We examined the effectiveness of a student-initiated and guidebook-supported high school club program aimed at reducing mental-illness stigma via humanization—largely through contact—hypothesizing that stigma measures would improve across a school year and as a function of the timing of club initiation. Forty-two Northern California high schools (731 students) participated from 2015–2017. Stigma measures (Knowledge, Attitudes, Social Distance, and Positive Actions) were collected in the fall (Time 1 [T1]), winter (Time 2 [T2]), and spring (Time 3 [T3]). Schools were matched on student-body demographics, then randomized into either an immediate (23 clubs at T1) or delayed (19 clubs at T2) start. The sample was diverse regarding race/ethnicity and class standing. Across both randomized groups, measures of stigma significantly improved from beginning to end of the school year; effect sizes ranged from small to medium (d = .22–.56). The hypothesized pattern of change was partially supported: the immediate group showed significant increases from T1–T2 for Attitudes and Positive Actions; the delayed group showed a stronger increase from T2-T3 for Knowledge. Ceiling effects at baseline were salient. Baseline stigma measures were in a more positive direction than in a prior, quasi-experimental study of the same club model 5 years earlier, with effect sizes ranging from d = .32 to .88, suggesting secular trends regarding lower stigma levels. Findings support the importance of school-based interventions for reducing mental-illness stigma, particularly via student-initiated, contact-based efforts. It is possible that youth mental-illness stigma has decreased in recent years, with more sensitive measures needed in future trials.

Background: Childhood sexual abuse (CSA) is a well-established risk factor for non-suicidal self-injury (NSSI) and suicide attempts (SA); still few studies have examined predictors of individual differences in NSSI/SA amongst CSA survivors. Objective: To examine predictors of NSSI and SA among adult CSA-survivors. Methods: In a sample of 516, primarily female adult CSA-survivors recruited from support centres for sexual abuse survivors in Norway, we examined the role of abuse/perpetrator characteristics, and the degree/severity of exposure to other types of childhood maltreatment (cumulative childhood maltreatment; CCM), as predictors of lifetime NSSI and SA. In a subsample of 138 individuals responding to follow-up waves two-and four years later, these same distal factors, as well as previous NSSI and proximal factors in the form of symptoms of mental health disorders (posttraumatic stress, anxiety, depression, sleep disturbances, and eating disorders), relational problems, and perceived social support, were examined as predictors of persistent NSSI. Finally, those attempting new SA during the follow-up period were compared to those who did not on these variables. Results: Higher CCM scores and having had an unknown perpetrator positively predicted lifetime NSSI scores. Higher CCM scores, violent abuse, and having had an unknown perpetrator predicted lifetime SA. Higher CCM scores, previous NSSI, having had a known perpetrator, as well as higher depression-, anxiety-and eating disorder scores, positively predicted persistent NSSI during the four-year follow-up period. Compared to those with no new SA, those reporting new SA during the follow-up period had higher CCM, lifetime NSSI, mental health symptoms and relational problem scores, lower perceived social support scores, and were more likely to have done a past SA and to have experienced abuse involving physical violence. Conclusions: A broad range of both distal and proximal factors should be assessed as potential predictors of NSSI and SA among adult CSA-survivors. Predictores y correlatos de autolesiones no suicidas e intentos suicidas en la vida y persistentes en adultos sobrevivientes de abuso sexual infantil Antecedentes: El abuso sexual infantil (CSA por sus siglas en inglés) es un factor de riesgo bien establecido para las autolesiones no suicidas (NSSI por sus siglas en inglés) y los intentos suicidas (SA por sus siglas en inglés); aun así, pocos estudios han examinado los predictores de las diferencias individuales en NSSI/SA en los sobrevivientes de CSA. Objetivo: Examinar los predictores de NSSI y SA entre adultos sobrevivientes de CSA. Métodos: En una muestra de 516, primariamente mujeres adultas sobrevivientes de CSA reclutadas de centros de apoyo para sobrevivientes de abuso sexual en Noruega, examinamos el rol de las características del abuso/perpetrador y el grado/severidad de la exposición a otros tipos de maltrato infantil (maltrato acumulativo infantil; CCM por sus siglas en ingles), como predictores de NSSI y SA en la vida. En una submuest...