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Tie B, Tang C, Zhu C, He J. Body dissatisfaction and non-suicidal self-injury among Chinese young adults: a moderated mediation analysis. Eat Weight Disord 2022; 27:2051-2062. [PMID: 35040078 DOI: 10.1007/s40519-021-01340-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Accepted: 11/22/2021] [Indexed: 02/06/2023] Open
Abstract
OBJECTIVE Extensive evidence from Western societies supports the role for body dissatisfaction in the etiological models of non-suicidal self-injury (NSSI). However, research of the underlying mechanisms of this relationship has been limited, especially in China. Therefore, the aim of this study was to examine the association between body dissatisfaction and NSSI among college students in China. Possible mediating roles for psychological distress and disordered eating, as well as a moderating role for self-compassion, were also examined. METHODS College students (n = 655, Mage = 20.32 years, SD = 1.02) were recruited from Henan province, China. Each participant completed questionnaires regarding body dissatisfaction, psychological distress, disordered eating, and self-compassion. RESULTS A close to medium positive relationship between body dissatisfaction and NSSI was revealed with r = 0.24 (p < .001). The relationship was found to be fully mediated by psychological distress and disordered eating. The mediation role for disordered eating was found to be further moderated by self-compassion, suggesting that self-compassion acted as a buffer against the relationship between disordered eating and NSSI. CONCLUSION These findings indicate that body dissatisfaction, psychological distress, disordered eating, and self-compassion may play important roles in Chinese young adults' NSSI. Researchers and practitioners need to pay closer attention to the underlying mechanisms of how body dissatisfaction links to NSSI to deepen the understanding of their linkage as well as to provide appropriate interventions. LEVEL OF EVIDENCE Level V, cross-sectional descriptive study.
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Affiliation(s)
- Bijie Tie
- School of Education, Zhengzhou University, Zhengzhou, Henan, China
| | - Chanyuan Tang
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, 518172, Guangdong, China
| | - Chengquan Zhu
- School of Education, Zhengzhou University, Zhengzhou, Henan, China
| | - Jinbo He
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, 518172, Guangdong, China.
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152
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Dixon-Gordon KL, Turner BJ, Haliczer LA, Gratz KL, Tull MT, Chapman AL. Self-injury motives: A person-centered examination. Suicide Life Threat Behav 2022; 52:812-827. [PMID: 35362639 DOI: 10.1111/sltb.12865] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 01/04/2022] [Accepted: 02/19/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION People report multiple motives for nonsuicidal self-injury (NSSI), but few studies have examined how these motives relate to one another. This study identified person-centered classes of NSSI motives, their NSSI and psychopathological correlates, and their utility in predicting future NSSI across two samples. METHODS Participants were adolescents and young adults (aged 15-35) with recent NSSI recruited from online forums (n = 155, Sample 1) or the community (n = 127, Sample 2). Participants completed measures of NSSI, emotion regulation difficulties, borderline personality disorder (BPD), depression, and reported on their NSSI over 12 months. RESULTS Latent profile analyses yielded five classes in each sample: low interpersonal, self-punishment/interpersonal, moderate intra/interpersonal, high intra/interpersonal, and mainly interpersonal motives. Classes were not associated with lifetime NSSI characteristics, but highly motivated participants reported more severe depression and BPD symptoms, and greater emotion dysregulation than low-motivated participants. Those in the mainly interpersonal (Sample 1) and self-punishment/interpersonal (Sample 2) motives classes reported greater NSSI frequency during follow-up. CONCLUSIONS This study identified five classes of NSSI motives. Participants who report multiple motives for NSSI may be more clinically severe, whereas those who report strong desires to communicate with others or punish themselves may be at the highest risk for more frequent NSSI over time.
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Affiliation(s)
- Katherine L Dixon-Gordon
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | - Brianna J Turner
- Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
| | - Lauren A Haliczer
- Department of Psychological and Brain Sciences, University of Massachusetts Amherst, Amherst, Massachusetts, USA
| | - Kim L Gratz
- Department of Psychology, University of Toledo, Toledo, Ohio, USA
| | - Matthew T Tull
- Department of Psychology, University of Toledo, Toledo, Ohio, USA
| | - Alexander L Chapman
- Department of Psychology, Simon Fraser University, Burnaby, British Columbia, Canada
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Dobias ML, Morris RR, Schleider JL. Single-Session Interventions Embedded Within Tumblr: Acceptability, Feasibility, and Utility Study. JMIR Form Res 2022; 6:e39004. [PMID: 35877163 PMCID: PMC9361144 DOI: 10.2196/39004] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 06/05/2022] [Accepted: 06/08/2022] [Indexed: 02/06/2023] Open
Abstract
Background Existing mental health treatments are insufficient for addressing mental health needs at scale, particularly for teenagers, who now seek mental health information and support on the web. Single-session interventions (SSIs) may be particularly well suited for dissemination as embedded web-based support options that are easily accessible on popular social platforms. Objective We aimed to evaluate the acceptability and effectiveness of three SSIs, each with a duration of 5 to 8 minutes (Project Action Brings Change, Project Stop Adolescent Violence Everywhere, and REFRAME)—embedded as Koko minicourses on Tumblr—to improve three key mental health outcomes: hopelessness, self-hate, and the desire to stop self-harm behavior. Methods We used quantitative data (ie, star ratings and SSI completion rates) to evaluate acceptability and short-term utility of all 3 SSIs. Paired 2-tailed t tests were used to assess changes in hopelessness, self-hate, and the desire to stop future self-harm from before to after the SSI. Where demographic information was available, the analyses were restricted to teenagers (13-19 years). Examples of positive and negative qualitative user feedback (ie, written text responses) were provided for each program. Results The SSIs were completed 6179 times between March 2021 and February 2022. All 3 SSIs generated high star ratings (>4 out of 5 stars), with high completion rates (approximately 25%-57%) relative to real-world completion rates among other digital self-help interventions. Paired 2-tailed t tests detected significant pre-post reductions in hopelessness for those who completed Project Action Brings Change (P<.001, Cohen dz=−0.81, 95% CI −0.85 to −0.77) and REFRAME (P<.001, Cohen dz=−0.88, 95% CI −0.96 to −0.80). Self-hate significantly decreased (P<.001, Cohen dz=−0.67, 95% CI −0.74 to −0.60), and the desire to stop self-harm significantly increased (P<.001, Cohen dz=0.40, 95% CI 0.33 to 0.47]) from before to after the completion of Project Stop Adolescent Violence Everywhere. The results remained consistent across sensitivity analyses and after correcting for multiple tests. Examples of positive and negative qualitative user feedback point toward future directions for SSI research. Conclusions Very brief SSIs, when embedded within popular social platforms, are one promising and acceptable method for providing free, scalable, and potentially helpful mental health support on the web. Considering the unique barriers to mental health treatment access that many teenagers face, this approach may be especially useful for teenagers without access to other mental health supports.
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Affiliation(s)
- Mallory L Dobias
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
| | | | - Jessica L Schleider
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
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154
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Fitzpatrick S, Varma S, Ip J. The Impact of Homeostatic and Circadian Sleep Processes on Non-Suicidal Self-Injury and Suicide Urges in Borderline Personality Disorder. Arch Suicide Res 2022; 26:1556-1571. [PMID: 34348588 DOI: 10.1080/13811118.2021.1932647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Borderline personality disorder (BPD) involves high rates of non-suicidal self-injury (NSSI) and suicidal behaviors, which are often preceded by urges. Disrupted sleep processes have been linked to NSSI and suicidal behaviors. However, it is unclear which specific sleep processes influence NSSI and suicide urges at rest (i.e., baseline) or in response to distress (i.e., reactivity) in BPD, and thus require targeting in BPD-specific interventions. This study examined whether two distinct homeostatic sleep processes (i.e., total sleep time [TST] and time in bed [TIB]), and one circadian sleep process (i.e., chronotype, or tendencies toward early versus late bed and rise times) predict baseline NSSI and suicide urges and urge reactivity in BPD. METHODS Forty adults with BPD completed a seven-day sleep diary to measure average TST and TIB. They then completed a questionnaire to measure chronotype and underwent an experiment wherein they rated NSSI and suicide urges at baseline and following an emotion induction. RESULTS Generalized estimating equations revealed that higher TST was associated with lower baseline NSSI urges, and lower suicide urge reactivity. Additionally, higher TIB predicted higher NSSI urge reactivity. CONCLUSIONS Sleep deprivation and extended time in bed may increase proclivity toward NSSI and/or suicide. Targeting these variables in BPD interventions may ultimately facilitate the reduction of NSSI and suicidal acts. HighlightsHigher total sleep time predicts lower baseline NSSI urges, suicide urge reactivityHigher time in bed predicts higher NSSI urge reactivityReducing sleep deprivation in BPD may facilitate reductions in suicide, NSSI urges.
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155
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What does being hard on yourself communicate to others? The role of symbolic implications of self-punishment in attributions of remorse. JOURNAL OF EXPERIMENTAL SOCIAL PSYCHOLOGY 2022. [DOI: 10.1016/j.jesp.2022.104305] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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156
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Guo J, Gao Q, Wu R, Ying J, You J. Parental Psychological Control, Parent-Related Loneliness, Depressive Symptoms, and Regulatory Emotional Self-Efficacy: A Moderated Serial Mediation Model of Nonsuicidal Self-Injury. Arch Suicide Res 2022; 26:1462-1477. [PMID: 34586982 DOI: 10.1080/13811118.2021.1922109] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Adolescent nonsuicidal self-injury (NSSI) has become an alarming public health concern. Parental psychological control has been identified as a risk factor for NSSI in some western samples. However, the relationship between parental psychological control and NSSI remains unclear among Chinese adolescents. Furthermore, little is known about how parental psychological control affects NSSI. This study aims to examine a moderated serial mediation model of NSSI, revealing the mediating and moderating mechanisms underlying the relationship between parental psychological control and NSSI. METHOD A total of 953 Chinese secondary school students (47.7% females, mean age = 12.53 years, SD = 0.63) completed questionnaires of NSSI, parental psychological control, parent-related loneliness, depressive symptoms, and regulatory emotional self-efficacy. RESULTS Parental psychological control was positively associated with NSSI. This association was mediated by parent-related loneliness and depressive symptoms independently. Also, it was serially mediated by parent-related loneliness and depressive symptoms. In addition, regulatory emotional self-efficacy moderated the indirect relationships between parental psychological control and NSSI. CONCLUSIONS Findings of this study shed light on how NSSI is affected by parental psychological control, parent-related loneliness, depressive symptoms, and regulatory emotional self-efficacy, and provide insights into the prevention and intervention measures targeting adolescent NSSI.HIGHLIGHTSParental psychological control was positively associated with NSSI.Parent-related loneliness and depressive symptoms independently and serially mediated the association between parental psychological control and NSSI.Regulatory emotional self-efficacy moderated the indirect relationships between parental psychological control and NSSI.
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Marti-Puig P, Capra C, Vega D, Llunas L, Solé-Casals J. A Machine Learning Approach for Predicting Non-Suicidal Self-Injury in Young Adults. SENSORS (BASEL, SWITZERLAND) 2022; 22:s22134790. [PMID: 35808286 PMCID: PMC9269418 DOI: 10.3390/s22134790] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/20/2022] [Accepted: 06/22/2022] [Indexed: 05/11/2023]
Abstract
Artificial intelligence techniques were explored to assess the ability to anticipate self-harming behaviour in the mental health context using a database collected by an app previously designed to record the emotional states and activities of a group of subjects exhibiting self-harm. Specifically, the Leave-One-Subject-Out technique was used to train classification trees with a maximum of five splits. The results show an accuracy of 84.78%, a sensitivity of 64.64% and a specificity of 85.53%. In addition, positive and negative predictive values were also obtained, with results of 14.48% and 98.47%, respectively. These results are in line with those reported in previous work using a multilevel mixed-effect regression analysis. The combination of apps and AI techniques is a powerful way to improve the tools to accompany and support the care and treatment of patients with this type of behaviour. These studies also guide the improvement of apps on the user side, simplifying and collecting more meaningful data, and on the therapist side, progressing in pathology treatments. Traditional therapy involves observing and reconstructing what had happened before episodes once they have occurred. This new generation of tools will make it possible to monitor the pathology more closely and to act preventively.
