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The multilevel psychosocial stressors associated with COVID-19 pandemic set the stage to investigate risk factors and groups susceptible for non-suicidal self-injury (NSSI). A national sample of 9,929 Brazilian adults aged 36.1 years on average participated in the study. Cross-sectional data were collected in 2020, 2021, 2022, and 2023. NSSI levels were considered high in the total sample (13.2%) when compared to other studies in this context. The variables with the highest explanatory power in the regression models were age, anxiety, and depression. The main risk factors were being younger, living in the South or Southeast regions of Brazil, having lower educational attainment, and having higher rates of anxiety and depression. Respondents had the highest probability of NSSI in 2022. The sustained higher rates of NSSI in 2023 compared to the beginning of the pandemic underscores the need for continuous monitoring and the development of preventive actions for self-injurious behaviors.

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OBJECTIVE: To analyse the related influencing factors of adolescent major depressive disorder (MDD) with suicidal and self-injurious behaviour (SSIB). METHODS: A total of 299 adolescents with MDD who were admitted to the psychiatric department of the hospital between February 2022 and July 2023 were selected using the convenience sampling method. The participants were divided into the SSIB group (n = 110) and the non-SSIB group (n = 189) according to whether SSIB was present, and related indicators were collected and compared. RESULTS: The patients' ages at the time of their first SSIB ranged from 10 to 18 years old, with a mean age of 13.30 ± 1.74 years. The most commonly injured parts were the lower arm and wrist (42.13%), and the most common injury was cutting, accounting for 40.00% of the total patients. The most common type of self-injury differed by sex (X2 = 17.798, P = 0.006); for men, hitting was the most common, and for women, cutting was the most common. In 51.41% of the patients, the period between the initial thought and the actual committing of the SSIB was less than 5 minutes. The scores of the Eysenck Personality Questionnaire, the Barratt Impulsivity Scale, the Buss-Perry Aggression Questionnaire, the Symptom Checklist-90 (all P < 0.001), and the health-risk behaviour scale (67.47 ± 12.59 vs. 41.58 ± 11.36, t = 9.587, P < 0.001) were significantly increased in the SSIB group compared with the non-SSIB group. In addition, the total score of quality of life (QOL) (11.36 ± 4.32 vs. 16.43 ± 5.64, t = 5.496, P < 0.001) was decreased in the SSIB group compared with the non-SSIB group. CONCLUSION: The SSIB of adolescent patients with MDD is related to various factors, including impulsiveness, aggressiveness, personality traits, QOL, and mental health level.

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Introducción: la salud mental de los estudiantes de medicina ha sido ampliamente investigada, demostrando que forman parte de un grupo vulnerable al desarrollo de trastornos mentales. Objetivo: el objetivo de esta investigación fue determinar la frecuencia de NSSI y sus factores asociados en estudiantes de medicina del Paraguay. Metodología: este fue un estudio descriptivo y transversal. Se lanzó una encuesta online para evaluar depresión, ansiedad y autolesiones, se utilizaron las escalas PHQ-2, GAD-7 y SHQ, respectivamente. Resultados: recibimos respuestas de 330 estudiantes de medicina. De los participantes, el 71,2 % eran mujeres. Se identificó que el 46,4 % de los participantes padecía depresión (PHQ-2 ≥ 3) y el 37,3 % ansiedad (GAD-7 ≥10). La frecuencia de NSSI fue del 27 % (n = 89). Los principales factores asociados a NSSI fueron un diagnóstico previo de un trastorno mental (que aumentó la probabilidad de NSSI en 3,76 veces) y/o una historia de abuso físico o sexual (con un aumento de 3,75 veces). Conclusión: esta investigación encontró la presencia de NSSI en casi 3 de cada 10 de los estudiantes de medicina encuestados. Los principales factores asociados con la conducta autolesiva fueron un diagnóstico previo de un trastorno mental y/o antecedentes de abuso físico o sexual.

Introduction: the mental health of medical students has been extensively researched, showing that they are part of a group vulnerable to the development of mental disorders. Aim: the aim of this research was to determine the frequency of NSSI and its associated factors in medical students in Paraguay. Methodology: this was a descriptive and cross-sectional study. An online survey was launched to assess depression, anxiety, and self-harm, the PHQ-2, the GAD-7 and SHQ scales were used, respectively. Results: we received responses from 330 medical students. Of the participants, 71.2 % were female. 46.4% of the participants were identified as having depression (PHQ-2 ≥ 3) and 37.3 % as having anxiety (GAD-7 ≥10). The frequency of NSSI was 27 % (n = 89). The main factors associated with NSSI were a previous diagnosis of a mental disorder (which increased the likelihood of NSSI by 3.76 times) and/ or a history of physical or sexual abuse (with a 3.75-fold increase). Conclusion: this research found the presence of NSSI in almost 3 out of 10 of the medical students surveyed. The main factors associated with self-injurious behavior were a previous diagnosis of a mental disorder and/or a history of physical or sexual abuse.

