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Mann AJD, Tull MT, Gratz KL. Examining the Presence, Frequency, and Associated Characteristics of Nonsuicidal Self-Injury by Proxy: Initial Validation of the Nonsuicidal Self-Injury by Proxy Questionnaire (NSSIBPQ). Behav Modif 2024; 48:3-50. [PMID: 37599465 DOI: 10.1177/01454455231191710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
Nonsuicidal self-injury (NSSI) by proxy is the intentional destruction of one's own body tissue through the elicitation of another being's actions. Despite its clinical relevance, research on NSSI by proxy is limited and there are no available measures of this behavior. This research aimed to characterize NSSI by proxy among young adults and provide preliminary data on the validity of a new self-report measure, the NSSI by Proxy Questionnaire (NSSIBPQ). Two nationwide community samples of young adults (one general community sample and one with a history of traditional NSSI and suicidality) completed online studies. NSSI by proxy was reported by 18% of the general community sample and 45% of the self-injuring sample. Findings support the clinical relevance of NSSI by proxy and its potential to meet criteria for an NSSI disorder diagnosis. Results also provide preliminary support for the internal consistency and convergent, discriminant, and concurrent validity of the NSSIBPQ.
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Marrero RJ, Bello M, Morales-Marrero D, Fumero A. Emotion Regulation Difficulties, Family Functioning, and Well-Being Involved in Non-Suicidal Self-Injury and Suicidal Risk in Adolescents and Young People with Borderline Personality Traits. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1057. [PMID: 37371288 DOI: 10.3390/children10061057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 06/06/2023] [Accepted: 06/12/2023] [Indexed: 06/29/2023]
Abstract
Individuals with a borderline personality disorder (BPD) or BPD traits usually have a lifetime history of harmful behaviors. Emotion regulation difficulties are a risk factor for suicide, whereas adequate family functioning and well-being play an important protective role. This study aims to determine the role of emotion regulation difficulties, well-being, and family functioning in the suicide risk and non-suicidal self-injury (NSSI) in adolescents and young people with BPD traits. From a sample of 285 young people, 103 (36.1%) had BPD traits (mean age = 16.82, SD = 2.71), and 68.93% were females. The results showed significant differences in personal and family variables according to the type of harmful behavior. Suicide attempts (SA) were mainly predicted by difficulties in impulse control, whereas NSSI was predicted by low family satisfaction. Programs designed to prevent SA and NSSI should consider individual differences, as well as the type of harmful behaviors exhibited.
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Affiliation(s)
- Rosario J Marrero
- Departamento de Psicología Clínica, Psicobiología y Metodología, Facultad de Psicología y Logopedia, Universidad de La Laguna, 38200 La Laguna, Spain
- Instituto Universitario de Neurociencia (IUNE), Universidad de La Laguna, 38200 La Laguna, Spain
| | - Macarena Bello
- Instituto Andrés Bello, 38007 Santa Cruz de Tenerife, Spain
| | - Daida Morales-Marrero
- Departamento de Psicología Clínica, Psicobiología y Metodología, Facultad de Psicología y Logopedia, Universidad de La Laguna, 38200 La Laguna, Spain
| | - Ascensión Fumero
- Departamento de Psicología Clínica, Psicobiología y Metodología, Facultad de Psicología y Logopedia, Universidad de La Laguna, 38200 La Laguna, Spain
- Instituto Universitario de Neurociencia (IUNE), Universidad de La Laguna, 38200 La Laguna, Spain
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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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Kahya Y, Munguldar K. Difficulties in Emotion Regulation Mediated the Relationship Between Reflective Functioning and Borderline Personality Symptoms Among Non-Clinical Adolescents. Psychol Rep 2022; 126:1201-1220. [PMID: 35048764 DOI: 10.1177/00332941211061072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The literature has established the associations between reflective functioning (RF), affect regulation, and the development of borderline personality disorder (BPD) symptoms. We aimed to examine the mediator role of difficulties in emotion regulation on the relationship between RF and BPD symptoms in a non-clinical adolescent sample. The sample was composed of 546 Turkish adolescents with a mean age of 16.18 (SD = 1.67). Of the sample, 62.5% were adolescent girls and 37.5% of boys. In the present cross-sectional research, volunteer adolescents along with parental permission filled out Socio-Demographics Form, Reflective Functioning Questionnaire, Difficulties in Emotion Regulation Scale, and Borderline Personality Inventory on paper during counseling sessions at schools. Process macro was used to conduct mediation analyses. Compromised RF was related to an increase in adolescent borderline personality symptoms, both directly and indirectly via difficulties in emotion regulation. In this non-clinical adolescent sample, a lower degree of certainty, as well as a higher degree of uncertainty about the mental states, were related to a propensity to emotion dysregulation, specifically experiencing emotions less clearly, approaching emotions impulsively, and facing emotions without a modulation strategy. These associations were in turn related to an increase in borderline personality symptoms. The present research results suggest RF and emotion regulation problems as one field of early intervention for adolescents with BPD symptoms.
