Addressing Nonsuicidal Self-injury in Schools

NCT05935345 | Completed

• 1 other identifier: 2021-01699
• Study Type: interventional
• Target: 267
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this study is to study the effectiveness of a whole-school approach that addresses non-suicidal self-injury and targets adolescents, parents and teachers. Whether training and interventions can influence NSSI will be examined. Furthermore, investigations will be conducted to examine whether this whole-school approach can reduce symptoms of mental health problems in adolescents, reduce stigma och increase help-seeking and perception of social support. Using a clustered waitlist control design, six lower secondary schools were randomized to either intervention or waitlist during four months (control groups were then given the intervention). Measures of NSSI, suicidality, mental well-being, stigma, attitudes, help-seeking and perceived social support were administered at baseline, after the intervention and at 6, 12 and 18-months follow-up. Two hundred and sixty-seven adolescents in seventh and eight grade participated in the study (135 active group and 132 control group). The interventions were delivered during four months. For adolescents, interventions were delivered in the class room and consisted of five sessions of the Youth Aware of Mental Health (YAM) program and one additional session focusing specifically on knowledge, stigma and attitudes toward NSSI (KRAS). Parents were offered an online psychoeducation on NSSI, as were all school staff during this time period. School health care personnel, nurses, psychologist and counsellors and other school staff, such as teachers' aids, support staff and mentors took part in a 2-day workshop on NSSI and suicidality.

Conditions

Nonsuicidal Self-injury; Suicidal Ideation; Stigmatization; Help-Seeking Behavior; Perceived Social Support; Mental Well-being

Keywords

Prevention; Whole-school approach; Nonsuicidal self-injury; Suicidality; Stigma; Help-seeking; Mental health

Outcome Measures

Primary Outcomes (2)

• Life-time prevalence of nonsuicidal self-injury

  Change in self-reported life-time prevalence of nonsuicidal self-injury is measured with a single-item (yes/no) from the Self-Injurious Thoughts and Behaviors Interview Self-Report Short-Form (SITBI-SR-SF).

  Change from baseline at 4 months and at 6, 12 and 18 months

• Frequency of nonsuicidal self-injury

  Change in self-reported frequency of nonsuicidal self-injury (NSSI) is measured with NSSI checklist from the Inventory of Statements About Self-injury (ISAS). Number of NSSI incidence is registered from 0 to the highest number that participants rate. High scores indicate more frequent NSSI.

  Change from baseline at 4 months and at 6, 12 and 18 months

Secondary Outcomes (6)

• Health-related quality of life

  Change from baseline at 4 months and at 6, 12 and 18 months

• nonsuicidal self-injury expectancy

  Change from baseline at 4 months and at 6, 12 and 18 months

• Perceived Social Support

  Change from baseline at 4 months and at 6, 12 and 18 months

• Stigma

  Change from baseline at 4 months and at 6, 12 and 18 months

• Help-seeking

  Change from baseline at 4 months and at 6, 12 and 18 months

Other Outcomes (2)

• Difficulties in emotion regulation

  Change from baseline at 4 months and at 6, 12 and 18 months

• Self-criticism

  Change from baseline at 4 months and at 6, 12 and 18 months

Study Arms (2)

Addressing NSSI in schools

EXPERIMENTAL

During the four months of active experimental condition, adolescents receive five sessions of the youth aware of mental health program in the class room, and one additional session on NSSI. Parents and school staff receive an online psychoeducation on NSSI. School health care personnel receive a 2-day workshop on NSSI and suicidality.

Behavioral: Addressing NSSI in schools

Control condition

OTHER

Participating adolescents, parents, teachers and school health care personnel receive no intervention during four months

Other: Control condition

Interventions

Addressing NSSI in schools BEHAVIORAL

During the four months of active experimental condition, adolescents receive five sessions of the youth aware of mental health program in the class room, and one additional session on NSSI. Parents and school staff receive an online psychoeducation on NSSI. School health care personnel receive a 2-day workshop on NSSI and suicidality.

Addressing NSSI in schools

Control condition OTHER

Participating adolescents, parents, teachers and health care personnel receive no intervention during four months

Control condition

Eligibility Criteria

• Age: 13 Years - 15 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Child (0-17)

You may qualify if:

• being a student in grade 7 and 8 in lower secondary school

You may not qualify if:

• special classes for refugees recently arrived in Sweden with insufficient knowledge of the Swedish language
• special classes for adolescents with intellectual disability

Sponsors & Collaborators

• Region Östergötland: lead

Study Sites (1)

Linköping university

Linköping, Östergötland County, 581 85, Sweden

Location

Related Publications (11)

• Bjureberg J, Ljotsson B, Tull MT, Hedman E, Sahlin H, Lundh LG, Bjarehed J, DiLillo D, Messman-Moore T, Gumpert CH, Gratz KL. Development and Validation of a Brief Version of the Difficulties in Emotion Regulation Scale: The DERS-16. J Psychopathol Behav Assess. 2016 Jun;38(2):284-296. doi: 10.1007/s10862-015-9514-x. Epub 2015 Sep 14.

