The Psychology of Self-Injury: Exploring Self-Harm & Mental Health

Emotion Regulation Individual Therapy for Adolescents (ERITA) and its internet-delivered version (IERITA) is just one of a couple of treatments developed specifically to address nonsuicidal self-injury (NSSI) among adolescents. In this episode, Dr. Johan Bjureberg from the Karolinska Institute in Stockholm, Sweden walks us through in detail each of the 11 sessions of IERITA and IERITA's 6 parallel sessions for parents.

Learn more about Dr. Bjureberg's work here, and follow the Bjureberg Research Lab and their projects and publications at https://bjureberglab.se/. Below are links to his research on ERITA/IERITA referenced in this episode:

1. Bjureberg, J., Ojala, O., Hesser, H., Häbel, H., Sahlin, H., Gratz, K. L., Tull, M. T., Knutsson, E. C., Hedman-Lagerlöf, E., Ljótsson, B., & Hellner, C. (2023). Effect of internet-delivered Emotion Regulation Individual Therapy for Adolescents with Nonsuicidal Self-Injury Disorder: A randomized clinical trial. JAMA Network Open, 6(7), e2322069.
2. Bjureberg, J., Sahlin, H., Hedman-Lagerlof, E., Gratz, K. L., Tull, M. T., Jokinen, J., Hellner, C., & Ljotsson, B. (2018). Extending research on emotion regulation individual therapy for adolescents (ERITA) with nonsuicidal self-injury disorder: Open pilot trial and mediation analysis of a novel online version. BMC Psychiatry, 18, 326.
3. Bjureberg, J., Sahlin, H., Hellner, C., Hedman-Lagerlof, E., Gratz, K. L., Bjarehed, J., Jokinen, J., Tull, M. T., & Ljotsson, B. (2017). Emotion regulation individual therapy for adolescents with nonsuicidal self-injury disorder: A feasibility study. BMC Psychiatry, 17, 411.

Want to have a bigger role on the podcast?:

1. Should you or someone you know be interviewed on the podcast? We want to know! Please fill out this Google doc form, and we will be in touch with more details if it’s a good fit.
2. Want to hear your question and have it answered on the podcast? Please send an audio clip of your question (60 seconds or less) to @DocWesters on Instagram or Twitter/X, or email us at [email protected]
3. Want to be involved in research? Send us a message at [email protected] and we will see if we can match you to an active study.
4. Want to interact with us through comments and polls? You can on Spotify!

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 as one of the "10 Best Self Harm Podcasts" and "20 Best Clinical Psychology Podcasts" by Feedspot  and one of the Top 100 Psychology Podcasts by Goodpods. It has also been featured in Audible's "Best Mental Health Podcasts to Defy Stigma and Begin to Heal."

Goodpods Top 100 Parents Podcasts Listen now to The Psychology of Self-Injury: Exploring
Self-Harm & Mental Health podcast 

Goodpods Top 100 Research Podcasts Listen now to The Psychology of Self-Injury: Exploring
Self-Harm & Mental Health podcast 

In this episode, host and producer of The Psychology of Self-Injury podcast, Dr. Nicholas Westers, shares his own thoughts about what we should consider when supporting friends, families, clients, and patients who engage in nonsuicidal self-injury (NSSI). This marks the first solo episode of the podcast, and Dr. Westers offers ways for listeners to have a bigger role on the podcast, including:

1. Should you or someone you know be interviewed on the podcast? We want to know! Please fill out this Google doc form, and we will be in touch with more details if it’s a good fit.
2. Want to hear your question and have it answered on the podcast? Please send an audio clip of your question (60 seconds or less) to @DocWesters on Instagram or Twitter/X, or email us at [email protected]
3. Want to be involved in research? Send us a message at [email protected] and we will see if we can match you to an active study.
4. Want to interact with us through comments and polls? You can on Spotify!

Below are a couple papers related to this episode with Dr. Westers:

1. Westers, N. J., Rehfuss, M., Olson, L., & Biron, D. (2012). The role of forgiveness in adolescents who engage in nonsuicidal self-injury. The Journal of Nervous and Mental Disease, 200(6), 535-541.
2. Westers, N. J., & Tinsley, B. (2023). Nonsuicidal self-injury risk assessment, intervention, and guidance for first responders and medical settings. In E. E. Lloyd-Richardson, I. Baetens, & J. Whitlock (Eds.), The Oxford handbook of nonsuicidal self-injury (pp. 873–893). Oxford University Press.

