1. Youth Wellbeing Study – Update Marc Wilson, Jessica Garisch, Robyn Langlands, Angelique O’Connell, Lynne Russell, Emma-Jayne Brown, Tahlia Kingi, Kealagh Robinson, and Maddie Judge Wellington, May 2014

2. Youth Wellbeing Study Longitudinal survey with secondary school students. Non-Suicidal Self-injury Primarily investigating – Risk and protective factors for the development of non-suicidal self- injury – Barriers to help-seeking

3. Trajectory of NSSI among young New Zealanders We have data spanning age-groups – 13 – 15 years olds...and you’ve heard us talk about before: – 16 – 19 year olds – University students (M=19 yo)

4. Prevalence YWS Wave 1 results – N=1027 (991 responded to questions on NSSI) 213 (21%) engaged in NSSI at least once – 81.6% had engaged in NSSI in the past year Senior secondary school students – N=1162 48.7% had engaged in NSSI at least once – 53.6% had engaged in NSSI in past year » 46.4% over a year ago University students – N= 593 43.7% had engaged in NSSI at least once

5. Participants indicated how they felt at the start, and again at the end, of the survey. If anything, participants report feeling on average happier at the end.

6. YWS wave 1: Further information on prevalence... Type of NSSINever thought about Thought about, never done Have done once Have done a few times Have done many times Cut80.26.03.86.23.8 Scratched87.52.73.84.01.9 Carved89.22.33.73.01.7 Punched/ banged 90.32.53.72.70.7 Stuck sharp objects 91.12.13.42.40.9 Prevent healing91.81.53.31.91.4 Bitten self93.82.4 1.00.4 Burn94.32.71.51.00.5 Rubbed glass96.01.41.50.80.3 Broken bones97.11.60.70.40.2 Rubbed sandpaper 97.71.10.80.30.1 Dripped acid99.20.30.20.0 Used bleach/ cleaning agent 99.20.70.10.0

7. Prevalence of Types of NSSI YWS Wave 1 sample – Cutting most common – Severe scratching, carving the skin, punching or banging Senior Secondary School students – Sticking sharp objects into the skin, carved, scratch most common – Cutting Other types assessed (e.g. using acid, sandpaper, etc.) much less frequently reported. Types of NSSI generally cluster into 2 factors: ‘common’ + ‘uncommon’

8. Engagement in multiple types of NSSI University student data suggests that the majority of young people engage in 1 – 3 types of NSSI...

9. Engagement in multiple types of NSSI YWS Wave 1 Of the 213 who reported NSSI – 25.6% reported 1 form – 17.4% reported 2 forms – 15.5% reported 3 forms – 37.1% reported > 3 forms

10. Self-reported Function of NSSI

11. YWS Wave 1: Four Clusters (Functions assessed using FASM (Klonsky & Olino, 2008) Interpersonal: Other-focused Interpersonal: self-focused Intrapersonal: Disconnection Intrapersonal: Affect & Punish

12. Functions & Psycho-social functioning Generally, intrapersonal functions (both disconnection and affect regulation/self-punishment) most strongly associated with indicators of poor functioning...

13. Anxiety Level of Function endorsement Depression Level of Function endorsement

14. Attachment to Parents Level of Function endorsement Attachment to Peers Level of Function endorsement

15. Emotion Regulation Level of Function endorsement Resilience Level of Function endorsement

16. Suicidal Ideation Level of Function endorsement Self-Esteem Level of Function endorsement

17. YWS: Participant Clusters by Function Cluster 1: Affect regulation & self-punishment (n=75) Cluster 2: Low on all (n=81) Cluster 3: Highest on intrapersonal (n=13) Cluster 4: High on all, highest on both interpersonal (n=22) C1 C4 C2 C3

18. YWS: Clusters + Psycho-social functioning Four clusters differed significantly on: – Suicidality (notably C1 and C3) – Self-esteem – Resilience – Depression – Anxiety – Emotion regulation – Attachment to parents (but not peers...) – NSSI behaviour Cluster 2 (low on all) generally the best

19. The NUMBER of types of self-injury engaged in is strongly predictive of suicidal ideation: For each additional form, SBQ scores increase: 1 form  SBQ = 3.5ish 2 forms  SBQ = 5ish 3 forms  SBQ = 7ish 7 is the recommended cutoff for concern…

20. YWS: Participant Clusters by NSSI forms C1 C4 C2 C3

21. YWS: Participant Clusters by NSSI forms C1 – 2 nd most likely to cut, 3 rd most likely for most forms C4 – most likely to self-bite, 2 nd most likely for most. Most likely to have thought about ‘atypical’ self-injury like bone breaking, using glass, bleach, etc C2 C3 – Most likely to cut, carve, insert

22. Implications for practice Results congruent with the idea that NSSI begins in early adolescents, and continues into early adulthood for some individuals Forms of NSSI: multiple behaviours need to be queried. Functions – Heterogeneity – Affect regulation most prevalent

23. Implications for practice continued... Functions can point to skills required... – Affect regulation Distress tolerance skills Labelling and communicating emotions Understanding beliefs regarding experiencing (and showing) emotion

24. Acknowledgements Participating schools, counsellors + students HRC Thanks for listening Any questions? Comments?