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Introducción: La investigación sobre la autolesión no suicida permite aumentar la conciencia sobre este fenómeno, posibilita su detección temprana y la implementación de estrategias más eficaces en prevención y tratamiento. Esto conlleva a una reducción del sufrimiento individual, los costos económicos y el impacto en la sociedad en su totalidad. Objetivo: Determinar la frecuencia y factores asociados a autolesión no suicida en una muestra de población adulta de Paraguay. Metodología: Estudio descriptivo de asociación cruzada, de corte transversal y prospectivo. Una encuesta en línea fue difundida a través de redes sociales y aplicaciones de mensajería. Esta incluía preguntas sobre datos sociodemográficos y clínicos. La presencia de autolesiones se determinó a través de la versión en español de la escala Self-Harm Questionnaire. Se utilizó estadística descriptiva para todas las variables. Para buscar asociaciones se utilizó la prueba chi cuadrado. Resultados: Participaron 241 personas (media de edad=32±12 años, 74,7% mujeres). Se encontró una frecuencia de autolesiones de 24,5% (n=59). De estos, el 91,5% había tenido ideación suicida al menos una vez. Se encontró asociación entre el nivel de ingresos y la frecuencia de autolesiones (χ

Introduction: Research on non-suicidal self-injury raises awareness of this phenomenon, enabling the early detection and implementation of more effective strategies in prevention and treatment. This leads to a reduction in individual suffering, economic costs, and impact on society. Objective: To determine the frequency and associated factors of non-suicidal self-injury in a sample of the adult population of Paraguay. Methodology: This was a descriptive, cross-sectional, and prospective study. An online survey was disseminated through social networks and messaging applications. The survey included questions on sociodemographic and clinical data. The presence of self-injury was determined by using the Spanish version of the Self-Harm Questionnaire. Descriptive statistics were used for all the variables. The chi-square test was used to examine associations. Results: There were 241 participants (mean age=32±12 years, 74.7%female). A non-suicidal self-injury frequency of 24.5% (n=59) was observed. Of these, 91.5% reported suicidal ideation at least once. An association was found between income level and the frequency of non-suicidal self-injury (χ

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Introducción: la salud mental de los estudiantes de medicina ha sido ampliamente investigada, demostrando que forman parte de un grupo vulnerable al desarrollo de trastornos mentales. Objetivo: el objetivo de esta investigación fue determinar la frecuencia de NSSI y sus factores asociados en estudiantes de medicina del Paraguay. Metodología: este fue un estudio descriptivo y transversal. Se lanzó una encuesta online para evaluar depresión, ansiedad y autolesiones, se utilizaron las escalas PHQ-2, GAD-7 y SHQ, respectivamente. Resultados: recibimos respuestas de 330 estudiantes de medicina. De los participantes, el 71,2 % eran mujeres. Se identificó que el 46,4 % de los participantes padecía depresión (PHQ-2 ≥ 3) y el 37,3 % ansiedad (GAD-7 ≥10). La frecuencia de NSSI fue del 27 % (n = 89). Los principales factores asociados a NSSI fueron un diagnóstico previo de un trastorno mental (que aumentó la probabilidad de NSSI en 3,76 veces) y/o una historia de abuso físico o sexual (con un aumento de 3,75 veces). Conclusión: esta investigación encontró la presencia de NSSI en casi 3 de cada 10 de los estudiantes de medicina encuestados. Los principales factores asociados con la conducta autolesiva fueron un diagnóstico previo de un trastorno mental y/o antecedentes de abuso físico o sexual.

Introduction: the mental health of medical students has been extensively researched, showing that they are part of a group vulnerable to the development of mental disorders. Aim: the aim of this research was to determine the frequency of NSSI and its associated factors in medical students in Paraguay. Methodology: this was a descriptive and cross-sectional study. An online survey was launched to assess depression, anxiety, and self-harm, the PHQ-2, the GAD-7 and SHQ scales were used, respectively. Results: we received responses from 330 medical students. Of the participants, 71.2 % were female. 46.4% of the participants were identified as having depression (PHQ-2 ≥ 3) and 37.3 % as having anxiety (GAD-7 ≥10). The frequency of NSSI was 27 % (n = 89). The main factors associated with NSSI were a previous diagnosis of a mental disorder (which increased the likelihood of NSSI by 3.76 times) and/ or a history of physical or sexual abuse (with a 3.75-fold increase). Conclusion: this research found the presence of NSSI in almost 3 out of 10 of the medical students surveyed. The main factors associated with self-injurious behavior were a previous diagnosis of a mental disorder and/or a history of physical or sexual abuse.

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A autolesão não suicida (ALNS) é um fenômeno de relevância crescente com altas taxas de prevalência em adolescentes e jovens adultos. Como método, foi realizada etnografia virtual em comunidade de autolesão no Facebook de modo a ampliar a compreensão dos aspectos simbólicos relacionados à prática. Em fevereiro de 2021, 133 publicações foram coletadas e divididas em três categorias de análise: autolesão, sofrimento e religião. A autolesão é compreendida como similar ao comportamento compulsivo por meio do qual praticantes buscam uma experiência de transcendência ainda que às custas de dor. Assemelha-se a uma dependência comportamental. O sofrimento descrito aponta processos depressivos e se caracteriza por solidão, dificuldade de expressão de sentimentos e necessidade de manutenção de uma persona funcional no cotidiano. Assim, a comunidade emerge como meio de expressão dos aspectos relegados à sombra no mundo offline.

