) followed by a clinical session and feedback survey (phase 2), and 2 follow-up surveys and an optional interview (phase 3). The EMA protocol consists of regular EMA surveys (6 times per day), additional burst EMA surveys spaced at a higher frequency when experiencing intense NSSI urges (3 surveys within 30 minutes), and event registrations of NSSI behavior. The primary outcomes are NSSI thoughts, NSSI urges, self-efficacy to resist NSSI, and NSSI behavior, with disordered eating (restrictive eating, binge eating, and purging), substance use (binge drinking and smoking cannabis), and suicidal thoughts and behaviors surveyed as secondary outcomes. The assessed predictors include emotions, cognitions, contextual information, and social appraisals. RESULTS: We will recruit approximately 120 individuals seeking treatment aged 15 to 39 years from mental health services across the Flanders region of Belgium. Recruitment began in June 2021 and data collection is anticipated to conclude in August 2023. CONCLUSIONS: The findings of the DAILY project will provide a detailed characterization of the short-term course and patterns of risk for NSSI and advance understanding of how, why, and when NSSI and other self-damaging behaviors unfold among individuals seeking treatment. This will inform clinical practice and provide the scientific building blocks for novel intervention approaches outside of the therapy room that support people who self-injure in real time. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/46244.

Trajectories of adaptive and disturbed identity dimensions in adolescence: developmental associations with self-esteem, resilience, symptoms of depression, and borderline personality disorder features.

To advance our understanding of adolescents' identity formation and how it may play into their psychological functioning, this study investigated developmental trajectory classes of adaptive and disturbed dimensions of identity formation, and whether adolescents belonging to different trajectory classes develop differently on self-esteem, resilience, symptoms of depression, and borderline personality disorder (BPD) features. Three-wave longitudinal data from 2,123 Flemish adolescents was used (54.2% girls; Mage = 14.64, range = 12-18 at T1). Results pointed to four trajectory classes of identity formation: adaptive identity, identity progression, identity regression, and diffused identity. The adaptive identity class presented with stable high levels of self-esteem and resilience, and stable low levels of symptoms of depression and BPD, whereas opposite results were obtained for the diffused identity class. The identity progression class reported an increase in self-esteem and resilience as well as a decrease in symptoms of depression and BPD, whereas opposite results were obtained for the identity regression class. These results emphasize that adaptive and disturbed dimensions of identity formation are closely related to markers of well-being and psychopathology among adolescents, and could help identify adolescents with an increased risk for negative psychological functioning or increased opportunity for positive psychological functioning.

Identity Formation and General and Cancer-specific Functioning in Adolescent and Emerging Adult Survivors of Childhood Cancer: A Longitudinal Study into Directionality of Effects.

BACKGROUND: Adolescent and emerging adult survivors of childhood cancer generally adjust well psychologically similar to their peers. Nevertheless, some survivors are at greater risk for developing psychological and physical difficulties. To shed light on the psychosocial functioning of adolescent and emerging adult survivors of childhood cancer, personal identity formation and its interplay with general and cancer-specific functioning need to be investigated. PURPOSE: To examine the longitudinal associations linking identity formation to general and cancer-specific functioning in adolescent and emerging adult childhood cancer survivors using three-wave data over a 2-year period. METHODS: Dutch-speaking survivors (at baseline: n = 125; 53% female; age range: 14-25 years) treated at the pediatric oncology department of the University Hospitals Leuven (Belgium), completed self-report questionnaires at three annual timepoints. Directionality of effects and correlated changes were examined using cross-lagged structural equation modeling. RESULTS: Regarding general functioning, bidirectional effects occurred. Life satisfaction positively predicted identity synthesis and both life satisfaction and good physical functioning negatively predicted identity confusion over time. Identity synthesis, in turn, positively predicted life satisfaction and identity confusion negatively predicted good physical functioning over time. Regarding cancer-specific functioning, mainly unidirectional effects occurred. Post-traumatic stress symptoms negatively predicted identity synthesis and positively predicted identity confusion over time, whereas the reverse pattern of associations was found for benefit finding. Several correlated changes were found linking identity formation and psychosocial functioning as well. CONCLUSIONS: The present study uncovered clinically meaningful pathways linking identity formation to psychosocial functioning over time in adolescents and emerging adults who survived childhood cancer.