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 as one of the "10 Best Self Harm Podcasts" and "20 Best Clinical Psychology Podcasts" by Feedspot  and one of the Top 100 Psychology Podcasts by Goodpods. It has also been featured in Audible's "Best Mental Health Podcasts to Defy Stigma and Begin to Heal."

Goodpods Top 100 Parents Podcasts Listen now to The Psychology of Self-Injury: Exploring
Self-Harm & Mental Health podcast 

Goodpods Top 100 Research Podcasts Listen now to The Psychology of Self-Injury: Exploring
Self-Harm & Mental Health podcast 

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:

1. 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.
2. 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.
3. 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.
4. 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.
5. 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.

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 as one of the "10 Best Self Harm Podcasts" and "20 Best Clinical Psychology Podcasts" by Feedspot  and one of the Top 100 Psychology Podcasts by Goodpods. It has also been featured in Audible's "Best Mental Health Podcasts to Defy Stigma and Begin to Heal."

If you or someone you know should be interviewed on the podcast, we want to know! Please fill out this form, and we will be in touch with more details if it’s a good fit.

Goodpods Top 100 Parents Podcasts Listen now to The Psychology of Self-Injury: Exploring
Self-Harm & Mental Health podcast 

Goodpods Top 100 Research Podcasts Listen now to The Psychology of Self-Injury: Exploring
Self-Harm & Mental Health podcast 

In this episode, Christina Robillard talks about how self-criticism can lead to increases in self-injury urges within the next two hours as well as the relationship between self-criticism and disordered eating. She explains how she and her team use ecological momentary assessment (EMA; see Season 1, Episode 11 with Dr. Glenn Kiekens) to assess self-criticism in real time.

Connect with Christina on LinkedIn here. See Christina's academic page at the University of Victoria here and her Google Scholar page here. Below are links to some of her papers as well as one about self-criticism and pain:

1. Robillard, C. L., Merrin, G. J., Legg, N. K., Ames, M. E., & Turner, B. J. (2024). Different self-damaging behaviours, similar motives? Testing measurement invariance of motives for nonsuicidal self-injury, disordered eating and substance misuse. British Journal of Clinical Psychology. Advance online publication.
2. Robillard, C. L., Legg, N. K., Ames, M. E.,  & Turner, B. J. (2022). Support for a transdiagnostic motivational model of self-damaging behaviors: Comparing the salience of motives for binge drinking, disordered eating, and nonsuicidal self-injury. Behavior Therapy, 53(6), 1219-1232.
3. Robillard, C. L., Chapman, A. L., & Turner, B. J. (2022). Learning from experience: Within- and between-person associations of the consequences, frequency, and versatility of nonsuicidal self-injury. Suicide and Life-Threatening Behavior, 52(5), 836-847.
4. Robillard, C. L., Turner, B. J., Ames, M. E., & Craig, S. G. (2021). Deliberate self-harm in adolescents during COVID-19: The roles of pandemic-related stress, emotion regulation difficulties, and social distancing. Psychiatry Research, 304, 114152.
5. Fox, K. R., O'Sullivan, I. M., Wang, S. B., & Hooley, J. M. (2019). Self-criticism impacts emotional responses to pain. Behavior Therapy, 50(2), 410-420.

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 as one of the "10 Best Self Harm Podcasts" and "20 Best Clinical Psychology Podcasts" by Feedspot  and one of the Top 100 Psychology Podcasts by Goodpods. It has also been featured in Audible's "Best Mental Health Podcasts to Defy Stigma and Begin to Heal."

If you or someone you know should be interviewed on the podcast, we want to know! Please fill out this form, and we will be in touch with more details if it’s a good fit.

Approximately 47% of transgender adults and 55.7% of transgender and non-binary youth report having engaged in nonsuicidal self-injury (NSSI) at some point in their life. In this episode, Thomas details his experience of self-harm beginning at age 12, how his self-injury evolved over time, and how it related to his gender dysphoria. He also discusses dissociation as a relatively constant function (i.e., reason) of his self-injury and what happened when he fully transitioned as a man.

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 as one of the "10 Best Self Harm Podcasts" and "20 Best Clinical Psychology Podcasts" by Feedspot  and one of the Top 100 Psychology Podcasts by Goodpods. It has also been featured in Audible's "Best Mental Health Podcasts to Defy Stigma and Begin to Heal."

