{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T16:59:31Z","timestamp":1788454771658,"version":"build-2803163510"},"reference-count":59,"publisher":"Royal College of Psychiatrists","issue":"3","license":[{"start":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T00:00:00Z","timestamp":1716249600000},"content-version":"unspecified","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2024,5]]},"abstract":"<jats:sec id=\"S2056472424007087_sec_a1\"><jats:title>Background<\/jats:title><jats:p>Non-suicidal self-injury (NSSI) is prevalent behaviour among adolescents. Although there are different etiological models of NSSI, there is a general lack of evidence-based, comprehensive and transdiagnostic models of NSSI in adolescents.<\/jats:p><\/jats:sec><jats:sec id=\"S2056472424007087_sec_a2\"><jats:title>Aims<\/jats:title><jats:p>The aim of this study was to investigate a model of transdiagnostic factors of NSSI in adolescents, testing a serial mediation model of the relationship between early maladaptive schemas (EMS), distress tolerance and NSSI through experiential avoidance and rumination.<\/jats:p><\/jats:sec><jats:sec id=\"S2056472424007087_sec_a3\" sec-type=\"methods\"><jats:title>Method<\/jats:title><jats:p>A community sample was identified of 1014 adolescents aged 13\u201317, of whom 425 had a history of NSSI. A serial mediation path analytic method was utilised to examine the relationships between NSSI and its associated functions as criterion variables, EMS and distress tolerance as predictors, experiential avoidance as the first mediator and rumination as the second mediator.<\/jats:p><\/jats:sec><jats:sec id=\"S2056472424007087_sec_a4\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>The path analytic model fit indices were good (X<jats:sup>2<\/jats:sup>\/d.f. = 2.25, goodness of fit index = 0.98, normed fit index = 0.97, comparative fit index = 0.98, root mean square error of approximation = 0.054, standardised root mean squared residual = 0.028). Rumination significantly mediated the relationship between schemas of \u2018vulnerability to harm\u2019, \u2018emotional deprivation\u2019, \u2018social isolation\u2019, \u2018insufficient self-control\u2019, and NSSI frequency and intrapersonal functions. In serial fashion, experiential avoidance mediated the role of rumination in the relationship between social isolation, and insufficient self-control and NSSI frequency and intrapersonal functions. All indirect effects were significant.<\/jats:p><\/jats:sec><jats:sec id=\"S2056472424007087_sec_a5\" sec-type=\"conclusions\"><jats:title>Conclusions<\/jats:title><jats:p>Key indirect effects were found linking maladaptive schemas and distress tolerance to NSSI frequency, and NSSI intrapersonal functions via experiential avoidance and rumination. Thus, it is important to address these transdiagnostic factors with particular emphasis on the sequential mediating role of experiential avoidance and rumination in conceptualisation and therapeutic interventions for NSSI.<\/jats:p><\/jats:sec>","DOI":"10.1192\/bjo.2024.708","type":"journal-article","created":{"date-parts":[[2024,5,21]],"date-time":"2024-05-21T08:27:16Z","timestamp":1716280036000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":8,"title":["Early maladaptive schemas, distress tolerance and self-injury in Iranian adolescents: serial mediation model of transdiagnostic factors"],"prefix":"10.1192","volume":"10","author":[{"given":"Maryam","family":"Babaeifard","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1576-5711","authenticated-orcid":false,"given":"Mehdi","family":"Akbari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shahram","family":"Mohammadkhani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jafar","family":"Hasani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Shahbazian","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8956-0236","authenticated-orcid":false,"given":"Edward A.","family":"Selby","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2024,5,21]]},"reference":[{"key":"S2056472424007087_ref16","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.21868"},{"key":"S2056472424007087_ref57","doi-asserted-by":"publisher","DOI":"10.1111\/j.1742-9536.2012.00055.x"},{"key":"S2056472424007087_ref58","doi-asserted-by":"publisher","DOI":"10.1080\/13811118.2011.540467"},{"key":"S2056472424007087_ref7","doi-asserted-by":"publisher","DOI":"10.1177\/070674371405901102"},{"key":"S2056472424007087_ref46","doi-asserted-by":"publisher","DOI":"10.1002\/1097-4679(199511)51:6<768::AID-JCLP2270510607>3.0.CO;2-1"},{"key":"S2056472424007087_ref35","doi-asserted-by":"publisher","DOI":"10.1007\/s10608-005-9630-0"},{"key":"S2056472424007087_ref26","volume-title":"Adolescents who Self-Harm: The Role of Early Maladaptive Schemas","author":"Walker","year":"2014"},{"key":"S2056472424007087_ref54","first-page":"59","article-title":"Non-suicidal self-injury in delinquent adolescents and adolescents with history of childhood maltreatment: motivation and suicide probability","volume":"6","author":"Khanipour","year":"2016","journal-title":"Psychol Except Individ"},{"key":"S2056472424007087_ref14","doi-asserted-by":"publisher","DOI":"10.1016\/j.brat.2005.03.005"},{"key":"S2056472424007087_ref19","doi-asserted-by":"publisher","DOI":"10.1111\/bjc.12350"},{"key":"S2056472424007087_ref56","doi-asserted-by":"publisher","DOI":"10.1080\/00754179708254531"},{"key":"S2056472424007087_ref55","doi-asserted-by":"publisher","DOI":"10.1002\/cpp.629"},{"key":"S2056472424007087_ref1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.clinpsy.121208.131258"},{"key":"S2056472424007087_ref20","doi-asserted-by":"publisher","DOI":"10.1080\/02699931.2016.1241219"},{"key":"S2056472424007087_ref32","volume-title":"Nonsuicidal and Suicidal Intent among Children and Youth with Histories of Trauma: The Role of Protective Factors","author":"West","year":"2019"},{"key":"S2056472424007087_ref43","unstructured":"43 Mansouri, A , Bakhshipour, RA , Mahmoud, AM , Farnam, A , Fakhari, A . 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