The relationships between sporadic and repetitive non-suicidal self-injury and mental disorders among first-year college students: results from the World Mental Health International College Student Initiative

doi:10.1017/s0033291725100688

The relationships between sporadic and repetitive non-suicidal self-injury and mental disorders among first-year college students: results from the World Mental Health International College Student Initiative

Research output: Contribution to journal › Article › peer-review

4 Downloads (Pure)

Abstract

Non-suicidal self-injury (NSSI) is associated with mental disorders, yet work regarding the direction of this association is inconsistent. We examined the prevalence, comorbidity, time-order associations with mental disorders, and sex differences in sporadic and repetitive NSSI among emerging adults. We used survey data from = 72,288 first-year college students as part of the World Mental Health-International College Student Survey Initiative (WMH-ICS) to explore time-order associations between onset of NSSI and mental disorders, based on retrospective age-of-onset reports using discrete-time survival models. We distinguished between sporadic (1-5 lifetime episodes) and repetitive (≥6 lifetime episodes) NSSI in relation to mood, anxiety, and externalizing disorders. We estimated a lifetime NSSI rate of 24.5%, with approximately half reporting sporadic NSSI and half repetitive NSSI. The time-order associations between onset of NSSI and mental disorders were bidirectional, but mental disorders were stronger predictors of the onset of NSSI (median RR = 1.94) than vice versa (median RR = 1.58). These associations were stronger among individuals engaging in repetitive rather than sporadic NSSI. While associations between NSSI and mental disorders generally did not differ by sex, repetitive NSSI was a stronger predictor for the onset of subsequent substance use disorders among females compared to males. Most mental disorders marginally increased the risk for persistent repetitive NSSI (median RR = 1.23). Our findings offer unique insights into the temporal order between NSSI and mental disorders. Further work exploring the mechanism underlying these associations will pave the way for early identification and intervention of both NSSI and mental disorders.

Original language	English
Pages (from-to)	1-15
Number of pages	15
Journal	Psychological Medicine
Volume	55
Early online date	25 Sept 2025
DOIs	https://doi.org/10.1017/s0033291725100688
Publication status	Published (in print/issue) - 30 Dec 2025