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Affiliation(s)
- Pere Marti-Puig
- Data and Signal Processing Group, University of Vic—Central University of Catalonia, 08500 Vic, Catalonia, Spain; (P.M.-P.); (C.C.)
| | - Chiara Capra
- Data and Signal Processing Group, University of Vic—Central University of Catalonia, 08500 Vic, Catalonia, Spain; (P.M.-P.); (C.C.)
- beHIT, Carrer de Mata 1, 08004 Barcelona, Spain;
| | - Daniel Vega
- Psychiatry and Mental Health Department, Hospital Universitari d’Igualada, Consorci Sanitari de l’Anoia & Fundació Sanitària d’Igualada, 08700 Igualada, Barcelona, Spain;
- Department of Psychiatry and Forensic Medicine, Institute of Neurosciences, Universitat Autònoma de Barcelona (UAB), 08193 Cerdanyola del Vallés, Barcelona, Spain
| | - Laia Llunas
- beHIT, Carrer de Mata 1, 08004 Barcelona, Spain;
| | - Jordi Solé-Casals
- Data and Signal Processing Group, University of Vic—Central University of Catalonia, 08500 Vic, Catalonia, Spain; (P.M.-P.); (C.C.)
- Correspondence: ; Tel.: +34-93-8815519
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158
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Xu H, Wang R, Li R, Jin Z, Wan Y, Tao F. Associations of Non-suicidal Self-Injury and Psychological Symptoms With Suicide Attempt in Adolescents: Are There Any Gender Differences? Front Psychiatry 2022; 13:894218. [PMID: 35795027 PMCID: PMC9251494 DOI: 10.3389/fpsyt.2022.894218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 05/23/2022] [Indexed: 11/28/2022] Open
Abstract
Background Psychological symptoms and non-suicidal self-injury (NSSI) are independently associated with suicide attempts (SA). Yet, no study has tested the interaction effects between NSSI and psychological symptoms on SA in community adolescent populations, or examined whether the interaction varies by gender. We sought to examine the interaction effects of NSSI and psychological symptoms on SA in adolescents and explore gender differences. Methods A school-based health survey in 3 provinces in China was conducted between 2013-2014. 14,820 students aged 10-20 years completed standard questionnaires, to record the details of various psychological symptoms, SA and NSSI. Results Psychological symptoms and NSSI were independently associated with a higher likelihood of SA in both boys and girls (p < 0.001). Adolescents with psychological, conduct or social adaptation symptoms without concurrent NSSI, were twice as likely to report SA (corresponding RORs were 1.80, 1.80 and 2.16, respectively; p < 0.01) than those who reported NSSI. Male adolescents with psychological, emotional, conduct or social adaptation symptoms had a higher risk of SA in the non-NSSI group than the NSSI group (corresponding RORs were 2.85, 2.26, 2.30 and 3.01 respectively; p < 0.01). While in girls, only adolescents with social adaptation symptoms had a higher risk of SA in the non-NSSI group than NSSI group (corresponding RORs was 1.71, p < 0.05). In the non-NSSI group, boys reporting psychological symptoms exhibited a higher likelihood of a SA than their female counterparts. Conclusion Psychological symptoms and NSSI are independently associated with an increased risk of SA in adolescents. However, to some extent, NSSI may reduce the risk of SA among individuals with psychological symptoms, especially in boys.
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Affiliation(s)
- Huiqiong Xu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Rui Wang
- Department of Information Technology, Anqing Medical College, Anqing, China
| | - Ruoyu Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Zhengge Jin
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
| | - Yuhui Wan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, Hefei, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China
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159
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Tang WC, Lin MP, Wu JYW, Lee YT, You J. Mediating role of depression in the association between alexithymia and nonsuicidal self-injury in a representative sample of adolescents in Taiwan. Child Adolesc Psychiatry Ment Health 2022; 16:43. [PMID: 35705987 PMCID: PMC9202208 DOI: 10.1186/s13034-022-00477-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 05/19/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Nock's (2009) integrated theoretical model suggests that specific intrapersonal vulnerability factors caused by distal risk factors contribute to the development of nonsuicidal self-injury (NSSI). Alexithymia and depression have been found to predict NSSI. Based on Nock's model, alexithymia plays a distal risk factor role to increase the risk of depression-an intrapersonal vulnerability factor-and further increase the risk of NSSI. However, small or unrepresentative samples in past studies limit the generalizability of the results. This study examined the roles of depression and alexithymia in predicting NSSI, as well as the mediating effect of depression in the relation between alexithymia and NSSI in a large representative sample of adolescents in Taiwan. METHODS Using a cross-sectional study design, a large representative sample of 2,170 senior high school students in Taiwan was assessed by self-report measures of alexithymia, depression, and NSSI. Mediation analyses were performed to examine whether the relation between alexithymia and NSSI was mediated by depression. The questionnaires were administered in classrooms. RESULTS Results showed that alexithymia positively predicted NSSI (β = 0.23, p < .001) and depression can also positively predict NSSI (β = 0.41, p < .001). Additionally, the association between alexithymia and NSSI was fully mediated by depression. CONCLUSIONS This study data provided evidence for the mediating role of depression between alexithymia and NSSI, which can be explained by Nock's (2009) integrated theoretical model. The implications of the findings for future research and intervention were discussed.
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Affiliation(s)
- Wen-Ching Tang
- Department of Educational Psychology and Counseling, National Taiwan Normal University, No.162, Sec. 1, Heping E. Rd., Da-an District, 106, Taipei City, Taiwan
| | - Min-Pei Lin
- Department of Educational Psychology and Counseling, National Taiwan Normal University, No.162, Sec. 1, Heping E. Rd., Da-an District, 106, Taipei City, Taiwan.
| | - Jo Yung-Wei Wu
- Good-Day Psychology Clinic, 5F., No. 167, Xialin Rd., South District, 702, Tainan City, Taiwan
| | - Yueh-Ting Lee
- Department of Counseling and Guidance, National University of Tainan, No.33, Sec. 2, Shu- Lin St, 700, Tainan, Taiwan
| | - Jianing You
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), & School of Psychology, Ministry of Education, South China Normal University, 510631, Guangzhou, People's Republic of China
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160
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Wilkinson PO, Qiu T, Jesmont C, Neufeld SAS, Kaur SP, Jones PB, Goodyer IM. Age and gender effects on non-suicidal self-injury, and their interplay with psychological distress. J Affect Disord 2022; 306:240-245. [PMID: 35304237 DOI: 10.1016/j.jad.2022.03.021] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 08/31/2021] [Accepted: 03/10/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION NSSI (non-suicidal self-injury) is an important public health issue, with high prevalence and associations with future mental illness and suicide. To date, no large single study has tested age and gender effects on NSSI and their interplay with psychological distress. METHOD NSSI and psychological distress were ascertained by questionnaire in a community study of 2368 young people aged 14-25; proportions at each age and of each gender were approximately equal. RESULTS There was a significant quadratic interaction between age and gender on last month NSSI prevalence (p = 0.025): NSSI was more common in females ages 16-19, but there were no significant gender differences at younger/older ages. General distress partially mediated the effects of age and gender on NSSI. The association between general distress and NSSI was not significantly moderated by age, gender nor their interactions. CONCLUSIONS Gender difference in NSSI is not a static gap, but evolves across time, widening in mid-adolescence and disappearing by early adulthood. Part of the reason for that gender gap being present at those ages is the increase levels of distress in young women at those ages. There was no evidence that the effects of general distress on NSSI differed by age/gender.
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Affiliation(s)
| | - Tianyou Qiu
- Department of Psychiatry, University of Cambridge, UK; University of British Columbia, Canada
| | - Ceit Jesmont
- Department of Psychiatry, University of Cambridge, UK; North West School of Paediatrics, UK
| | | | - Sahaj P Kaur
- Department of Psychiatry, University of Cambridge, UK; Medway NHS Foundation Trust, UK
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge, UK
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Lan Z, Pau K, Md Yusof H, Huang X. The Effect of Emotion Regulation on Non-Suicidal Self-Injury Among Adolescents: The Mediating Roles of Sleep, Exercise, and Social Support. Psychol Res Behav Manag 2022; 15:1451-1463. [PMID: 35698565 PMCID: PMC9188465 DOI: 10.2147/prbm.s363433] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 05/26/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose To explore the relationship between adolescents’ emotion regulation ability and non-suicidal self-injury (NSSI) behavior and the role of sleep, exercise, and social support in this relationship. Methods A total of 2573 adolescents were investigated with the Cognitive Emotion Regulation Scale, the Social Support Scale for Children and Adolescents, the Ottawa Self-Injury Questionnaire, and the Self-Made Living Condition Questionnaire, and path analysis was conducted based on the structural equation model (SEM). Results 1) There was a significant correlation between emotion regulation ability and NSSI behavior; 2) sleep and social support played a mediating role between emotion regulation ability and NSSI behavior; and 3) sleep modulated the direct effect of negative emotion regulation ability on NSSI, while exercise modulated the direct effect of positive emotion regulation ability on NSSI, which indicated that sleep and exercise could effectively alleviate NSSI behavior caused by the lack of emotion regulation in adolescents.
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Affiliation(s)
- Zhensong Lan
- School of Public Administrations, Hechi University, Hechi, Guangxi, 546300, People’s Republic of China
- National Child Development Research Centre, Sultan Idris Education University, Tanjong Malim Perak, 35900, Malaysia
| | - Kee Pau
- Department of Psychology and Counseling, Faculty of Human Development, Sultan Idris Education University, Tanjong Malim Perak, 35900, Malaysia
- Correspondence: Kee Pau, Director of Counseling Center, Bangunan Bitarasiswa, Tingkat Bawah, Kampus Sultan Abdul Jalil Shah Universiti Pendidikan Sultan Idris, Tanjong Malim Perak, 35900, Malaysia, Tel +60 167228023, Email
| | - Hapsah Md Yusof
- Department of Psychology and Counseling, Faculty of Human Development, Sultan Idris Education University, Tanjong Malim Perak, 35900, Malaysia
| | - Xuefang Huang
- College of Humanities & Social Sciences, Huazhong Agricultural University, Wuhan, Hubei, 430070, People’s Republic of China
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162
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Nam G, Moon H, Lee JH, Hur JW. Self-referential processing in individuals with nonsuicidal self-injury: An fMRI study. Neuroimage Clin 2022; 35:103058. [PMID: 35671558 PMCID: PMC9168135 DOI: 10.1016/j.nicl.2022.103058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 05/18/2022] [Accepted: 05/21/2022] [Indexed: 12/03/2022]
Abstract
Individuals with NSSI rated negative adjectives as more relevant. Altered self-referential processing in NSSI related to temporoparietal and subcortical areas. Brain activity in inferior parietal lobe related to ‘nonsuicidality’ in people with NSSI.