Non-suicidal self-injury (NSSI) is a phenomenon of increasing relevance, with high prevalence rates in adolescents and young adults. NSSI is one of the main risk factors for future. The method of virtual ethnography was carried out in a self-injury community on Facebook in order to broaden the understanding of the symbolic aspects related to the practice. In February 2021, 133 publications were collected and divided into three categories of analysis: self-injury, suffering and religion. Self-injury was understood as a compulsive behavior through which practitioners seek an experience of transcendence at the expense of pain. It resembles an addict behavior. The suffering described refers to depressive processes and is characterized by loneliness, difficulty in expressing feelings and the need to maintain a functional persona in everyday life. Therefore, the group emerges as a means of expressing aspects relegated to the shadows in the offline world.

La autolesión no suicida (ALNS) es un fenómeno de creciente relevancia con altas tasas de prevalencia en adolescentes y adultos jóvenes. Como método, se realizó una etnografía virtual en una comunidad de autolesiones en Facebook con el fin de ampliar la comprensión de los aspectos simbólicos relacionados con la práctica. En febrero de 2021 se recopilaron 133 publicaciones y se dividieron em tres categorías de análisis: autolesiones, sufrimiento y religión. Se entiende que la autolesión es similar al comportamiento compulsivo por el cual los practicantes buscan una experiencia de trascendencia incluso a expensas del dolor. Se asemeja a una adicción conductual. El sufrimiento descrito apunta a procesos depresivos y se caracteriza por la soledad, la dificultad para expresar los sentimientos y la necesidad de mantener una personalidad funcional en la vida cotidiana. Así, la comunidad surge como medio de expresión de aspectos relegados a la sombra en el mundo offline.

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BACKGROUND: Through the culture of thinness, increasingly promoted in our society as a beauty canon, it is not surprising that the number of people affected by eating disorders is increasing. OBJECTIVE: This research aims to study the relationship between non-suicidal self-injuries and nuclear aspects of eating disorders specified along with this article. METHODS: The sample consisted of 60 women diagnosed with anorexia and bulimia. Questionnaires assessing impulsivity, body satisfaction, alexithymia, body attitude and self-esteem were administered. Participants with non-suicidal self-harm were compared with those without it, and participants with anorexia with and without self-harm and participants with bulimia with and without self-harm were compared. RESULTS: Differences were found in body dissatisfaction= 5.71; p ≤0.01), body attitudes= 4.80; p ≤0.02), self-esteem= 14.09; p ≤0.00) and impulsivity (t= 3.39; p ≤0.01) between participants with and without non-suicidal self-harm. CONCLUSIONS: These are key factors for the clinical area in the treatment of eating disorders to prevent the presence of self-harm, as it allows focusing the treatment target on those aspects such as dissatisfaction and impulsivity, which are key in the development of self-harm.

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Abstract Objective: Comprehend the profile and prevalence of non-suicidal self-injury (NSSI) in adolescents and its association with impulsiveness and loneliness. Methods: Cross-sectional study carried out in 2017 in Maceió-Alagoas, Northeast Brazil, in the households of 505 adolescents aged 12-17 years, using a sample stratified and randomized by gender and neighborhood. The following instruments were used: a sociodemographic questionnaire, Brazilian version of Functional Assessment of Self-Mutilation (FASM), the Brazilian Barratt Impulsiveness Scale (BIS-11), and the Brazilian Loneliness Scale (UCLA-BR). Results: A prevalence of 6.53% was found for non-suicidal self-injury disorder (DSM-5). Significant differences ( p ≤ 0.05) were observed regarding: the most frequently used forms of NSSI were the items "cut oneself" and "scratch oneself"; engaging in three or more different forms of self-injurious behavior (66.67%) and, reporting as reasons, "to relieve feelings of emptiness or indifference" and "to stop bad feelings/sensations." Significance was also related to the sociodemographic profile: 72.73% were females and 63.54% had family income below one minimum wage. Individuals with self-injurious behavior also had higher impulsiveness and loneliness scores (p ≤ 0.05). Conclusions: The study identified a direct association between NSSI and impulsiveness and loneliness among adolescents, being more prevalent in females and in young individuals with socioeconomic vulnerability. The data provide support for improving public health policies, aimed at education, prevention, and treatment of adolescents with NSSI.

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Abstract Introduction Suffering from psychosocial vulnerability, particularly during adolescence, increases the likelihood of experiencing adverse life circumstances, psychiatric conditions, and non-suicidal self-injury (NSSI). Objective We studied: 1. record-based demographic and clinical characteristics, as well as the frequency of NSSI in adolescents, beneficiaries of services for vulnerable population of one of six Non-Governmental Organizations (NGO's), we compared by beneficiary type: internal (IB) versus external (EB); 2. predictive relationship of NSSI with depression, difficulties in emotion regulation (DER) and suicidal ideation (administered measures); 3. Comparison of average scores on measures by: quality of attachment (QOA) and presence/absence of NSSI. Method A convenience sample of 255 adolescents (45.5% women, ages 11-15) answered instruments in institutional facilities (Mexico City and Puebla), where 181 (71%) resided as IB and 74 (29%) resided in family home (EB). The mental health staff of each NGO specified according to the record: demographics, psychiatric diagnoses, history of trauma, and QOA between the minor and his attachment figure. Results 42% denied NSSI episodes, 16.9% indicated a non-significant pattern, and 35.6% reported a significant and recent pattern. IB presented higher scores in all measurements, higher report of interpersonal trauma, depressive, anxiety, and behavior disorders. Minors with positive QOA obtained significantly lower scores. Discussion and conclusion Compared to EB's, adolescents residing in NGOs have a higher risk profile, particularly those without a positive QOA, a fact that is associated with a greater presence of psychopathology and significant and recent NSSI.