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Affiliation(s)
- Yasemin Kahya
- Faculty of Social Sciences and Humanities, Department of Psychology, RinggoldID:390121Social Sciences University of Ankara, Ankara, Turkey
| | - Koret Munguldar
- Department of Clinical Psychology, The Center for Attachment Research, RinggoldID:5926The New School for Social Research, New York, NY, USA
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Guerrini Usubini A, Cattivelli R, Bertuzzi V, Varallo G, Rossi AA, Volpi C, Bottacchi M, Tamini S, De Col A, Pietrabissa G, Mannarini S, Castelnuovo G, Molinari E, Sartorio A. The ACTyourCHANGE in Teens Study Protocol: An Acceptance and Commitment Therapy-Based Intervention for Adolescents with Obesity: A Randomized Controlled Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18126225. [PMID: 34207494 PMCID: PMC8296029 DOI: 10.3390/ijerph18126225] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/18/2021] [Accepted: 06/04/2021] [Indexed: 12/21/2022]
Abstract
This Randomized Controlled Trial [(RCT) aims to evaluate the effectiveness of a brief Acceptance and Commitment Therapy (ACT)-based intervention combined with treatment as usual (TAU) compared to TAU only in improving psychological conditions in a sample of adolescents with obesity (body mass index, BMI > 97th percentile for age and sex) within the context of a wider multidisciplinary rehabilitation program for weight loss. Fifty consecutive adolescents (12-17 years) of both genders with obesity will be recruited among the patients hospitalized in a clinical center for obesity rehabilitation and randomly allocated into two experimental conditions: ACT + TAU vs. TAU only. Both groups will attend a three-week in-hospital multidisciplinary rehabilitation program for weight loss. The ACT + TAU condition comprises a psychological intervention based on ACT combined with a standard psychological assessment and support to the hospitalization. The TAU comprises the standard psychological assessment and support to the hospitalization. At pre- to post-psychological intervention, participants will complete the Avoidance and Fusion Questionnaire for Youth, the Psychological Well-Being Scale, the Depression Anxiety Stress Scale, the Difficulties in Emotion Regulation Scale, and the Emotional Eating subscale of the Dutch Eating Behavior Questionnaire to assess psychological well-being as the primary outcome and experiential avoidance, psychological distress, emotional dysregulation, and emotional eating as secondary outcomes. Repeated-measures ANOVAs (2 × 2) will be conducted. The study will assess the effectiveness of a brief ACT-based intervention for adolescents with obesity in improving their psychological conditions by targeting specific core processes of the ACT framework (openness, awareness, and engagement). Future directions of the study will assess whether these psychological processes will contribute to addressing long-term weight loss.
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Affiliation(s)
- Anna Guerrini Usubini
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, 20145 Milan, Italy; (R.C.); (G.V.); (C.V.); (M.B.); (G.P.); (G.C.); (E.M.)