Nonsuicidal self-injury (NSSI) is associated with considerable deficits in managing negative self-directed internal experiences. The present study explores the neurophysiological correlates of self-referential processing in individuals with NSSI. A total of 26 individuals with NSSI (≥5 episodes of NSSI behavior in the past year, without suicide attempts) and 35 age-, sex-, education-, and intelligence quotient (IQ)-matched controls participated in this study. Participants underwent fMRI scanning as they performed a personal relevance rating task, which required them to evaluate the personal relevance of emotional words. As predicted, we found that individuals engaging in NSSI tended to rate negative adjectives as more relevant and positive adjectives as less relevant. An analysis of functional neuroimaging data showed that the NSSI group had increased activity relative to the control group in the inferior parietal lobe, inferior temporal gyrus, calcarine, insula, and thalamus in response to positive adjectives. The NSSI group also demonstrated greater activation in the calcarine and reduced activation in the inferior frontal gyrus in response to negative self-referential stimuli compared with the control group. In addition, increased right inferior parietal lobe activity during positive self-referential processing was correlated with reduced suicidal ideation in the NSSI group. Our study provides neural evidence for self-referential processing bias in individuals with NSSI and highlights the need for further research to clarify the pathophysiological features that are specific to NSSI.
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Affiliation(s)
- Gieun Nam
- Department of Psychology, Chung-Ang University, Seoul, Republic of Korea
| | - Hyeri Moon
- School of Psychology, Korea University, Seoul, Republic of Korea
| | - Jang-Han Lee
- Department of Psychology, Chung-Ang University, Seoul, Republic of Korea.
| | - Ji-Won Hur
- School of Psychology, Korea University, Seoul, Republic of Korea.
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Guo J, Ying J, Zhou X, Wang C, Lin N, You J. Double hurt: The impact of interpersonal-level stigma on nonsuicidal self-injury among lesbian, gay, and bisexual individuals. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03166-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Dåstøl A, Stänicke LI, Mossige S. “Treat me like a fellow human”: how young adults who blog about self-harm describe positive encounters with health care workers. NORDIC PSYCHOLOGY 2022. [DOI: 10.1080/19012276.2022.2063929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Astrid Dåstøl
- Department of Psychology, Oslo Psykologkollektiv, Oslo, Norway
| | - Line Indrevoll Stänicke
- Department of Psychology, University of Oslo, Oslo, Norway
- Department of Psychology, Nic Waals Institute, Lovisenberg Diakonale Sykehus AS, Oslo, Norway
| | - Svein Mossige
- Department of Psychology, University of Oslo, Oslo, Norway
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Cakin Memik N, Hunc F, Kalayci S, Demir N, Senturk E, Yildiz Gundogdu O, Ozlen Dillioglugil M. Assessment of Plasma-Endogenous Opioid Neuropeptide Levels and Psychometric Properties of Non-Suicidal Self-Injury in Adolescents. Arch Suicide Res 2022; 27:749-768. [PMID: 35499526 DOI: 10.1080/13811118.2022.2066494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVE Non-suicidal self-injury (NSSI) is one of the most common mental health problems and growing public-health issues, coupled with a significant population-level burden among adolescents in both developed and developing countries. We aimed to assess the role of endogenous opioid system-emotion regulation circuitry in NSSI through measurement of plasma beta-endorphin (β-EP), met-enkephalin (MENK) levels, and determination of psychometric features of Turkish adolescent subjects. METHOD In this research, we measured plasma β-EP and MENK levels of 49 adolescents with NSSI and 39 control subjects without NSSI between the ages of 12-18 years. All adolescent subjects were observed in the outpatient clinic, and their clinical and sociodemographic characteristics were examined. All subjects were assessed using the Brief Symptom Inventory (BSI) and Inventory of Statements About Self Injury (ISAS). RESULTS Plasma β-EP levels were statistically lower in adolescents with NSSI than control group, whereas there was no statistically significant difference in MENK levels. β-EP levels showed a negative correlation with depression severity. The data obtained from BSI and ISAS were not found to be associated with both β-EP and MENK levels, while subscale scores exhibited versatile correlations. CONCLUSION Our findings supported the salient role of β-EP in NSSI behavior. Also, decreased plasma β-EP could be assessed as a reliable indicator for NSSI. However, it is possible that measurement of basal plasma levels of neuropeptides might also bring many confounders and could cause bias. Therefore, repeated measurements of plasma-endogenous opioid neuropeptides in a time-dependent manner-concomitant to engage of NSSI behavior-might give more reliable results.
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166
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Calvo N, García-González S, Perez-Galbarro C, Regales-Peco C, Lugo-Marin J, Ramos-Quiroga JA, Ferrer M. Psychotherapeutic interventions specifically developed for NSSI in adolescence: A systematic review. Eur Neuropsychopharmacol 2022; 58:86-98. [PMID: 35325633 DOI: 10.1016/j.euroneuro.2022.02.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 02/18/2022] [Accepted: 02/24/2022] [Indexed: 11/27/2022]
Abstract
Non-suicidal self-injury (NSSI) is a clinically significant behavior with high relevance and prevalence, especially affecting approximately 17-18% of the adolescent population worldwide. The aim of this study is to perform a systematic review to evaluate the effectiveness of the available Specific Psychotherapeutic Interventions (SPI) focused on the reduction of NSSI behaviors. A systematic review was performed analyzing PsychINFO, MEDLINE, Web of Science, PubMed and Cochrane CentralRegister of Controlled Trials to identify studies of interest from January 2010 to December 2020. According to PRISMA guidelines, only 13 studies were included in the review. Six SPI were found to specifically and significantly reduce NSSI in adolescents: Developmental Group Psychotherapy (DGP), Therapeutic Assessment (TA), Cutting Down Program (CDP), Emotional Regulation Individual Therapy for Adolescents (ERITA), Treatment for Self-Injurious Behaviors (T-SIB) and Intensive Contextual Treatment (ICT). Furthermore, relevant improvements in anxiety and depression symptoms were observed. The results of this review demonstrate the effectiveness of these interventions, mainly the CPD and T-SIB, which are the only SPI that have been studied using Randomized Controlled Trial (RCT). Considering the clinical relevance and associated functional impairment of NSSI, more research is needed to replicate the results and to increase knowledge about SPIs.
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Affiliation(s)
- Natalia Calvo
- Psychiatry Department, Hospital Universitari Vall d'Hebron, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Psychiatry, Mental Health and Addictions Group, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Psychiatry and Legal Medicine Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Grup TLP Barcelona.
| | - Sara García-González
- Psychiatry Department, Hospital Universitari Vall d'Hebron, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Citlalli Perez-Galbarro
- Psychiatry Department, Hospital Universitari Vall d'Hebron, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Christina Regales-Peco
- Psychiatry Department, Hospital Universitari Vall d'Hebron, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Jorge Lugo-Marin
- Psychiatry Department, Hospital Universitari Vall d'Hebron, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Psychiatry, Mental Health and Addictions Group, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain
| | - Josep-Antoni Ramos-Quiroga
- Psychiatry Department, Hospital Universitari Vall d'Hebron, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Psychiatry, Mental Health and Addictions Group, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Psychiatry and Legal Medicine Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Grup TLP Barcelona
| | - Marc Ferrer
- Psychiatry Department, Hospital Universitari Vall d'Hebron, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Psychiatry, Mental Health and Addictions Group, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Psychiatry and Legal Medicine Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Grup TLP Barcelona
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167
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Emotion Regulation Difficulties and Health-Risk Behaviours in Adolescents. BEHAVIOUR CHANGE 2022. [DOI: 10.1017/bec.2022.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Abstract
Health-Risk Behaviours (HRBs) are significantly associated with avoidable mortality in adolescents, and preventing HRBs requires an adequate understanding of related factors. Among associated factors, emotion regulation difficulties may impact youths’ engagement in HRBs. Researchers explored the relation of emotion regulation with HRBs; however, specific emotion regulation difficulties for less severe and more prevalent HRBs, such as self-harming behaviour, risky-driving, violence, unhealthy dietary behaviour, and poor adherence to prescribed medication, has not been much explored. The current study aimed to explore the predictability of adolescents’ specific difficulties in emotion regulation in relation to their engagement in HRBs. For this purpose, six different HRBs, that is, self-harm, violence, risky-driving, unhealthy dietary behaviour, inadequate physical activity, and lack of medication adherence, were studied. A total of 617 (Males = 356) adolescents (Mage = 15.77) from five districts of Punjab state (India) provided required information on standardised self-report measures. The data were subjected to regression analysis, and the findings show that the participants who scored high on emotion regulation difficulties reported engagement in HRBs more than their counterparts. Some specific difficulties are more important than others for different forms of HRBs. It implies that the intervention programmes targeting specific HRBs should address specific facets of emotional dysregulation.
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168
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Pechtel P, Harris J, Karl A, Clunies-Ross C, Bower S, Moberly NJ, Pizzagalli DA, Watkins ER. Emerging ecophenotype: reward anticipation is linked to high-risk behaviours after sexual abuse. Soc Cogn Affect Neurosci 2022; 17:1035-1043. [PMID: 35438797 PMCID: PMC9629466 DOI: 10.1093/scan/nsac030] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 02/28/2022] [Accepted: 04/19/2022] [Indexed: 01/12/2023] Open
Abstract
Adolescents frequently engage in high-risk behaviours (HRB) following childhood sexual abuse (CSA). Aberrant reward processes are implicated in HRB, and their underlying fronto-striatal networks are vulnerable to neurodevelopmental changes during adversity representing a promising candidate for understanding links between CSA and HRB. We examined whether fronto-striatal responses during reward anticipation and feedback (i) are altered in depressed adolescents with CSA compared to depressed, non-abused peers and (ii) moderate the relationship between CSA and HRB irrespective of depression. Forty-eight female adolescents {14 with CSA and depression [CSA + major depressive disorder (MDD)]; 17 with MDD but no CSA (MDD); 17 healthy, non-abused controls} completed a monetary reward task during functional magnetic resonance imaging. No differences in fronto-striatal response to reward emerged between CSA + MDD and MDD. Critically, high left nucleus accumbens activation during reward anticipation was associated with greater HRB in CSA + MDD compared to MDD and controls. Low left putamen activation during reward feedback was associated with the absence of HRB in CSA + MDD compared to MDD. Striatal reward responses appear to play a key role in HRB for adolescents with CSA irrespective of depression, providing initial support for a CSA ecophenotype. Such information is pivotal to identify at-risk youth and prevent HRB in adolescents after CSA.
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Affiliation(s)
- Pia Pechtel
- Correspondence should be addressed to Pia Pechtel, Department of Psychology, University of Exeter, Sir Henry Wellcome Building for Mood Disorders Research, Perry Road, Exeter EX4 4QQ, UK. E-mail:
| | - Jennifer Harris
- Department of Psychology, College of Life and Environmental Sciences (CLES), University of Exeter, Exeter EX4 4QG, UK
| | - Anke Karl
- Department of Psychology, College of Life and Environmental Sciences (CLES), University of Exeter, Exeter EX4 4QG, UK
| | - Caroline Clunies-Ross
- Child and Adolescent Mental Health Services, Children and Family Health Devon, Exeter EX2 4NU, UK
| | - Susie Bower
- Child and Adolescent Mental Health Services, Children and Family Health Devon, Exeter EX2 4NU, UK
| | - Nicholas J Moberly
- Department of Psychology, College of Life and Environmental Sciences (CLES), University of Exeter, Exeter EX4 4QG, UK
| | - Diego A Pizzagalli
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont MA 02478, USA,Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA,McLean Imaging Center, McLean Hospital, Belmont, MA 02478 USA
| | - Edward R Watkins
- Department of Psychology, College of Life and Environmental Sciences (CLES), University of Exeter, Exeter EX4 4QG, UK
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169
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Köllensperger E, Walter C, Germann G, Engel H, Reichenberger M. [Non-suicidal self-injurious Behaviour: Insights into a littleknown Patient Population in Plastic Surgery]. HANDCHIR MIKROCHIR P 2022; 54:112-118. [PMID: 35419781 DOI: 10.1055/a-1759-3068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Despite its high prevalence in adolescents and young adults, non-suicidal self-injury (NSSI) is poorly known and understood in areas other than psychiatry. Due to this lack of knowledge, affected patients often face a lack of understanding as well as rejection and discrimination when seeking help from medical professionals. This not only hampers a lasting improvement of NSSI and the development of a trustful physician-patient relationship but may also lead to traumatisation of affected patients. Based on our patients' data, this article aims to inform interested plastic surgeons about NSSI and thus to support the treatment of affected patients. PATIENTS AND METHODS 600 patients with scars from NSSI presenting to our outpatient clinic for the first time during the past five years were enrolled in this study. Extensive data collected during the first contact was analysed and compared with the current literature. RESULTS 95 % of the patients were female; 5 % were male. On average, patients presented 8.4 years after the last NSSI event and with a mean age of 26 years. NSSI scars were most often located on the left forearm (48 %), followed by both forearms (40 %), the left upper arm (20 %), both upper arms (15 %) and both thighs (14 %). In 57 % of patients, scars were only present on one side. A mean of 380 cm2 of the body surface was affected by NSSI scars. 47 % of patients reported having at least one additional diagnosis, with thyroid dysfunction and depression being the most common. 21 % of patients had ongoing psychiatric or psychological therapy at the time of their first consultation in our clinic. CONCLUSION Our data provides first insight into a large population of NSSI patients seeking treatment options for their NSSI-associated scars in a plastic surgery outpatient clinic. Most patients were female with scars located on their forearms. A mean of more than 8 years had passed between their last NSSI and their first presentation to our clinic. Our findings offer a data-based approach to a group of patients with a disease pattern that is largely misunderstood in surgical disciplines and needs more attention, especially in the light of its high prevalence and life-long consequences.