To shed light on the psychosocial functioning of adolescent and emerging adult survivors of childhood cancer, personal identity formation and its longitudinal interplay with general and cancer-specific functioning need to be investigated. Dutch-speaking survivors treated at the pediatric oncology department of the University Hospitals Leuven (Belgium), completed self-report questionnaires at three annual timepoints, resulting in three-wave data over a 2-year period. Regarding identity formation and general functioning, bidirectional effects occurred. Life satisfaction positively predicted identity synthesis and both life satisfaction and good physical functioning negatively predicted identity confusion over time. Identity synthesis, in turn, positively predicted life satisfaction and identity confusion negatively predicted good physical functioning over time. Regarding identity formation and cancer-specific functioning, mainly unidirectional effects occurred. Post-traumatic stress symptoms negatively predicted identity synthesis and positively predicted identity confusion over time, whereas the reverse pattern of associations was found for benefit finding. The present study uncovered meaningful pathways linking identity formation to psychosocial functioning over time in adolescents and emerging adults who survived childhood cancer. These longitudinal findings may provide important guidance for clinical practice, given that identity formation in today's western society has become particularly challenging.

Age and sex differences of the PID-5-100 maladaptive personality traits throughout adulthood.

In this cross-sectional study including a heterogeneous Belgian community sample of adults (N = 1,930), two central questions were addressed pertaining to age differences of self-reported Personality Inventory for DSM-5 (PID-5) maladaptive personality traits: (a) What kind of mean-level changes occur in the PID-5 traits from age 21 to 65? and (b) What kind of variance-level changes occur in the PID-5 traits from age 21 to 65? In exploring these research questions, we also aimed to examine potential sex differences. With regard to latent mean-level age differences of the PID-5 traits, changes across adulthood were overall small to moderate and included a mix of decreasing, flat, and increasing age trends. Regarding the decreasing trends, quadratic regressions showed that the initial downward trend often either stagnated at a certain age, or subtly started increasing again from a certain age onwards. In more than half of the PID-5 traits (15/25), small but significant sex differences were found in the latent mean-level changes across adulthood. In these cases, men tended to score overall higher, except for the negative affectivity facets, on which women tended to score higher. Furthermore, variance stability was found for the majority of the PID-5 personality traits (17/25), indicating that the magnitude of individual differences in PID-5 traits is relatively stable across adulthood. Implications for individual assessment and evaluation of PID-5 scores are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

The Self-Concept and Identity Measure in Patients with Personality Disorders: A Psychometric Evaluation and Associations With Identity Processes, Core Domains of Self-Functioning, and Personality Disorder Symptoms.

As developmental and clinical research on identity has largely developed in disconnect, scholars recommend adopting a developmental psychopathology perspective on identity, which considers adaptive and pathological identity functioning. Such a perspective has also been introduced in the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5) Alternative Model for Personality Disorders (AMPD), which suggests that all personality disorders (PDs) are marked by moderate to extreme deficits in self-functioning (i.e., identity and self-direction). The present study aims to validate the Dutch Self-Concept and Identity Measure (SCIM), a 27-item self-report questionnaire that assesses consolidated identity, disturbed identity, and lack of identity, in 153 psychiatric inpatients with PDs (75.2% female; Mage = 31.73). We investigated the factor structure and reliability of the SCIM, and examined associations of SCIM scales with typical identity processes, AMPD domains of self-functioning, and symptoms of all PDs. Results indicated that a 23-item Dutch SCIM produced valid and reliable scores among patients with PDs. Furthermore, SCIM scales were significantly and differentially related to identity commitment processes, ruminative identity exploration, domains of self-functioning, and symptoms of all PDs. Moreover, findings indicated that PDs varied regarding the severity of identity impairment.

The effect of imagery rescripting on core beliefs and eating disorder symptoms in a subclinical population.

