To Örebro University

Adolescent sleep quality and quantity is commonly linked to worse emotion regulation. One maladaptive emotion regulation strategy that is on the rise is non-suicidal self-injury (NSSI), which includes burning, hitting, or scratching one's own body tissue without suicidal intent. The aim of this study was to explore the frequency of NSSI among different longitudinal trajectories of insomnia symptoms and short sleep duration to identify at-risk adolescents. We used questionnaire data collected annually (3 time points over 2 years) from a sample of Swedish adolescents (N = 1,294; Mage = 13.2 [range: 12-15 years], SD = 0.4; 46.8% girls). Adolescents answered questions about their sleep duration, symptoms of insomnia, NSSI, depressive symptoms, and demographics. Adolescents who reported persistent or increasing sleep problems over time also reported more NSSI. A notable pattern was that adolescents whose insomnia symptoms were high and increasing reported the highest frequency of NSSI, also compared to adolescents who started at the same high level of insomnia symptoms but improved over time. Therefore, measuring NSSI may help identify a risk-group for persistent sleep problems and self-injury. Because sleep disturbances, especially insomnia, and NSSI go hand-in-hand for most adolescents, sleep interventions would benefit the treatment and prevention of self-injury.

(1) Background: Many studies have used a well-known social exclusion task, namely Cyberball, to assess the psychophysiological reactions to ostracism in laboratory settings. However, this task has been recently criticized for its lack of realism. Instant messaging communication platforms are currently central communication channels where adolescents conduct their social life. These should be considered when recreating the emotional experiences that fuel the development of negative emotions. To overcome this limitation, a new ostracism task, namely SOLO (Simulated On-Line Ostracism), recreating hostile interactions (i.e., exclusion and rejection) over WhatsApp was developed. The aim of this manuscript is to compare adolescents' self-reported negative and positive affect, as well as physiological reactivity (i.e., heat rate, HR; heart rate variability, HRV) exhibited during SOLO to Cyberball.

(2) Method: A total of 35 participants (Mage = 15.16; SD = 1.48; 24 females) took part in the study. The first group (n = 23; transdiagnostic group), recruited at an inpatient and outpatient unit of a clinic for children and adolescent psychiatry, psychotherapy, and psychosomatic therapy in Baden-Württemberg (Germany), reported clinical diagnoses linked with emotional dysregulation (e.g., self-injury and depression). The second group (n = 12; control group), recruited in the district of Bavaria and Baden-Württemberg, had no pre-existing clinical diagnoses.

(3) Results: The transdiagnostic group showed higher HR (b = 4.62, p < 0.05) and lower HRV (b = 10.20, p < 0.01) in SOLO than in Cyberball. They also reported increased negative affect (interaction b = -0.5, p < 0.01) after SOLO but not after Cyberball. In the control group, no differences in either HR (p = 0.34) or HRV (p = 0.08) between tasks were found. In addition, no difference in negative affect after either task (p = 0.83) was found.

(4) Conclusion: SOLO could be an ecologically valid alternative to Cyberball when assessing reactions to ostracism in adolescents with emotional dysregulation.

OBJECTIVE: Although nonsuicidal self-injury is a public health concern, there is little information on how it changes across adolescence or what contributes to stability or change. We aimed to identify trajectories of stability and change in self-injury from ages 13 to 17 years, and to identify interpersonal and intrapersonal correlates that differentiate between trajectories of stability and change.

METHOD: We used five annual waves of cohort-sequential data, targeting 7th and 8th graders attending all public schools in three municipalities in central Sweden. The data were gathered via questionnaires, using a multi-item measure of non-suicidal self-injury and assessing negative experiences at home, in school, with peers, and in romantic settings, as well as intrapersonal issues (internalizing symptoms and difficulties with emotional, and behavioral regulation). The analytic sample was 3195 adolescents (51.7% boys, 48.3% girls; ages 12-16 years at T1, M = 13.61; SD = 0.66), most of whom were born in Sweden (88.6%) to at least one parent of Swedish origin (77.4%).

RESULTS: Latent growth curve modeling revealed three self-injury trajectories: a stable-low, a low-increasing, and an increasing-decreasing trajectory. Adolescents in the stable-low class reported the best overall adjustment at ages 13 and 16. Comparatively, adolescents in the other two classes reported similar levels of difficulty interpersonally and intrapersonally. Where they differed, the increase-decrease class fared worse than the low-increasing class. CONCLUSIONS: This study suggests the need to frame self-injury as having multiple directions of development during adolescence and develop theory that aligns with differential patterns of self-injury development.

Research has rarely focused on what might make adolescents less likely to engage in deliberate self-harm. Because the sports domain is an important context promoting positive adjustment, we proposed that engaging in organized sport activities could help adolescents refrain from self-harming through affecting their psychosocial well-being. Using two annual waves of longitudinal data from 998 Swedish adolescents in grades 7 and 8 (52% boys), we tested whether depressive symptoms and self-esteem mediated the link between organized sport activities and self-harm. Results showed that self-esteem, but not depressive symptoms, mediated the association between organized sport activities and lower self-harm. Our findings reinforce the idea that organized sport activities could be a viable way of promoting mental health, laying the foundation for future interventions.

BACKGROUND: Instant messaging platforms seem to positively contribute to adolescent emotional well-being. However, some scholars show a link between the use of these platforms and negative emotional experiences. These emotions could be perceived as even more overwhelming for certain subgroups of adolescents, such as those who engage in non-suicidal self-injury (NSSI), and lead to self-injury to deal with otherwise difficult to handle feelings.