Bibliographical note

Funding

Funding to support this initiative was received from the National Institute of Mental Health (NIMH) R56MH109566 (RPA), and the content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or NIMH. Local funding for surveys in each country is listed below: Australia: PH has received funding for this work from Suicide Prevention Australia, the Feilman Foundation, and the National Health and Medical Research Council (ID 2032058). Belgium: The Belgian Fund for Scientific Research (11N0514N/11N0516N/ 1114717 N), the King Baudouin Foundation (2014-J2140150–102905) (RB), the Ministry of Education, Flanders - Grant# EDC-E3738, institutional payment, awarded to RB. Canada: Health Canada - Substance Use and Addictions Program. Grant for the Mental Health Systems and Services Laboratory at the University of British Columbia. Chile: VM, JG, ÁIL, and DN received funding from ANID/Millennium Science Initiative Program-NCS2021_081 and ANID/FONDECYT 1221230. SM-G received funding from ANID/Millennium Science Initiative ProgramNCS2021_081 and ANID/PFCHA/DOCTORADO EN EL EXTRANJERO BECAS CHILE/2019–72200092. Germany: BARMER, a health care insurance company, for project StudiCare. Hong Kong: Shandong Taishan Scholar Young Expert Project (tsqn201909145. Mexico: Consejo Nacional de Ciencia y Tecnología (Mexican National Council of Science and Technology). Grant CONACYT 285548 awarded to institution (National Institute of Psychiatry Ramon de la Fuente Muñiz) with CB as PI. The Netherlands: ZonMw (Netherlands Organisation for Health Research and Development; grant number 636110005) and the PFGV (PFGV; Protestants Fonds voor de Geestelijke Volksgezondheid) in support of the student survey project. New Zealand: The WMH-ICS NZ surveys were supported by a Rutherford Discovery Fellowship awarded to Associate Professor Damian Scarf, with additional support from the James Hume Bequest Fund and a research grant from University of Otago. Northern Ireland: The Student Psychological Intervention Trial (SPIT) was supported by Clinical Healthcare Intervention Trials in Ireland Network (CHITIN). CHITIN has received €10.6 million funding from the European Union’s INTERREG VA programme managed by the Special EU Programmes Body (SEUPB) with match funding from the Departments of Health in NI and ROI (CHI/5433/18). Romania:This work was supported by Romanian National Authority for Scientific Research, CNCS—UEFISCDI, Grant number PN-III-P2–2.1- PED-2021-3882, awarded to OD. Saudi Arabia: The Saudi University Mental Health Survey is conducted by the King Salman Center for Disability Research; funded by Saudi Basic Industries Corporation, King Abdulaziz City for Science and Technology, Ministry of Health (Saudi Arabia) and King Saud University. Funding in-kind was provided by King Faisal Specialist Hospital & Research Center, and Ministry of Economy & Planning, General Authority for Statistics, Riyadh. South Africa: The work reported herein was made possible through funding by the South African Medical Research Council (SAMRC) through its Division of Research Capacity Development under the MCSP (awarded to JB and XH). Spain: The PROMES-U study, is supported by Instituto de Salud Carlos III (ISCIII) and cofunded by the European Union, grant number PI20/00006; the Departament de Recerca i Universitats of the Generalitat de Catalunya (AGAUR 2021 SGR 00624); and CIBER -Consorcio Centro de Investigación Biomédica en Red- (CB06/02/0046), Instituto de Salud Carlos III, Ministerio de Ciencia e Innovación and Unión Europea. For surveys directed by Parc Sanitari Sant Joan de Déu, funding was provided by Fundació Sant Joan de Déu. Sweden: CA, MB and AHB received funding for this work from the Swedish Research Council (ID 2019–01127) as well as from a Public Health Agency in Sweden (ID 04252–2021-2.3.2). Both grants were awarded to AHB. The World Mental Health International College Student (WMH-ICS) initiative is carried out as part of the World Mental Health (WMH) Survey Initiative. The WMH survey is supported by the National Institute of Mental Health NIMH R01MH070884, the John D. and Catherine T. MacArthur Foundation, the Pfizer Foundation, the US Public Health Service (R13-MH066849, R01-MH069864, and R01 DA016558), the Fogarty International Center (FIRCA R03-TW006481), the Pan American Health Organization, Eli Lilly and Company, Ortho-McNeil Pharmaceutical, GlaxoSmithKline, and Bristol-Myers Squibb (RCK). None of the funders had any role in the design, analysis, interpretation of results, decision to publish, or preparation of this paper. A complete list of all within-country and cross-national WMH-ICS publications can be found at http://www.hcp.med.harvard.edu/wmh/college_student_ survey.php

Keywords

college students
NSSI
non-suicidal self-injury
mental disorders
Universities - statistics & numerical data
Mental Disorders - epidemiology
Prevalence
Comorbidity
Humans
Male
Young Adult
Self-Injurious Behavior - epidemiology
Adolescent
Sex Factors
Adult
Female
Students - statistics & numerical data - psychology

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

Access to Document

10.1017/s0033291725100688

S0033291725100688a.pdfFinal published version, 944 KBLicence: CC BY-NC-ND

Fingerprint

Dive into the research topics of 'The relationships between sporadic and repetitive non-suicidal self-injury and mental disorders among first-year college students: results from the World Mental Health International College Student Initiative'. Together they form a unique fingerprint.

Cite this

@article{52b8d66975e84411a91952507edb5558,

title = "The relationships between sporadic and repetitive non-suicidal self-injury and mental disorders among first-year college students: results from the World Mental Health International College Student Initiative",

abstract = "Non-suicidal self-injury (NSSI) is associated with mental disorders, yet work regarding the direction of this association is inconsistent. We examined the prevalence, comorbidity, time-order associations with mental disorders, and sex differences in sporadic and repetitive NSSI among emerging adults. We used survey data from = 72,288 first-year college students as part of the World Mental Health-International College Student Survey Initiative (WMH-ICS) to explore time-order associations between onset of NSSI and mental disorders, based on retrospective age-of-onset reports using discrete-time survival models. We distinguished between sporadic (1-5 lifetime episodes) and repetitive (≥6 lifetime episodes) NSSI in relation to mood, anxiety, and externalizing disorders. We estimated a lifetime NSSI rate of 24.5\%, with approximately half reporting sporadic NSSI and half repetitive NSSI. The time-order associations between onset of NSSI and mental disorders were bidirectional, but mental disorders were stronger predictors of the onset of NSSI (median RR = 1.94) than vice versa (median RR = 1.58). These associations were stronger among individuals engaging in repetitive rather than sporadic NSSI. While associations between NSSI and mental disorders generally did not differ by sex, repetitive NSSI was a stronger predictor for the onset of subsequent substance use disorders among females compared to males. Most mental disorders marginally increased the risk for persistent repetitive NSSI (median RR = 1.23). Our findings offer unique insights into the temporal order between NSSI and mental disorders. Further work exploring the mechanism underlying these associations will pave the way for early identification and intervention of both NSSI and mental disorders.",