If you or someone you know should be interviewed on the podcast, we want to know! Please fill out this form, and we will be in touch with more details if it’s a good fit.

In this episode, Dr. Jonas Bjärehed from Lund University in Sweden walks us through his research on nonsuicidal self-injury (NSSI) that he began in 2007 as part of his dissertation project. For example, he shares high prevalence rates of NSSI in Sweden (~40%) and discusses gender differences of NSSI among adolescents in 2007 compared to 2023. He also explains the results of a 10-year longitudinal study in which he surveyed individuals as adolescents about their self-harm and then surveyed the same group as adults 10 years later.

Learn more about Dr. Bjärehed's research here and connect with him on LinkedIn at www.linkedin.com/in/jonasbjarehed. Below are a couple of his publications along with a couple papers on "phubbing."

1. Wångby-Lundh, M., Lundh L.-G., Claréus, B., Bjärehed, J.,& Daukantaitė, D. (2023). Developmental pathways of repetitive nonsuicidal self-injury: predictors in adolescence and psychological outcomes in young adulthood. Child and Adolescent Psychiatry and Mental Health, 17(1), 116.
2. Daukantaitė, D., Lundh, L.-G., Wångby-Lundh, M., Claréus, B., Bjärehed, J., Zhou, Y., & Liljedahl, S. I. (2021). What happens to young adults who have engaged in self-injurious behavior as adolescents? A 10-year follow-up. European Child & Adolescent Psychiatry, 30(3), 475–492.
3. Liu, S., Wu, P., Han, X., Wang, M., Kan, Y., Qin, K., & Lan, J. (2024). Mom, dad, put down your phone and talk to me: how parental phubbing influences problematic internet use among adolescents. BMC Psychology, 12, 125.
4. Lv, H., Ye, W., Chen, S., Zhang, H., & Wang, R. (2022). The effect of mother phubbing on young children’s emotional and behavioral problems: A moderated mediation model of mother–child attachment and parenting stress. International Journal of Environmental Research and Public Health, 19, 16911.

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."

If you or someone you know should be interviewed on the podcast, we want to know! Please fill out this form, and we will be in touch with more details if it’s a good fit.

In this episode, Dr. Amy Lucas from Speek Health in the United Kingdom talks about supporting siblings of those who engage in nonsuicidal self-injury (NSSI). How can parents and caregivers of those who self-injure determine if they should share that information with siblings? What should parents do or say if they learn that the one self-injuring has made their siblings promise not to tell their parents about their self-injury? How might the sibling’s age influence these decisions and conversations, and what if parents are worried that a sibling will pick up the same behavior from their brother or sister who self-injures?

Connect with Dr. Lucas on LinkedIn at www.linkedin.com/in/amyhlucas, and learn more about her work at Speek Health, a resource for parents and caregivers of individuals who self-harm, at www.joinspeek.com. Below is one of the few (and free) research articles about siblings of those who engage in NSSI:

1. Tschan, T., Lüdtke, J., Schmid, M., & In-Albon, T. (2019). Sibling relationships of female adolescents with nonsuicidal self-injury disorder in comparison to a clinical and a nonclinical control group. Child and Adolescent Psychiatry and Mental Health, 13, 15.  https://doi.org/10.1186/s13034-019-0275-2

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."

If you or someone you know should be interviewed on the podcast, we want to know! Please fill out this form, and we will be in touch with more details if it’s a good fit.

In 2013, the 5th edition of the Diagnostic & Statistical Manual of Mental Disorders (DSM-5) was released, and for the first time it included Nonsuicidal Self-Injury Disorder as a Condition for Further Study. It is not an actual diagnosis at this time, but there are  currently six criteria listed (see below, bottom of page). In this episode, Dr. Greg Lengel from Drake University in Iowa walks us through what research says about each of the six criteria, and he discusses the pros and cons of formalizing NSSI Disorder as a diagnosis.

