Co-developmental trajectories of suicidal ideation and non-suicidal self-injury among Chinese adolescents: Transdiagnostic predictors and association with suicide attempts.

INTRODUCTION: Adolescent suicidal ideation (SI) and non-suicidal self-injury (NSSI) are crucial public health issues, yet their co-developmental trajectories during early adolescence and their associations with predictors and outcomes are unclear. This study aimed to (a) identify heterogeneous co-developmental trajectories of SI and NSSI, (b) explore associations between transdiagnostic predictors and trajectories, and (c) assess suicide attempt risk across trajectories. METHODS: Four hundred fifty-three adolescents (Mage = 12.35 years, 48.3% boys) completed surveys at 6-month intervals across 2 years. At Time 1 (Nov 2020), participants completed surveys encompassing SI, and NSSI, along with family, peer, and individual predictors. Subsequent surveys (Times 2-4) measured SI and NSSI, with suicide attempts queried at Time 4. RESULTS: Parallel process latent class growth models revealed three co-developmental groups (i.e., Stable low NSSI and SI; Moderate-NSSI and high-SI, parallel decreasing; High-NSSI and moderate-SI, parallel increasing). Multivariate logistic regression indicated that group membership was predicted by parental rejection, parental warmth, bullying victimization, depressive and anxiety symptoms, thwarted belongingness, and perceived burdensomeness. Adolescents in the "High-NSSI and moderate-SI, parallel increasing" group reported the highest suicide attempt frequency. CONCLUSION: These findings underscore subgroup distinctions and transdiagnostic predictors in comprehending SI and NSSI progression, emphasizing the necessity of dynamic monitoring and tailored interventions for distinct subgroup characteristics.

Construction and Application of a Traditional Chinese Medicine Syndrome Differentiation Model for Dysmenorrhea Based on Machine Learning.

BACKGROUND: Dysmenorrhea is one of the most common ailments affecting young and middle-aged women, significantly impacting their quality of life. Traditional Chinese Medicine (TCM) offers unique advantages in treating dysmenorrhea. However, an accurate diagnosis is essential to ensure correct treatment. This research integrates the age-old wisdom of TCM with modern Machine Learning (ML) techniques to enhance the precision and efficiency of dysmenorrhea syndrome differentiation, a pivotal process in TCM diagnostics and treatment planning. METHODS: A total of 853 effective cases of dysmenorrhea were retrieved from the CNKI database, including patients' syndrome types, symptoms, and features, to establish the TCM information database of dysmenorrhea. Subsequently, 42 critical features were isolated from a potential set of 86 using a selection procedure augmented by Python's Scikit-Learn Library. Various machine learning models were employed, including Logistic Regression, Random Forest Classifier, Support Vector Machine (SVM), K-Nearest Neighbors (KNN), and Artificial Neural Networks (ANN), each chosen for their potential to unearth complex patterns within the data. RESULTS: Based on accuracy, precision, recall, and F1-score metrics, SVM emerged as the most effective model, showcasing an impressive precision of 98.29% and an accuracy of 98.24%. This model's analytical prowess not only highlighted the critical features pivotal to the syndrome differentiation process but also stands to significantly aid clinicians in formulating personalized treatment strategies by pinpointing nuanced symptoms with high precision. CONCLUSION: The study paves the way for a synergistic approach in TCM diagnostics, merging ancient wisdom with computational acuity, potentially innovating the diagnosis and treatment mode of TCM. Despite the promising outcomes, further research is needed to validate these models in real-world settings and extend this approach to other diseases addressed by TCM.

The impacts of latent profiles and transitions of stresses on adolescent mental health: A person-centred analysis.