  PMID: 27239096 BACKGROUND

• Hooley JM, Ho DT, Slater J, Lockshin A. Pain perception and nonsuicidal self-injury: a laboratory investigation. Personal Disord. 2010 Jul;1(3):170-9. doi: 10.1037/a0020106.

  PMID: 22448633 BACKGROUND

• Klonsky ED, Glenn CR. Assessing the functions of non-suicidal self-injury: Psychometric properties of the Inventory of Statements About Self-injury (ISAS). J Psychopathol Behav Assess. 2009 Sep;31(3):215-219. doi: 10.1007/s10862-008-9107-z. Epub 2008 Oct 30.

  PMID: 29269992 BACKGROUND

• McKeague L, Hennessy E, O'Driscoll C, Heary C. Peer Mental Health Stigmatization Scale: psychometric properties of a questionnaire for children and adolescents. Child Adolesc Ment Health. 2015 Sep;20(3):163-170. doi: 10.1111/camh.12088. Epub 2015 Feb 16.

  PMID: 32680400 BACKGROUND

• Nearchou F, O'Driscoll C, McKeague L, Heary C, Hennessy E. Psychometric properties of the Peer Mental Health Stigmatization Scale-Revised in adolescents and young adults. Early Interv Psychiatry. 2021 Feb;15(1):201-205. doi: 10.1111/eip.12933. Epub 2020 Feb 9.

  PMID: 32037717 BACKGROUND

• Nock MK, Holmberg EB, Photos VI, Michel BD. Self-Injurious Thoughts and Behaviors Interview: development, reliability, and validity in an adolescent sample. Psychol Assess. 2007 Sep;19(3):309-17. doi: 10.1037/1040-3590.19.3.309.

  PMID: 17845122 BACKGROUND

• Ravens-Sieberer U, Gosch A, Rajmil L, Erhart M, Bruil J, Duer W, Auquier P, Power M, Abel T, Czemy L, Mazur J, Czimbalmos A, Tountas Y, Hagquist C, Kilroe J, Kidscreen Group E. KIDSCREEN-52 quality-of-life measure for children and adolescents. Expert Rev Pharmacoecon Outcomes Res. 2005 Jun;5(3):353-64. doi: 10.1586/14737167.5.3.353.

  PMID: 19807604 BACKGROUND

• Wyman PA, Brown CH, Inman J, Cross W, Schmeelk-Cone K, Guo J, Pena JB. Randomized trial of a gatekeeper program for suicide prevention: 1-year impact on secondary school staff. J Consult Clin Psychol. 2008 Feb;76(1):104-15. doi: 10.1037/0022-006X.76.1.104.

  PMID: 18229988 BACKGROUND

• Zetterqvist M, Lundh LG, Dahlstrom O, Svedin CG. Prevalence and function of non-suicidal self-injury (NSSI) in a community sample of adolescents, using suggested DSM-5 criteria for a potential NSSI disorder. J Abnorm Child Psychol. 2013 Jul;41(5):759-73. doi: 10.1007/s10802-013-9712-5.

  PMID: 23344701 BACKGROUND

• Hasking P, Boyes M. The Non-Suicidal Self-Injury Expectancy Questionnaire: Factor structure and initial validation. Clinical Psychologist. 2018;22(2):251-261. doi:10.1111/cp.12127

  BACKGROUND

• Zimet GD, Powell SS, Farley GK, Werkman S, Berkoff KA. Psychometric characteristics of the Multidimensional Scale of Perceived Social Support. J Pers Assess. 1990 Winter;55(3-4):610-7. doi: 10.1080/00223891.1990.9674095.

  PMID: 2280326 BACKGROUND

MeSH Terms

Conditions

Self-Injurious Behavior; Suicidal Ideation; Stereotyping; Help-Seeking Behavior; Psychological Well-Being; Social Stigma

Interventions

Schools

Condition Hierarchy (Ancestors)

Behavioral Symptoms; Behavior; Suicide; Social Behavior; Personal Satisfaction

Intervention Hierarchy (Ancestors)

Non-Medical Public and Private Facilities

Study Officials

• Maria A Zetterqvist, PhD

  CSAN, BKV, Linköping university

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: PREVENTION
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal investigator

Study Record Dates

• First Submitted: April 30, 2023
• First Posted: July 7, 2023
• Study Start: January 10, 2022
• Primary Completion: June 12, 2023
• Study Completion: June 12, 2023
• Last Updated: July 7, 2023

Record last verified: 2023-07

Data Sharing

• IPD Sharing: Will not share

Locations

SE (1)