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Affiliation(s)
- Eva Köllensperger
- ETHIANUM Klinik für Plastische Chirurgie, Ästhetik und Rekonstruktion, Wirbelsäulenchirurgie, Handchirurgie, Orthopädie und Präventive Medizin
| | - Clara Walter
- ETHIANUM Klinik für Plastische Chirurgie, Ästhetik und Rekonstruktion, Wirbelsäulenchirurgie, Handchirurgie, Orthopädie und Präventive Medizin
| | - Günter Germann
- ETHIANUM Klinik für Plastische Chirurgie, Ästhetik und Rekonstruktion, Wirbelsäulenchirurgie, Handchirurgie, Orthopädie und Präventive Medizin
| | - Holger Engel
- ETHIANUM Klinik für Plastische Chirurgie, Ästhetik und Rekonstruktion, Wirbelsäulenchirurgie, Handchirurgie, Orthopädie und Präventive Medizin
| | - Matthias Reichenberger
- ETHIANUM Klinik für Plastische Chirurgie, Ästhetik und Rekonstruktion, Wirbelsäulenchirurgie, Handchirurgie, Orthopädie und Präventive Medizin
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170
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Johnson BN, McKernan LC, Bruehl S. A Theoretical Endogenous Opioid Neurobiological Framework for Co-occurring Pain, Trauma, and Non-suicidal Self-injury. Curr Pain Headache Rep 2022; 26:405-414. [PMID: 35380406 DOI: 10.1007/s11916-022-01043-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/15/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE OF REVIEW Individuals with chronic pain are significantly more likely to have experienced overwhelming trauma early and often in key developmental years. There is increasing acknowledgment that childhood trauma disrupts how individuals process and cope with both physical and emotional pain. Emerging studies acknowledge elevated rates of non-suicidal self-injury (NSSI) in chronic pain populations. This review provides a theoretical framework to understand the relationship between NSSI behavior and pain experience in persons with chronic pain and childhood trauma histories. We discuss how NSSI may act to regulate neurobiological (e.g., endogenous opioid systems) and psychological (e.g., heightened negative affect and emotion dysregulation) systems affected by childhood trauma, leading to temporary pain relief and a cycle of negative reinforcement perpetuating NSSI. As these concepts are greatly understudied in pain populations, this review focuses on key areas relevant to chronic pain that may provide a testable, conceptual framework to support hypothesis generation, future empirical investigation, and intervention efforts. RECENT FINDINGS See Fig. 1. See Fig. 1.
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171
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Argento A, Simundic A, Mettler J, Mills DJ, Heath NL. Evaluating the Effectiveness of a Brief Mindfulness Activity in University Students With Non-Suicidal Self-Injury Engagement. Arch Suicide Res 2022; 26:871-885. [PMID: 33135590 DOI: 10.1080/13811118.2020.1841052] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
UNLABELLED Current theoretical frameworks posit that engagement in non-suicidal self-injury (NSSI) is due to an inability to regulate one's emotions. In turn, mindfulness-based interventions have been shown to enhance emotion regulatory processes in those who engage in NSSI. OBJECTIVE The purpose of the present study was to determine whether a brief mindfulness activity was differentially effective at increasing state mindfulness and decreasing stress following a stress induction task in university students with versus without a history of NSSI engagement. METHOD The sample consisted of two groups of participants who identified as women: participants with a history of NSSI engagement (NSSI; n = 57; Mage=20.09, SD = 2.05) and participants without (no-NSSI; n = 87; Mage=20.22, SD = 1.94). All participants were asked to complete pre-intervention measures of state mindfulness and stress and were randomly assigned to either a mindfulness activity (body scan) or control task condition. Following the completion of their respective activities, a Stroop stress induction task was conducted and participants completed post-intervention measures of state mindfulness and stress. RESULTS Two 3-way mixed ANOVAs (Time X NSSI status X Condition) were conducted and revealed significant time by condition interactions for both state mindfulness, Wilk's Λ = .93, F(1, 140) = 10.70, p = .001, ηp2 = .07, and stress, Wilk's Λ = .97, F(1, 140) = 4.21, p = .04, ηp2 = .03. As such, both groups (NSSI/no-NSSI) demonstrated similar increases in state mindfulness and decreases in stress in response to the brief mindfulness activity following the stress induction. Implications for future research and practice will be discussed.HIGHLIGHTSThe brief mindfulness activity effectively increased state mindfulness.The brief mindfulness activity effectively decreased stress.Benefits were experienced similarly among both groups (NSSI/no-NSSI).
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172
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Gromatsky M, Patel TA, Wilson SM, Mann AJ, Aho N, Carpenter VL, Calhoun PS, Beckham JC, Goodman M, Kimbrel NA. Qualitative analysis of participant experiences during an ecological momentary assessment study of nonsuicidal self-injury among veterans. Psychiatry Res 2022; 310:114437. [PMID: 35183989 PMCID: PMC9169428 DOI: 10.1016/j.psychres.2022.114437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 01/28/2022] [Accepted: 02/10/2022] [Indexed: 10/19/2022]
Abstract
Ecological momentary assessment (EMA) is a useful tool to investigate antecedents and consequences of nonsuicidal self-injury (NSSI), a robust predictor of Veteran suicide risk. Despite elucidating temporal changes among dynamic variables, EMA remains underutilized to study NSSI among veterans, perhaps due to concerns of safety and utility. The present study analyzed data collected from semi-structured interviews of veterans following a 28-day EMA study of NSSI, including benefits, challenges, and recommendations for improvement. Participants included 34 veterans endorsing NSSI history, most meeting criteria for NSSI Disorder. Qualitative analysis of de-identified transcripts used the rigorous and accelerated data reduction (RADaR) technique and thematic analysis. Findings revealed all veterans reported at least one emotional/social benefit to participation, including finding it therapeutic, gaining self-awareness/insight, and improved social functioning. Challenges and recommendations were primarily technology-related, including adjustment to device use. Many expressed interest in incorporation of clinical resources, use of personal devices/VA app, and ability to share responses with providers. Assessment frequency/content was never described as triggering suicidal/nonsuicidal urges and over half of participants noted urge/behavior reduction. Results support acceptability and safety of EMA for NSSI among veterans and potential clinical utility as a psychotherapy adjunct to promote self-awareness and NSSI reduction.
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Affiliation(s)
- Molly Gromatsky
- VISN 2 Mental Illness Research, Education and Clinical Center (MIRECC), James J. Peters Veterans Affairs Medical Center, 130 W Kingsbridge Rd, Bronx, NY 10468, United States; Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States.
| | - Tapan A. Patel
- Durham Veterans Affairs (VA) Health Care System, Durham, NC,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
| | - Sarah M. Wilson
- Durham Veterans Affairs (VA) Health Care System, Durham, NC,VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC,VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
| | - Adam J. Mann
- Department of Psychology, University of Toledo, Toledo, OH
| | - Natalie Aho
- Durham Veterans Affairs (VA) Health Care System, Durham, NC,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
| | | | - Patrick S. Calhoun
- Durham Veterans Affairs (VA) Health Care System, Durham, NC,VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC,VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
| | - Jean C. Beckham
- Durham Veterans Affairs (VA) Health Care System, Durham, NC,VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
| | - Marianne Goodman
- VISN 2 Mental Illness Research, Education and Clinical Center (MIRECC), James J. Peters Veterans Affairs Medical Center, Bronx, NY,Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Nathan A. Kimbrel
- Durham Veterans Affairs (VA) Health Care System, Durham, NC,VA Mid-Atlantic Mental Illness Research, Education and Clinical Center, Durham, NC,VA Health Services Research and Development Center of Innovation to Accelerate Discovery and Practice Transformation, Durham, NC,Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
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173
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Woo J, Wrath AJ, Adams GC. The Relationship Between Attachment and Self-Injurious Behaviors in the Child and Adolescent Population: A Systematic Review of the Literature. Arch Suicide Res 2022; 26:406-427. [PMID: 32780672 DOI: 10.1080/13811118.2020.1804024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Adolescents have high rates of self-injurious behavior (SIB), with suicide being the second leading cause of death. A consistent relationship between individual attachment and SIB was previously found in adult population; however, no such review has been undertaken for the child and adolescent population. A systematic search of PubMED, OVID, and PsychINFO up to March 31, 2020 was performed. Twenty-two articles met the inclusion criteria. Of the 22 articles, 21 found a positive association between attachment insecurity and SIB. Our results show a consistent relationship between attachment insecurity and SIB in children and adolescents, complementing the results found in the adult literature. These findings make a case for preventive strategies aimed at reducing self-injurious behaviors in youth by targeting attachment security.
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174
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Miola A, Cattarinussi G, Antiga G, Caiolo S, Solmi M, Sambataro F. Difficulties in emotion regulation in bipolar disorder: A systematic review and meta-analysis. J Affect Disord 2022; 302:352-360. [PMID: 35093412 DOI: 10.1016/j.jad.2022.01.102] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 01/19/2022] [Accepted: 01/26/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Bipolar disorder (BD) is a severe mental disorder characterized by mood swings and functional impairment. Although alterations in emotional regulation (ER) are a key feature, a comprehensive meta-analysis on abnormalities in emotion regulation in BD is still lacking. METHODS We performed a random-effects meta-analysis on studies comparing the ER measured with the Difficulties in Emotion Regulation Scale (DERS) in BD and healthy controls (HC) or borderline personality disorder (BPD) and calculated the standardized mean difference (SMD) of the total DERS score between those with BD and HC (primary outcome). Secondary outcomes were the SMD of the DERS subscales between BD and HC, as well as the SMD of the total score of DERS and the subscales between BD and BPD. RESULTS Twelve studies (858 BD, 540 BPD, 285 HC) were included. Compared to HC, BD showed significantly higher total DERS score (k=8, SMD 0.962, p<0.001) and subscale scores, including non-acceptance (k=6, SMD=0.85, p<0.001), goal-directed behavior (k=6, SMD=0.894, p<0.001), impulse control (k=6, SMD=1.08, p<0.001), strategies (k=6, SMD=1.25, p<0.001) and emotional clarity (k=6, SMD=0.694, p=0.001). Relative to BPD, BD presented significantly lower scores in all the DERS subscales. Sensitivity analyses confirmed the main analyses. The age of the participants and sample size moderated the primary outcome. LIMITATIONS The small number of studies and the cross-sectional design limit the generalizability of the results. CONCLUSIONS Our findings suggest that alterations of specific ER abilities are present in BD and their magnitude is smaller relative to BPD. Future therapeutic interventions should target ER strategies.