Research has demonstrated robust links between adolescent stress and serious psychological problems. The current study aimed to identify latent stress profiles of 1510 adolescents (59.7% females; Mage  = 16.77 years, SD = 0.86) based on five stresses (parental stresses, family environment stresses, academic stresses, teacher stresses, and peer stresses) at three time points (T1/2/3). Moreover, this study would investigate the transition patterns of these profiles over time and examine the associations between the profiles and adverse psychological symptoms (e.g., anxiety, depression, nonsuicidal self-injury [NSSI], and suicidal ideation). Three latent stress profiles were identified, including High-stress profile, Medium-stress profile, and Low-stress profile. The three profiles were significantly different on the levels of T1/2/3 anxiety, depression, NSSI, and suicidal ideation. The profile memberships remained relatively stable across three time points. Notably, the present study found gender differences, with boys were more likely to be in the High-stress profile and to transition from the Medium- to the High-stress profile, compared to girls. Furthermore, left-behind adolescents were more likely to be in the High-stress profile than non-left-behind adolescents. The findings highlight the importance of adopting 'this-approach-fits-this-profile' interventions for adolescents. Parents and teachers are advised to adopt different strategies for girls and boys.

Patterns and Transitions of Nonsuicidal Self-Injury Outcome Expectancies and Their Associations with Nonsuicidal Self-Injury among Adolescents.

Nonsuicidal self-injury (NSSI) outcome expectancies (i.e., the expectations that certain outcomes will follow NSSI) have been confirmed to predict NSSI engagement. However, it remains unclear whether adolescents hold different patterns of NSSI outcome expectancies and therefore vary in their risks of NSSI engagement. Moreover, little is known about whether patterns transition over time, influencing the development of NSSI. Additionally, possible gender differences in the patterns and their transitions need to be explored. This study aims to address these research gaps. A total of 679 adolescents (55.8% females; Mage = 15.19, SDage = 1.40) completed questionnaires and were surveyed semiannually for three times. Using latent profile analysis, regular latent transition analysis, and random intercept latent transition analysis, this study identified four patterns of NSSI outcome expectancies: High Affect Regulation and Moderate Negative Expectancies, Low Negative Expectancies, High Negative Expectancies, and High Communication and Negative Expectancies. The first two patterns showed high risks of NSSI, whereas the latter two patterns showed low risks of NSSI. Low Negative Expectancies was an unstable pattern. It had higher probabilities of transitioning to another high-risk pattern than transitioning to the low-risk patterns. The other three patterns had high stability. Gender had no significant effects on the four patterns or their transitions. The findings highlight the combined effects of NSSI outcome expectancies and underscore that NSSI outcome expectancies may change over time. Prevention and interventions targeting multiple factors corresponding to these expectancies should be developed.

Internet use time and subjective well-being during the COVID-19 outbreak: serial mediation of problematic internet use and self-esteem.

The coronavirus disease (COVID-19) outbreak is a threat to adolescents' mental health and livelihoods, and lowers their subjective well-being (SWB). Expanding on previous literatures, this study examined whether internet use time was related to SWB and whether this relationship was mediated by problematic internet use (PIU) and self-esteem during the COVID-19 outbreak. In Taiwan, the COVID-19 epidemic broke out in February, 2020. During March 2 to 27, this study recruited a total of 1,060 adolescents from junior high schools by both stratified and cluster sampling, and administered a comprehensive investigation. The results displayed that SWB was significantly and negatively predicted by internet use time. PIU fully mediated the relationship. Moreover, PIU predicted a decrease of self-esteem, which played a full mediation role between PIU and SWB. The results provide evidence in explaining how increased internet use time is associated with a greater level of PIU, which relates to lower self-esteem, correlating with lower SWB in adolescents. This study can provide reference to mental health organizations and educational agencies to design appropriate SWB promotion programs for the junior high school population in terms of epidemic prevention.

A major QTL simultaneously increases the number of spikelets per spike and thousand-kernel weight in a wheat line.

