Conference Agenda

While most engage in NSSI to regulate distress (Kuehn et al., 2022), some report using it to avoid attempting suicide (Kraus et al., 2020). Prior cross-sectional work found that those reporting greater perceived effectiveness of NSSI in achieving these functions were more likely to have attempted suicide (Brausch & Muehlenkamp, 2018). It is unclear how perceived effectiveness of NSSI behavior affects suicide risk in the short-term.

This study examined how perceived NSSI effectiveness relates to same- and next-day ability to resist suicide and suicide intent. Participants included 130 young adults (Mage = 19.46, SD = 1.43; 70% female) with a past-month history of both NSSI and suicide ideation who completed a 28-day daily diary protocol (Nsurveys=3,126; Compliance = 85.9%). Dynamic Structural Equation Modeling with Bayesian estimation (McNeish & Hamaker, 2020) was used.

NSSI acts were associated with a same-day increase in suicide intent (β = 0.29; 95%Crl = 0.24, 0.34) and decreased efficacy to resist suicide (β = -0.15; 95%Crl = -0.21,-0.09). However, greater perceived NSSI effectiveness was linked to a same-day increase in the ability to resist suicide (β = 0.09; 95%Crl = 0.02, 0.17). NSSI acts were negatively associated with next-day suicide intent (β = -0.08; 95%Crl = -0.14, -0.01), but prior-day effectiveness was not related to next-day suicide intent or ability to resist suicide. Individuals who reported greater mean effectiveness of NSSI also reported higher intensity of suicide intent over the 28 days (β=1.37; 95%Crl = 0.83, 1.98).

Our findings indicate that when acts of NSSI are perceived as more effective, one’s short-term efficacy to resist attempting suicide may also be enhanced, even though greater effectiveness was associated with higher suicide intent over time. These results suggest momentary decreases in perceived effectiveness of NSSI may signal increased suicide risk and should be monitored.

Background. Self-harm is a heterogeneous behaviour with a lifetime prevalence of around 20% in young people aged 16-25 years old. Recent neurobiological evidence suggests that for some individuals, self-harm is associated with biases in motivational processes such as reward anticipation and goal pursuit. These may represent so-far neglected theraputic targets. However, our knowledge of young people’s subjective experience of rewards and goals attainment in relation to self-harm behaviour remains limited. 

This study aimed to explore how young people who self-harm anticipate and experience rewards, set goals and experience goal-achievement. We also aimed to explore how young people use mental imagery to simulate rewards and goals, as mental imagery is a key cognitive process supporting motivation

Methods. We conducted two parallel focus groups online (total of N=12) with young people aged 16-25 with a past-year history of self-harm behaviour. Qualitative data was analysed using inductive thematic analysis. Two young people with lived experience of self-harm informed the topic guide and data interpretation.

Results. There were six themes: rewards need deserving, high self-standards, keeping control, trapped into long-term goals, unhelpful mental imagery and self-harm alters the experience and anticipation of rewards and goal attainment. Most young people reported enjoying conditional rewards and working towards long-term goals that tend to be unattainable and beyond their control. Most also did not find imagining goal achievement a motivational tool, but rather an unhelpful escapism. For all young people, periods of self-harm thwarted enjoyment and goal achievement, shifted the preference to short-term immediate gratification, including from self-harm behaviour, and devalued long-term goals.

Conclusions. Our findings indicate an intricate relationship between reward and motivational biases and self-harm behaviour in young people. Helping individuals develop more adaptive rewards and goals, including via the use of motivational mental imagery, could represent a valued support for young people with self-harm.

Approximately 20% of young people (YP) aged 16-25 have self-harmed in their lives. Current treatments are long, costly, and do not suit all YP. Current research focuses on low doses of the psychedelic psilocybin to augment a therapeutic intervention for YP who self-harm. Although societal attitudes are cautiously favourable toward psychedelic therapeutics (Davis et al., 2021), there is no research on YP’s attitudes and knowledge of psychedelics and their therapeutic use. This study aims to explore the beliefs, attitudes, and acceptability of a psychedelic-augmented-therapy for YP who self-harm.

Three online YP focus groups (FGs) were conducted (age 16-25). Inclusion criteria included: minimum 2 lifetime self-harm episodes, 1 in the past year, none in the past 3 months. Previous psychedelic experience was not mandatory. FGs were recorded and transcribed. Thematic analysis was performed.

We screened N=207 individuals, N=58 were eligible, and N_total=15 took part in the FGs. The majority of participants were female (N=12), white-British (N=9), LGBTQIA+ (N=10), and students (N=11). Three people reported previous psychedelic experience. Our themes were ‘Limited knowledge/misconceptions around psychedelics’, ‘Stigma around psychedelics’ and ‘Cautiously open to psychedelics use in therapy’.

