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About Self-Injury Self-Injury and Suicide Resources / About Self-Injury / Self-Injury and Suicide "Related but not the same" The relationship between NSSI and suicide is complex. Although NSSI is not a suicidal behavior itself, it is a reliable predictor of later suicidal thoughts, plans, and attempts (Kiekens et al., 2018, Ribeiro et al., 2016). So, why is this the case? There are lots of factors that contribute to the relationship between NSSI and suicidal behaviours. A recent review by Griep and MacKinnon (2020) found that past-year NSSI frequency and depressive symptoms increase an individual's risk of attempting suicide. There were mixed findings regarding age and sex differences. Suicidality can fluctuate over time. It is important to continually check in with clients and loved ones regarding their self-injury and suicidality. References Kiekens, G., Hasking, P., Boyes, M., Claes, L., Mortier, P., Auerbach, R. P., Cuijpers, P., Demyttenaere, K., Greene, J. G., Kessler, R. C., Myin-Germeys, I., Nock, M. K., & Bruffaerts, R. (2018). The associations between non-suicidal self-injury and first onset suicidal thoughts and behaviors. Journal of Affective Disorders , 239 , 171-179. https://doi.org/10.1016/j.jad.2018.06.033 Griep, S. K., & MacKinnon, D. F. (2020). Does nonsuicidal self-injury predict later suicidal attempts? A review of studies. Archives of Suicide Research , 26 , 428-446. https://doi.org/10.1080/13811118.2020.1822244 Ribeiro, J. D., Franklin, J. C., Fox, K. R., Bentley, K. H., Kleiman, E. M., Chang, B. P., & Nock, M. K. (2015). Self-injurious thoughts and behaviors as risk factors for future suicide ideation, attempts, and death: A meta-analysis of longitudinal studies. Psychological Medicine , 46 , 225-236. https://doi.org/10.1017/S0033291715001804

ISSS Rising Stars About /Awards / ISSS Rising Stars Recognizing Potential ISSS Rising Stars are dedicated early-career researchers, clinicians, or advocates whose work demonstrates potential and commitment to make a significant contribution to the field and to the lives of people with lived experience. 2023 Rising Star Read more Dr Kathryn Fox Dr Fox is an Assistant Professor in the clinical child psychology Ph.D. Program at the University of Denver, where she also directs the Fox Lab in the Department of Psychology. Rising Stars of ISSS 2023 Dr. Kathryn Fox Dr. Fox is an Assistant Professor in the clinical child psychology Ph.D. Program at the University of Denver, where she also directs the Fox Lab in the Department of Psychology. Read more...

Home / Awards / Invited Fellow / Dr. Barent W. Walsh Dr. Barent W. Walsh Previous Dr. Barent (Barry) Walsh is a Clinical Social Worker , educator, and one of the earliest and most influential figures in the study and treatment of self-injury. Author of Treating Self-Injury: A Practical Guide , a foundational text for clinicians, Dr. Walsh has trained thousands of professionals in compassionate, evidence-based care. His decades of work have profoundly shaped the clinical understanding of self-injury, emphasizing empathy, validation, and therapeutic skill. Dr. Walsh continues to consult and teach internationally, bridging the gap between research and frontline practice. He is widely admired for his humility, generosity, and unwavering commitment to improving the lives of those with lived experience of NSSI. For many, Barry is a symbol of a true science-based clinician. He epitomizes the spirit of collaboration, approachability, and friendship that is a hallmark of ISSS. Next ISSS Fellow | 2021