KEY MESSAGE: A novel and stably expressed QTL QSNS.sicau-SSY-7A for spikelet number per spike in wheat without negative effects on thousand-kernel weight was identified and validated in different genetic backgrounds. Spikelet number per spike (SNS) is an important determinant of yield in wheat. In the present study, we combined bulked segregant analysis (BSA) and the wheat 660 K single-nucleotide polymorphism (SNP) array to rapidly identify genomic regions associated with SNS from a recombinant inbred line (RIL) population derived from a cross between the wheat lines S849-8 and SY95-71. A genetic map was constructed using Kompetitive Allele Specific PCR markers in the SNP-enriched region on the long arm of chromosome 7A. A major and stably expressed QTL, QSNS.sicau-SSY-7A, was detected in multiple environments. It was located in a 1.6 cM interval on chromosome arm 7AL flanked by the markers AX-109983514 and AX-109820548. This QTL explained 6.86-15.72% of the phenotypic variance, with LOD values ranging from 3.66 to 8.66. Several genes associated with plant growth and development were identified in the interval where QSNS.sicau-SSY-7A was located on the 'Chinese Spring' wheat and wild emmer reference genomes. Furthermore, the effects of QSNS.sicau-SSY-7A and WHEAT ORTHOLOG OFAPO1(WAPO1) on SNS were analyzed. Interestingly, QSNS.sicau-SSY-7A significantly increased SNS without negative effects on thousand-kernel weight, anthesis date and plant height, demonstrating its great potential for breeding aimed at improving grain yield. Taken together, these results indicate that QSNS.sicau-SSY-7A is a promising locus for yield improvement, and its linkage markers are helpful for fine mapping and molecular breeding.

Sublinear information bottleneck based two-stage deep learning approach to genealogy layout recognition.

As an important part of human cultural heritage, the recognition of genealogy layout is of great significance for genealogy research and preservation. This paper proposes a novel method for genealogy layout recognition using our introduced sublinear information bottleneck (SIB) and two-stage deep learning approach. We first proposed an SIB for extracting relevant features from the input image, and then uses the deep learning classifier SIB-ResNet and object detector SIB-YOLOv5 to identify and localize different components of the genealogy layout. The proposed method is evaluated on a dataset of genealogy images and achieves promising results, outperforming existing state-of-the-art methods. This work demonstrates the potential of using information bottleneck and deep learning object detection for genealogy layout recognition, which can have applications in genealogy research and preservation.

Management of Heart Failure With Preserved Ejection Fraction in Elderly Patients: Effectiveness and Safety.

The proportion of the elderly population continues to increase due to the global increase in longevity. Heart failure with preserved ejection fraction (HFpEF) is common in the elderly due to cellular aging, myocardial stiffness, and multiple comorbidities. This age group is often under-represented in clinical trials. In this narrative review, we looked into the latest evidence-based lines of management of HFpEF in this vulnerable cohort. In this narrative review, we brought the latest evidence on the treatment of HFpEf in the elderly. We searched the largest three scientific databases (Pubmed, Google Scholar, and EMBASE) using the search words (elderly, HFpEF, heart failure with preserved ejection fraction, guidelines, treatment, and management) in different combinations. To date, screening for and treatment of the causes of HFpEF (such as hypertension, coronary artery disease [CAD], valvular heart disease, and cardiac amyloidosis) and associated comorbidities (such as diabetes mellitus [DM], iron deficiency, obesity, and thyroid dysfunction) are the main line of management of HFpEF. A multidisciplinary team, including an HF specialist cardiologist, an HF nurse, a geriatrician, a dietician, a psychologist, a physiotherapist, and an occupational therapist, should manage HFpEF elderly patients. Other specialist input may be needed according to the patient's requirements. The evidence on the effective management of HFpEF in the elderly age group is scarce and controversial. Some studied non-pharmacological approaches include supervised exercise training, pulmonary artery pressure monitoring, and the interatrial shunt device (an emerging modality that includes a small percutaneously inserted interatrial left to right valve aiming to reduce the left atrial and pulmonary wedge pressures). These modalities can only improve the symptoms and HF hospitalizations without robustly impacting cardiovascular (CV) death. Among the pharmacological approaches to treat HFpEF, only the sodium-glucose cotransporter 2 (SGLT-2) inhibitors proved efficacy in reducing the hard outcomes of CV death, HF hospitalizations, and urgent visits for HF when used in elderly HFpEF patients, irrespective of the presence of diabetes mellitus. Diuretics are only beneficial to alleviate the symptoms of fluid overload, with a risk of renal impairment in volume-depleted patients. The evidence on the effectiveness of other HF-specific disease-modifying agents in elderly HFpEF patients is controversial. Elderly patients have a higher risk of having side effects from HF medications due to the higher prevalence of polypharmacy, cognitive decline, and impairment of kidney and liver functions. Therefore, cautious initiation of HF treatment with a close follow-up of the blood pressure, liver functions, kidney functions, and electrolytes are of utmost importance.