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy;
- Correspondence:
| | - Roberto Cattivelli
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, 20145 Milan, Italy; (R.C.); (G.V.); (C.V.); (M.B.); (G.P.); (G.C.); (E.M.)
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy;
| | - Vanessa Bertuzzi
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy;
| | - Giorgia Varallo
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, 20145 Milan, Italy; (R.C.); (G.V.); (C.V.); (M.B.); (G.P.); (G.C.); (E.M.)
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy;
| | - Alessandro Alberto Rossi
- Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, 35139 Padova, Italy; (A.A.R.); (S.M.)
- Interdepartmental Center for Family Research, University of Padova, 35139 Padova, Italy
| | - Clarissa Volpi
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, 20145 Milan, Italy; (R.C.); (G.V.); (C.V.); (M.B.); (G.P.); (G.C.); (E.M.)
| | - Michela Bottacchi
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, 20145 Milan, Italy; (R.C.); (G.V.); (C.V.); (M.B.); (G.P.); (G.C.); (E.M.)
| | - Sofia Tamini
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, 28824 Piancavallo (VB), Italy; (S.T.); (A.D.C.); (A.S.)
| | - Alessandra De Col
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, 28824 Piancavallo (VB), Italy; (S.T.); (A.D.C.); (A.S.)
| | - Giada Pietrabissa
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, 20145 Milan, Italy; (R.C.); (G.V.); (C.V.); (M.B.); (G.P.); (G.C.); (E.M.)
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy;
| | - Stefania Mannarini
- Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, 35139 Padova, Italy; (A.A.R.); (S.M.)
- Interdepartmental Center for Family Research, University of Padova, 35139 Padova, Italy
| | - Gianluca Castelnuovo
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, 20145 Milan, Italy; (R.C.); (G.V.); (C.V.); (M.B.); (G.P.); (G.C.); (E.M.)
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy;
| | - Enrico Molinari
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory, 20145 Milan, Italy; (R.C.); (G.V.); (C.V.); (M.B.); (G.P.); (G.C.); (E.M.)
- Department of Psychology, Catholic University of Milan, 20123 Milan, Italy;
| | - Alessandro Sartorio
- Istituto Auxologico Italiano, IRCCS, Experimental Laboratory for Auxo-Endocrinological Research, 28824 Piancavallo (VB), Italy; (S.T.); (A.D.C.); (A.S.)
- Istituto Auxologico Italiano, IRCCS, Division of Auxology, 28824 Piancavallo (VB), Italy
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Lanfredi M, Macis A, Ferrari C, Meloni S, Pedrini L, Ridolfi ME, Zonca V, Cattane N, Cattaneo A, Rossi R. Maladaptive behaviours in adolescence and their associations with personality traits, emotion dysregulation and other clinical features in a sample of Italian students: a cross-sectional study. Borderline Personal Disord Emot Dysregul 2021; 8:14. [PMID: 33941285 PMCID: PMC8094601 DOI: 10.1186/s40479-021-00154-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 04/08/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Emotion Dysregulation (ED), childhood trauma and personality are linked to the occurrence of maladaptive behaviours in adolescence which, in turn, may be related to increased risk for psychopathology in the life course. We sought to explore the relationship among the occurrence of different clusters of maladaptive behaviours and ED, clinical features (i.e. impulsivity, childhood maltreatment, anxiety, depressive symptoms) and personality traits that have been found to be associated to Borderline Personality Disorder (BPD), in a sample of 179 adolescent students. METHODS Multiple Correspondence Analysis (MCA) was applied to detect clustered types of maladaptive behaviours and groups of students were defined as individuals engaging in these clustered behaviours (non-suicidal self-injury-NSSI, binge eating, binge drinking, cannabis use, and sexual risk behaviours). Logistic models were used to evaluate the association among clinical scales, and student groups. Mediation analysis was used to evaluate whether clinical features affected the association between personality traits and student groups. RESULTS MCA analysis allowed to identify three student groups: NSSI/binge eating (NSSI-BE) behaviours, other maladaptive behaviours and "none". Higher scores in ED, impulsivity, childhood maltreatment, anxiety and depressive symptoms increased the risk of belonging to the cluster of NSSI-BE behaviours compared to the other two groups. ED, depression and anxiety symptoms were found to be mediators of the relationship between specific personality traits, mainly pertaining to the negative affectivity construct, and NSSI/BE. CONCLUSIONS Individuals engaging in NSSI-BE behaviours represent a vulnerable adolescent population. ED, depression and anxiety were mediators of the relationship between a variety of personality traits related to BPD and NSSI and binge eating behaviours. Findings have important clinical implications in terms of prevention and interventions among adolescents engaging in self-damaging behaviours.