OBJECTIVE: The current study aimed at providing a deeper understanding of what kind of experiences during instant messaging communications are perceived as emotionally upsetting by adolescents with and without NSSI, and which situations could trigger NSSI thoughts or attempts in adolescents with lived experiences.

METHOD: We used content analysis to analyze short interviews conducted with a total of 17 adolescents with and without lived experiences of NSSI.

RESULTS: Our results showed that experience of Involvement in conflicts, and especially Name-calling and insults, triggered negative emotional experiences for most adolescents (76.5%). Interpersonal stressors like Name-calling and insults, Disagreements or arguments, Unwanted contact, Friendship break-up and “Ghosting” were identified as major triggers for NSSI.

CONCLUSION: These findings could be used for the purpose of facilitating future research into mapping negative experiences adolescents have on instant messaging platforms, as well as used as a clinical guide to identify situations related to NSSI thoughts or episodes.

Objective: Immigrant adolescents are at risk of harming themselves. Interpersonal or acculturative stressors, including ethnic harassment, may contribute to adolescents’ engagement in self-harm. Despite a growing interest in the link between ethnic harassment and self-harm among immigrant youth, we have limited knowledge on the conditions that make ethnically harassed adolescents likely to self-harm. Thus, we aimed (a) to examine reasons why ethnically harassed youth self-harm and (b) to identify the conditions that elevate ethnically harassed youth’s engagement in self-harm.

Method: A total of 536 first- and second-generation immigrant adolescents living in Sweden (261 girls; Mage = 14.42; SD = 1.01) participated in the study and were followed over 1 year. Adolescents who reported more depressive symptoms and who harmed themselves were more likely to drop out. Results: The cross-sectional results showed that when adolescents were exposed to ethnic harassment, they felt more depressed, and they engaged in self-harm. This pattern was especially true for adolescents who had a strong desire to be perceived as part of the majority (βindirect = .07, z = 2.81, p = .01, 95% confidence interval [.03, .13]). These results were not confirmed longitudinally.

Conclusion: The cross-sectional findings suggest that immigrant adolescents wanting to be part of Swedish society may experience a clash between that desire and the responses they get from the society and may use self-harm as a viable way of overcoming ethnic-devaluation experiences. Future studies are needed to replicate our lack of longitudinal results and to provide explanations for this pattern of association.

We propose a theoretical model of insomnia symptoms and non-suicidal self-injury (NSSI) that posits bidirectional linkages. We hypothesised that heightened depressive symptoms and impulsivity that result from insomnia increase NSSI. We also posit that the shame associated with NSSI triggers repetitive negative thinking, in turn increasing insomnia. Using three longitudinal waves of questionnaire data collected annually from a sample of Swedish adolescents (n = 1,457; Mage = 13.2, SD = 0.43; 52.7% boys), we assessed the mediating role of depressive symptoms, impulsivity, rumination, and worry on the link between insomnia and NSSI. After controlling for depressive symptoms, we found that insomnia was related to increases in NSSI from the second to the third time point (ß23 = 0.09, p = .01). NSSI was consistently related to increased insomnia (ß12 = 0.09, p = .01; ß23 = 0.11, p < .001). In addition, depressive symptoms (ßind = 0.01, p = .02), but not impulsivity (ßind = 0.01, p = .09), mediated the path from insomnia to increased NSSI. Neither worry (ßind = 0.00, p = .59) nor rumination (ßind = 0.00, p = .96) mediated the link between NSSI and increased insomnia. We conclude that NSSI and insomnia maintain each other over time. Thus, screening adolescents for insomnia symptoms may help identify those at risk of NSSI. Although depression seems to explain why insomnia is a risk factor for NSSI, further studies should investigate why NSSI plays a role in the maintenance of insomnia. This understanding will lay the foundation for intervention.

We proposed that having mutually hostile interactions with others is a strong environmental stress factor that, together with diverse psychosocial problems, characterizes adolescents who self-harm. Using cluster analysis, this study examined the naturally occurring patterns of hostility conditions and psychosocial difficulties in a normative sample of 2,029 adolescents (50% boys; Mage  = 13.89). Results showed that self-harming behavior was significantly higher among the subgroup of adolescents with mutually hostile interactions who exhibited both internalizing and externalizing problems than among adolescents with other interpersonal-psychosocial configurations. Also, this subgroup of adolescents reported high impulsivity, anger dysregulation, and low self-esteem. These findings support recent research that indicates that adolescents who self-harm also tend to expose others to hostility and display externalizing symptoms.

In the literature, bully-victims report a wider range of adjustment problems than “pure” bullies or victims. This may not be confined to the school context, but might be found in other settings as well. Involvement in mutually hostile interactions across everyday settings may more reflect adolescents' characteristic way of handling conflicts with others. We used data from a longitudinal study of a community sample of adolescents (N = 992). Cluster analyses for specific everyday settings and across settings yielded clusters high on both exposing others and being exposed to hostility. Adolescents in these clusters, and particularly across settings, reported a wider range of externalizing, internalizing, and academic problems, than adolescents in other cluster groups. Longitudinal analyses showed support for bidirectional relationships between mutually hostile conditions and problematic adjustment. We conclude that adolescents' mutual hostility experiences are associated with profoundly problematic adjustment.