Nonsuicidal self-injury (NSSI) amongst LGBT+ young adults: the role of psychological distress
Nonsuicidal self-injury (NSSI) amongst LGBT+ young adults: the role of psychological distress
Rates of nonsuicidal self-injury (NSSI) among lesbian, gay, bisexual, transgender, and other sexual or gender minority (LGBTQ+) young adults are high. Research is needed to elucidate potential mechanisms underpinning this elevated risk. In 2021, young adults in the United Kingdom and United States (n = 1475, aged 18-30) reported their NSSI history and psychological distress (Kessler Psychological Distress Scale) in an online survey. Participants were cisgender heterosexual (CH; n = 1100), cisgender sexual minority (CSM; lesbian, gay, bisexual, asexual) (n = 272), or gender minority (GM; transgender, non-binary) (n = 103). Rates of lifetime NSSI and psychological distress were significantly higher for GM participants than CSM participants (NSSI: OR = 2.68, p < 0.001 | Distress: Coef. = 5.22, p < 0.001), and significantly higher for CSM participants than CH participants (NSSI: OR = 3.39, p < 0.001, | Distress: Coef. = 3.08, p < 0.001). Cross-sectional mediational models (i.e., associational variable analysis) revealed that psychological distress partially accounted for the relationship between identity group and lifetime NSSI in a stepwise fashion, contributing to higher NSSI in the GM group compared to the CSM group, and higher NSSI in the CSM group compared to the CH group. Findings suggest GM young people are at elevated risk of NSSI and psychological distress relative to both CSM and CH peers, and disparities in distress levels may be a key driver of disparities in NSSI rates. While longitudinal mediation models are needed to verify this mechanism, findings support interventions aimed at reducing psychological distress and NSSI among LGBTQ+ young people.
Ramsay-Patel, Tara
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Chamberlain, Samuel R.
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Grant, Jon E.
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Lochner, Christine
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Neufeld, Sharon A.S.
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Ford, Tamsin J.
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Lutz, Nina M.
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7 January 2026
Ramsay-Patel, Tara
bdcf266c-4fb3-4ab9-8382-815f2ca3a7dd
Chamberlain, Samuel R.
8a0e09e6-f51f-4039-9287-88debe8d8b6f
Grant, Jon E.
07372bd5-8a0d-42b4-b41b-e376c652acf3
Lochner, Christine
554eb8d3-d922-489a-ade0-4d92e60196a8
Neufeld, Sharon A.S.
da9682dc-557b-4596-93b1-ca0b0362627d
Ford, Tamsin J.
2c091f47-db6f-40ad-84e0-e40c72a324a2
Lutz, Nina M.
9fbcb9d4-266a-4da1-a38b-02361584a264
Ramsay-Patel, Tara, Chamberlain, Samuel R., Grant, Jon E., Lochner, Christine, Neufeld, Sharon A.S., Wilkinson, Paul O., Ford, Tamsin J. and Lutz, Nina M.
(2026)
Nonsuicidal self-injury (NSSI) amongst LGBT+ young adults: the role of psychological distress.
Journal of Affective Disorders, 399, [121027].
(doi:10.1016/j.jad.2025.121027).
Abstract
Rates of nonsuicidal self-injury (NSSI) among lesbian, gay, bisexual, transgender, and other sexual or gender minority (LGBTQ+) young adults are high. Research is needed to elucidate potential mechanisms underpinning this elevated risk. In 2021, young adults in the United Kingdom and United States (n = 1475, aged 18-30) reported their NSSI history and psychological distress (Kessler Psychological Distress Scale) in an online survey. Participants were cisgender heterosexual (CH; n = 1100), cisgender sexual minority (CSM; lesbian, gay, bisexual, asexual) (n = 272), or gender minority (GM; transgender, non-binary) (n = 103). Rates of lifetime NSSI and psychological distress were significantly higher for GM participants than CSM participants (NSSI: OR = 2.68, p < 0.001 | Distress: Coef. = 5.22, p < 0.001), and significantly higher for CSM participants than CH participants (NSSI: OR = 3.39, p < 0.001, | Distress: Coef. = 3.08, p < 0.001). Cross-sectional mediational models (i.e., associational variable analysis) revealed that psychological distress partially accounted for the relationship between identity group and lifetime NSSI in a stepwise fashion, contributing to higher NSSI in the GM group compared to the CSM group, and higher NSSI in the CSM group compared to the CH group. Findings suggest GM young people are at elevated risk of NSSI and psychological distress relative to both CSM and CH peers, and disparities in distress levels may be a key driver of disparities in NSSI rates. While longitudinal mediation models are needed to verify this mechanism, findings support interventions aimed at reducing psychological distress and NSSI among LGBTQ+ young people.
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Accepted/In Press date: 20 December 2025
e-pub ahead of print date: 22 December 2025
Published date: 7 January 2026
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Local EPrints ID: 509875
URI: http://eprints.soton.ac.uk/id/eprint/509875
ISSN: 0165-0327
PURE UUID: 5ccd9698-33ce-4aa8-b91b-53a04b951d0c
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Date deposited: 09 Mar 2026 17:59
Last modified: 10 Mar 2026 03:01
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Author:
Tara Ramsay-Patel
Author:
Samuel R. Chamberlain
Author:
Jon E. Grant
Author:
Christine Lochner
Author:
Sharon A.S. Neufeld
Author:
Paul O. Wilkinson
Author:
Tamsin J. Ford
Author:
Nina M. Lutz
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