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Affiliation(s)
- Mariangela Lanfredi
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, via Pilastroni 4, I-25125, Brescia, Italy.
| | - Ambra Macis
- Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Clarissa Ferrari
- Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Serena Meloni
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, via Pilastroni 4, I-25125, Brescia, Italy
| | - Laura Pedrini
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, via Pilastroni 4, I-25125, Brescia, Italy
| | | | - Valentina Zonca
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Stress, Psychiatry and Immunology Laboratory, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Nadia Cattane
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Anna Cattaneo
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Department of Pharmacological Biomolecular Sciences, University of Milan, Milano, Italy
| | - Roberta Rossi
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, via Pilastroni 4, I-25125, Brescia, Italy
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7
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Paulus FW, Ohmann S, Möhler E, Plener P, Popow C. Emotional Dysregulation in Children and Adolescents With Psychiatric Disorders. A Narrative Review. Front Psychiatry 2021; 12:628252. [PMID: 34759846 PMCID: PMC8573252 DOI: 10.3389/fpsyt.2021.628252] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 08/27/2021] [Indexed: 12/14/2022] Open
Abstract
Background: Emotional dysregulation (ED) is a transdiagnostic construct defined as the inability to regulate the intensity and quality of emotions (such as, fear, anger, sadness), in order to generate an appropriate emotional response, to handle excitability, mood instability, and emotional overreactivity, and to come down to an emotional baseline. Because ED has not been defined as a clinical entity, and because ED plays a major role in child and adolescent psychopathology, we decided to summarize current knowledge on this topic based on a narrative review of the current literature. Methods: This narrative review is based on a literature search of peer-reviewed journals. We searched the databases ERIC, PsycARTICLES, PsycINFO and PSYNDEX on June 2, 2020 for peer reviewed articles published between 2000 and 2020 in English language for the preschool, school, and adolescent age (2-17 years) using the following search terms: "emotional dysregulation" OR "affect dysregulation," retrieving 943 articles. Results: The results of the literature search are presented in the following sections: the relationship between ED and psychiatric disorders (ADHD, Mood Disorders, Psychological Trauma, Posttraumatic Stress Disorder, Non-suicidal Self-Injury, Eating Disorders, Oppositional Defiant Disorder, Conduct Disorder, Disruptive Disruptive Mood Dysregulation Disorder, Personality Disorders, Substance Use Disorder, Developmental Disorders, Autism Spectrum Disorder, Psychosis and Schizophrenia, and Gaming Disorder), prevention, and treatment of ED. Conclusion: Basic conditions of ED are genetic disposition, the experience of trauma, especially sexual or physical abuse, emotional neglect in childhood or adolescence, and personal stress. ED is a complex construct and a comprehensive concept, aggravating a number of various mental disorders. Differential treatment is mandatory for individual and social functioning.