Rachel Acheson, PhD, and Maria Papadima, PhD, from the Association of Child Psychotherapists in London describe how today's "adolescent crisis," including self-injury and self-harm, is often expressed through mental health language. Season 3 | Episode 39 Podcast/ Season 3 | Episode 39 Youth Crisis, Self-Harm, & Mental Health Language Jul 28, 2023 with Drs. Rachel Acheson & Maria Papadima Youth Crisis, Self-Harm, & Mental Health Language with Drs. Rachel Acheson & Maria Papadima 00:00 / 01:04 Amidst a global youth mental health crisis, is it possible that many young people are experiencing adolescent development challenges but are using mental health language to describe their distress? Even to the degree of experiencing crises that include self-harm like nonsuicidal self-injury and suicidal thoughts and behaviors? In this episode, Drs. Maria Papadima and Rachel Acheson share observations from their clinical work with youth, consider trends such as self-diagnosing through TikTok and Instagram, discuss how they walk parents and youth through these mental health crises, and offer a psychoanalytic perspective of current trends. Learn more about Dr. Papadima and her work at www.mariapapadima.com , and read her blog about "Self-diagnosis via TikTok" here . Below is the reference and link to their paper discussed in this episode: Acheson, R., & Papadima, M. (2023). The search for identity: Working therapeutically with adolescents in crisis . Journal of Child Psychotherapy, 49 (1), 95-119. Follow Dr. Westers on Instagram and Twitter (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter (@ITripleS). The Psychology of Self-Injury podcast has been rated #1 by Feedspot in their list of " 10 Best Self Harm Podcasts " and #5 in their " 20 Best Clinical Psychology Podcasts ." It has also been featured in Audible's " Best Mental Health Podcasts to Defy Stigma and Begin to Heal ." Previous Next

Caroline Roberts from the University of Minnesota bridges the conversation gap between self-injurious behavior (SIB) and nonsuicidal self-injury (NSSI), including self-harm among individuals with intellectual and developmental disabilities (IDD). Season 3 | Episode 41 Podcast/ Season 3 | Episode 41 Self-Injury in Intellectual & Developmental Disabilities (IDD) Sep 29, 2023 with Caroline Roberts Self-Injury in Intellectual & Developmental Disabilities (IDD) with Caroline Roberts 00:00 / 01:04 Up to 1 in 5 (20%) individuals with intellectual and developmental disabilities (IDD) and about 3 in 7 (42%) individuals with autism spectrum disorder (ASD) engage in self-injurious behavior (SIB). Common forms of SIB include repetitive head banging, head-hitting, self-biting, self-hitting, eye-poking, skin-picking, and trichotillomania (hair pulling), among other forms of self-harm. In this episode, Caroline Roberts from the University of Minnesota and Masonic Institute for the Developing Brain discusses the differences and similarities between SIB and nonsuicidal self-injury (NSSI) and how we can bridge the gap between NSSI research and clinical practice, and SIB among those with IDD. She also shares 4 key topics from her interviews with experts in SIB and NSSI: (1) case ascertainment, (2) perceptions of causal variables, (3) pathways to treatment, and (4) treatment goals and outcomes. Learn more about the Masonic Institute for the Developing Brain and their interdisciplinary approaches to understanding and improving SIB workgroup here . Follow Caroline on Twitter/X at @clrobz . Below are one of her papers and other research referenced in today's episode: Roberts, C. L., Avina, A. H., & Symons, F. J. (2023). A qualitative analysis of family caregiver experiences accessing treatment for self-injurious behavior in individuals with intellectual and developmental disabilities . Journal of Mental Health Research in Intellectual Disabilities . Dimian, A. F., & Symons, F. J. (2022). A systematic review of risk for the development and persistence of self-injurious behavior in intellectual and developmental disabilities. Clinical Psychology Review, 94 , 102158. Steenfeldt-Kristensen, C., Jones, C. A., & Richards, C. (2020). The prevalence of self-injurious behaviour in autism: A meta-analytic study . Journal of Autism and Developmental Disorders, 50 (11), 3857-3873. Follow Dr. Westers on Instagram and Twitter/X (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter/X (@ITripleS). The Psychology of Self-Injury podcast has been rated #1 by Feedspot in their list of " 10 Best Self Harm Podcasts " and #5 in their " 20 Best Clinical Psychology Podcasts ." It has also been featured in Audible's " Best Mental Health Podcasts to Defy Stigma and Begin to Heal ." Previous Next

