To celebrate the 10th anniversary of BJPsych Open, this Editorial highlights papers published in BJPsych Open over the past decade that have focused on university student mental health. Common mental disorders are increasing in young people and those going on to higher education make up an important and sizeable sector of this population. At the same time, success in university studies is a major determinant of individual and societal health and prosperity. As a field of inquiry, university student mental health research gained momentum through the COVID-19 pandemic and associated campus closures, pivot to remote learning and social restrictions. Although research describing student well-being and mental health burden align globally, not enough is known about determinants that inform sustainable and scalable prevention and early intervention. Furthermore, research evidence should inform university policies, practices and benchmarks to ensure responsive and effective student well-being and mental health support that underpins academic and life success.

Background Non-suicidal self-injury (NSSI) is a prevalent behavioural health concern during adolescence and has been consistently linked to emotionally invalidating interpersonal environments. Aims This study tested whether distress tolerance and negative urgency prospectively explained the link between invalidating environments and adolescent NSSI. Method The study used a 2-wave longitudinal design with a 6-month interval; 300 Iranian adolescents (70% female, aged 13–17 years) participated. Results Cross-lagged panel modelling showed that invalidating environments at wave 1 predicted higher NSSI at wave 2, when we controlled for baseline NSSI, and were associated with increases in negative urgency. Although both negative urgency and distress tolerance were related to later NSSI, only negative urgency significantly mediated this relationship; distress tolerance and the hypothesised serial pathway did not show significant associations. Sensitivity analyses indicated developmental differences across age groups. Conclusions The findings highlight impulsive response under distress as a central mechanism linking environmental invalidation to adolescent NSSI and identify negative urgency as a key intervention target.

Individuals with chronic pain have increased risk of suicide, however, few receive suicide prevention interventions. Problem-solving therapy is an evidence-based treatment for chronic pain that seeks to improve problem-solving ability, an executive function associated with suicide risk and related outcomes. The goal of this pilot randomized controlled trial was to estimate if problem-solving therapy improves problem-solving ability and other outcomes for Veterans with chronic pain and moderate suicide risk (n = 44). Veterans were randomized to receive 12-weeks of video delivered problem-solving therapy or supportive psychotherapy. At post-treatment, problem-solving therapy was estimated to result in a greater increase in problem-solving ability (Cohen's d = 0.33, small effect) and a greater reduction in perceived burdensomeness (Cohen's d = 0.60, large effect), compared to supportive psychotherapy. These between-group differences were estimated to be maintained for problem-solving ability (Cohen's d = 0.94, large effect) and perceived burdensomeness (Cohen's d = 0.45, medium effect) at 6-month follow-up. It was estimated that problem-solving therapy did not have a differential effect on thwarted belongingness compared to supportive psychotherapy. In exploratory analysis, problem-solving therapy was estimated to reduce suicide ideation intensity, suicide ideation frequency, and suicide coping at post-treatment, however, in between-group analysis, only suicide ideation frequency was estimated to be reduced as compared to supportive psychotherapy. Results for the exploratory pain outcomes were mixed. This study suggests problem-solving therapy may improve problem-solving ability and reduce feelings of perceived burdensomeness. A fully powered clinical trial is needed to confirm these results and to determine if problem-solving therapy reduces suicide risk and improves pain outcomes.

INTRODUCTION:Non-suicidal self-injury (NSSI) is commonly understood as a behavior that serves to regulate affect, yet less is known about how specific emotional states relate to physical sensations during NSSI. This study examined whether high-arousal negative emotions (HANEs) and low-arousal negative emotions (LANEs) before NSSI were differentially associated with physical pain and numbness during NSSI episodes. METHODS:Forty adolescents and emerging adults with recent NSSI completed a 14-day ecological momentary assessment protocol. Across 143 NSSI episodes, participants reported negative emotions immediately before NSSI and physical pain and numbness during NSSI. Linear mixed-effects models separated within-person emotion fluctuations from between-person differences. RESULTS:At the between-person level, individuals who reported higher average HANEs before NSSI reported greater pain and lower numbness during NSSI, whereas individuals who reported higher average LANEs reported lower pain and greater numbness. At the within-person level, episodes preceded by higher-than-usual LANEs were associated with greater pain, but no within-person emotion predictors were significantly associated with numbness. CONCLUSION:Findings suggest that high- and low-arousal negative emotions may correspond to distinct somatic experiences during NSSI, highlighting the importance of assessing both emotional antecedents and physical sensations during self-injury.