keywords = "college students, NSSI, non-suicidal self-injury, mental disorders, Universities - statistics \& numerical data, Mental Disorders - epidemiology, Prevalence, Comorbidity, Humans, Male, Young Adult, Self-Injurious Behavior - epidemiology, Adolescent, Sex Factors, Adult, Female, Students - statistics \& numerical data - psychology",

author = "Penelope Hasking and Glenn Kiekens and Petukhova, \{Maria V.\} and Yesica Albor and Ahmad Al-Hadi and Jordi Alonso and Nouf Al-Saud and Yasmin Altwaijri and Claes Andersson and Lukoye Atwoli and \{Ayuya Muaka\}, Caroline and Patricia B{\'a}ez-Mansur and Laura Ballester and Jason Bantjes and Harald Baumeister and Marcus Bendtsen and Corina Benjet and Anne Berman and Ronny Bruffaerts and Paula Carrasco and Silver Chan and Irina Cohut and \{Covarrubias D{\'i}az Couder\}, Maria and Paula Crist{\'o}bal-Narvaez and Pim Cuijpers and Oana David and Dong Dong and David Ebert and Jorge Gaete and \{Garc{\'i}a Forero\}, Carlos and Ra{\'u}l Guti{\'e}rrez-Garc{\'i}a and Josep Haro and Xanthe Hunt and Petra Hurks and Mathilde Husky and Florence Jaguga and Leontien Jansen and Ana Jim{\'e}nez-P{\'e}rez and Fanny K{\"a}hlke and Elisabeth Klinkenberg and {\'A}lvaro Langer and Sue Lee and Lima, \{Rodrigo Antunes\} and Yan Liu and Christine Lochner and Scarlett Mac-Ginty and Vania Mart{\'i}nez and Andre Mason and Margaret McLafferty and Elaine Murray",

note = "{\textcopyright} The Author(s), 2025. Published by Cambridge University Press.",

year = "2025",

month = dec,

day = "30",

doi = "10.1017/s0033291725100688",

language = "English",

volume = "55",

pages = "1--15",

journal = "Psychological Medicine",

issn = "0033-2917",

publisher = "Cambridge University Press",

}

TY - JOUR

T1 - The relationships between sporadic and repetitive non-suicidal self-injury and mental disorders among first-year college students: results from the World Mental Health International College Student Initiative

AU - Hasking, Penelope

AU - Kiekens, Glenn

AU - Petukhova, Maria V.