Resumen Introducción Padecer vulnerabilidad psicosocial, particularmente durante la adolescencia, incrementa la probabilidad de experimentar circunstancias vitales adversas, afecciones psiquiátricas y autolesiones no suicidas (ALNS). Objetivo Se estudiaron: 1. características demográficas y clínicas con base en expediente, así como la frecuencia de ALNS en adolescentes, usuarios de servicios para población vulnerable de una de seis Organizaciones No Gubernamentales (ONG's), se comparó por tipo de beneficiario: interno (BI) versus externo (BE); 2. relación predictiva de ALNS con depresión, dificultades en la regulación emocional (DRE) e ideación suicida (medidas administradas); 3. comparación de puntajes promedio de las mediciones por: calidad del vínculo (CV) y presencia/ausencia de ALNS. Método Una muestra de conveniencia de 255 adolescentes (45.5% mujeres, edades 11-15), contestaron instrumentos en instalaciones institucionales (Ciudad de México y Puebla), donde 181 (71%) residían como BI y 74 (29%) residían en casa de familiar (BE). El personal de salud mental de cada ONG especificó conforme a expediente: demografía, diagnósticos psiquiátricos, historial de trauma y CV entre el menor y su figura de apego. Resultados 42% negó episodios de ALNS, 16.9% indicó una pauta no significativa y 35.6% reportó un pauta significativa y reciente. Los BI presentaron puntuaciones superiores en todas las mediciones, mayor reporte de trauma interpersonal, trastornos depresivos, de ansiedad y conducta. Los menores con CV positiva obtuvieron puntuaciones significativamente menores. Discusión y conclusión En comparación con los BE, los adolescentes que residen en las ONG's presentan un perfil de mayor riesgo, particularmente, aquellos sin una CV positiva, hecho que se asocia con mayor presencia de psicopatología y ALNS reciente y significativa.

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Abstract Background: Through the culture of thinness, increasingly promoted in our society as a beauty canon, it is not surprising that the number of people affected by eating disorders is increasing. Objective: This research aims to study the relationship between non-suicidal self-injuries and nuclear aspects of eating disorders specified along with this article. Methods: The sample consisted of 60 women diagnosed with anorexia and bulimia. Questionnaires assessing impulsivity, body satisfaction, alexithymia, body attitude and self-esteem were administered. Participants with non-suicidal self-harm were compared with those without it, and participants with anorexia with and without self-harm and participants with bulimia with and without self-harm were compared. Results: Differences were found in body dissatisfaction= 5.71; p ≤0.01), body attitudes= 4.80; p ≤0.02), self-esteem= 14.09; p ≤0.00) and impulsivity (t= 3.39; p ≤0.01) between participants with and without non-suicidal self-harm. Conclusions: These are key factors for the clinical area in the treatment of eating disorders to prevent the presence of self-harm, as it allows focusing the treatment target on those aspects such as dissatisfaction and impulsivity, which are key in the development of self-harm.

Resumen Introducción: A través de la cultura de la delgadez, cada vez más promovida en nuestra sociedad como canon de belleza, no es de extrañar que este aumentado el número de personas afectadas por Trastornos de Conducta alimentaria. Objetivo: Estudiar la relación entre las autolesiones no suicidas y aspectos nucleares del trastorno de conducta alimentaria que se especifican a lo largo de este artículo. Métodos: La muestra ha sido formada por 60 mujeres diagnosticadas de anorexia y bulimia. Se administraron cuestionarios que evaluaban la impulsividad, satisfacción corporal, alexitimia, actitud corporal y autoestima. Se compararon aquellas participantes que presentaban autolesiones no suicidas con las que no lo presentaban, además se compararon participantes con anorexia con y sin autolesiones y participantes con bulimia con y sin autolesiones. Resultados: Se encontraron diferencias en insatisfacción corporal = 5,71; p ≤0.01), en actitudes corporales= 4.80; p ≤0.02), autoestima= 14.09; p ≤0.00) e impulsividad, (t= 3.39; p ≤0.01) entre participantes con y sin autolesiones no suicidas. Conclusiones: Estos son factores clave para la clínica en el tratamiento de los trastornos de conducta alimentaria para prevenir la presencia de autolesiones, ya que permite enfocar el objetivo del tratamiento a aquellos aspectos como la insatisfacción e impulsividad, que son claves en el desarrollo de autolesiones.

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BACKGROUND: Youth non-suicidal self-injury (NSSI) and suicide are major public health concerns, but limited data are available on the prevalence and correlates of these problems in developing countries. The aim of this study is to describe experiences of three suicidal phenomena (NSSI, suicidal ideation [SI], and suicide attempt [SA]) among children and adolescents from two developing countries. We also examine how depression, anxiety, sleep problems, child maltreatment, and other socio-demographic variables associate with the risk of NSSI only, SI only, SA only, and co-occurring NSSI/SI/SA. METHODS: We conducted a population-based cross-sectional study of school-based Ugandan and Jamaican children and adolescents. Participants were 11,518 (52.4% female) Ugandan and 7,182 (60.8% female) Jamaican youths aged 9-17 years. RESULTS: The estimated lifetime prevalence of NSSI, SI, and SA was 25.5%, 25.6%, and 12.8% respectively among Ugandan boys and 23.2%, 32.5%, and 15.3% respectively among Ugandan girls. As for the Jamaican sample, the estimated lifetime prevalence of NSSI, SI, and SA was 21%, 27.7%, and 11.9% respectively among boys and 32.6%, 48.6%, and 24.7% respectively among girls. The odds of experiencing SI only, SA only, and co-occurring NSSI/SI/SA were significantly elevated among participants with mild, moderate, and severe depression in both countries. LIMITATIONS: The current study relied on retrospective data. CONCLUSIONS: This study found that suicidal phenomena are common among youths from Uganda and Jamaica, with rates substantially higher than among youths from high-income countries. The risk of suicidal phenomena was especially high among youths with severe depression.