Lotte Rubæk, MSc, from Denmark discusses the role of social media among individuals who self-injure as well as why she resigned from her role on Meta's (Facebook, Instagram, WhatsApp) self-harm global expert panel. Season 4 | Episode 50 Podcast/ Season 4 | Episode 50 Social Media, Meta, & Self-Injury Jun 28, 2024 with Lotte Rubæk Social Media, Meta, & Self-Injury with Lotte Rubæk 00:00 / 01:04 In this episode, Lotte Rubæk, MSc, who leads the Self-Injury Team in Child and Adolescent Psychiatry in the Capital Region of Denmark, talks about why interaction on image-based social media platforms like Instagram can be particularly appealing to young people who self-harm. She discusses the dynamics that can arise between users in the more closed social media networks, and she explains why she so publicly resigned from Meta's global expert panel on self-harm after serving on it for 3.5 years. Connect with Lotte on LinkedIn here , and read The Guardian's article about her decision to resign from Meta here . Listen to her podcast, Selvskadens Psykologi , which means The Psychology of Self-Injury in Danish, here . Read about the U.S. Surgeon General's May 2023 advisory about the effects social media use has on youth mental health here , and read about his June 2024 call on Congress to require warning labels on social media platforms and their effects on young people’s lives here . Below are Lotte's two book chapters in the new Oxford Handbook of Nonsuicidal Self-Injury and a few additional papers related to social media and self-injury: Rubæk, L., & Møhl, B. (2023). Direct and indirect self-injury . In E. E. Lloyd-Richardson, I. Baetens, & J. Whitlock (Eds.), The Oxford handbook of nonsuicidal self-injury (pp. 41-71). Oxford University Press. Møhl, B., & Rubæk, L. (2023). Understanding the link between direct and indirect self-injurious behavior . In E. E. Lloyd-Richardson, I. Baetens, & J. Whitlock (Eds.), The Oxford handbook of nonsuicidal self-injury (pp. 680-701). Oxford University Press. Westers, N. J., Lewis, S. P., Whitlock, J., Schatten, H. T., Ammerman, B., Andover, M. S., & Lloyd-Richardson, E. E.(2021). Media guidelines for the responsible reporting and depicting of non-suicidal self-injury . The British Journal of Psychiatry, 219 (2), 415-418. Zhu, L., Westers, N. J.,Horton, S. E., King, J. D., Diederich, A., Stewart, S. M., & Kennard, B. D. (2016). Frequency of exposure to and engagement in nonsuicidal self-injury among inpatient adolescents . Archives of Suicide Research, 20 (4), 580-590. Bridge, J. A., Greenhouse, J. B., Ruch, D., Stevens, J., Ackerman, J., Sheftall, A. H., Horowitz, L. M., Kelleher, K. J., & Campo, J. V. (2020). Association between the release of Netflix’s 13 Reasons Why and suicide rates in the United States: An interrupted time series analysis . Journal of the American Academy of Child & Adolescent Psychiatry, 59 (2), 236-243. Previous Next

Moye Xin, PhD, from Xi’an University in China shares insights from his research exploring how conflict about one's gender role may increase risk for engaging in nonsuicidal self-injury and self-harm. Season 5 | Episode 60 Podcast/ Season 5 | Episode 60 Does Conflict About One’s Gender Role Predict Self-Injury? Apr 25, 2025 with Dr. Moye Xin Does Conflict About One’s Gender Role Predict Self-Injury? with Dr. Moye Xin 00:00 / 01:04 In this episode, Dr. Moye Xin from Xi'an University in the Shaanxi Province of central China discusses how nonsuicidal self-injury (NSSI) is viewed in Asia and shares his thoughts about how gender role conflict may affect rates of self-harm among university students, particularly young Chinese men. Connect with Dr. Xin on ResearchGate at www.researchgate.net/profile/Moye-Xin or visit his work on SciProfiles at sciprofiles.com/profile/1469611 . Below are a few of his research studies referenced in this episode: Xin, M., Petrovic, J., Yang, C., Zhang L., & Yang, X. (2024). Nonsuicidal self-injury among Chinese university students during the post-COVID-19 era: analysis of sex differences and the impact of gender role conflict . Frontiers in Psychology, 15 , 1362762. Xin, M., Zhang, L., Yang, C., Yang, X., and Xiang, M. (2022). Risky or protective? Online social support's impact on nssi amongst Chinese youth experiencing stressful life events . BMC Psychiatry, 22 , 782. Yang, X., & Xin, M. (2018). "Boy crisis" or "girl risk"? The gender difference in nonsuicidal self-injurious behavior among middle-school students in China and its relationship to gender role conflict and violent experiences . American Journal of Men's Health, 12 (5), 1275–1285. Previous Next