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Affiliation(s)
- Alessandro Miola
- Department of Neuroscience (DNS), University of Padova, Padua, Italy;; Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Giulia Cattarinussi
- Department of Neuroscience (DNS), University of Padova, Padua, Italy;; Padua Neuroscience Center, University of Padova, Padua, Italy
| | - Gilberto Antiga
- Department of Neuroscience (DNS), University of Padova, Padua, Italy
| | - Stefano Caiolo
- Department of Neuroscience (DNS), University of Padova, Padua, Italy
| | - Marco Solmi
- Department of Psychiatry, University of Ottawa, Ontario, Canada; Department of Mental Health, The Ottawa Hospital, Ontario, Canada
| | - Fabio Sambataro
- Department of Neuroscience (DNS), University of Padova, Padua, Italy;; Padua Neuroscience Center, University of Padova, Padua, Italy.
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175
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Bresin K, Mekawi Y. Different Ways to Drown Out the Pain: A Meta-Analysis of the Association Between Nonsuicidal Self-Injury and Alcohol Use. Arch Suicide Res 2022; 26:348-369. [PMID: 32780651 DOI: 10.1080/13811118.2020.1802378] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE There is a significant overlap in the motivations for nonsuicidal self-injury (NSSI) and alcohol use. Moreover, several theories would predict that more frequent alcohol use is likely associated with more NSSI engagement. Still, the size and direction of this association has not been well documented in the literature. METHOD To address this gap, the goal of this article was to conduct a meta-analysis of the relation between alcohol use and NSSI. RESULTS Across 57 samples and 141,669 participants, we found that there was a significant positive association between NSSI and alcohol use, odds ratio = 1.78, 95% confidence interval [1.53, 2.07], k = 64, m = 52. Moderator analyses found that this effect was stronger for younger samples and samples with more severe alcohol use problems. CONCLUSIONS These results help establish a link between NSSI and alcohol use. Implications and future directions for NSSI research and intervention are discussed.HighlightsThere are several reasons to think that NSSI and alcohol use are linked.No reviews or meta-analyses have been conducted.We found a significant and small effect linking greater NSSI with greater alcohol use.
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176
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Mendez I, Sintes A, Pascual JC, Puntí J, Lara A, Briones-Buixassa L, Nicolaou S, Schmidt C, Romero S, Fernández M, Carmona I Farrés C, Soler J, Santamarina-Perez P, Vega D. Borderline personality traits mediate the relationship between low perceived social support and non-suicidal self-injury in a clinical sample of adolescents. J Affect Disord 2022; 302:204-213. [PMID: 35038480 DOI: 10.1016/j.jad.2022.01.065] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 01/11/2022] [Accepted: 01/13/2022] [Indexed: 02/08/2023]
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) is a serious public health concern among adolescents, especially in clinical settings. Social support plays a critical role in the onset and maintenance of NSSI in adolescence. NSSI is closely associated with borderline personality disorder (BPD), yet no previous work has analyzed the mediating role of borderline traits in the relationship between perceived social support (PSS) and NSSI. This study aimed to address this gap. METHODS Participants were 228 adolescent patients (12 to 18 years old), who completed a clinical interview and self-report measures of BPD-traits, current psychological distress, emotion dysregulation and PSS. They were grouped based on the presence (vs. absence) of NSSI. Univariate and multivariate logistic regression analyses were used to identify risk factors of NSSI, and a mediation analysis was conducted to examine the intermediary role of borderline traits in the relationship between PSS and NSSI. RESULTS NSSI was highly prevalent in our sample (58%) and was associated with higher clinical severity. Low PSS predicted NSSI in univariate, but not multivariate regression. Mediation analyses showed that borderline traits fully accounted for the relationship between low PSS and NSSI, even when controlling for current psychological distress and gender. LIMITATIONS Cross-sectional design through self-report assessment. CONCLUSIONS Findings suggest that adolescents with low PSS are especially vulnerable for developing NSSI due to elevated BPD traits. In clinical settings, interventions aimed to reduce borderline symptoms may be a promising treatment option for adolescents with NSSI and low PSS.
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Affiliation(s)
- Iria Mendez
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Anna Sintes
- Servicio de salud mental infantojuvenil, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Juan Carlos Pascual
- Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain; Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Institute of Neurosciences, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joaquim Puntí
- Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain; Hospital de Dia de Adolescentes. Servicio de Salud Mental. Consorci Corporació Sanitària Parc Taulí, Sabadell, Barcelona, Spain; Departamento de Psicología Clínica y de la Salud, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Anaís Lara
- Servicio de Psiquiatría y Psicología, ALTHAIA, Xarxa Assistencial i Universitària de Manresa, Barcelona, Manresa, Spain
| | - Laia Briones-Buixassa
- Mental Health and Social Innovation Research Group and Centre for Health and Social Care Research, Universitat de Vic - Universitat Central de Catalunya, Catalonia, Spain
| | - Stella Nicolaou
- PhD Programme in Biomedicine, University of Barcelona, Spain; Psychiatry and Mental Health Department, Consorci Sanitari de l'Anoia & Fundació Sanitària d'Igualada, Hospital Universitari d'Igualada. Av. Catalunya 11, Barcelona, Igualada 08700, Spain
| | - Carlos Schmidt
- Psychiatry and Mental Health Department, Consorci Sanitari de l'Anoia & Fundació Sanitària d'Igualada, Hospital Universitari d'Igualada. Av. Catalunya 11, Barcelona, Igualada 08700, Spain
| | - Soledad Romero
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Marta Fernández
- Servicio de salud mental infantojuvenil, Hospital Sant Joan de Déu, Esplugues de Llobregat, Barcelona, Spain
| | - Cristina Carmona I Farrés
- Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain; Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Institute of Neurosciences, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Joaquim Soler
- Centro de Investigación Biomédica en Red de Salud Mental. CIBERSAM, Madrid, Spain; Department of Psychiatry, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Institute of Neurosciences, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Pilar Santamarina-Perez
- Department of Child and Adolescent Psychiatry and Psychology, 2017SGR88, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Institut d'Investigacions Biomediques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Daniel Vega
- Department of Psychiatry and Forensic Medicine, Institute of Neurosciences, School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain; Psychiatry and Mental Health Department, Consorci Sanitari de l'Anoia & Fundació Sanitària d'Igualada, Hospital Universitari d'Igualada. Av. Catalunya 11, Barcelona, Igualada 08700, Spain.
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177
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16/m mit Schnittverletzungen am Körper. Monatsschr Kinderheilkd 2022. [DOI: 10.1007/s00112-022-01449-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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178
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Nicol A, Mak AS, Murray K, Kavanagh PS. The relationship between early maladaptive schemas and the functions of self-injurious behaviour in youth. CLIN PSYCHOL-UK 2022. [DOI: 10.1080/13284207.2022.2046976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Annemarie Nicol
- Centre for Applied Psychology, University of Canberra, Canberra, ACT, Australia
| | - Anita S. Mak
- Centre for Applied Psychology, University of Canberra, Canberra, ACT, Australia
| | - Kristen Murray
- Research School of Psychology, Australian National University, Canberra, ACT, Australia
| | - Phillip S. Kavanagh
- Centre for Applied Psychology, University of Canberra, Canberra, ACT, Australia
- Justice and Society, University of South Australia, Adelaide, SA, Australia
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179
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Himelein-Wachowiak M, Giorgi S, Kwarteng A, Schriefer D, Smitterberg C, Yadeta K, Bragard E, Devoto A, Ungar L, Curtis B. Getting "clean" from nonsuicidal self-injury: Experiences of addiction on the subreddit r/selfharm. J Behav Addict 2022; 11:128-139. [PMID: 35312631 PMCID: PMC9109623 DOI: 10.1556/2006.2022.00005] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 01/21/2022] [Accepted: 02/27/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND & AIMS Previous studies have shown that nonsuicidal self-injury (NSSI) has addictive features, and an addiction model of NSSI has been considered. Addictive features have been associated with severity of NSSI and adverse psychological experiences. Yet, there is debate over the extent to which NSSI and substance use disorders (SUDs) are similar experientially. METHODS To evaluate the extent that people who self-injure experience NSSI like an addiction, we coded the posts of users of the subreddit r/selfharm (n = 500) for each of 11 DSM-5 SUD criteria adapted to NSSI. RESULTS A majority (76.8%) of users endorsed at least two adapted SUD criteria in their posts, indicative of mild, moderate, or severe addiction. The most frequently endorsed criteria were urges or cravings (67.6%), escalating severity or tolerance (46.7%), and NSSI that is particularly hazardous. User-level addictive features positively predicted number of methods used for NSSI, number of psychiatric disorders, and particularly hazardous NSSI, but not suicidality. We also observed frequent use of language and concepts common in SUD recovery circles like Alcoholics Anonymous. DISCUSSION & CONCLUSION Our findings support previous work describing the addiction potential of NSSI and associating addictive features with clinical severity. These results suggest that NSSI and SUD may share experiential similarities, which has implications for the treatment of NSSI. We also contribute to a growing body of work that uses social media as a window into the subjective experiences of stigmatized populations.
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Affiliation(s)
| | - Salvatore Giorgi
- National Institute on Drug Abuse Intramural Research Program, Baltimore, MD, USA,Department of Computer and Information Sciences, University of Pennsylvania, Philadelphia, PA, USA
| | - Amy Kwarteng
- National Institute on Drug Abuse Intramural Research Program, Baltimore, MD, USA
| | - Destiny Schriefer
- National Institute on Drug Abuse Intramural Research Program, Baltimore, MD, USA
| | - Chase Smitterberg
- National Institute on Drug Abuse Intramural Research Program, Baltimore, MD, USA
| | - Kenna Yadeta
- National Institute on Drug Abuse Intramural Research Program, Baltimore, MD, USA
| | - Elise Bragard
- National Institute on Drug Abuse Intramural Research Program, Baltimore, MD, USA,Department of Psychology, Fordham University, Bronx, NY, USA
| | - Amanda Devoto
- National Institute on Drug Abuse Intramural Research Program, Baltimore, MD, USA
| | - Lyle Ungar
- Department of Computer and Information Sciences, University of Pennsylvania, Philadelphia, PA, USA
| | - Brenda Curtis
- National Institute on Drug Abuse Intramural Research Program, Baltimore, MD, USA,Corresponding author. Biomedical Research Center, 251 Bayview Blvd. Suite 200, Baltimore, MD 21224, USA. Tel.:+ 443-740-2126. E-mail:
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180
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Yang F, Jiang L, Miao J, Xu X, Ran H, Che Y, Fang D, Wang T, Xiao Y, Lu J. The association between non-suicidal self-injury and negative life events in children and adolescents in underdeveloped regions of south-western China. PeerJ 2022; 10:e12665. [PMID: 35287346 PMCID: PMC8917796 DOI: 10.7717/peerj.12665] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 11/30/2021] [Indexed: 01/07/2023] Open
Abstract
Background The association between negative life events and Non-suicidal self-injury (NSSI) in children and adolescents has been extensively discussed. Nevertheless, little is known about the relationship between negative life events and repetition and severity of NSSI. This survey aims to understand the association between NSSI prevalence, severity, repetition and the negative life events in children and adolescents in underdeveloped regions in south-western China. Methods In this population-based cross-sectional study, 3,146 children and adolescents were included from underdeveloped regions of south-western China, and each of them requested to complete a self-assessment questionnaire. The Modified Version of Adolescents Self-Harm Scale (MASHS) and the Adolescent Self-rating negative Life Events Check-list were used to evaluate NSSI behaviors and negative life events, respectively. The statistical implementation of this study was carried out in the R statistical software, and the logistic regression analysis method was used to analyze the relationship between negative life events and adolescents' non-suicidal self-injury behaviors. Results The average age of all included participants was 13.31 years old. The lifetime prevalence of NSSI was 47.0% (95% CI [36.3-58.0%]). Gender, grade level and ASLEC was positively associated with NSSI. Further analysis revealed that, for all five dimensions of ASLEC, only interpersonal relationship factor (IRF) (OR 1.77 (95% CI [1.06-2.97])), health adaptation factor (HAF) (OR 2.08 (95% CI [1.31-3.31])) showed prominent association with NSSI. Multivariate Logistic regression models revealed that, repetitive NSSI (OR 4.54 (95% CI [3.66-5.63])) and NSSI severity (OR 9.01 (95% CI [6.11-13.29])) were positively associated with ASLEC. Conclusion NSSI is very common among children and adolescents in underdeveloped regions of south-western China. Negative life event are positively associated with NSSI, repeated NSSI, and severe NSSI. Negative life events centered intervention measures might be effective in reducing NSSI among school children and adolescents in underdeveloped regions of south-western China.