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OBJECTIVE: Comprehend the profile and prevalence of non-suicidal self-injury (NSSI) in adolescents and its association with impulsiveness and loneliness. METHODS: Cross-sectional study carried out in 2017 in Maceió-Alagoas, Northeast Brazil, in the households of 505 adolescents aged 12-17 years, using a sample stratified and randomized by gender and neighborhood. The following instruments were used: a sociodemographic questionnaire, Brazilian version of Functional Assessment of Self-Mutilation (FASM), the Brazilian Barratt Impulsiveness Scale (BIS-11), and the Brazilian Loneliness Scale (UCLA-BR). RESULTS: A prevalence of 6.53% was found for non-suicidal self-injury disorder (DSM-5). Significant differences ( p ≤ 0.05) were observed regarding: the most frequently used forms of NSSI were the items "cut oneself" and "scratch oneself"; engaging in three or more different forms of self-injurious behavior (66.67%) and, reporting as reasons, "to relieve feelings of emptiness or indifference" and "to stop bad feelings/sensations." Significance was also related to the sociodemographic profile: 72.73% were females and 63.54% had family income below one minimum wage. Individuals with self-injurious behavior also had higher impulsiveness and loneliness scores (p ≤ 0.05). CONCLUSIONS: The study identified a direct association between NSSI and impulsiveness and loneliness among adolescents, being more prevalent in females and in young individuals with socioeconomic vulnerability. The data provide support for improving public health policies, aimed at education, prevention, and treatment of adolescents with NSSI.

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Estudos indicam importante defasagem na formação profissional em saúde sobre a autolesão não suicida (ALNS) com consequente fragilização da assistência e notificação. Trata-se de pesquisa metodológica com objetivo de elaborar e validar material educativo para subsidiar a capacitação de profissionais da saúde sobre a ALNS. Realizado estudo misto para identificação de necessidades sobre ALNS no Twitter, sendo coletadas 6.302 postagens em português, publicadas entre 2016 e 2017. Os dados quantitativos foram analisados com estatística descritiva e testes de associação (p≤0,005). Para a abordagem qualitativa foram incluídas 663 postagens de incentivo à ALNS analisadas por Análise Temática. Para aprofundamento na temática foi realizada uma Umbrella Review com análise qualitativa de revisões sistemáticas publicadas entre 2010 a 2021. Todos os dados foram sintetizados na construção visual e textual do material educativo, sendo validados por especialistas que atenderam a critérios de expertise. Após correções, o material educativo foi avaliado por profissionais de saúde. Os dados de validação e avaliação foram coletatos através de questionário sociodemográfico e o instrumento Suitability Assessment of Materials for evaluation of health-related information for adults. Os dados foram analisados com estatística descritiva simples, índice de validade de conteúdo (IVC) e teste AC1 de Gwet. A pesquisa foi aprovada sob o número do parecer nº 3.627.052 pelo CEP/EERP-USP. Destaca-se o compartilhamento de material educativo embasado cientificamente e validado (boa aceitação geral=IVC≥0,8 e confiabilidade p=0,0000) para a qualificação profissional em saúde sobre a ALNS. O trabalho ressalta o compromisso social da ciência através da popularização científica, sendo reforçado pela premiação no 3º Edital Prêmio Vídeo Pós-Graduação USP e II Encontro de Pós-graduação (2021)

Studies indicate an important gap in professional training in health on non-suicidal selfinjury (ALNS) with a consequent weakening of care and notification. This is a methodological research aimed at developing and validating educational material to support the training of health professionals on ALNS. A mixed study was carried out to identify needs on ALNS on Twitter, collecting 6,302 posts in Portuguese, published between 2016 and 2017. Quantitative data were analyzed using descriptive statistics and association tests (p≤0.005). For the qualitative approach, 663 posts encouraging the ALNS were included, analyzed by Thematic Analysis. To deepen the theme, an Umbrella Review was carried out with qualitative analysis of systematic reviews published between 2010 and 2021. All data were synthesized in the visual and textual construction of the educational material, being validated by experts who met the criteria of expertise. After corrections, the educational material was evaluated by health professionals. Validation and evaluation data were collected through a sociodemographic questionnaire and the instrument Suitability Assessment of Materials for evaluation of health-related information for adults. Data were analyzed with simple descriptive statistics, content validity index (CVI) and AC1 Gwet test. The research was approved under opinion number 3.627,052 by CEP/EERP-USP. The sharing of scientifically based and validated educational material stands out (good general acceptance=CV≥0.8 and reliability p=0.0000) for professional qualification in health on the ALNS. The work emphasizes the social commitment of science through scientific popularization, being reinforced by the award in the 3rd USP Post-Graduate Video Award and II Post-Graduate Meeting (2021)