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Affiliation(s)
- Frank W Paulus
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Saarland University Medical Center, Homburg, Germany
| | - Susanne Ohmann
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria.,Austrian Society of Cognitive Behavioral Therapy (OeGVT), Vienna, Austria
| | - Eva Möhler
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Saarland University Medical Center, Homburg, Germany
| | - Paul Plener
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Christian Popow
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria.,Austrian Society of Cognitive Behavioral Therapy (OeGVT), Vienna, Austria.,Department of Child and Adolescent Psychiatry and Psychotherapy, Regional Psychiatric Hospital, Mauer, Austria
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Vigfusdottir J, Dale KY, Gratz KL, Klonsky ED, Jonsbu E, Høidal R. The psychometric properties and clinical utility of the Norwegian versions of the deliberate self-harm inventory and the inventory of statements about self-injury. CURRENT PSYCHOLOGY 2020. [DOI: 10.1007/s12144-020-01189-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AbstractDeliberate self-harm (DSH) is a widespread transdiagnostic health problem with increasing prevalence among adolescences, and young adults. It is therefore essential to effectively chart the epidemiology of DSH, as well as to assess the efficacy of interventions designed to modify this behavior. The aim was to translate and analyze the psychometric properties of the Norwegian versions of two instruments designed to assess DSH: the Deliberate Self-harm Inventory (DSHI) and the Inventory of Statements About Self-Injury (ISAS), as well as to assess the prevalence of DSH within a nonclinical Norwegian adult population. Of the 402 participants who completed a questionnaire packet comprising the DSHI, ISAS, general questions about DSH, and other related measures, 30.6% reported some form of DSH. Those with a history of DSH reported greater difficulties with emotion regulation than those without. Participants with and without a history of DSH did not differ in unrelated constructs, including social desirability. The frequency of specific DSH behaviors was in accordance with previous research, with cutting being the most frequent. The factor structure of DSH functions in the Norwegian ISAS was generally comparable to the factor structure of the English version. Overall, results indicate that: a) the Norwegian versions of the DSHI and ISAS behave as expected and in accordance with prior research in other languages and other populations, and b) both the DSHI and ISAS have high internal consistency and adequate construct, convergent, and discriminant validity, and may be applied to evaluate DSH in adult Norwegian populations.
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Rossi R, Ridolfi ME. Borderline personality disorder in young people: state of the art and future plans in Italy. Curr Opin Psychol 2020; 37:61-65. [PMID: 32877857 DOI: 10.1016/j.copsyc.2020.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/10/2020] [Accepted: 08/11/2020] [Indexed: 11/30/2022]
Abstract
Treatment of Borderline Personality Disorder (BPD) in Italy has a relatively recent history. In the last few years, based on the increasing number of BPD patients admitted in Italian Mental Health Services (MHS), several regions have introduced treatment for BPD among their clinical priorities. A general 'call for action' has been launched within the psychiatric community. The aim of the current review is to describe the state of the art of research and clinical programs for personality disorders in young people. The Italian clinical context will be described with a focus on the transition discontinuity of care between adult and child/adolescent services. Prevention and early intervention programs available in Italy will be reviewed and a new agenda will be discussed.
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Affiliation(s)
- Roberta Rossi
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio - FBF, Brescia, Italy.
