Baetens Imke, Decruy Christine, Vatandoost Shokoufeh, Vanderhaegen Birgit, Kiekens Glenn
Brussels University Consultation Center, Department of Psychology, Faculty of Psychology & Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium.
Department of Neuroscience, School of Medicine, Institute for Family and Sexuality Studies KU Leuven, Leuven, Belgium.
Front Psychiatry. 2020 May 29;11:437. doi: 10.3389/fpsyt.2020.00437. eCollection 2020.
Non-suicidal self-injury (NSSI) is prevalent in adolescence and is associated with increased risk for a variety of subsequent negative mental health outcomes, necessitating an evidence-based preventive approach. This pilot study examines the potential iatrogenic effects and feasibility of an evidence-based school program for the prevention of NSSI. Differences are examined between a general in-classroom prevention program (Happyles) and this program combined with a 1-h in-classroom psychoeducation module on NSSI (HappylesPLUS) in terms of primary (e.g., delay in NSSI onset and decrease in NSSI frequency, urges, probability of future engagement) and secondary outcomes (e.g., psychological distress, emotion regulation, help-seeking, and stigma) using a mixed-method design. A total of 651 secundary school pupils (M = 12.85 years; 49.8% female versus 50.2% male) were assigned to the Happyles program and HappylesPLUS. Participants filled out validated self-report questionnaires pre (T0) and post (T1, 6 weeks after T0) the school prevention program, including the Youth Outcome Questionnaire (YOQ), the Brief Non-Suicidal Self-Injury Assessment Test (BNSSI-AT), the Difficulties in Emotion Regulation Scale (DERS), the Attitudes Toward Seeking Professional Psychological Help Scale-Short Form (ATSPPH-SF), and the Peer Mental Health Stigmatization Scale (PMHSS). Qualitative semi-structured interviews (at T2,6 weeks after T1) were conducted with participants with and without a history of NSSI. Overall, results show no iatrogenic effects of the NSSI-focused psychoeducation module. In terms of our primary outcome, both groups reported a reduced likelihood of future NSSI engagement from T0 to T1. Regarding secondary outcome measures, we also observed increased emotional awareness in both groups. The qualitative data suggest that the addition of the NSSI-specific module to the Happyles program may have direct benefits to some students with lived experience, such as increased help-seeking behavior for NSSI. Findings of this pilot study show that incorporating NSSI-specific modules into evidence-based school prevention programs is feasible and does not lead to iatrogenic effects. Future work is needed to evaluate the potential (longer-term) benefits of incorporating NSSI-focused modules to evidence-based mental health programs in the prevention of NSSI.
非自杀性自伤行为（NSSI）在青少年中很普遍，并且与随后出现各种负面心理健康结果的风险增加相关，因此需要一种基于证据的预防方法。这项试点研究考察了一项基于证据的学校预防NSSI计划的潜在医源性影响和可行性。采用混合方法设计，研究了普通课堂预防计划（快乐成长计划）与该计划结合1小时课堂NSSI心理教育模块（快乐成长增强版）在主要结果（如NSSI开始时间延迟、NSSI频率、冲动、未来发生可能性降低）和次要结果（如心理困扰、情绪调节、寻求帮助和污名化）方面的差异。共有651名中学生（平均年龄12.85岁；女生占49.8%，男生占50.2%）被分配到快乐成长计划和快乐成长增强版。参与者在学校预防计划前（T0）和后（T1，T0后6周）填写经过验证的自我报告问卷，包括青少年结果问卷（YOQ）、简短非自杀性自伤行为评估测试（BNSSI-AT）、情绪调节困难量表（DERS）、寻求专业心理帮助态度量表简版（ATSPPH-SF）和同伴心理健康污名化量表（PMHSS）。对有和没有NSSI病史的参与者进行了定性半结构化访谈（在T2，T1后6周）。总体而言，结果表明以NSSI为重点的心理教育模块没有医源性影响。在我们的主要结果方面，两组均报告从T0到T1未来发生NSSI的可能性降低。关于次要结果指标，我们还观察到两组的情绪意识均有所提高。定性数据表明，在快乐成长计划中增加NSSI特定模块可能对一些有实际经历的学生有直接益处，比如增加对NSSI的求助行为。这项试点研究的结果表明，将NSSI特定模块纳入基于证据的学校预防计划是可行的，且不会导致医源性影响。未来需要开展工作，以评估将以NSSI为重点的模块纳入基于证据的心理健康计划在预防NSSI方面的潜在（长期）益处。