The aim of the study was to validate the 30-item version of the Multidimensional Experiential Avoidance Questionnaire (MEAQ-30) in a sample of individuals who smoke combustible cigarettes and to examine the relationship between nicotine dependence, cigarette smoking, and experiential avoidance. Confirmatory factor analysis (CFA) was used to verify the structure of the MEAQ-30 and to test measurement invariance in a general population sample (n = 1040) and a sample of individuals who smoke combustible cigarettes (n = 550). Correlation and regression analyses were performed in a sample of individuals who smoke combustible cigarettes (n = 242) to evaluate the stability, dependability, convergent validity, discriminant validity, predictive validity and incremental predictive validity of the measure. The MEAQ-30 demonstrated adequate model fit and met criteria for measurement invariance. It exhibited good internal consistency, good stability, good discriminant validity, weak incremental predictive validity, and lower than expected levels of dependability. Based on our findings, the MEAQ-30 appears to be a valid measure of experiential avoidance in individuals who smoke combustible cigarettes.

INTRODUCTION:Basic psychological needs (BPN) include feelings of autonomy, competence, and relatedness. Both unsatisfied BPN and frustrated BPN have been linked to suicidal thoughts. However, the relationship between real-time BPN and suicidal thoughts remains unknown. This study utilized ecological momentary assessment (EMA) to explore how BPN relates to subsequent suicidal thoughts. METHODS:Undergraduate students (n = 460) completed baseline self-report measures of BPN frustration and satisfaction, then 6 daily EMA surveys with items assessing suicidal thoughts, frustrated BPN, and satisfied BPN. RESULTS:Four hundred and sixty students completed a total of 57,972 assessments during the study period. Multi-level regression models indicated that within-person frustrated competence (b = 0.02, 95% CI = 0.01-0.02, p < 0.001), frustrated relatedness (b = 0.02, 95% CI = 0.01-0.03, p < 0.001), satisfied autonomy (b = -0.01, 95% CI = -0.02 to -0.01, p < 0.001), BPN satisfied competence (b = -0.01, 95% CI = -0.01 to -0.00, p < 0.001), and BPN satisfied relatedness (b = -0.01, 95% CI = -0.01 to -0.00, p < 0.001) were significantly related to suicidal thoughts at the following timepoint. CONCLUSION:Real-time BPN (2/3 frustration subscales, all satisfaction subscales) are significantly associated with subsequent suicidal thoughts over short time periods. Further research is warranted to determine if these findings hold true among clinical populations and whether BPN are relevant treatment targets for individuals with suicidal thoughts.

Sustaining physical activity is essential for long-term health benefits, yet most theory-driven interventions often show only short-lived effects. The reliance on effortful self-control may be critical for promoting behavioral maintenance and explaining why autonomous motivation and habit support long-term engagement in physical activity. This investigation was cross-sectional and examined whether effortful self-control is associated with physical activity behavior (Study 1) and whether it mediates the associations between autonomous motivation and habit with physical activity (Study 2). We also tested whether temptations mediate the associations between autonomous motivation and habit with effortful self-control. In Study 1, 897 adults completed a single-item measure of effortful self-control and self-reported moderate-to-vigorous physical activity (MVPA). In Study 2, 603 adults completed multi-item measures of effortful self-control, autonomous motivation, habit, and temptations, along with self-reported MVPA. In Study 1, higher effortful self-control was associated with lower MVPA, rs = -.56, 95% CI [-.61, -.51]. This association was replicated in Study 2, rs = -.51, 95% CI [-.58, -.44]. Mediation analyses showed that the relationships between autonomous motivation and habit with MVPA have a significant indirect effect through effortful self-control. Additionally, temptations partially mediated the associations between both motivational constructs and effortful self-control. These findings provide preliminary support for the role of effortful self-control as a psychological process linking autonomous motivation and habit with physical activity behavior. Reducing the amount of effortful self-control for physical activity, by strengthening motivation for physical activity and weakening temptations, may be a promising strategy to support sustained engagement in physical activity.

