ArticleFrontiers in child and adolescent psychiatry2026
Psychological risk profiles are associated with severity and motivational-volitional mechanisms of non-suicidal self-injury in adolescents and young adults.
Article in Frontiers in child and adolescent psychiatry, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Non-suicidal self-injury (NSSI) is a prevalent behavior among adolescents and young adults. According to the Integrated Motivational-Volitional (IMV) model, pre-motivational vulnerabilities such as depression, anxiety, and low self-efficacy underlie self-harming behavior. It remains unclear how these factors combine into distinct clinical profiles and how such profiles differ regarding intrusive prospective mental imagery, emotion regulation, and NSSI frequency. Therefore, this study aimed to identify psychological subgroups based on distress and self-efficacy using a person-centered cluster approach, and to examine how these profiles, together with NSSI age of onset, relate to imagery intrusiveness, emotion regulation strategies, and NSSI frequency. Methods: Five hundred fifty-seven adolescents and young adults with a history of NSSI completed an online survey. A TwoStep cluster analysis based on depression (BDI-II), anxiety (STAI-T), and self-efficacy (WIRKALL_r) identified psychological profiles. General Linear Models (GLMs) with bootstrapping (1,000 resamples) examined the independent and interactive effects of cluster membership and NSSI age of onset (early: <12 vs. late: ≥12 years) on intrusive imagery (IFES-S), emotion regulation strategies (ERQ), and NSSI behavior (SITBI). Results: Two profiles emerged: a High-Risk cluster (high distress, low self-efficacy) and a Low-Risk cluster (low distress, high self-efficacy). The High-Risk cluster showed significantly higher NSSI frequency, greater intrusive imagery, increased suppression, and reduced cognitive reappraisal. Early NSSI age of onset was independently associated with higher lifelong NSSI frequency and greater imagery intrusiveness across both clusters. No significant cluster-by-onset interactions were found, supporting an additive risk model. Discussion: Findings support the pre-motivational phase of the IMV model and suggest that intrusive imagery and maladaptive emotion regulation align with the transition from distress to NSSI. The additive effects of psychological risk profile and early NSSI age of onset highlight the need for targeted interventions, including Imagery Rescripting and self-efficacy training.
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