Kathryn Gardner, PhD, from the University of Central Lancashire in the United Kingdom discusses the significance of where on the body individuals choose to engage in self-cutting behavior and the psychology of self-injury and self-harm location. Season 2 | Episode 25 Podcast/ Season 2 | Episode 25 Self-Injury Location: Visible vs Concealed May 27, 2022 with Dr. Kathryn Gardner Self-Injury Location: Visible vs Concealed with Dr. Kathryn Gardner 00:00 / 01:04 Does it matter where on the body someone cuts, whether on typically more visible sites such as the forearm and wrist, or in typically more concealed areas, such as the upper arm and torso? Is there a relationship between where someone cuts on their body and their likelihood of continuing to engage in the behavior? In this episode, Dr. Gardner discusses her research on the psychology of self-injury location and where on the body one chooses to self-injure as well as intrapersonal (emotional) reasons and interpersonal (social) reasons for engaging in self-injury and self-harm. Learn more about Dr. Gardner and her work at https://www.uclan.ac.uk/academics/dr-kathryn-gardner , and follow her on Twitter @KathrynJGardner . Below are links to some of her research referenced in this episode: Gardner, K. J., Bickley, H., Turnbull, P., Kapur, N., Taylor, P., & Clements, C. (2020). The significance of site of cut in self-harm in young people . Journal of Affective Disorders, 266 , 603-609. Gardner, K. J., Paul, E., Selby, E. A., Klonsky, E. D., Mars, B. (2021). Intrapersonal and interpersonal functions as pathways to future self-harm repetition and suicide attempts . Frontiers in Psychology, 12 , 688472. Follow Dr. Westers on Instagram and Twitter (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter (@ITripleS). The Psychology of Self-Injury podcast has been rated #5 by Feedspot in their " Best 20 Clinical Psychology Podcasts " and by Welp Magazine in their " 20 Best Injury Podcasts ." Previous Next

Spencer Ellison and Jennifer Muehlenkamp, PhD, from the University of Wisconsin-Eau Claire tell us what they learned when they asked therapists about their willingness to treat individuals who engage in nonsuicidal self-injury or self-harm. Season 5 | Episode 57 Podcast/ Season 5 | Episode 57 Are Therapists Willing to Treat Self-Injury? Jan 31, 2025 with Spencer Ellison & Dr. Jennifer Muehlenkamp Are Therapists Willing to Treat Self-Injury? with Spencer Ellison & Dr. Jennifer Muehlenkamp 00:00 / 01:04 In this episode, Spencer Ellison and Dr. Jennifer Muehlenkamp read a hypothetical case vignette of a client who engages in nonsuicidal self-injury (NSSI), has experienced suicidal thoughts or behaviors, or is experiencing significant depression. They then tell us how willing therapists are to treat each case (self-injury vs. suicide vs. depression), if therapists would accept them into their clinical practice, and if it depends on the therapists' (1) liability concerns, (2) comfort/skill confidence to treat self-harm, (3) attitude toward self-harm in general, and (4) attitude towards clients who self-harm. Learn more about Dr. Muehlenkamp at her University of Wisconsin-Eau Claire faculty page here , and see her growing list of peer-reviewed publications on Google Scholar here . Learn more about Trinity Equestrian Center at www.trinity-ec.com . Below are a couple research studies referenced in this episode: Levi-Belz, Y., Barzilay, S., Levy, D., & David, O. (2020). To treat or not to treat: The effect of hypothetical patients' suicidal severity on therapists' willingness to treat . Archives of Suicide Research, 24 (3), 355-366. Groth, T., & Boccio, D. E. (2019). Psychologists’ willingness to provide services to individuals at risk of suicide . Suicide and Life-Threatening Behavior, 49 (5), 1241-1254. Previous Next