The present study examined the relationships between character virtues, social-emotional learning (SEL) skills, purpose, student mental health reports, and academic grades within the framework of a social-emotional learning and character development (SECD) approach. Path analyses were conducted using data collected from a SECD intervention in an urban mid-Atlantic school district. Participants consisted of 389 students from three participating middle schools. Analysis of cross-sectional data extracted from a single time point within the broader longitudinal study revealed significant relationships between character virtues and mental well-being, as well as between social-emotional learning (SEL) competencies and academic performance. A path analysis model demonstrated satisfactory fit, with character virtues and SEL skills as predictors, purpose as a "superordinate" virtue, and mental health and academic grades as outcome variables. These findings illuminate the potential pathways through which SECD components relate to academic grades and mental health, highlighting the importance of positive purpose within the SECD approach. Implications for further research and program development are discussed.Impact StatementOur study fills a critical research gap by examining the impact of integrating social-emotional learning and character development (SECD) pedagogy on two key student outcomes: academic grades and mental health. Using data from a district-wide SECD curriculum implemented in multiple schools, we investigate the relationship between social-emotional skills, character virtues, and positive purpose, offering valuable empirical evidence to support this pedagogical approach. This research not only sheds light on the SECD-student outcomes link but also provides recommendations for future evidence-based SECD programs and policies, informing further research and advancing the field.

Weight stigma is associated with a range of adverse health outcomes (e.g., disordered eating). Women, sexual minorities, and higher weight individuals are at increased risk of experiencing weight stigma, but little is known about its influence on emotions, cognitions, and behaviors in real-world contexts, particularly among multiply marginalized individuals such as higher weight sexual minority women (SMW). The 4 present study examined how lifetime and daily weight stigma experiences relate to momentary weight/shape concerns, size-based avoidance, and negative affect in this population. Fifty-five higher weight (body mass index [BMI] > 25 kg/m(2)) SMW completed a baseline survey and a 5-day Ecological Momentary Assessment protocol (five prompts per day) assessing weight stigma events, weight/shape concerns, size-based avoidance, and negative affect. Greater frequency of lifetime weight stigma experiences was significantly associated with greater odds of engaging in size-based avoidance at least once during the 5-day period. Reporting momentary weight stigma events at any given prompt was significantly associated with greater odds of reporting momentary weight/shape concerns, but not negative affect, at the same prompt. Greater frequency of lifetime weight stigma experiences was also marginally associated with greater odds of reporting momentary weight/shape concerns at any given prompt. Both lifetime and momentary experiences of weight stigma are linked to negative consequences (e.g., weight/shape concerns, size-based avoidance) among higher weight SMW. Although structural interventions are needed to reduce weight stigma at its source, individual interventions can help higher weight SMW to cope with weight stigma in ways that may reduce its negative consequences.

Sexual minoritized individuals engage in non-suicidal self-injury (NSSI) at higher rates than their heterosexual peers. Disclosing one's sexual minoritized identity can put one at risk for experiencing discrimination, which is linked to greater engagement in NSSI. However, discrimination has yet to be tested as a mechanism linking sexual identity disclosure to NSSI. Understanding how sexual identity disclosure impacts NSSI has the potential to inform interventions to reduce sexual orientation disparities in NSSI. To address this gap, the current study examined sexual orientation-based discrimination as a mediator of the longitudinal association between sexual identity disclosure and NSSI among 792 sexual minoritized young adults. Higher levels of disclosure at baseline were associated with greater likelihood of NSSI at two-month follow-up via greater discrimination at one-month follow-up, even after controlling for baseline levels of depression and demographic characteristics. The indirect effect became non-significant after controlling for previous levels of discrimination and NSSI. Findings provide partial support for the hypothesis that identity disclosure may precede exposure to discrimination and, in turn, engagement in NSSI. However, identity disclosure does not appear to predict acute increases in discrimination. Future research is encouraged to examine these prospective associations with longer intervals between assessments, as the indirect effect of identity disclosure on NSSI via discrimination may continue to accumulate over time. Findings highlight the need to reduce discrimination following sexual identity disclosure through the implementation of equitable and affirmative practices in school, healthcare, and other settings to improve the well-being of sexual minoritized young adults.