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OBJETIVO: apreender por meio da Terapia Comunitária Integrativa (TCI) os fatores relacionados à autolesão não suicida em adolescentes e à contribuição da mesma para as estratégias de enfrentamento. MÉTODO: estudo qualitativo, conduzido com adolescentes que participaram das rodas de Terapia Comunitária Integrativa, as quais foram gravadas e registradas em diário de campo. Utilizou-se análise temática e fundamentou-se no Modelo de Habilidades de Vida. RESULTADOS: a autolesão emergiu em seis rodas, como tema ou envolto a outro sofrimento vivenciado pelas adolescentes mulheres. Foram evidenciadas as categorias "Adolescência e autolesão não suicida: alívio da angustia", "Roda de Terapia Comunitária Integrativa: espaço terapêutico" e suas subcategorias. CONCLUSÕES: as adolescentes encontram na autolesão não suicida uma forma para materializar e aliviar o sofrimento decorrente de múltiplos fatores. A Terapia Comunitária revelou um espaço vivo de partilha e de ressignificação do sofrimento.

OBJECTIVE: to learn though the Integrative Community Therapy (ICT) the factors related to non-suicidal self-harm in adolescents and their contribution to coping strategies. METHOD: a qualitative study, conducted with adolescents who participated in the Integrative Community Therapy wheels, which were saved and recorded in a field diary. Thematic analysis was used and it was based on the Life Skills Model. RESULTS: self-harm has emerged on six wheels, as a theme or wrapped in other suffering. The following categories emerged from the analysis: "Adolescence and non-suicidal self-harm: Anguish relief" and "Integrative Community Therapy Wheel: Therapeutic space" and its subcategories. CONCLUSIONS: adolescents find in non-suicidal self-harm a way to materialize and alleviate the suffering resulting from multiple factors. Community Therapy revealed a living space of sharing and re-signification of suffering.

OBJETIVO: aprender a través de la Terapia Comunitaria Integradora (TCI) los fatores relacionados con la autolesión no suicida en adolescentes y su contribución a las estrategias de afrontamiento. METODO: estudio cualitativo, conducido con adolescentes que participaron en las ruedas de TCI, las cuales fueron grabadas y registradas en diario de campo. Se utilizó análisis temáticos y se fundó en el Modelo de Habilidades de Vida. RESULTADOS: La autolesión surgió en seis ruedas, como tema vinculado a otro sufrimiento. Del análisis surgieron las categorías "Adolescencia y autolesiones no suicidas: alivio de la angustia" y "Rueda de Terapia Comunitaria Integrativa: espacio terapéutico" y sus subcategorías. CONCLUSIONES: Las adolescentes utilizan la autolesión no suicida como forma de materializar y aliviar el sufrimiento resultante de múltiples factores. La Terapia Comunitaria reveló un espacio vivo de compartir y redefinir el sufrimiento.

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Gambling is prevalent among adolescents and adolescents are vulnerable to experiencing gambling-related problems. Although problem gambling and suicidal behavior have been linked in adults and self-injurious behaviors may predict future suicidality, prior studies have not investigated relationships between problem-gambling severity and self-injurious behavior in adolescents. Data from 2234 Connecticut high-school students were analyzed in chi-square tests and logistic regression models to examine self-injurious behaviors in relation to at-risk/problem gambling with respect to sociodemographic characteristics, gambling attitudes and perceptions, and extracurricular and health measures. Individuals who engaged in self-injurious behavior (versus those who did not) reported more permissive views towards gambling and were more likely to exhibit at-risk/problem gambling. Stronger relationships between problem-gambling severity and gambling in casinos (OR 4.85, 95%CI 1.94, 12.12) and non-strategic gambling (1.92, 95%CI 1.01, 3.66) were observed in adolescents who acknowledged engagement in self-injurious behavior versus those who did not. Links between self-injurious behaviors and more permissive gambling attitudes and perceptions and at-risk/problem gambling suggest the need for improved interventions targeting co-occurring self-injurious behaviors and gambling. Stronger relationships between problem-gambling severity and casino and non-strategic gambling among adolescents with self-injurious behaviors suggest adolescents with self-injurious behavior may engage in specific forms of gambling as maladaptive coping strategies to alleviate suffering. Prevention and treatment approaches targeting distress management and improving adaptive coping skills may be important for targeting self-injurious behaviors in adolescents with at-risk/problem gambling.

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Dentro de los daños intencionales en adolescentes, las autoagresiones se han convertido en los últimos años en un tema de interés clínico, social y público, en constante investigación. Una conducta autolesiva es toda conducta autodeliberada destinada a producir daño físico directo en el cuerpo, sin la intención de provocar la muerte. Objetivos: Describir los casos de pacientes con autoagresiones que fueron atendidos por el equipo de adolescencia (clínica pediátrica y salud mental) en el Hospital Garrahan desde el año 2015 al 2017. Diseño observacional, descriptivo y retrospectivo. Se incluyeron todos los adolescentes que fueron evaluados en conjunto por el servicio de adolescencia y salud mental. Resultados: Se atendieron 17 casos, rango de edad 12 a 16 años, 14 mujeres. Los motivos de consulta fueron variados, el principal mecanismo de autoagresión elegido fue cortes superficiales en antebrazo y piernas. La mayoría presentó como factor de riesgo principal conflictos familiares, coincidiendo con la bibliografía revisada. Un abordaje integral por personal capacitado en un servicio amigable es necesario para no perder la oportunidad de pesquisar estas situaciones. Así, mediante un trabajo interdisciplinario disminuir los riesgos que conllevan estas conductas (AU)