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Affiliation(s)
- Fan Yang
- First Affiliated Hospital of Kunming Medical University, Psychiatric Department, Kunming, Yunnan, China
| | - Linling Jiang
- First Affiliated Hospital of Kunming Medical University, Psychiatric Department, Kunming, Yunnan, China
| | - Jing Miao
- First Affiliated Hospital of Kunming Medical University, Psychiatric Department, Kunming, Yunnan, China
| | - Xiufeng Xu
- First Affiliated Hospital of Kunming Medical University, Psychiatric Department, Kunming, Yunnan, China
| | - Hailiang Ran
- Kunming Medical University, School of Public Health, Kunming, Yunnan, China
| | - Yusan Che
- Kunming Medical University, School of Public Health, Kunming, Yunnan, China
| | - Die Fang
- Kunming Medical University, School of Public Health, Kunming, Yunnan, China
| | - TianLan Wang
- Lincang Psychiatric Hospital, Lincang, Yunnan, China
| | - Yuanyuan Xiao
- Kunming Medical University, School of Public Health, Kunming, Yunnan, China
| | - Jin Lu
- First Affiliated Hospital of Kunming Medical University, Psychiatric Department, Kunming, Yunnan, China
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181
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Forbes CN, Tull MT, Lavender JM, Dixon-Gordon KL, Gratz KL. Development and Initial Validation of the Body-focused Self-damaging Behavior Expectancies Questionnaire. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2022. [DOI: 10.1007/s10862-021-09906-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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182
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Brausch AM, Clapham RB, Littlefield AK. Identifying Specific Emotion Regulation Deficits that Associate with Nonsuicidal Self-injury and Suicide Ideation in Adolescents. J Youth Adolesc 2022; 51:556-569. [PMID: 34686951 PMCID: PMC9554798 DOI: 10.1007/s10964-021-01525-w] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 10/07/2021] [Indexed: 01/04/2023]
Abstract
It is not known how emotion regulation deficits and strategies may differentially relate to nonsuicidal self-injury (NSSI) and suicide ideation in samples of community-based adolescents. The current study examined emotion regulation using comprehensive multi-method assessment to identify which specific deficits are uniquely related to NSSI and suicide ideation in a sample of high school students. Regarding specific deficits, it was expected that lack of emotional awareness, lack of access to emotion regulation strategies, poor cognitive reappraisal, and poorer automatic emotion processing would uniquely associate with past-year NSSI engagement. It was also predicted that lack of access to strategies, lack of impulse control, lack of awareness, and nonacceptance of emotion would uniquely associate with past-year presence of suicide ideation and suicide ideation severity. The sample included 696 adolescents (54.8% female; ages 14-17; mean age = 15.5) recruited from public high schools. Self-report measures were administered assessing suicide ideation, NSSI engagement, dimensions of emotion regulation, and automatic emotion processing (Emotion Stroop). Emotion suppression was the only unique and significant predictor of past-year NSSI engagement, and lack of access to emotion regulation strategies was the strongest predictor of both past-year presence of suicide ideation and recent suicide ideation severity when accounting for all deficits in the same model. Acquiring emotion regulation skills during the period of adolescence has great potential to buffer from occurrence of NSSI and severity of suicide ideation.
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Affiliation(s)
- Amy M. Brausch
- Department of Psychological Sciences, Western Kentucky University, Bowling Green, KY, USA
| | - Rebekah B. Clapham
- Department of Psychological Sciences, Western Kentucky University, Bowling Green, KY, USA
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183
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Campos RC, Morujão IS, Martins LC, Lambert CE, Tomás G, Holden RR. Results from Two Countries on How Thwarted Interpersonal Needs Contribute to Understanding Self-Harm. THE JOURNAL OF PSYCHOLOGY 2022; 156:185-199. [DOI: 10.1080/00223980.2021.2015567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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184
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Non-Suicidal Self-Injury Among Adolescents: A Structural Model with Socioecological Connectedness, Bullying Victimization, and Depression. Child Psychiatry Hum Dev 2022:10.1007/s10578-022-01319-6. [PMID: 35178654 DOI: 10.1007/s10578-022-01319-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/17/2022] [Indexed: 11/03/2022]
Abstract
The objective was to examine the associations of socioecological connectedness with bullying victimization and depressive symptoms in early adolescence and with non-suicidal self-injury (NSSI) in mid-adolescence, and how these might differ between genders. Diverse adolescents (N = 4115; 49.1% girls) in the 7th grade reported on connections with parents/family, peers, school, and neighborhood, as well as bullying victimization and depressive symptoms, and NSSI in 10th grade (Me = 16.1 years). Structural equation modeling with WSLMV indicated that the lower likelihood of NSSI in 10th grade was associated with higher perceptions of connections between adolescents and their families, both directly as well as indirectly through reduced bully victimization and depressive symptoms three years earlier. Higher school connectedness was indirectly associated with the lower likelihood of NSSI through bullying victimization and depressive symptoms. Paths to NSSI varied for girls and boys. Results advance the understanding of developmental pathways leading to NSSI in adolescent girls and boys.
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185
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Wang Y, Zhou X, Cao B, Chen L, Wang R, Qi L, Meng L, Zeng L, Liu X, Wang W, Li C, Yang J, Gu X, Li Z, Zhou Y. The psychological characteristics and risk factors of suicidal attempt among mood disorders adolescents accompany with non-suicidal self-injury: A multi-center study. J Affect Disord 2022; 298:301-307. [PMID: 34728289 DOI: 10.1016/j.jad.2021.10.130] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2021] [Revised: 09/11/2021] [Accepted: 10/23/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Identifying the risk factors of suicide attempts(SA) in adolescents with mood disorders(MD) who engage in non-suicidal self-injury(NSSI) is of great significance for suicide prevention. The aim of the present study was to explore the psychological characteristics and risk factors of SA among MD adolescents engaged in NSSI. METHODS We recruited MD outpatients accompany with NSSI aged 12-18 years. SA, NSSI methods and function, suicidal ideation(SI), psychological distress(PD), self-esteem, stress mindset and perceived social support were assessed by valid scales. Classification and regression tree analysis (CART) was employed to explore the characteristics and risk factors of SA among MD adolescent with NSSI. RESULTS We included 658 participants in this study. Of 58.1% participants reported SA during the past 12 months. Compared with the adolescents without SA, the attempters used more different NSSI methods and reported more frequent NSSI. SA, SI, PD, self-esteem and amount of thinking time before engaging in self-injury were risk factors of SA among MD adolescents. Interactions between the four risk factors resulted in varying degrees of risk of SA. Compared to adolescents with the characteristics of low level of SI - little consideration before self-injury, adolescents who having multiple characteristics of the high level of SI -high level of PD - low self-esteem were associated with a 15.1-fold increased risk of SA(P < 0.001), and those with the characteristics of high SI - deliberated before engaging in self-injury were associated with a 28.1-fold increased risk of attempted suicide(P < 0.001). CONCLUSIONS Our findings identify multiple correlates for SA in MD adolescents accompany with NSSI, including SI, PD, self-esteem and deliberate time they thought before self-injury, which may contribute to the development of suicidal behaviors in an interactive manner.
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Affiliation(s)
- Yanni Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Lanzhou, China
| | - Xin Zhou
- Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, China; Department of Psychiatric Rehabilitation, Shenzhen Kangning Hospital, Shenzhen, China
| | - Bo Cao
- Department of Psychiatry, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Canada
| | - Lijuan Chen
- School of Literature, Journalism & Communication, South-Central University for Nationalities, Wuhan, China
| | - Ruoxi Wang
- School of Medicine and Health Management, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Ling Qi
- School of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | | | | | - Xia Liu
- Shenzhen Kangning Hospital, Shenzhen, China
| | - Wenjia Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Chuanxiao Li
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Jiezhi Yang
- Shenzhen Health Development Research Center, Shenzhen, China
| | - Xueyan Gu
- Department of Toxicology, School of Public Health, Lanzhou University, Lanzhou, China
| | - Zezhi Li
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China.
| | - Yongjie Zhou
- Department of Psychiatric Rehabilitation, Shenzhen Kangning Hospital, Shenzhen, China.
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186
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Carranza AB, Wallis CRD, Jonnson MR, Klonsky ED, Walsh Z. Nonsuicidal Self-Injury and Intimate Partner Violence: Directionality of Violence and Motives for Self-Injury. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:1688-1707. [PMID: 32437310 DOI: 10.1177/0886260520922372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Nonsuicidal self-injury (NSSI) is associated with intimate partner violence (IPV) perpetration and victimization. However, extant research has not distinguished between unidirectional and bidirectional IPV and has not examined relationships between IPV and functions of self-injury. This study of 1,018 university students revealed a significantly higher prevalence of NSSI among those who reported bidirectional IPV compared with nonviolent individuals. However, rates of NSSI in the unidirectional IPV groups are more similar to rates of NSSI in the bidirectional group than in nonviolent individuals. Individuals who engaged in bidirectional IPV were more likely to endorse interpersonal functions of self-injury than those who engaged in unidirectional IPV or no IPV. In contrast, intrapersonal functions of NSSI were not associated with IPV. Findings suggest that the association between IPV and NSSI may be best understood in the context of relationship conflict, rather than as a distinct correlate of either IPV victimization or IPV perpetration.
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Affiliation(s)
| | | | | | | | - Zach Walsh
- University of British Columbia, Kelowna, Canada
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187
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Nester MS, Boi C, Brand BL, Schielke HJ. The reasons dissociative disorder patients self-injure. Eur J Psychotraumatol 2022; 13:2026738. [PMID: 35126883 PMCID: PMC8812737 DOI: 10.1080/20008198.2022.2026738] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 12/30/2021] [Accepted: 12/30/2021] [Indexed: 11/07/2022] Open
Abstract
Background Most individuals with dissociative disorders (DDs) report engaging in self-injury. Objective The present study aimed to understand the reasons for self-injury among a clinical sample of 156 DD patients enrolled in the TOP DD Network study. Method Participants answered questions about self-injury, including a prompt asking how often they are aware of the reasons they have urges to self-injure, as well as a prompt asking them to list three reasons they self-injure. Results Six themes of reasons for self-injury, each with subthemes, were identified in the qualitative data: (1) Trauma-related Cues, (2) Emotion Dysregulation, (3) Stressors, (4) Psychiatric and Physical Health Symptoms, (5) Dissociative Experiences, and (6) Ineffective Coping Attempts. Participants reported that they were able to identify their reasons for self-injuring sometimes (60.26%) or almost always (28.85%), with only 3.20% unable to identify any reasons for their self-injury. Conclusion Results suggest that the vast majority of DD patients (92.31%) reported being at least partially unaware of what leads them to have self-injury urges, and many individuals with DDs experience some reasons for self-injury that are different from those with other disorders. The treatment implications of these findings are discussed.