BACKGROUND AND OBJECTIVES: This study compared the effect of imagery rescripting focusing on self-compassion, imagery rescripting focusing on mastery, and a positive memory control condition on (1) emotional responses towards the memory (one day after), (2) changes in the believability of negative core beliefs, and dysfunctional eating behaviors (one week after) in individual at risk for developing an eating disorder. METHODS: Female participants (N = 69) were allocated to one of three conditions: ImRs focusing on self-compassion (N = 24), ImRs focusing on self-mastery (N = 23), and positive memory control condition (N = 22). Participants in the ImRs conditions received a 20-min self-guided ImRs intervention, whereas participants in the control condition received a 20-min self-guided task focusing on an unrelated positive memory. RESULTS: The experimental manipulation successfully induced the use of self-compassion and mastery strategies in the respective imagery rescripting condition. However, our data show that a single 20-min session of self-guided imagery rescripting focusing on compassion and/or mastery has no effect on the emotional response towards the aversive memory or in the change of core beliefs and eating behaviors at follow up. LIMITATIONS: We discuss potential reasons for the null findings, including the use of a single imagery rescripting session, the sample size and the measurement of manipulation checks. CONCLUSION: Future studies are needed to rule out methodological explanations for the null results. These findings may be of value for the development of future experimental lab paradigms which aim to evaluate the causal effects and working mechanisms of imagery rescripting.

A longitudinal investigation of non-suicidal self-injury persistence patterns, risk factors, and clinical outcomes during the college period.

BACKGROUND: Although non-suicidal self-injury (NSSI) is known typically to begin in adolescence, longitudinal information is lacking about patterns, predictors, and clinical outcomes of NSSI persistence among emerging adults. The present study was designed to (1) estimate NSSI persistence during the college period, (2) identify risk factors and high-risk students for NSSI persistence patterns, and (3) evaluate the association with future mental disorders and suicidal thoughts and behaviors (STB). METHODS: Using prospective cohorts from the Leuven College Surveys (n = 5915), part of the World Mental Health International College Student Initiative, web-based surveys assessed mental health and psychosocial problems at college entrance and three annual follow-up assessments. RESULTS: Approximately one in five (20.4%) students reported lifetime NSSI at college entrance. NSSI persistence was estimated at 56.4%, with 15.6% reporting a high-frequency repetitive pattern (≥five times yearly). Many hypothesized risk factors were associated with repetitive NSSI persistence, with the most potent effects observed for pre-college NSSI characteristics. Multivariate models suggest that an intervention focusing on the 10-20% at the highest predicted risk could effectively reach 34.9-56.7% of students with high-frequency repetitive NSSI persistence (PPV = 81.8-93.4, AUC = 0.88-0.91). Repetitive NSSI persistence during the first two college years predicted 12-month mental disorders, role impairment, and STB during the third college year, including suicide attempts. CONCLUSIONS: Most emerging adults with a history of NSSI report persistent self-injury during their college years. Web-based screening may be a promising approach for detecting students at risk for a highly persistent NSSI pattern characterized by subsequent adverse outcomes.

Identity Formation, Body Image, and Body-Related Symptoms: Developmental Trajectories and Associations Throughout Adolescence.

Emerging evidence highlights the intricate link between identity and one's body, however, integrative longitudinal research on this identity-body interplay is lacking. The current study used three-wave longitudinal data (Time 1: N = 403; 52.1% female; Mage = 14.85, SD = 0.89, range = 13-19 years) spanning two years (2019-2021; T1 and T2 being pre-pandemic, T3 peri-pandemic) to identify identity trajectory classes and examine their co-development with negative and positive body image and various body-related variables (i.e., sociocultural pressures, internalization of appearance ideals, self-objectification, appearance comparison, and eating disorder symptoms). First, four identity classes emerged using latent class growth analysis (achievement, moratorium, carefree diffusion, and troubled diffusion). Second, using multigroup latent growth curve modeling, adolescents in less adaptive identity trajectory classes (i.e., engaging less in pro-active processes and more in ruminative processes) displayed higher levels of negative body image and body-related symptoms. The current study testified to the clinically meaningful associations linking identity formation to adolescents' body image and other body-related symptoms.

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.

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.