Within intentional harm in adolescents, over the last years selfinjury has become an issue of clinical, social, and public interest in ongoing research. Self-injurious behavior is all deliberate behavior aimed at producing direct physical harm to the body, without the intention to cause death. Objectives: To describe cases of patients with self-injurious behavior seen by the adolescents team (pediatrics and mental health) at Garrahan Hospital between 2015 and 2017. A retrospective, observational, descriptive study was conducted. All adolescents seen together by the Departments of Adolescence and Mental Health were included in the study. Results: 17 patients were evaluated, with ages ranging from 12 to 16 years; 14 were girls. Main complaints were varied. The main mechanism of self-injury were superficial cuts on the forearms and legs. The main risk factor in the majority of patients were family conflicts, as reported in the literature. A comprehensive approach by trained personnel from a friendly team is necessary so as not to lose the opportunity to screen this type of situations. An interdisciplinary approach may reduce the risks associated with these behaviors (AU)

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Actualmente uno de los debates centrales en el campo de la suicidología refiere a si los comportamientos suicidas y las autolesiones no suicidas (NSSI) representan clusters diferentes o un continuum en el espectro autodestructivo. Si se las considerara entidades nosológicas separadas debiera ser factible identificar características diferenciales entre ellas de manera que, por ejemplo, fuera posible predecir en qué casos de NSSI sería más probable que un adolescente cometiera un intento suicida. Este estudio se propuso establecer la capacidad predictiva de habilidades emocionales e interpersonales para ambos tipos de comportamientos. Para ello se administraron el Inventario de Orientaciones Suicidas ISO-30, la Escala Rasgo de Metaconocimientos sobre Estados Emocionales TMMS-24 y las escalas Recursos Sociales de las Escalas de Recursos Psicológicos a 510 adolescentes escolarizados de la ciudad de Mar del Plata, Argentina. Se seleccionaron 81 casos con autolesiones no suicidas (Grupo NSSI) y 61 con ideaciones suicidas (Grupo IS). Los resultados muestran que los modelos de regresión obtenidos para cada grupo son diferentes. El ajuste general del modelo del Grupo IS resultó adecuado (χ² = 10.54; p = .22), los coeficientes de determinación revelan una capacidad explicativa que da cuenta de entre un 25 y 46% de la varianza total y la variable de mayor peso en el modelo fue la Incapacidad para Pedir Ayuda. En cambio el modelo del grupo NSSI mostró un pobre ajuste y solamente quedaron incluidas las variables emocionales. Se discuten los resultados según consecuencias aplicadas y futuras líneas de investigación.

Currently, one of the central debates in the field of suicidology refers to whether suicidal behavior and non suicidal self-injury (NSSI) represent different clusters or a continuum in the self-harm spectrum. The first approach, which runs in the same line than DSM-5, defines the NSSI as self-inflected injuries on any surface the own body with the goal of releasing negative thought or feelings, as a reaction to an interpersonal conflict, aiming at the achievement of a positive affective state, clearly understanding that in any case these injuries could cause death. The second approach states that the non-suicidal qualification represents a restriction and is potentially dangerous, given the close link between NSSI and suicidal behavior. If they were separate nosological entities it should be possible to identify differential features in each one. Literature focused on the study of pathological variables, suggest that it seems to be a difference of degree rather than qualitative since adolescents showing suicidal behaviors report more severe psychopathological symptoms, more depression, more hopelessness and loneliness, many family conflicts, and finding less reasons to stay alive compared to those who only exhibit NSSI. These data, somehow, offer support to both approaches. Following this debate, this study aimed at establishing the predictive value of emotional and interpersonal skills as inde-pendent variables for both types of behaviors. The selection of these variables was based on previous research findings, which provide robust evidence regarding the huge difficulties showed by adolescents with suicidal behaviors and NSSI in emotional expression and regulation. As for of interpersonal variables, diverse studies offer consistent results about the low perception of social support, the presence of intense feeling of loneliness and alienation, as well as the communication difficulties manifested by adolescents with suicidal behaviors. Based on this background, the hypothesis states that such difficulties with emotional skills will be useful predictors for both groups, only showing differences of degree. This way, adolescents with NSSI will show fewer difficulties in this aspect than the suicidal ideation group; mean while difficulties in interpersonal skills will arise as predictors only for the suicidal ideation group. The Inventory for Suicidal Orientations, the Trait Meta-Mood Scale and the Social Resources Scales from the Psychological Resources Scales were used to examine to 510 adolescent students from the city of Mar del Plata, Argentina. From the total sample, 142 participants were selected and separated into two groups. Suicidal Ideation Group -IS- (82% females, M = 16.16; SD = 1.11) accomplished at least one of the following criteria for high suicidal risk with active suicidal ideation: a) total score of ISO-30 ≥ 45; b) score ≥ 2 in the item #30 of the ISO-30 scale, "If my problems get worst, I will kill myself"; c) score≥ 1 in item 30 and total score ≥ 37 (P 84) in ISO-30, or d) explicit information on ideation and/or suicidal attempt in responses to personal data survey. The other group -NSSI- was composed of 81 cases (71.6% females, M = 16.35; SD =1.13) according to the following criteria: (a) having reported self-injury thoughts and/or committing self-injuries; (b) not achieving any of the 4 criteria established for the suicidal ideation group. Results identified different regression models for each group. The overall fit showed for IS-Group model was adequate (χ²= 10.54; p =.22). As for coefficients of determination reported, 25 to 46% of the total variance was explained, and the inability to ask for help played a major role within predictive variables. Instead, the model for the NSSI Group achieved a poor fit, including only emotional variables, as hypothesized. Results and further research lines are discussed.