Listen to his interview with Dr. Brooke Ammerman from Season 3 ("How Should Self-Harm Be Defined?") here. Learn more about Dr. Lengel at his faculty profile at Drake University here and follow him on Twitter/X at @DrGregLengel. Below are links to many of the papers discussed in this episode as well as other important papers on NSSI as a disorder in the DSM-5:

1. Shaffer, D., & Jacobson, C. (2009). Proposal to the DSM-V childhood disorder and mood disorder work groups to include non-suicidal self-injury (NSSI) as a DSM-V disorder. American Psychiatric Association, 1-21.
2. Lengel, G. J., Ammerman, B. A., & Washburn, J. J. (2023). NSSI in the DSM-5. In E. E. Lloyd-Richardson, I. Baetens, & J. Whitlock (Vol. Eds.), The Oxford Handbook of Nonsuicidal Self-Injury. New York: Oxford University Press .
3. Lengel, G. J., Ammerman, B. A., & Washburn, J. J. (2022). Clarifying the definition of nonsuicidal self-injury: Clinician and researcher perspectives. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 43, 119-126.
4. Lengel, G. J. & Mullins-Sweatt, S. N. (2013). Nonsuicidal self-injury disorder: Clinician and expert ratings. Psychiatry Research, 210, 940-944.
5. Ammerman, B. A., Jacobucci, R., Kleiman, E. M., Muehlenkamp, J. J., & McCloskey, M. S. (2017). Development and validation of empirically derived frequency criteria for NSSI disorder using exploratory data mining. Psychological Assessment, 29, 221-231.
6. Ammerman, B. A., Jacobucci, R., & McCloskey, M. S. (2019). Reconsidering important outcomes of the nonsuicidal self‐injury disorder diagnostic criterion A. Journal of Clinical Psychology, 75, 1084-1097.
7. Ammerman, B. A., Lengel, G. J, & Washburn J. J. (2021). Consideration of clinician and researcher opinions on the parameters of nonsuicidal self-injury disorder diagnostic criteria. Psychiatry Research, 296, 113642.
8. Ghinea, D., Edinger, A., Parzer, P., Koenig, J., Resch, F., & Kaess, M. (2020). Non-suicidal self-injury disorder as a stand-alone diagnosis in a consecutive help-seeking sample of adolescents. Journal of Affective Disorders, 274, 1122-1125.
9. Muehlenkamp, J. J. (2005). Self-injurious behavior as a separate clinical syndrome. American Journal of Orthopsychiatry, 75, 324–333.
10. Muehlenkamp, J. J., Brausch, A. M., & Washburn, J. J. (2017). How much is enough? Examining frequency criteria for NSSI disorder in adolescent inpatients. Journal of Consulting and Clinical Psychology, 85, 611619.
11. Washburn, J. J., Potthoff, L. M., Juzwin, K. R., & Styer, D. M. (2015). Assessing DSM-5 nonsuicidal self-injury disorder in a clinical sample. Psychological Assessment, 27, 31-41.
12. Zetterqvist, M. (2015). The DSM-5 diagnosis of nonsuicidal self-injury disorder: A review of the empirical literature. Child and Adolescent Psychiatry and Mental Health, 9, 31.

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."

If you or someone you know should be interviewed on the podcast, we want to know! Please fill out this form, and we will be in touch with more details if it’s a good fit.

NONSUICIDAL SELF-INJURY DISORDER (PROPOSED DIAGNOSIS):

A. In the last year, the individual has, on 5 or more days, engaged in intentional self-inflicted damage to the surface of his or her body of a sort likely to induce bleeding, bruising, or pain (e.g., cutting, burning, stabbing, hitting, excessive rubbing), with the expectation that the injury will lead to only minor or moderate physical harm (i.e., there is no suicidal intent). Note: The absence of suicidal intent has either been stated by the individual or can be inferred by the individual's repeated engagement in a behavior that the individual knows, or has learned, is not likely to result in death.

B. The individual engages in the self-injurious behavior with one or more of the following expectations: 

1. To obtain relief from a negative feeling or cognitive state.
2. To resolve an interpersonal difficulty.
3. To induce a positive feeling state.

Note: The desired relief or response is experienced during or shortly after the self-injury, and the individual may display patterns of behavior suggesting a dependence on repeatedly engaging in it.

C. The intentional self-injury is associated with at least one of the following: 

1. Interpersonal difficulties or negative feelings or thoughts, such as depression, anxiety, tension, anger, generalized distress, or self-criticism, occurring in the period immediately prior to the self-injurious act.
2. Prior to engaging in the act, a period of preoccupation with the intended behavior that is difficult to control.
3. Thinking about self-injury that occurs frequently, even when it is not acted upon.

D. The behavior is not socially sanctioned (e.g., body piercing, tattooing, part of a religious or cultural ritual) and is not restricted to picking a scab or nail biting. 

E. The behavior or its consequences cause clinically significant distress or interference in interpersonal, academic, or other important areas of functioning. 

