Background and Purpose: Non-suicidal self-injury (NSSI) is a global concern in adolescent mental health. Rural boarding middle school students, as a unique and vulnerable population, remain understudied regarding the potential heterogeneity and longitudinal trajectories of NSSI. This study aimed to identify latent classes of NSSI among this group, examine their transition patterns over time, and evaluate the effectiveness of an emotion management group intervention. Methods: Study 1 cross-sectionally surveyed 927 adolescents; we split samples into non-NSSI and NSSI subgroups and ran latent profile analysis (LPA) only among participants with NSSI ( n =285). Study 2 conducted a 6-month follow-up of 550 participants and applied latent transition analysis (LTA) to examine class shifts and predictive factors. Study 3 was a randomized controlled trial in which 30 students from the High-NSSI received an 8-week emotion-management group intervention. Intervention effects were evaluated using repeated-measures ANCOVA with demographic covariates. Results: Within the NSSI subgroup ( n = 285), two classes were identified: a High-NSSI class ( n = 21, 7.4%) and a Low-NSSI class ( n = 264, 92.6%). Poor sleep quality and bullying victimization independently predicted High-NSSI membership. Longitudinal analysis revealed high stability in the Low-NSSI class (91%) and high fluidity in the High-NSSI class (83% transitioning to low-risk). The emotion-management intervention significantly reduced both NSSI frequency and negative affect. Discussion: These findings demonstrate that clinically meaningful NSSI subtypes exist among rural boarding adolescents and that sleep quality and bullying are key modifiable risk factors. The results support a stepped-care approach in school settings, where the High-NSSI class requires intensive intervention and the Low-NSSI class may benefit from less intensive, universal supports. The emotion-management group intervention is an effective school-based program for the most severe NSSI subtype. Keywords: non-suicidal self-injury, latent profile analysis, latent transition analysis, emotion management, group intervention
People with longstanding eating disorders (EDs) are often conceptualised as 'treatment-resistant' when they are not currently benefitting from established recovery-focused treatments. This may encourage a shift from recovery-focused treatments to care approaches that for many individuals do not foster recovery. As a result, the present article offers an explicitly hope-holding and recovery-fostering care (RFC) approach that neither demands recovery nor abandons the possibility of recovery, whatever recovery may mean to the individual being cared for. RFC is guided by the following principles, which were developed in response to limitations identified in current care approaches for people with longstanding EDs: [1] Holding hope for meaningful recovery and enabling opportunities for it; [2] Building therapeutic alliances; [3] Formulation-based and epistemically just care; [4] Unconditional safeguarding; and [5] Supporting caregivers. RFC is not a scientific model with the level of specification often demanded by academic frameworks. Rather, it is a creative, flexible, and person-led approach to care that prioritises people with lived experience over strict adherence to manuals, and values humanity-based care alongside evidence-based care.
افراد مبتلا به اختلالات خوردن (EDs) مزمن اغلب زمانی که از درمان‌های مبتنی بر بهبودی مرسوم بهره‌مند نمی‌شوند، به عنوان «مقاوم به درمان» مفهوم‌سازی می‌شوند. این امر ممکن است موجب تغییر رویکرد از درمان‌های بازیابی‌محور به رویکردهای مراقبتی شود که برای بسیاری از افراد، بهبودی را تقویت نمی‌کنند. در نتیجه، مقاله حاضر رویکردی صریحاً امیدمحور و بازیابی‌پرور (RFC) ارائه می‌دهد که نه بهبودی را مطالبه می‌کند و نه امکان بهبودی را ـ صرف‌نظر از معنایی که بهبودی برای فرد تحت مراقبت دارد ـ کنار می‌گذارد. RFC بر اساس اصول زیر هدایت می‌شود که در پاسخ به محدودیت‌های شناسایی‌شده در رویکردهای مراقبتی کنونی برای افراد با EDs مزمن توسعه یافته‌اند: [۱] حفظ امید به بهبودی معنادار و فراهم‌سازی فرصت‌هایی برای آن؛ [۲] ایجاد اتحاد درمانی؛ [۳] مراقبت مبتنی بر فرمول‌بندی و عدالت معرفتی؛ [۴] حمایت بی‌قید و شرط؛ و [۵] حمایت از مراقبان. RFC یک مدل علمی با سطح مشخص‌سازی مورد انتظار در چارچوب‌های دانشگاهی نیست، بلکه رویکردی خلاقانه، انعطاف‌پذیر و فردمحور به مراقبت است که تجربه زیسته افراد را بر پایبندی سخت‌گیرانه به دستورالعمل‌ها مقدم می‌داند و مراقبت مبتنی بر انسانیت را در کنار مراقبت مبتنی بر شواهد ارزشمند می‌شمارد.
