000165035 001__ 165035 000165035 005__ 20251204150239.0 000165035 0247_ $$2doi$$a10.1017/S0033291725100688 000165035 0248_ $$2sideral$$a146477 000165035 037__ $$aART-2025-146477 000165035 041__ $$aeng 000165035 100__ $$aHasking, Penelope 000165035 245__ $$aThe relationships between sporadic and repetitive non-suicidal self-injury and mental disorders among first-year college students: results from the World Mental Health International College Student Initiative 000165035 260__ $$c2025 000165035 5060_ $$aAccess copy available to the general public$$fUnrestricted 000165035 5203_ $$aBackground: Non-suicidal self-injury (NSSI) is associated with mental disorders, yet work regarding the direction of this association is inconsistent. We examined the prevalence, comorbidity, time–order associations with mental disorders, and sex differences in sporadic and repetitive NSSI among emerging adults. Methods: We used survey data from n = 72,288 first-year college students as part of the World Mental Health-International College Student Survey Initiative (WMH-ICS) to explore time–order associations between onset of NSSI and mental disorders, based on retrospective age-of-onset reports using discrete-time survival models. We distinguished between sporadic (1–5 lifetime episodes) and repetitive (≥6 lifetime episodes) NSSI in relation to DSM-5 mood, anxiety, and externalizing disorders. Results: We estimated a lifetime NSSI rate of 24.5%, with approximately half reporting sporadic NSSI and half repetitive NSSI. The time–order associations between onset of NSSI and mental disorders were bidirectional, but mental disorders were stronger predictors of the onset of NSSI (median RR = 1.94) than vice versa (median RR = 1.58). These associations were stronger among individuals engaging in repetitive rather than sporadic NSSI. While associations between NSSI and mental disorders generally did not differ by sex, repetitive NSSI was a stronger predictor for the onset of subsequent substance use disorders among females compared to males. Most mental disorders marginally increased the risk for persistent repetitive NSSI (median RR = 1.23). Conclusions: Our findings offer unique insights into the temporal order between NSSI and mental disorders. Further work exploring the mechanism underlying these associations will pave the way for early identification and intervention of both NSSI and mental disorders. 000165035 536__ $$9info:eu-repo/grantAgreement/ES/ISCIII/PI20-00006 000165035 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc-nd$$uhttps://creativecommons.org/licenses/by-nc-nd/4.0/deed.es 000165035 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion 000165035 700__ $$aKiekens, Glenn 000165035 700__ $$aPetukhova, Maria V. 000165035 700__ $$aAlbor, Yesica 000165035 700__ $$aAl-Hadi, Ahmad 000165035 700__ $$aAlonso, Jordi 000165035 700__ $$aAl-Saud, Nouf 000165035 700__ $$aAltwaijri, Yasmin 000165035 700__ $$aAndersson, Claes 000165035 700__ $$aAtwoli, Lukoye 000165035 700__ $$aAyuya Muaka, Caroline 000165035 700__ $$aBáez-Mansur, Patricia 000165035 700__ $$aBallester, Laura 000165035 700__ $$aBantjes, Jason 000165035 700__ $$aBaumeister, Harald 000165035 700__ $$aBendtsen, Marcus 000165035 700__ $$aBenjet, Corina 000165035 700__ $$aBerman, Anne 000165035 700__ $$aBruffaerts, Ronny 000165035 700__ $$aCarrasco, Paula 000165035 700__ $$aChan, Silver 000165035 700__ $$aCohut, Irina 000165035 700__ $$aCovarrubias Díaz Couder, Maria 000165035 700__ $$aCristóbal-Narvaez, Paula 000165035 700__ $$aCuijpers, Pim 000165035 700__ $$aDavid, Oana 000165035 700__ $$aDong, Dong 000165035 700__ $$aEbert, David 000165035 700__ $$aGaete, Jorge 000165035 700__ $$aGarcía Forero, Carlos 000165035 700__ $$aGutiérrez-García, Raúl 000165035 700__ $$aHaro, Josep 000165035 700__ $$aHunt, Xanthe 000165035 700__ $$aHurks, Petra 000165035 700__ $$aHusky, Mathilde 000165035 700__ $$aJaguga, Florence 000165035 700__ $$aJansen, Leontien 000165035 700__ $$aJiménez-Pérez, Ana 000165035 700__ $$aKählke, Fanny 000165035 700__ $$aKlinkenberg, Elisabeth 000165035 700__ $$aLanger, Álvaro 000165035 700__ $$aLee, Sue 000165035 700__ $$aLima, Rodrigo Antunes 000165035 700__ $$aLiu, Yan 000165035 700__ $$aLochner, Christine 000165035 700__ $$aMac-Ginty, Scarlett 000165035 700__ $$aMartínez, Vania 000165035 700__ $$aMason, Andre 000165035 700__ $$aMcLafferty, Margaret 000165035 700__ $$aMori, Tiana 000165035 700__ $$aMurray, Elaine 000165035 700__ $$aMusyoka, Catherine 000165035 700__ $$aNedelcea, Caitalin 000165035 700__ $$aNúñez, Daniel 000165035 700__ $$aO’Neill, Siobhan 000165035 700__ $$aPiqueras, José 000165035 700__ $$aPopescu, Codruta 000165035 700__ $$aRapsey, Charlene 000165035 700__ $$aRobinson, Kealagh 000165035 700__ $$aRoca, Miquel 000165035 700__ $$aRodriguez-Jimenez, Tiscar$$uUniversidad de Zaragoza 000165035 700__ $$aSalemink, Elske 000165035 700__ $$aSampson, Nancy 000165035 700__ $$aScarf, Damian 000165035 700__ $$aSiu, Oi-ling 000165035 700__ $$aStein, Dan 000165035 700__ $$aStruijs, Sascha Y. 000165035 700__ $$aTomoiaga, Cristina 000165035 700__ $$aValdés-García, Karla 000165035 700__ $$avan der Heijde, Claudia 000165035 700__ $$aVigo, Daniel 000165035 700__ $$aVoorspoels, Wouter 000165035 700__ $$aWang, Angel 000165035 700__ $$aWong, Samuel 000165035 700__ $$aNock, Matthew 000165035 700__ $$aKessler, Ronald 000165035 700__ $$a 000165035 7102_ $$14009$$2680$$aUniversidad de Zaragoza$$bDpto. Psicología y Sociología$$cÁrea Person.Eval.Trat.Psicoló. 000165035 773__ $$g55 (2025), [15 pp.]$$pPsychol. med.$$tPsychological Medicine$$x0033-2917 000165035 8564_ $$s1016112$$uhttps://zaguan.unizar.es/record/165035/files/texto_completo.pdf$$yVersión publicada 000165035 8564_ $$s3310409$$uhttps://zaguan.unizar.es/record/165035/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada 000165035 909CO $$ooai:zaguan.unizar.es:165035$$particulos$$pdriver 000165035 951__ $$a2025-12-04-14:39:44 000165035 980__ $$aARTICLE