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RESUMEN En el presente trabajo se compilan los hallazgos de diferentes publicaciones sobre las conductas autolesivas sin intención suicida en adolescentes. En relación a su conceptualización y tipología, se define que las conductas autolesivas son un acto de expresión y autorregulación de emociones de forma intencional, a través de las cuales los sujetos se autoinflingen daño físico sin ningún deseo consciente de morir, por lo que se excluye el intento suicida. Hay una amplia clasificación que circunscribe a las conductas autolesivas desde una perspectiva de enfermedad psiquiátrica, hasta la expresada solo como una forma de identificación y necesidad de aceptación y seguridad en la etapa de la adolescencia dentro de su entorno, caracterizada comúnmente por cortarse la piel y quemarse. Desde una perspectiva de la salud pública es importante reconocer este comportamiento en los adolescentes. Respecto a aspectos epidemiológicos, se reporta la prevalencia de esta conducta en un 13-29 % de la población adolescente, quienes la presentan al menos una vez en su vida, siendo más frecuente en las mujeres. Por último, el artículo refiere los factores determinantes para el desarrollo de dicha conducta en lo biológico, lo psicológico y lo social. La investigación supone un aporte para la intervención de la salud pública en el fenómeno, a partir de las funciones de promoción y prevención que tiene esta.

ABSTRACT In the present paper, we compile the findings of different publications about self-injurious behaviors without suicidal intention in adolescents. In relation to its conceptualization and typology, it is defined that self-injurious behaviors are act of expression and self-regulation of emotions in an intentional way, through which the subjects self-inflict physical damage without any conscious desire to die, for which reason suicidal attempt is excluded. There is a broad classification of the this type of behavior describing it like a psychiatric illness or an expression and identification form in teenagers in order to fit into their environment, usually characterized by skin cutting and burns. Epidemiology reported a prevalence of this behavior in 13-29 % of the adolescent population, presented at least once in their lives. This behavior is reported as more common in women. Finally, references of the determining factors on biological, psychological and social aspects that may influence the presence of this behavior are presented, finding within them a great contribution to develop public health interventions to comply with essential functions of promotion and prevention.

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Objective: To characterize non-suicidal self-injury (NSSI) behaviors, methods, and functions as well as suicide ideation in the adolescent population of a Portuguese community in São Miguel Island, Azores. Increasing rates of NSSI behaviors among adolescents have been observed globally, while suicidal behavior has been pointed as a major cause of death during adolescence. Methods: A sample of 1,763 adolescents, aged 14 to 22, was randomly drawn from public and private schools and administered a set of self-report questionnaires. Descriptive and regression analyses were used to look for specific relationships and predictors of NSSI and suicide ideation in this isolated community. Results: Approximately 30% of youths reported at least one NSSI behavior, a rate that is twice as high as most studies carried out in mainland Portugal and in other European countries. Biting oneself was the most frequent form of NSSI, and NSSI behaviors served predominantly automatic reinforcement purposes (i.e., regulation of disruptive emotional states). NSSI and suicide ideation encompassed different distal and proximal risk factors. Conclusions: Exploring and characterizing these phenomena is necessary to provide a better understanding, enhance current conceptualizations, and guide the development of more effective prevention and intervention strategies in youths.

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BACKGROUND: Non-suicidal self-injury (NSSI) may lead to scarring, infection, accidental death and psychological distress. Little is known about NSSI in the general population of young adults in developing countries like Mexico. The current study examined the prevalence of any NSSI and each type of NSSI, the prevalence of meeting DSM-5 proposed criteria, and finally the association of NSSI with socio-demographic variables, suicidal behavior and psychiatric disorders. METHODS: This study was conducted in a community sample of 1071 young adults between 19 and 26 years of age residents of Mexico City. RESULTS: The lifetime prevalence of NSSI was 18.56% with females having 87% greater odds. The 12-month prevalence was 3.19%. Only 0.22% of the total sample and 6.96% of those that self-injured in the past 12 months met full criteria proposed by DSM-5, in part due to the lack of reported impairment; 39.99% of those that self-injured reported impairment. Suicidal behavior commonly co-occurred with NSSI. All lifetime anxiety, mood, disruptive behavior and substance use disorders were associated with greater risk for lifetime NSSI whereas only 12-month depression and substance use disorder was associated with greater risk of 12-month NSSI. LIMITATIONS: The cross-sectional nature of the study precludes conclusions of causality and directionality and the study excluded institutionalized and homeless young adults. CONCLUSIONS: NSSI is a concerning problem in young adults from Mexico City due to the important associations with all types of psychiatric disorders and suicidal behavior. Because many who self-injure do not perceive impairment, they are unlikely to seek treatment.

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