Non-Suicidal Self-Injury: A School-Based Peer Education Program for Adolescents During COVID-19 Pandemic

Abstract

Introduction: Non-suicidal self-injury (NSSI) constitutes a major health concern among youth. However, less is known about the useful ways to prevent NSSI. As such, the NSSI- Peer Education Program (NSSI-PEP) aims to intervene on the vulnerability factors that predispose to NSSI by applying a peer education approach. The NSSI-PEP is grounded on the psychoanalytic tradition's tenets, implementing modules targeting four crucial risk factors for NSSI: pubertal transformation, body image, self-esteem, and emotion regulation.Methods: Selected 8th grade students were trained to serve as peer educators and held a peer-education intervention for 6th and 7th grade students. Pre- and post-intervention assessments were conducted in order to evaluate the program's effectiveness.Results: Results revealed preliminary support for the program's feasibility, as students reported greater emotion regulation abilities (p = 0.038) and significant changes in self-esteem (p<0.001), personal alienation (p = 0.005), body image (p < 0.001), and maturity fear (p < 0.001). Also, NSSI-PEP was positively evaluated by participants.Discussion: Our pilot study provides preliminary empirical support for the NSSI-PEP, representing a promising way to address areas of vulnerability for NSSI onset. Findings may also help current policies to promote targeted preventive activities and produce sizable benefits to society.

Universal prevention for non-suicidal self-injury in adolescents is scarce - A systematic review

“…Groschwitz et al ( 25 ) aimed to advance NSSI prevention at schools via training of school staff in Germany ( n = 257), and Robinson et al ( 26 ) trained school social workers in Australia with similar intent ( n = 213, mean age = 42.5 years). Cipriano et al ( 24 ) selected eight 8th grade pupils as peer educators who conducted a peer education intervention for 6th and 7th grade pupils ( n = 68, mean age = 11.59 years). Two studies aimed to change knowledge and attitudes about NSSI (i.e., “psychoeducation”) and to improve confidence and distress-coping when dealing with affected pupils ( 25 , 26 ).…”

Micro‐sequences of anger and shame and non‐suicidal self‐injury in youth: an ecological momentary assessment study

“…Inward expression of anger is also consistent with markedly elevated self‐criticism and self‐hatred among adolescents with NSSI (Glassman, Weierich, Hooley, Deliberto, & Nock, 2007; Glenn, Michel, Franklin, Hooley, & Nock, 2014; Nock, Prinstein, & Sterba, 2009). Both holding angry feelings in and acting out of anger (e.g., losing one's temper) mediated the link between experiencing parental rejection and engaging in NSSI in adolescents, highlighting the potential role of experiencing and acting on challenging affect in NSSI occurrences (Cipriano et al., 2020).…”

“…As such, anger has been identified as a powerful emotional antecedent by the largest proportion of female participants who engaged in NSSI (Chapman & Dixon‐Gordon, 2007). Inward expression of anger specifically was linked to greater NSSI among adolescents (Cipriano, Cella, & Cotrufo, 2020). Inward expression of anger is also consistent with markedly elevated self‐criticism and self‐hatred among adolescents with NSSI (Glassman, Weierich, Hooley, Deliberto, & Nock, 2007; Glenn, Michel, Franklin, Hooley, & Nock, 2014; Nock, Prinstein, & Sterba, 2009).…”

Predictors of non-suicidal self-injury in adolescents with depressive disorder: the role of alexithymia, childhood trauma, and body investment

“…These factors include both intrapersonal and interpersonal relationships. Several risk factors for NSSI have been identified, including alexithymia, childhood trauma, and low levels of body investment ( Liu et al, 2018 ; Cipriano et al, 2020 ; Iskric et al, 2020 ). However, there is still much to be explored about how these factors interact and ultimately lead to the development of NSSI behaviors in adolescents.…”