F. The behavior does not occur exclusively during psychotic episodes, delirium, substance intoxication, or substance withdrawal. In individuals with a neurodevelopmental disorder, the behavior is not part of a pattern of repetitive stereotypies. The behavior is not better explained by another mental disorder or medical condition (e.g., psychotic disorder, autism spectrum disorder, intellectual disability, Lesch-Nyhan syndrome, stereotypic movement disorder with self-injury, trichotillomania [hair-pulling disorder], excoriation [skin-picking] disorder).

What exactly constitutes nonsuicidal self-injury (NSSI)? Dr. Brooke Ammerman from the University of Notre Dame and Dr. Greg Lengel from Drake University discuss the complexities of defining NSSI. They also describe the difference between deliberate self-harm and NSSI and share their research about what many clinicians, researchers, and people with lived experience tell them about what they think constitutes NSSI and how we should define it.

Learn more about Dr. Ammerman and her work in the Affect, Suicide, Self-Injury, and Social Triggers (ASSIST) Lab at https://assistlab.nd.edu/.  Listen to her interview from Season 1 ("Disclosures of Self-Injury") here. Learn more about Dr. Lengel at his faculty profile at Drake University here.  Follow them on Twitter/X at @brooke_ammerman and @DrGregLengel. Below are links to some of the papers discussed in this episode:

1. Lengel, G. J., Ammerman, B. A., & Washburn, J. J. (2022). Clarifying the definition of nonsuicidal self-injury: Clinician and researcher perspectives. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 43(2), 119–126.
2. Ammerman, B. A., Lengel, G. J., & Washburn, J. J. (2021). Consideration of clinician and researcher opinions on the parameters of nonsuicidal self-injury disorder diagnostic criteria. Psychiatry Research, 296, 113642.

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."

If you or someone you know should be interviewed on the podcast, we want to know! Please fill out this form, and we will be in touch with more details if it’s a good fit.

The term "self-harm" is an umbrella term, encompassing a broad range of behaviors, under which is included substance abuse and misuse, eating disorders, suicide, and nonsuicidal self-injury (NSSI). In this episode, Dr. Brianna Turner from the University of Victoria in British Columbia, Canada discusses how often self-damaging behaviors, including risky sex, financial and physical recklessness, co-occur with NSSI and where NSSI fits within the umbrella of self-harming behaviors. She also simplifies research using structural models of self-damaging behaviors in a way that helps us understand the co-occurrences of potentially harmful coping behaviors.

Learn more about Dr. Turner and her work in the Risky Behaviour Lab at the University of Victoria here, and access many of her publications at https://uvic.academia.edu/BriannaTurner. Follow Dr. Turner on Twitter/X (@BriannaT_Psyc) and connect with the Risky Behaviour Lab on Instagram (@riskybehaviourlab_uvic) and Twitter/X (@RBL_UVic), especially if you are interested in participating in NSSI research. Below are the structural models of self-damaging behaviors discussed in this episode:

1. St. Germain, S. A., & Hooley, J. M. (2012). Direct and indirect forms of non-suicidal self-injury: Evidence for a distinction. Psychiatry Research, 197(1-2), 78-84.
2. Green, J. D., Hatgis, C., Kearns, J. C., Nock, M. K., & Marx, B. P. (2017). The Direct and Indirect Self-Harm Inventory (DISH): A new measure for assessing high-risk and self-harm behaviors among military veterans. Psychology of Men & Masculinity, 18(3), 208–214.
3. Bresin, K. (2020). Toward a unifying theory of dysregulated behaviors. Clinical Psychology Review, 80, 101885.
4. Kotov, R., Krueger, R. F., Watson, D., Achenbach, T. M., Althoff, R. R., Bagby, R. M., . . . Zimmerman, M. (2017). The Hierarchical Taxonomy of Psychopathology (HiTOP): A dimensional alternative to traditional nosologies. Journal of Abnormal Psychology, 126(4), 454–477.
5. Barlow, D. H., et al. (2017). Unified Protocol for Transdiagnostic Treatment of Emotional Disorders: Therapist Guide (2nd ed.). Oxford University.
6. Ehrenreich-May, J., et al. (2018). Unified Protocols for Transdiagnostic Treatment of Emotional Disorders in Children and Adolescents: Therapist Guide. Oxford University.

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."

If you or someone you know should be interviewed on the podcast, we want to know! Please fill out this form, and we will be in touch with more details if it’s a good fit.