Bulimia nervosa and non-suicidal self-injury (NSSI) co-occur at high rates, and both have been conceptualized as maladaptive emotion regulation strategies. Treatments focusing on emotion regulation have been designed for both problem behaviors, yet, there exists very little research examining the temporal emotional states surrounding acts of NSSI. Using ecological momentary assessment (EMA) methodology, the current study examined the temporal association between positive and negative emotional states prior to and consequent to acts of NSSI within a subset of bulimia nervosa patients. Results indicate significant increases in negative affect, and decreases in positive affect, prior to an NSSI act. Post-NSSI, positive affect significantly increased while negative affect remained unchanged. The findings offer partial support for an emotion regulation paradigm to understanding NSSI within bulimic populations and implications for treatment are discussed. Keywordsnon-suicidal self-injury; emotion regulation; EMA; deliberate self-harm; bulimia; eating disorder Non-suicidal self-injury (NSSI; the deliberate damage of one's body tissue without suicidal intent, Muehlenkamp, 2005) is a troubling behavior that many clinicians are encountering, yet struggle to understand (White-Kress, 2003;Zila & Kiselica, 2001). Prevalence rates among non-clinical samples of adolescents and young adults range from 4% (Klonsky & Muehlenkamp, 2007) to 38% (Whitlock, Eckenrode, & Silverman, 2006;Lloyd-Richardson et al 2007), whereas prevalence rates among inpatient adolescents have been reported at 30 to 68% (Makikyro et al., 2004;Nixon, Cloutier, & Aggarwal, 2002). Of particular interest are findings that rates of NSSI tend to be quite high among a subset of persons with select psychiatric disorders including borderline personality disorder (Zanarini, Frankenburg, Ridolfi, & Jager-Hyman, 2006), and eating disorders; especially bulimia nervosa (BN; Anderson, Carter, & McIntosh, 2002;Claes, Vandereycken, & Vertommen, 2001;Favaro & Santonastaso, 1999;Wonderlich, Myers, Norton, & Crosby, 2002).Correspondence regarding this article should be addressed to: Jennifer J Muehlenkamp, PhD, Department of Psychology, 319 Harvard St stop 8380, University of North Dakota, Grand Forks, ND 58202; E-mail: jennifer.muehlenkamp@und.edu; Phone: 701-777-4496, Fax: 701-777-3454. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author ManuscriptBehav Res Ther. Author manuscript; available in PMC 2010 January 1. & Telch, 1998; Kjelsas, Borsting, & Gudde, 2004;Smyth, Wonderlich, & Heron, 2007;Telch & ...

Background The COVID-19 pandemic has profoundly affected cancer services. Our objective was to determine the effect of the COVID-19 pandemic on decision making and the resulting outcomes for patients with newly diagnosed or recurrent intracranial tumours. Methods We performed a multi-centre prospective study of all adult patients discussed in weekly neuro-oncology and skull base multidisciplinary team meetings who had a newly diagnosed or recurrent intracranial (excluding pituitary) tumour between 01 April and 31 May 2020. All patients had at least 30-day follow-up data. Descriptive statistical reporting was used. Results There were 1357 referrals for newly diagnosed or recurrent intracranial tumours across fifteen neuro-oncology centres. Of centres with all intracranial tumours, a change in initial management was reported in 8.6% of cases (n=104/1210). Decisions to change the management plan reduced over time from a peak of 19% referrals at the start of the study to 0% by the end of the study period. Changes in management were reported in 16% (n=75/466) of cases previously recommended for surgery and 28% of cases previously recommended for chemotherapy (n=20/72). The reported SARS-CoV-2 infection rate was similar in surgical and non-surgical patients (2.6% vs. 2.4%, p>0.9). Conclusions Disruption to neuro-oncology services in the UK caused by the COVID-19 pandemic was most marked in the first month, affecting all diagnoses. Patients considered for chemotherapy were most affected. In those recommended surgical treatment this was successfully completed. Longer-term outcome data will evaluate oncological treatments received by these patients and overall survival.

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