The effects of childhood abuse, depression, and self-compassion on adolescent nonsuicidal self-injury: A moderated mediation model.

BACKGROUND: Nonsuicidal self-injury (NSSI) is a widespread public health issue in adolescents. Exploring the risk and protective variables of NSSI is critical for prevention and intervention. Based on the experiential avoidance model (Chapman et al., 2006) and Nock's (2009) integrated model of NSSI, the current study tested a moderated mediation model to examine the impact of two risk factors, childhood abuse and depression, and one protective factor, self-compassion, on NSSI. METHODS: Self-report measures were conducted among 758 Chinese adolescents (329 females and 429 males, mean age = 14.16 years, SD = 1.92) in Hong Kong, China regarding childhood abuse, depression, self-compassion, and NSSI. RESULTS: Childhood abuse was found to be positively linked to NSSI, and this connection was mediated by depression. Self-compassion weakened the strength between childhood abuse and NSSI, along with that between childhood abuse and depression. CONCLUSIONS: These results assist in understanding how NSSI develops and facilitate future studies to investigate how the risk and protective variables for NSSI interact. The clinical application of these findings was also discussed.

Emotion Reactivity and Suicide Ideation Among Chinese Adolescents: A Longitudinal Serial Mediation Model.

OBJECTIVE: Previous studies have indicated that emotion reactivity is an important predictive factor for suicide ideation. However, the mechanism underlying their association has remained largely unexplored. The current study aims to investigate a serial mediation model to examine the potential mechanism in the relationship between emotion reactivity and suicide ideation. METHOD: A total of 5,423 Chinese adolescents (52.7% females, Mage = 14.63 years, SD = 1.25) completed self-report questionnaires regarding emotion reactivity, suicide ideation, distress intolerance, and depressive symptoms. Assessment was conducted for two waves, 6 months apart. RESULTS: In descriptive analyses, the prevalence of suicide ideation in this study was 15.3% for Wave 1 and 14.3% for Wave 2. Emotion reactivity, distress intolerance, and depressive symptoms were positively related to suicide ideation. In serial mediation analyses, there was a significant total effect of emotion reactivity on suicide ideation. After controlling for baseline variables, distress intolerance and depressive symptoms played serial mediating roles in the relation between emotion reactivity and suicide ideation, with emotion reactivity influencing suicide ideation through three mediation pathways. CONCLUSIONS: This study demonstrates a potential mechanism underlying the path from emotion reactivity to suicide ideation. Interventions that target emotion reactivity may be an effective way to reduce the risk of developing suicide ideation. HIGHLIGHTSEmotion reactivity was positively related to suicide ideation.Distress intolerance and depressive symptoms mediated the relationship between emotion reactivity and suicide ideation.Emotion reactivity also exerted an influence on suicide ideation through serial mediation of distress intolerance and depressive symptoms, after controlling for baseline variables.

The Relationship between Ambivalence over Emotional Expression and Nonsuicidal Self-Injury Among Chinese Adolescents: A Longitudinal Moderated Mediation Model.

