Understanding Tolerance Towards Individuals with Non-suicidal Self-Injury: Predictors and Changes Over Six Months in a University Student Sample

Purpose Non-suicidal self-injury (NSSI) is increasingly prevalent yet remains heavily stigmatised. While research focuses on healthcare professionals’ tolerant attitudes, public attitudes – especially among friends and family – are underexplored. However, these groups are often the first to receive NSSI disclosures, making their tolerant attitudes towards individuals with NSSI crucial for encouraging help-seeking. This study investigates predictors of tolerance towards individuals with NSSI and examines changes over six months, specifically in those newly aware of friends or family with NSSI. Methods A survey of 1,430 Swedish university students was conducted, and 721 participated in the six-month follow-up. A correlation analysis examined relationships between four variables related to tolerance towards those with NSSI, and a multiple regression analysis assessed their individual and combined predictive strength. Changes over time were measured using a paired samples t-test. Results Gender, personal experience with NSSI, personal experience with mental health problems, and awareness of NSSI among friends or family significantly predicted more tolerant attitudes, together accounting for 16% of the variance in tolerance scores. Personal experience with NSSI was the most robust predictor. Tolerance scores increased significantly in participants who had become aware of friends or family with NSSI at follow-up (n = 67). Conclusions The study identified key predictors of tolerance towards individuals with NSSI and the novel finding that awareness of NSSI among friends and family is associated with greater tolerant attitudes. We propose a model to explain this interaction and discuss promoting awareness of NSSI within personal networks to foster tolerance, thereby informing stigma-reducing interventions.