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Affiliation(s)
- M. Shae Nester
- Department of Psychology, Towson University, Towson, Maryland, USA
| | - Cinzia Boi
- Department of Psychology, Towson University, Towson, Maryland, USA
| | - Bethany L. Brand
- Department of Psychology, Towson University, Towson, Maryland, USA
| | - Hugo J. Schielke
- Traumatic Stress Injury & Concurrent Program, Homewood Health Centre, Guelph, Ontario, Canada
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188
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Rayner GC, Bowling G, Bluff L, Wright K, Ashworth‐Lord A, Laird C. A multi‐method evaluation of a compassion‐focused cognitive behavioural psychotherapy group for people who self‐harm. COUNSELLING & PSYCHOTHERAPY RESEARCH 2022. [DOI: 10.1002/capr.12516] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Gillian Clare Rayner
- Reader in Counselling & Psychotherapy, University of Central Lancashire (UCLan) Lancashire UK
| | - Gosia Bowling
- National Lead Emotional Wellbeing Nuffield Health Manchester UK
| | - Lisa Bluff
- Perinatal Mental Health Training Lead Greater Manchester Mental Health NHS Foundation Trust Manchester UK
| | - Karen Wright
- Professor of Nursing University of Central Lancashire (UCLan) Preston UK
| | | | - Catriona Laird
- Cognitive Behavioural Psychotherapist Greater Manchester Mental Health NHS Foundation Trust Manchester UK
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189
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Brager-Larsen A, Zeiner P, Klungsøyr O, Mehlum L. Is age of self-harm onset associated with increased frequency of non-suicidal self-injury and suicide attempts in adolescent outpatients? BMC Psychiatry 2022; 22:58. [PMID: 35081930 PMCID: PMC8790924 DOI: 10.1186/s12888-022-03712-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Accepted: 01/12/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Self-harm in adolescents is an increasing public health concern and an important risk factor for suicide. We aimed to examine how age of self-harm onset in adolescents was associated with frequency of subsequent suicidal and non-suicidal self-harm (NSSI) episodes, and how age of onset and duration of self-harm may influence the frequency of self-harm. METHODS Data from 103 adolescents with recurrent self-harm recruited from child and adolescent psychiatric outpatient clinics were collected through clinical interviews and self-reports, and analysed with negative binomial and hurdle models. RESULTS A lower age of self-harm onset and a longer duration of self-harm were both significantly associated with increased frequency of subsequent episodes of NSSI and risk of a first suicide attempt. There was an increase in repeated suicide attempts when the age of onset of self-harm decreased and the duration increased, and dramatically more for long duration of NSSI before first suicide attempt. CONCLUSION Initiating self-harm behaviour at the youngest age had the highest risk of increased frequency of NSSI and suicide attempts. Longer duration of self-harm behaviour increased this risk. This underlines the importance of early identification of self-harm behaviour in adolescents, and the use of effective interventions.
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Affiliation(s)
- Anne Brager-Larsen
- Child and Adolescent Mental Health Research Unit, Department of Research and Innovation, Division of Mental Health and Addiction, Oslo University Hospital, Sognsvannsveien 12, Bygg 12, N-0372, Oslo, Norway.
| | - Pål Zeiner
- grid.55325.340000 0004 0389 8485Child and Adolescent Mental Health Research Unit, Department of Research and Innovation, Division of Mental Health and Addiction, Oslo University Hospital, Sognsvannsveien 12, Bygg 12, N-0372 Oslo, Norway
| | - Ole Klungsøyr
- grid.55325.340000 0004 0389 8485Section for treatment research, Department of Research and Innovation, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Lars Mehlum
- grid.5510.10000 0004 1936 8921National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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190
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Bordalo F, Carvalho IP. The role of alexithymia as a risk factor for self-harm among adolescents in depression - A systematic review. J Affect Disord 2022; 297:130-144. [PMID: 34695502 DOI: 10.1016/j.jad.2021.10.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 10/06/2021] [Accepted: 10/20/2021] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Considering the suggested role of alexithymia in increasing the risk of self-harm, especially when depression is also present, and that rates of self-harm tend to peak in adolescence, the aim of this systematic review was to synthetize the most relevant research studies on this topic and provide an understanding on whether alexithymia can be considered as an important risk factor for non-suicidal self-harm among adolescents with depression. METHODS Searches were conducted in PubMed, Web of Science, and PsycINFO, resulting in 290 records. After removal of duplicates, 273 records were left and after reading the titles and abstracts, 231 articles were excluded, leaving 42 articles that were read in full. Of these 42, nine articles were included in this review. RESULTS The sample of this review consists of eight case-control studies and one cross-sectional and longitudinal survey. All nine studies concluded that the most important variables associated with self-harming behavior were depression and alexithymia, among all other variables assessed. The self-harming groups showed significantly higher scores on alexithymia (overall and particularly Factor 1- difficulties identifying feelings and differentiating them from bodily sensations), when compared to the control (no self-harming) groups, and the mean depression scores for self-harming groups were significantly higher than those for non-harming groups. All nine studies included in this review shared the limitation of self-reported information. CONCLUSION These results indicate that alexithymia is a risk factor for non-suicidal self-harm among adolescents with depression, even when other variables were also inspected, and may be a prevention and therapeutic target in the future.
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Affiliation(s)
- Felícia Bordalo
- Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, Porto 4200-319, Portugal.
| | - Irene P Carvalho
- Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, Porto 4200-319, Portugal; Medical Psychology Unit, Department of Clinical Neuroscience and Mental Health, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, Porto 4200-319, Portugal; CINTESIS, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, Porto 4200-319, Portugal
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191
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Gu H, Hu C, Wang L. Maladaptive perfectionism and adolescent NSSI: A moderated mediation model of psychological distress and mindfulness. J Clin Psychol 2022; 78:1137-1150. [PMID: 34993958 DOI: 10.1002/jclp.23304] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 09/10/2021] [Accepted: 12/21/2021] [Indexed: 11/08/2022]
Abstract
OBJECTIVES Maladaptive perfectionism has been shown to be associated with non-suicidal self-injury (NSSI) in adolescents. Based on the functional model of self-injury, we predicted that this association is due to the mediating effect of psychological distress. We also tested the assumption that being mindful-that is, being able to accept rather than escape the psychological distress-would be a protective factor in this process. METHODS Eight hundred and forty-one Chinese adolescents completed online questionnaires concerning maladaptive perfectionism, psychological distress, mindfulness, and NSSI. RESULTS Regression-based analyses showed that maladaptive perfectionism predicted adolescents' NSSI through the indirect effect of psychological distress. Mindfulness weakened the indirect effect. CONCLUSIONS These findings suggest that self-injury serves a function in emotion regulation and the communication of distress. The results also have implications for practice: Maladaptive perfectionism should be assessed as a risk factor for NSSI, and teaching mindfulness may be an effective intervention for adolescents who engage in this high-risk behavior.
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Affiliation(s)
- Honglei Gu
- Department of Psychology, Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China
| | - Chang Hu
- School of Public Finance and Taxation, Central University of Finance and Economics, Beijing, China
| | - Lizhao Wang
- Department of Student Affairs, Guangzhou Civil Aviation College, Guangzhou, China
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192
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Kandsperger S, Schleicher D, Ecker A, Keck F, Bentheimer S, Brunner R, Jarvers I. Emotional Reactivity in Adolescents With Non-suicidal Self-injury and Its Predictors: A Longitudinal Study. Front Psychiatry 2022; 13:902964. [PMID: 35873231 PMCID: PMC9304980 DOI: 10.3389/fpsyt.2022.902964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 06/13/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The management of emergency presentations at child and adolescent psychiatric outpatient clinics, by children and adolescents with self-injurious thoughts and behaviors, represents very responsible tasks but also offers the opportunity for immediate interventions. The stability and degree of emotional reactivity (ER) is a significant psychopathological symptom for development and maintenance of self-injurious behavior, differentiating between those who have continued to injure themselves and those who have not. In general, the relationship between ER and self-injurious behavior has been shown to be bidirectional. However, the stability of ER over time, as well as important predictors for ER itself have not been investigated so far. Therefore, this present study aimed at investigating the stability of ER over time and the relationship between non-suicidal self-injury (NSSI) and ER. Reinforcement functions and several variables of psychological functioning were considered as possible influencing factors. METHODS As part of a longitudinal study, 97 adolescents aged 11-18 years who presented due to self-injurious thoughts or behaviors underwent standardized emergency management. This included a specified detailed psychiatric assessment at baseline (including the Emotion Reactivity Scale, ERS, and the Self-Injurious Thoughts and Behaviors Interview, SITBI) and treatment recommendations. These were followed by a catamnestic examination with two follow-up appointments. Changes over time in ER, NSSI, reinforcement functions of NSSI and general indicators of psychological functioning (General Severity Index, GSI) were examined and significant correlations were followed up by a linear-mixed effect model predicting the ERS score over time. RESULTS Data analysis revealed a statistically significant decrease in ERS scores and GSI over time. However, reinforcement functions for and the symptomatology of NSSI did not change. Furthermore, no predictive relationship from ER to NSSI could be identified. A linear-mixed effect model predicting the ERS identified the GSI, automatic positive reinforcement (as a reinforcement function for NSSI) and age as the only significant predictors. CONCLUSION Results demonstrate the importance of NSSI reinforcement functions for heightened emotional reactivity and emphasize their role as a point for therapeutic intervention by providing alternatives to NSSI and thereby possibly reducing emotional reactivity.
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Affiliation(s)
- Stephanie Kandsperger
- Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Daniel Schleicher
- Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Angelika Ecker
- Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Florentina Keck
- Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Sebastian Bentheimer
- Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Romuald Brunner
- Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - Irina Jarvers
- Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Regensburg, Germany
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193
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Zhang Y, Suo X, Zhang Y, Zhang S, Yang M, Qian L, Shang L, Zhang D, Xu F, Li W. The Relationship Between Negative Life Events and Nonsuicidal Self-Injury Among Chinese Adolescents: A Moderated-Mediation Model. Neuropsychiatr Dis Treat 2022; 18:2881-2890. [PMID: 36540672 PMCID: PMC9760044 DOI: 10.2147/ndt.s386179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Accepted: 11/25/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE This study aimed to investigate whether anxiety mediates the relationship between negative life events and nonsuicidal self-injury (NSSI) in adolescents and whether this mediating role is moderated through social support. METHODS The model consisted of an anonymous questionnaire survey of 506 Chinese adolescents (253 boys and 253 girls, mean age 15.11 years (SD = 1.83, range 11-18 years)). Self-designed questionnaires were used to collect demographic data. The frequency of NSSI, state anxiety, and social support degree of adolescents was assessed by the Adolescent Life Events Scale, the Chinese version of the Beck Anxiety Inventory, and the social support scale, respectively. RESULTS Negative life events were significantly and positively correlated with anxiety and the frequency of NSSI, and anxiety was significantly and positively correlated with the frequency of NSSI. The positive association between negative life events and the frequency of NSSI among adolescents was mediated by anxiety after controlling for demographic variables. Furthermore, this mediated relationship was moderated by social support. CONCLUSION Anxiety was a potential mechanism linking negative life events to NSSI in adolescents and low social support important risk factor for amplifying this indirect effect. Our findings provide an empirical basis for reducing NSSI in adolescents.