BACKGROUND: Nonsuicidal self-injury (NSSI) has become a significant mental health concern for adolescents. Previous empirical studies have shown that ambivalence over emotional expression is positively associated with negative emotions and behaviors. However, little is known about the relationship between ambivalence over emotional expression and NSSI among adolescents. Therefore, this study used a longitudinal design to examine the relationship between ambivalence over emotional expression and NSSI among Chinese adolescents, and also to explore the mediating and moderating mechanisms underlying this relationship. METHOD: A total of 1,672 students (45.8% males; Mage = 16.12 years, SD = 1.56) in a middle school in Guangzhou were tracked. The investigation was conducted twice, with an interval of 6 months. RESULTS: Ambivalence over emotional expression was positively correlated with NSSI. After controlling for gender and baseline NSSI, anxiety symptoms fully mediated the association between ambivalence over emotional expression and NSSI. In addition, the relationship between ambivalence over emotional expression and NSSI was moderated by NSSI refusal self-efficacy. CONCLUSIONS: These findings imply that to decrease ambivalence over emotional expression, to reduce anxiety symptoms, and to promote NSSI refusal self-efficacy may be useful for interventions and preventions of NSSI.HIGHLIGHTSTested the relationship between ambivalence over emotional expression and NSSI in adolescents.Examined a moderated-mediation model over six months.Found the mediated effect of anxiety symptoms and moderated effect of NSSI refusal self-efficacy in the relationship between ambivalence over emotional expression and NSSI.

Sexual Minority Stigma and Nonsuicidal Self-Injury Among Sexual Minorities: the Mediating Roles of Sexual Orientation Concealment, Self-Criticism, and Depression.

Introduction: Nonsuicidal self-injury (NSSI), a significant predictor of suicide, is more frequent in sexual minorities (e.g., lesbian, gay, and bisexual) than in heterosexuals. The Minority Stress Model proposed that sexual minority stigma (SMS) may lead to maladaptive behaviors, including NSSI. However, the potential mechanism underlying the relationship between SMS and NSSI remains unclear. Therefore, the current study will examine the relationship between SMS and NSSI, and explore the serial mediating roles of sexual orientation concealment (SOC), self-criticism, and depression. Methods: A total of 666 individuals who self-identified as sexual minorities (64.0% male, M age = 24.49 years, SD = 6.50) completed questionnaires of SMS, SOC, self-criticism, depression, and NSSI, in 2020. Results: The findings indicated that (1) SMS, SOC, self-criticism, depression, and NSSI were positively correlated; (2) SOC, self-criticism, and depression independently played partial mediating roles between SMS and NSSI; and (3) SOC, self-criticism, and depression played serial mediating roles between SMS and NSSI. Conclusions: The current study supported the relation between SMS and NSSI among Chinese sexual minorities, and also implied a potential mechanism underlying the relation. Specifically, SMS was related to increased NSSI by higher SOC, self-criticism, and depression. SOC had dual-edged effects on NSSI. Policy Implications: To reduce NSSI and other psychological problems among sexual minorities, policy makers should take more measures to eliminate SMS. Specifically, policy makers are encouraged to provide more support for changing sexual minorities' living environment, such as repealing bills that could cause SMS and popularizing the knowledge about sexual orientation.

Mediating role of depression in the association between alexithymia and nonsuicidal self-injury in a representative sample of adolescents in Taiwan.