AU - Albor, Yesica

AU - Al-Hadi, Ahmad

AU - Alonso, Jordi

AU - Al-Saud, Nouf

AU - Altwaijri, Yasmin

AU - Andersson, Claes

AU - Atwoli, Lukoye

AU - Ayuya Muaka, Caroline

AU - Báez-Mansur, Patricia

AU - Ballester, Laura

AU - Bantjes, Jason

AU - Baumeister, Harald

AU - Bendtsen, Marcus

AU - Benjet, Corina

AU - Berman, Anne

AU - Bruffaerts, Ronny

AU - Carrasco, Paula

AU - Chan, Silver

AU - Cohut, Irina

AU - Covarrubias Díaz Couder, Maria

AU - Cristóbal-Narvaez, Paula

AU - Cuijpers, Pim

AU - David, Oana

AU - Dong, Dong

AU - Ebert, David

AU - Gaete, Jorge

AU - García Forero, Carlos

AU - Gutiérrez-García, Raúl

AU - Haro, Josep

AU - Hunt, Xanthe

AU - Hurks, Petra

AU - Husky, Mathilde

AU - Jaguga, Florence

AU - Jansen, Leontien

AU - Jiménez-Pérez, Ana

AU - Kählke, Fanny

AU - Klinkenberg, Elisabeth

AU - Langer, Álvaro

AU - Lee, Sue

AU - Lima, Rodrigo Antunes

AU - Liu, Yan

AU - Lochner, Christine

AU - Mac-Ginty, Scarlett

AU - Martínez, Vania

AU - Mason, Andre

AU - McLafferty, Margaret

AU - Murray, Elaine

PY - 2025/12/30

Y1 - 2025/12/30

N2 - Non-suicidal self-injury (NSSI) is associated with mental disorders, yet work regarding the direction of this association is inconsistent. We examined the prevalence, comorbidity, time-order associations with mental disorders, and sex differences in sporadic and repetitive NSSI among emerging adults. We used survey data from = 72,288 first-year college students as part of the World Mental Health-International College Student Survey Initiative (WMH-ICS) to explore time-order associations between onset of NSSI and mental disorders, based on retrospective age-of-onset reports using discrete-time survival models. We distinguished between sporadic (1-5 lifetime episodes) and repetitive (≥6 lifetime episodes) NSSI in relation to mood, anxiety, and externalizing disorders. We estimated a lifetime NSSI rate of 24.5%, with approximately half reporting sporadic NSSI and half repetitive NSSI. The time-order associations between onset of NSSI and mental disorders were bidirectional, but mental disorders were stronger predictors of the onset of NSSI (median RR = 1.94) than vice versa (median RR = 1.58). These associations were stronger among individuals engaging in repetitive rather than sporadic NSSI. While associations between NSSI and mental disorders generally did not differ by sex, repetitive NSSI was a stronger predictor for the onset of subsequent substance use disorders among females compared to males. Most mental disorders marginally increased the risk for persistent repetitive NSSI (median RR = 1.23). Our findings offer unique insights into the temporal order between NSSI and mental disorders. Further work exploring the mechanism underlying these associations will pave the way for early identification and intervention of both NSSI and mental disorders.

AB - Non-suicidal self-injury (NSSI) is associated with mental disorders, yet work regarding the direction of this association is inconsistent. We examined the prevalence, comorbidity, time-order associations with mental disorders, and sex differences in sporadic and repetitive NSSI among emerging adults. We used survey data from = 72,288 first-year college students as part of the World Mental Health-International College Student Survey Initiative (WMH-ICS) to explore time-order associations between onset of NSSI and mental disorders, based on retrospective age-of-onset reports using discrete-time survival models. We distinguished between sporadic (1-5 lifetime episodes) and repetitive (≥6 lifetime episodes) NSSI in relation to mood, anxiety, and externalizing disorders. We estimated a lifetime NSSI rate of 24.5%, with approximately half reporting sporadic NSSI and half repetitive NSSI. The time-order associations between onset of NSSI and mental disorders were bidirectional, but mental disorders were stronger predictors of the onset of NSSI (median RR = 1.94) than vice versa (median RR = 1.58). These associations were stronger among individuals engaging in repetitive rather than sporadic NSSI. While associations between NSSI and mental disorders generally did not differ by sex, repetitive NSSI was a stronger predictor for the onset of subsequent substance use disorders among females compared to males. Most mental disorders marginally increased the risk for persistent repetitive NSSI (median RR = 1.23). Our findings offer unique insights into the temporal order between NSSI and mental disorders. Further work exploring the mechanism underlying these associations will pave the way for early identification and intervention of both NSSI and mental disorders.

KW - college students

KW - NSSI

KW - non-suicidal self-injury

KW - mental disorders

KW - Universities - statistics & numerical data

KW - Mental Disorders - epidemiology

KW - Prevalence

KW - Comorbidity

KW - Humans

KW - Male

KW - Young Adult

KW - Self-Injurious Behavior - epidemiology

KW - Adolescent

KW - Sex Factors

KW - Adult

KW - Female

KW - Students - statistics & numerical data - psychology

UR - https://www.scopus.com/pages/publications/105016909087

U2 - 10.1017/s0033291725100688

DO - 10.1017/s0033291725100688

M3 - Article

SN - 0033-2917

VL - 55

SP - 1

EP - 15

JO - Psychological Medicine

JF - Psychological Medicine

ER -

The relationships between sporadic and repetitive non-suicidal self-injury and mental disorders among first-year college students: results from the World Mental Health International College Student Initiative

Abstract

Bibliographical note

Funding

Keywords

UN SDGs

Access to Document

Other files and links

Fingerprint

Cite this