Home / Awards / Invited Fellow / Dr. Kim L. Gratz Dr. Kim L. Gratz Previous Dr. Kim L. Gratz is a Professor and Chair of the Department of Psychology at the University of Toledo (United States) who is an influential figure in the study of emotion regulation and self-injury. Her pioneering research on borderline personality disorder, emotion dysregulation, and the mechanisms underlying self-destructive behaviors has shaped modern understanding and treatment approaches. She is recognized for her exceptional clinical insight, innovative research, and her mentorship of emerging clinicians and scientists. Her compassion, intellect, and advocacy have made her a cornerstone of the self-injury research community. Next ISSS Fellow | 2024

Who We Are Home / About It is a direct expression of thusness or this-moment-as-it-is - Seo, 2007 "Enso" is a Japanese word meaning circular form and is a symbol from Zen Buddhism that represents enlightenment, strength, connection, and imperfection (Seo, 2007). The enso was chosen as the symbol for ISSS because it reflects the imperfect, cyclical nature of life. Our Mission The mission of the International Society for the Study of Self-Injury (ISSS) and its members is to promote the understanding, prevention, and treatment of nonsuicidal self-injury (NSSI) and foster well-being among those with lived NSSI experience and those impacted by NSSI. To accomplish these aims, ISSS focuses its efforts on the following goals: Research Conduct and disseminate state-of-the art research to advance the understanding, assessment, treatment, and prevention of NSSI. Care & Support Develop, evaluate, and promote, and provide evidence-based care to advance clinical understanding of NSSI and its treatment across diverse settings. Outreach Engage in public outreach to improve knowledge of evidence-based prevention, assessment, and treatment options for NSSI. Connection Enhance networking, collaboration, and resource sharing among all stakeholders with an interest in improving the lives of people who engage in NSSI. Membership in ISSS is open to researchers, clinicians, students, people with lived experience with NSSI, advocates, and other stakeholders with an interest in improving the lives of people who engage in NSSI. Executive Board Open Positions Ready to join our leadership team? Click on each position to learn more and apply! Treasurer The Treasurer fulfils a crucial administrative role and is responsible for the receipt, custody, and disbursement of all funds and securities of ISSS. They are also responsible for all financial and security related records and communications. Representative at Large: Membership The Rep. at Large (Membership) ensures the growth, satisfaction, and active involvement of ISSS members. Through collaboration and outreach, the Membership RAL fosters and maintains a vibrant, engaged, and expanding community of members. Representative at Large: Social Media The Rep. at Large (Social Media) is responsible for the online presence of ISSS, promoting its mission, activities, and initiatives to stakeholders through consistent and creative engagement across social media platforms. Student Representative Student Representatives are critical members of the ISSS Executive Board. They serve as a liaison between student Members and the Board, advocating for student interests and cultivating community and connection among the student body. Meet the Leadership ISSS is led by a team of experts in the field and comprises researchers, clinicians, students, advocates, and most importantly, individuals with lived experience of self-injury. All members of the Executive Board are democratically elected by the ISSS Membership, with positions holding varying terms. Find open appointments and meet the team below! A/Prof. Nicholas Westers President Dr. Karl Tooher Secretary-Elect Jason Washburn, PhD Founding Treasurer Professor Stephen Lewis Chair of Strategic Planning Ruth Tatnell, PhD International Member at Large Professor Marc Wilson International Member at Large Brooke Ammermann, PhD Representative at Large Kaylee Kruzan, PhD Representative at Large Greg Lengel, PhD Chair of Media & Communications Michelle Hiner, MS Webmaster Michaela Ahrenholtz, MS Student Representative Professor Imke Baetens Past President Elizabeth Lloyd-Richardson, PhD Past President Our History From list-serve to leaders The International Society for the Study of Self-Injury was esta blished in 2006 by a group of passionate and curious researchers led by Janis Whitlo ck and Nancy Heath. Today, ISSS boasts more than100 members dedicated to our mission. Learn more below about how ISSS came to be the leading international organisation for the study of self-injury. Pre-ISSS In January of 2005, a year before the first ISSS meeting, the findings of the Adolescent Mental Health Initiative were disseminated in a book titled, Treating and Preventing Adolescent Mental Health Disorders: What We Know and What We Don’t Know . Although intended to summarize the state of the field in adolescent mental health disorders, the volume included no more than half of a page on nonsuicidal self-Injury (NSSI). The absence of NSSI in this volume largely r eflected its nominal presence in academic journals prior to this point. Despite its absence in the literature however, its growing presence in clinical and non-clinical settings had begun to command the attention of a small but increasing group of scholars from diverse disciplines. Although acquainted with each others’ work, there were few forums through which these scholars regularly, if ever, came together as a group. The First Meeting In response to this growing gap between the literature and field experience, Nancy Heath’s Research Team at McGill University initiated a list-serve for professionals interested in the study of self-injury. This was a means of encouraging communication among NSSI scholars within and outside of the US. Shortly after this, in 2006, Janis Whitlock and several colleagues from Cornell University invited a small group of NSSI researchers and treatment specialists to attend a meeting devoted to discussion of what we knew, what we needed to know, and strategies for building a larger field of research and collaboration. The opportunity for exchange created by the gathering was well received and very productive. By the end of the second day, the group had identified a name for the association and plans for continuing ISSS were set. By the group’s second meeting the following year, hosted by Nancy Heath at McGill, over 20 new collaborations had been formed and the group’s membership had swelled considerably. During the third year’s meeting, hosted by Matt Nock at Harvard University, the group collectively decided to begin the process of developing a formal charter and membership. By the fifth year, hosted by David Klonsky at Stony Brook University, we had appointed our first round of officers. The Organisation Today Today, we comprise over 100 members and are in our 17th year of research, care, outreach, and connection. ISSS hosts vibrant and intellectually stimulating annual meetings and fosters meaningful and productive collaborations. Although ISSS continues to expand, our commitment to improving the field of NSSI remains unchanged. Be part of an organisation dedicated to improving wellbeing and reducing stigma, join u s today .