BACKGROUND: Nock's (2009) integrated theoretical model suggests that specific intrapersonal vulnerability factors caused by distal risk factors contribute to the development of nonsuicidal self-injury (NSSI). Alexithymia and depression have been found to predict NSSI. Based on Nock's model, alexithymia plays a distal risk factor role to increase the risk of depression-an intrapersonal vulnerability factor-and further increase the risk of NSSI. However, small or unrepresentative samples in past studies limit the generalizability of the results. This study examined the roles of depression and alexithymia in predicting NSSI, as well as the mediating effect of depression in the relation between alexithymia and NSSI in a large representative sample of adolescents in Taiwan. METHODS: Using a cross-sectional study design, a large representative sample of 2,170 senior high school students in Taiwan was assessed by self-report measures of alexithymia, depression, and NSSI. Mediation analyses were performed to examine whether the relation between alexithymia and NSSI was mediated by depression. The questionnaires were administered in classrooms. RESULTS: Results showed that alexithymia positively predicted NSSI (ß = 0.23, p < .001) and depression can also positively predict NSSI (ß = 0.41, p < .001). Additionally, the association between alexithymia and NSSI was fully mediated by depression. CONCLUSIONS: This study data provided evidence for the mediating role of depression between alexithymia and NSSI, which can be explained by Nock's (2009) integrated theoretical model. The implications of the findings for future research and intervention were discussed.

Parental Psychological Control, Parent-Related Loneliness, Depressive Symptoms, and Regulatory Emotional Self-Efficacy: A Moderated Serial Mediation Model of Nonsuicidal Self-Injury.

OBJECTIVE: Adolescent nonsuicidal self-injury (NSSI) has become an alarming public health concern. Parental psychological control has been identified as a risk factor for NSSI in some western samples. However, the relationship between parental psychological control and NSSI remains unclear among Chinese adolescents. Furthermore, little is known about how parental psychological control affects NSSI. This study aims to examine a moderated serial mediation model of NSSI, revealing the mediating and moderating mechanisms underlying the relationship between parental psychological control and NSSI. METHOD: A total of 953 Chinese secondary school students (47.7% females, mean age = 12.53 years, SD = 0.63) completed questionnaires of NSSI, parental psychological control, parent-related loneliness, depressive symptoms, and regulatory emotional self-efficacy. RESULTS: Parental psychological control was positively associated with NSSI. This association was mediated by parent-related loneliness and depressive symptoms independently. Also, it was serially mediated by parent-related loneliness and depressive symptoms. In addition, regulatory emotional self-efficacy moderated the indirect relationships between parental psychological control and NSSI. CONCLUSIONS: Findings of this study shed light on how NSSI is affected by parental psychological control, parent-related loneliness, depressive symptoms, and regulatory emotional self-efficacy, and provide insights into the prevention and intervention measures targeting adolescent NSSI.HIGHLIGHTSParental psychological control was positively associated with NSSI.Parent-related loneliness and depressive symptoms independently and serially mediated the association between parental psychological control and NSSI.Regulatory emotional self-efficacy moderated the indirect relationships between parental psychological control and NSSI.

Internet addiction and nonsuicidal self-injury in adolescence: Associations with offline and online social support.

OBJECTIVES: Both nonsuicidal self-injury (NSSI) and Internet addiction (IA) are important health issues for adolescents, and social support has been extensively examined as a protective factor for both. This study aims to compare the effect of offline and online social support on IA, and that on NSSI as well. METHOD: A total of 1911 Chinese adolescents (53.27% females, Mage = 16.83 ± 0.37) completed self-report questionnaires assessing offline social support, online social support, IA, and NSSI. RESULTS: The structural equation modeling analysis showed that offline social support was negatively associated with IA and NSSI, while online social support was positively associated with IA and NSSI; IA was positively associated with NSSI. Furthermore, implications for preventions and interventions of IA and NSSI were discussed. The indirect model explained a relatively small variance of NSSI, indicating the possibility of additional factors in the development of NSSI that should be further investigated. CONCLUSION: This study indicated the differences between offline and online social support, and their different associations with IA and NSSI.

Genetic identification and characterization of chromosomal regions for kernel length and width increase from tetraploid wheat.