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Affiliation(s)
- Yang Zhang
- Department of Psychiatry, Shandong Daizhuang Hospital, Jining, People's Republic of China
| | - Xingbo Suo
- Department of Psychiatry, Jining Medical University, Jining, People's Republic of China
| | - Yuebing Zhang
- Department of Psychiatry, Shandong Daizhuang Hospital, Jining, People's Republic of China
| | - Shenshuai Zhang
- Department of Psychiatry, Jining Medical University, Jining, People's Republic of China
| | - Menglan Yang
- Department of Psychiatry, Jining Medical University, Jining, People's Republic of China
| | - Liju Qian
- Department of Psychiatry, Shandong Daizhuang Hospital, Jining, People's Republic of China
| | - Luning Shang
- Department of Psychiatry, Shandong Daizhuang Hospital, Jining, People's Republic of China
| | - Dong Zhang
- Department of Psychiatry, Shandong Daizhuang Hospital, Jining, People's Republic of China
| | - Fangfang Xu
- Department of Psychiatry, Jining Medical University, Jining, People's Republic of China
| | - Wu Li
- Department of Psychiatry, Shandong Daizhuang Hospital, Jining, People's Republic of China
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194
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Tan WK, Chiang MH. Readers' perceptions of self-harm messages on social media. COMPUTERS IN HUMAN BEHAVIOR 2022. [DOI: 10.1016/j.chb.2022.107209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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195
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Norman H, Marzano L, Oskis A, Coulson M. " My Heart and My Brain Is What's Bleeding, These Are Just Cuts." An Interpretative Phenomenological Analysis of Young Women's Experiences of Self-Harm. Front Psychiatry 2022; 13:914109. [PMID: 35911219 PMCID: PMC9330153 DOI: 10.3389/fpsyt.2022.914109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 06/23/2022] [Indexed: 11/13/2022] Open
Abstract
Engagement in self-harm, defined as intentional self-poisoning or self-injury irrespective of the apparent purpose of the act, is increasing, particularly among girls and young women. Understanding the behavior from the perspective of those who self-harm is, therefore, vital in designing effective interventions and treatments. The current brief research report presents a key theme from an Interpretative Phenomenological Analysis of the experience of self-harm among eight young women, aged between 18 and 29. The theme Is Self-Harm Bad? concerns the way in which participants both acknowledged and resisted a negative conception of self-harm that was often constructed from other people's attitudes. Three subthemes explore the reasons why participants were reluctant to endorse self-harm as bad: Self-Harm is the Symptom, Self-Harm Works (Until it Doesn't) and Self-Harm is Part of Me. The findings highlight the disparity between the characterization of self-harm as a highly risky behavior and the lived experience of self-harm as a functional means of emotion regulation. From a clinical perspective, the findings explored in this brief report suggest that highlighting the risks of self-harm may not be a sufficient deterrent. The recently revised draft National Institute for Health and Care Excellence (NICE) guidance recommends that everyone presenting to hospital following self-harm should be given a comprehensive psychosocial assessment, of which the function is, in part, to understand why the person has self-harmed. The current study underlines the importance of seeing past the behavior to the underlying causes and exploring the meaning of self-harm to the individual in order to implement effective preventative interventions.
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Affiliation(s)
- Hilary Norman
- Faculty of Science and Technology, Middlesex University, London, United Kingdom
| | - Lisa Marzano
- Faculty of Science and Technology, Middlesex University, London, United Kingdom
| | - Andrea Oskis
- Faculty of Science and Technology, Middlesex University, London, United Kingdom
| | - Mark Coulson
- School of Psychology, Faculty of Social Sciences, University of East Anglia, Norwich, United Kingdom
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196
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Pal A, Roy P. Nonsuicidal self-injury and family environment among college students in Kolkata, West Bengal: Mixed method explanatory sequential design. JOURNAL OF MENTAL HEALTH AND HUMAN BEHAVIOUR 2022. [DOI: 10.4103/jmhhb.jmhhb_11_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
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197
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Nester MS, Brand BL, Schielke HJ, Kumar S. An examination of the relations between emotion dysregulation, dissociation, and self-injury among dissociative disorder patients. Eur J Psychotraumatol 2022; 13:2031592. [PMID: 35145611 PMCID: PMC8823688 DOI: 10.1080/20008198.2022.2031592] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
BACKGROUND Dissociative disorder (DD) patients report high rates of self-injury. Previous studies have found dissociation and self-injury to be related to emotional distress. To the best of our knowledge, however, the link between emotion dysregulation and self-injury has not yet been examined within a DD population. OBJECTIVE The present study investigated relations between emotion dysregulation, dissociation, and self-injury in DD patients, and explored patterns of emotion dysregulation difficulties among DD patients with and without recent histories of self-injury. METHOD We utilized linear and logistic regressions and t-test statistical methods to examine data from 235 patient-clinician dyads enrolled in the TOP DD Network Study. RESULTS Analyses revealed emotion dysregulation was associated with heightened dissociative symptoms and greater endorsement of self-injury in the past six months. Further, patients with a history of self-injury in the past six months reported more severe emotion dysregulation and dissociation than those without recent self-injury. As a group, DD patients reported the greatest difficulty engaging in goal-directed activities when distressed, followed by lack of emotional awareness and nonacceptance of emotional experiences. DD patients demonstrated similar patterns of emotion dysregulation difficulties irrespective of recent self-injury status. CONCLUSIONS Results support recommendations to strengthen emotion regulation skills as a means to decrease symptoms of dissociation and self-injury in DD patients.
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Affiliation(s)
- M Shae Nester
- Department of Psychology, Towson University, Towson, MD, USA
| | - Bethany L Brand
- Department of Psychology, Towson University, Towson, MD, USA
| | - Hugo J Schielke
- Traumatic Stress Injury & Concurrent Program, Homewood Health Centre, Guelph, Ontario, Canada
| | - Shaina Kumar
- Department of Psychology, University of Nebraska-Lincoln, Lincoln, NE, USA
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198
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Toukhy N, Ophir S, Stukalin Y, Halabi S, Hamdan S. The relationship between non-suicidal self-injury, identity conflict, and risky behavior among Druze adolescents. Front Psychiatry 2022; 13:938825. [PMID: 36440397 PMCID: PMC9681829 DOI: 10.3389/fpsyt.2022.938825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 10/25/2022] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES This study aimed to explore the prevalence of non-suicidal self-injury (NSSI) among Druze adolescents in Israel, an ethnic minority, and examine the influence of identity conflict, depression, and performance of risky behaviors on such adolescents' engagement in NSSI. This investigation is important because little is known about NSSI among adolescents from ethnic minorities. METHODS Overall, 290 Druze adolescents aged 16-18 (mean = 16.26, standard deviation = 0.9) years (63.9% female) participated in this study. They were recruited through snowball sampling from three Druze schools that agreed to participate in the study. All participants completed self-report measures for NSSI, depression, anxiety, engagement in risky behaviors, emotion regulation, sleep problems, and identity integration. RESULTS Almost 20% of the total sample engaged in NSSI. Those who engaged in NSSI reported more significant depression, anxiety, sleep problems, and engagement in risky behaviors when compared with those who did not engage in NSSI. Moreover, those who engaged in NSSI reported experiencing a higher level of identity conflict. Further analysis revealed an indirect effect of identity conflict on NSSI through engagement in risky behaviors. CONCLUSIONS This study's findings clarify the prevalence of NSSI among Druze adolescents, as well as contributing factors, and also highlights the importance of developing interventions that specifically target this unique ethnic group.
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Affiliation(s)
- Nermin Toukhy
- Department of Psychology, Bar Ilan University, Ramat Gan, Israel.,School of Behavioral Sciences, Academic College of Tel-Aviv Yaffo (MTA), Tel Aviv-Yafo, Israel.,Department of Psychological Medicine, Schneider Children's Medical Center, Petah Tikva, Israel
| | - Shir Ophir
- School of Behavioral Sciences, Academic College of Tel-Aviv Yaffo (MTA), Tel Aviv-Yafo, Israel
| | - Yelena Stukalin
- School of Behavioral Sciences, Academic College of Tel-Aviv Yaffo (MTA), Tel Aviv-Yafo, Israel
| | - Samer Halabi
- School of Behavioral Sciences, Academic College of Tel-Aviv Yaffo (MTA), Tel Aviv-Yafo, Israel
| | - Sami Hamdan
- School of Behavioral Sciences, Academic College of Tel-Aviv Yaffo (MTA), Tel Aviv-Yafo, Israel
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199
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Yang SY, Lee D, Jeong H, Cho Y, Ahn JE, Hong KS, Baek JH. Comparison of Patterns of Non-suicidal Self-Injury and Emotion Dysregulation Across Mood Disorder Subtypes. Front Psychiatry 2022; 13:757933. [PMID: 35633812 PMCID: PMC9133457 DOI: 10.3389/fpsyt.2022.757933] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Non-suicidal self-injury (NSSI) is frequently encountered in patients with mood disorders. Emotion dysregulation (ED), frequently observed in mood disorders, could be a major mediating factor in NSSI. The aim of this study was to explore differences in NSSI behavior and ED across mood disorder subtypes. The relationships between childhood trauma and NSSI and ED were also explored. METHODS A total of 191 patients with mood disorders were included in this study. The patterns of NSSI behavior and ED across patients with bipolar I disorder (BD-I), bipolar II disorder (BD-II), and major depressive disorder (MDD) were compared. RESULTS More than half (54%) of the subjects experienced NSSI. Patients with BD-II and MDD engaged in NSSI behavior more frequently than those diagnosed with BD-I. NSSI behaviors in patients with BD-II most commonly included cutting, whereas hitting behaviors were most common among other groups. Patients with BD-II and MDD reported more severe ED than those with BD-I. In the case of childhood trauma, those with BD-II and MDD reported greater emotional neglect than those with BD-I. Structural equation modeling revealed that ED mediated the association between childhood trauma and NSSI. CONCLUSION BD-I was associated with less frequent NSSI behavior and less severe ED than BD-II and MDD. ED mediated the association between childhood trauma and NSSI. Promoting emotion regulation strategies could prevent NSSI behavior in patients with mood disorders.
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Affiliation(s)
- So Yung Yang
- Department of Psychiatry, National Health Insurance Service Ilsan Hospital, Goyang-si, South Korea.,Institute of Behavioral Sciences in Medicine, College of Medicine, Yonsei University, Seoul, South Korea
| | - Dongbin Lee
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea
| | - Hyewon Jeong
- Center for Clinical Research, Samsung Biomedical Research Institute (SBRI), Seoul, South Korea
| | - Yunji Cho
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea
| | - Jae Eun Ahn
- Center for Clinical Research, Samsung Biomedical Research Institute (SBRI), Seoul, South Korea
| | - Kyung Sue Hong
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea.,School of Medicine, Sungkyunkwan University, Suwon, South Korea
| | - Ji Hyun Baek
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea.,School of Medicine, Sungkyunkwan University, Suwon, South Korea
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200
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Reinhardt M, Horváth Z, Urbán R, Rice KG, Drubina B, Kökönyei G. Dissociative Tendencies Aggregate the Impact of Negative Life Events on Non-Suicidal Self-Injury among Male Juvenile Delinquents. Arch Suicide Res 2022; 26:226-244. [PMID: 32603215 DOI: 10.1080/13811118.2020.1784335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Non-suicidal self-injury is a significant global public health problem during adolescence, nevertheless there is a lack of investigations among juvenile offenders. Our cross-sectional study aimed to investigate the relationship between negative life events and self-harm, including the effects of dissociation and experiential avoidance that accounted for this link in a sample of underaged male offenders (N = 226; Mage = 16.97, SD = 1.31; 23.5% performed self-harm in the past month). Structural equation modeling showed that dissociation can explain the effect of friendship- and romantic relationship-related negative life events on self-harm. Our findings pointed out that dissociative tendencies could reduce intense emotions stemming from negative life events associated with peer relationships, but consequences of such tendencies might be self-harm in a correctional context.
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