This is the first of its kind study to investigate YP’s (who self-harm) views, attitudes and knowledge on psychedelic therapeutics. Our findings suggest that psychedelic education should be the first step in implementing potential psychedelic-assisted interventions in this population. Our sample size was small and not representative of the population. We will conduct one more FG, aiming for a more inclusive sample regarding gender, ethnicity and psychedelic use. Moving forward, we will combine our findings with findings from interviews with clinicians on their views, attitudes, and knowledge on psychedelic therapeutics for YP who self-harm, hoping for a more rounded approach in the implementation of this intervention.

Funding was provided by the Economic & Social Research Council.

Introduction: Self-harm (SH) is a maladaptive behaviour with increasing prevalence in young people that lacks accessible and scalable interventions. Mental imagery of SH has recently emerged as a proximal mechanism driving SH that could be targeted by Imagery Re-Scripting (ImRS) intervention techniques. However, it remains unclear how ImRS may work. This study tested the hypothesis that an ImRS-based manipulation changes emotions and beliefs associated with SH mental imagery.

Methods: Young people (aged 16-25) who SH underwent a single ImRS experimental manipulation. Participants were exposed to their SH mental image and then guided to switch to a more adaptive “antidote” mental image over 3 rounds. Vividness, emotional intensity and believability of associated cognitions for both SH and “antidote” mental images were rated after each round. Cognitions were mapped onto Early Maladaptive Schemas (EMS).

Results: There was a significant reduction in vividness of the SH image and believability of associated cognitions overall but not in emotional intensity. Cognitions believability significantly decreased for four of the five maladaptive schema domains. The antidote image’s vividness, positive emotional intensity and believability of associated cognitions overall significantly increased throughout the experimental manipulation.

Conclusion: A single ImRS manipulation may target SH by weakening maladaptive schemas encapsulated in SH mental imagery and by generating alternative imagery eliciting adaptive emotions and beliefs. ImRs offers a promising novel approach to the treatment of SH in young people. Future investigations should test whether this may translate to long-term changes in SH behaviour and its underlying mechanisms including EMS.

Introduction: Despite decades of investments, rates of youth self-harm appear to be rising, while suicide remains a leading cause of death of young people. Empirical data and theory-based research has continually demonstrated that self-harm and suicidal ideation are dynamic and interactive phenomena, where risk can escalate rapidly. However, significant gaps remain in our understanding of their real-time (i.e., hour-to-hour) fluctuation in young people. The aims of this study were to measure young people’s self-harm and suicidal ideation in real-time while also investigating the influence of proximal variables relating to social connection, and burdensomeness.

Method: Utilising the experience sampling method, self-harm and suicidal ideation were measured among young Australians (aged 18-25) who reported self-harm and/or suicidal ideation in the past two weeks. Proximal variables of belongingness, burdensomeness, and social media use were also measured among other predictors of risk. Participants were recruited from the community and received 10 surveys a day for a six-day period.

Results: In total 81 participants completed their six-day study period. Survey compliance was recorded as 72.38%, with 24 instances of participants being flagged as high (n=22) or very high (n=2) risk, primarily due to not being sure that they could keep themselves safe. This presentation will also report on a range of generalized linear mixed models and standard linear mixed-effects models that were used to investigate concurrent and lagged associations between variables of social connection, burdensomeness, and social media use, with outcomes of self-harm and suicidal ideation.

Conclusions: This presentation will share quantitative findings of this study, emphasising the importance between social predictors of risk (burdensomeness, belongingness) and the real-time fluctuation of young people’s self-harm and suicidal ideation. The unique needs and considerations of working with young people currently managing suicidal distress will be discussed, including safety and feasibility implications for future studies.

Background: Exposure to suicide and suicide attempts is a major risk factor for suicide attempts and death in others. Understanding the daily life experiences of those recently exposed to non-fatal attempts could shed light on why exposure increases suicide risk. However, this is also a highly sensitive period and understanding participant experiences in ESM research on suicide attempt exposure is crucial to determining feasibility, and ensuring the safe and ethical conduct of this research. To our knowledge, the SCOUT-Community study is the only ESM study to date of suicide attempt exposure. Methods: N=22 young adults aged 18 – 25, who had been exposed to a friend’s non-fatal suicide attempt in the past ~4 weeks were recruited for a 3 x six-day ESM study with 10 beeps per day. ESM periods were completed immediately, then one- and three-months following baseline. Follow-up telephone interviews were conducted with all participants after each ESM period, and participants also completed self-report questionnaires and ESM items assessing participant experience and reactivity. Results: One participant dropped out of the study. A further two participants experienced the subsequent re-attempt and suicide death of their friend, and they chose to continue with the study. Interview, questionnaire, and ESM data regarding participant experience are currently being analysed. Conclusions: Findings from the SCOUT-Community study will shed light on the general and momentary participation experiences of young adults taking part in ESM research on exposure to suicide attempts. These insights will help shape future research with this neglected, yet highly vulnerable group.