Brittany Tinsley of @brittanytinsleywrites Instagram explains how she navigates talking about her wounds and scars of self-injury and self-harm with her medical providers during routine doctor visits. Season 1 | Episode 18 Podcast/ Season 1 | Episode 18 Navigating Self-Injury During Routine Doctor Visits Oct 1, 2021 with Brittany Tinsley Navigating Self-Injury During Routine Doctor Visits with Brittany Tinsley 00:00 / 01:04 If you’ve never engaged in self-injury or self-harm, then you may have never considered the anxieties related to something as seemingly simple as a routine doctor visit. In this episode, Brittany Tinsley explains what questions she asks herself prior to attending routine doctor visits in order to ease her anxiety about medical providers seeing her self-injury wounds and scars. We take a unique peek into what doctor visits can be like for those who self-injure or have self-injured, as well as discuss tips on navigating those visits, whether as a treatment provider or someone with lived experience. Follow Brittany on Instagram at @brittanytinsleywrites and read her blog at https://brittanytinsley.com/ . Follow Dr. Westers on Instagram and Twitter (@DocWesters). To join ISSS, visit itriples.org and follow ISSS on Facebook and Twitter (@ITripleS). The Psychology of Self-Injury podcast has been rated #5 by Feedspot in their " Top 15 Clinical Psychology Podcasts You Must Follow in 2021 " and by Welp Magazine in their " 20 Best Injury Podcasts of 2021 ." Previous Next