Who are we missing? Self-selection bias in nonsuicidal self-injury research.

BACKGROUND: Despite the threat of self-selection bias to the generalizability of research findings, remarkably little is known about who chooses to take part in non-suicidal self-injury (NSSI) research specifically. We aimed to establish the extent of willingness to take part in NSSI research within a commonly sampled population before assessing whether individual differences in demographic characteristics, NSSI lived experience, and participation experiences were associated with willingness to take part in future NSSI research. METHODS: New Zealand university students (n = 3098) completed self-report measures of their NSSI, psychological distress, emotional dysregulation, experience of their participation in the current study, and willingness to participate in future NSSI research. RESULTS: Most participants (78.2%) indicated that they were willing to take part in future NSSI research. Men, older participants, people with NSSI lived experience, and those with more frequent past-year NSSI were more likely to be willing to take part in future NSSI research. Participants who reported a more positive subjective experience of the current study also indicated greater willingness. CONCLUSIONS: Findings demonstrate systematic differences in who is willing to take part in NSSI research. Future research should implement methodological and statistical approaches to mitigate the impact of self-selection bias on NSSI research.

Why Are Individuals Who Have Not Disclosed Self-Injury Comfortable Discussing Their Experiences in Research?

ABSTRACT: Not everyone who shares their lived experience of nonsuicidal self-injury (NSSI) in research has disclosed this previously outside of a research context. Our objective was to identify reasons people who have not previously disclosed their NSSI felt comfortable discussing their self-injury in research contexts. The sample consisted of 70 individuals with lived experience of self-injury who had not previously disclosed this experience outside of research (Mage = 23.04 years, SD = 5.90; 75.70% women). Using content analysis of open-ended responses, we identified three reasons participants felt comfortable discussing their NSSI in research. Most commonly, participants did not anticipate negative consequences discussing their NSSI due to the way the research was conducted (e.g., confidentiality). Second, participants valued NSSI research and wanted to contribute to such work. Third, participants referenced feeling mentally and emotionally prepared to discuss their NSSI. The findings indicate that individuals who have not previously disclosed their NSSI may wish to discuss their experience in research for a variety of reasons. Such findings highlight implications for how we foster safe spaces in research for people with lived experience of NSSI.

What is important to the decision to disclose nonsuicidal self-injury in formal and social contexts?

OBJECTIVE: Disclosure of nonsuicidal self-injury (NSSI) is associated with a range of both positive (e.g., help-seeking) and negative (e.g., discrimination) outcomes. The aim of this study was to assess the importance of a range of factors concerned with: NSSI experiences, self-efficacy to disclose self-injury, interpersonal factors, and reasons for or expectations of disclosure, to the decision to disclose self-injury to friends, family members, significant others, and health professionals. METHODS: Three hundred seventy-one participants with lived experience of NSSI completed a survey in which they rated the importance of the aforementioned factors to the decision of whether to disclose NSSI to different people. A mixed-model analysis of variance was conducted to investigate whether the factors differed in importance and if this importance differed across relationship types. RESULTS: All factors held importance, though to differing degrees, with those related to relationship quality being most important overall. Generally, factors relating to tangible aid were considered more important when considering disclosure to health professionals than to other people. Conversely, interpersonal factors, particularly trust, were more important when disclosing to individuals in social or personal relationships. CONCLUSION: The findings provide preliminary insight into how different considerations may be prioritized when navigating NSSI disclosure, in a way that may be tailored to different contexts. For clinicians, the findings highlight that clients may expect tangible forms of support and nonjudgment in the event that they disclose their self-injury in this formal setting.

Further Silencing the Voiceless: The Role of Gatekeepers in Accessing Information About Self-Injury.

ABSTRACT: Gatekeepers play a pivotal role in protecting individuals under their care and are central to keeping people safe and away from harm. In the field of nonsuicidal self-injury (NSSI), a range of gatekeepers exist, including those who protect access to vulnerable research participants, those who protect school children, those charged with making decisions about funding priorities, and those in charge of clinical care for people who self-injure. The aim of this commentary is to outline the roles these different gatekeepers have in protecting access to research participants, access to NSSI knowledge, and access to clinical care for individuals who self-injure. We provide examples in which gatekeepers may present barriers and offer solutions for how to work with gatekeepers for mutual benefit.