BACKGROUND: Improvement of wheat gercTriticum aestivum L.) yield could relieve global food shortages. Kernel size, as an important component of 1000-kernel weight (TKW), is always a significant consideration to improve yield for wheat breeders. Wheat related species possesses numerous elite genes that can be introduced into wheat breeding. It is thus vital to explore, identify, and introduce new genetic resources for kernel size from wheat wild relatives to increase wheat yield. RESULTS: In the present study, quantitative trait loci (QTL) for kernel length (KL) and width (KW) were detected in a recombinant inbred line (RIL) population derived from a cross between a wild emmer accession 'LM001' and a Sichuan endemic tetraploid wheat 'Ailanmai' using the Wheat 55 K single nucleotide polymorphism (SNP) array-based constructed linkage map and phenotype from six different environments. We identified eleven QTL for KL and KW including two major ones QKL.sicau-AM-3B and QKW.sicau-AM-4B, the positive alleles of which were from LM001 and Ailanmai, respectively. They explained 17.57 to 44.28% and 13.91 to 39.01% of the phenotypic variance, respectively. For these two major QTL, Kompetitive allele-specific PCR (KASP) markers were developed and used to successfully validate their effects in three F3 populations and two natural populations containing a panel of 272 Chinese wheat landraces and that of 300 Chinese wheat cultivars, respectively. QKL.sicau-AM-3B was located at 675.6-695.4 Mb on chromosome arm 3BL. QKW.sicau-AM-4B was located at 444.2-474.0 Mb on chromosome arm 4BL. Comparison with previous studies suggested that these two major QTL were likely new loci. Further analysis indicated that the positive alleles of QKL.sicau-AM-3B and QKW.sicau-AM-4B had a great additive effect increasing TKW by 6.01%. Correlation analysis between KL and other agronomic traits showed that KL was significantly correlated to spike length, length of uppermost internode, TKW, and flag leaf length. KW was also significantly correlated with TKW. Four genes, TRIDC3BG062390, TRIDC3BG062400, TRIDC4BG037810, and TRIDC4BG037830, associated with kernel development were predicted in physical intervals harboring these two major QTL on wild emmer and Chinese Spring reference genomes. CONCLUSIONS: Two stable and major QTL for KL and KW across six environments were detected and verified in three biparental populations and two natural populations. Significant relationships between kernel size and yield-related traits were identified. KASP markers tightly linked the two major QTL could contribute greatly to subsequent fine mapping. These results suggested the application potential of wheat related species in wheat genetic improvement.

Different profiles with multiple risk factors of nonsuicidal self-injury and their transitions during adolescence: A person-centered analysis.

BACKGROUND: Nonsuicidal self-injury (NSSI) is a serious public health concern among adolescents. However, adolescents with different combinations of NSSI risk factors may constitute different subgroups that vary in subsequent risks of NSSI engagement, and the membership in these subgroups may change during early adolescence. Gender differences related to risk profiles and transition patterns may also exist. This study thus aimed to address these three questions. METHODS: A total of 2,942 participants ranging from 12 to 17 years old (55.2% females; Mage = 14.60, SD = 1.21) completed a series of questionnaires about NSSI and its risk factors on three occasions, every six months. Latent profile and latent transition analyses were used to examine NSSI risk profiles (subgroups), their transition patterns, and gender differences. RESULTS: Three distinct risk profiles were identified: Low-risk profile, Medium-risk profile, and High-risk profile. The profile membership was fairly stable over one year, and the shift across profiles represented a "resilient" pattern. Regarding gender differences, boys were less likely to be in either the Medium- or the High-risk groups, but more likely to transition from the Medium- to the Low-risk group, relative to girls. LIMITATIONS: This study relied upon self-report measures. Additional research is needed to investigate the generalizability of the results to other populations, and to examine more predictors of class membership and transitions. CONCLUSIONS: The results highlight the importance of considering subgroup differences in understanding NSSI risks. Differentiated interventions with multi-pronged approaches tailoring to different risk classes and gender groups may therefore prove more efficient and effective.

Prevalence and psychosocial risk factors of nonsuicidal self-injury among adolescents during the COVID-19 outbreak.

The research investigated the prevalence of nonsuicidal self-injury (NSSI) during the COVID-19 outbreak and identified the psychosocial risk factors among junior high school students in Taiwan. Cross-sectional design was applied and 1,060 participants (Mage = 14.66, SD = 0.86 years) were recruited into the study. The prevalence of NSSI was found to be 40.9% (95% confidence interval, 37.9%-43.9%) during the COVID-19 outbreak. The results suggested that the self-injurers group were mostly female, and scored significantly higher in neuroticism, depression, impulsivity, alexithymia, virtual social support, dissatisfaction with academic performance, and lower in subjective wellbeing, self-esteem, actual social support, and family function than the non-injurers group. In addition, high neuroticism, low self-esteem, high virtual social support, high impulsivity, and high alexithymia were independently predictive in the logistic regression analysis. The principal results of this study suggested that NSSI was extremely prevalent among adolescents during the COVID-19 outbreak, and in particularly, personality and virtual environment risk factors and enhancing self-esteem should be the focus of NSSI preventive strategies when targeting this age population. Our results provide a reference towards designing NSSI prevention programs geared toward the high school population during the COVID-19 pandemic.

The relations between childhood experience of negative parenting practices and nonsuicidal self-injury in Chinese adolescents: The mediating roles of maladaptive perfectionism and rumination.

BACKGROUND: Nonsuicidal self-injury (NSSI) is a highly prevalent and serious public health concern among adolescents worldwide, and family experiences are influential in its development. However, the potential mediating mechanisms underlying the relations between childhood experience of negative parenting practices and NSSI are not fully understood. This study tested a mediating model to examine the roles of maladaptive perfectionism and rumination in these relations. METHODS: A total of 5,619 Chinese adolescents (54.7 % males; mean age = 15.92 years, SD = 0.73) participated in this study and completed self-report measures of negative parenting practices, maladaptive perfectionism, rumination, and NSSI. RESULTS: There were significant positive correlations among negative parenting practices, maladaptive perfectionism, rumination, and NSSI. In the mediation analyses, all negative parenting practices were indirectly related to NSSI via maladaptive perfectionism, while rumination only mediated the relation of maternal overprotection to NSSI. In addition, among all negative parenting practices, maternal rejection was the most closely associated with maladaptive perfectionism. CONCLUSION: The findings of the study expand our understanding of the influences of negative parenting practices on NSSI. Clinicians may pay special attention to maternal rejection and focus on adolescents' maladaptive perfectionism and rumination when interacting with individuals with NSSI.

Bullying Experiences and Nonsuicidal Self-injury among Chinese Adolescents: A Longitudinal Moderated Mediation Model.

Bullying experiences play an important role in non-suicidal self-injury (NSSI). However, little is known about how and in what conditions different bullying experiences (i.e., experiences of being pure bullies, pure victims, and bully-victims) may influence NSSI. Guided by the transactional model of development and the integrated model of NSSI, the current study investigated two potential mediators (i.e., peer acceptance and depressive symptoms) and one potential moderator (i.e., psychological resilience) of the relations between different bullying experiences and NSSI. Participants were 812 Chinese adolescents (43% female; Mage at Wave 1 = 13.15 years) from a two-wave longitudinal study with data spanning 1 year. The results show that all three types of bullying experiences can relate to a higher likelihood of NSSI through two indirect pathways: (a) lower peer acceptance to more depressive symptoms, or (b) more depressive symptoms. These indirect effects were weaker for adolescents with higher (versus lower) levels of psychological resilience. Moreover, when bully-victims were distinguished from pure bullies and pure victims and the unique effects for all three groups were tested, the direct and indirect effects were most evident among bully-victims. These findings imply that it is necessary to distinguish bully-victims from pure bullies and pure victims. The results indicate that NSSI may be effectively reduced if interventions focus on promoting peer acceptance and reducing adolescent depressive symptoms, particularly for bully-victims with lower levels of psychological resilience.