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10
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Wolff JC, Thompson E, Thomas SA, Nesi J, Bettis AH, Ransford B, Scopelliti K, Frazier EA, Liu RT. Emotion dysregulation and non-suicidal self-injury: A systematic review and meta-analysis. Eur Psychiatry 2019; 59:25-36. [PMID: 30986729 DOI: 10.1016/j.eurpsy.2019.03.004] [Citation(s) in RCA: 139] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 03/15/2019] [Accepted: 03/17/2019] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Over the past several years there has been considerable interest in the relation between emotion dysregulation and non-suicidal self-injury (NSSI), particularly given that rates of NSSI have been increasing and NSSI is a critical risk factor for suicidal behavior. To date, however, no synthesis of empirical findings exists. METHODS The present study presents a comprehensive meta-analytic review of the literature on the association between NSSI and emotion dysregulation. A total of 48 publications, including 49 independent samples, were included in this analysis. RESULTS Overall, a significant association was found between emotion dysregulation and NSSI (pooled OR = 3.03 [95% CI = 2.56-3.59]). This association was reduced but remained significant (OR = 2.40 [95% CI = 2.01-2.86]) after adjustment for publication bias. Emotion dysregulation subscales most strongly associated with NSSI included limited access to regulation strategies, non-acceptance of emotional responses, impulse control difficulties, and difficulties engaging goal-directed behavior. Lack of emotional awareness/clarity and cognitive aspects of dysregulation yielded weaker, yet significant, positive associations with NSSI. CONCLUSIONS Findings support the notion that greater emotion dysregulation is associated with higher risk for NSSI among individuals across settings, regardless of age or sex. Furthermore, findings reveal facets of dysregulation that may have unique implications for NSSI. This meta-analysis highlights the importance of better understanding emotion dysregulation as a treatment target for preventing NSSI.
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Affiliation(s)
- Jennifer C Wolff
- The Alpert Medical School of Brown University, 1 Hoppin St, Suite 204, 02093, Providence, RI, United States.
| | - Elizabeth Thompson
- The Alpert Medical School of Brown University, 1 Hoppin St, Suite 204, 02093, Providence, RI, United States
| | - Sarah A Thomas
- The Alpert Medical School of Brown University, 1 Hoppin St, Suite 204, 02093, Providence, RI, United States
| | - Jacqueline Nesi
- The Alpert Medical School of Brown University, 1 Hoppin St, Suite 204, 02093, Providence, RI, United States
| | - Alexandra H Bettis
- The Alpert Medical School of Brown University, 1 Hoppin St, Suite 204, 02093, Providence, RI, United States
| | - Briana Ransford
- The Alpert Medical School of Brown University, 1 Hoppin St, Suite 204, 02093, Providence, RI, United States
| | - Katie Scopelliti
- The Alpert Medical School of Brown University, 1 Hoppin St, Suite 204, 02093, Providence, RI, United States
| | - Elisabeth A Frazier
- The Alpert Medical School of Brown University, 1 Hoppin St, Suite 204, 02093, Providence, RI, United States
| | - Richard T Liu
- The Alpert Medical School of Brown University, 1 Hoppin St, Suite 204, 02093, Providence, RI, United States
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11
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Zinchuk MS, Avedisova AS, Guekht AB. Nonsuicidal self-injury behavior in non-psychotic disorders: epidemiology, social and clinical risk factors. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:108-119. [DOI: 10.17116/jnevro2019119031108] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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12
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Biberdzic M, Ensink K, Normandin L, Clarkin JF. Empirical typology of adolescent personality organization. J Adolesc 2018; 66:31-48. [DOI: 10.1016/j.adolescence.2018.04.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Revised: 04/23/2018] [Accepted: 04/25/2018] [Indexed: 11/15/2022]
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Drzał-Fiałkiewcz E, Makarewicz A, Walczak M, Walczak A, Futyma-Jędrzejewska M, Kozak G, Frończuk P, Karakuła-Juchnowicz H. Self-harm - an overview of the tools used to assess non-suicidal self-harming behaviors. CURRENT PROBLEMS OF PSYCHIATRY 2017. [DOI: 10.1515/cpp-2017-0027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Introduction: Non-Suicidal Self-Injury (NSSI) is the deliberate injury to one’s own body intended to cause mental or physical harm to oneself. In view of the growing scale of the NSSI, especially among young people without identifying any other psychiatric disorders, the disorder was included in both DSM-5 and ICD10 as independent diagnostic entity. Many etiopathogenetic hypotheses and research tools assessing various aspects of NSSI have been developed.
The aim of the work is to present and discuss the most commonly used scales for NSSI assessment.
Method: A review of available literature was made using the databases Medline / PubMed, using the key words: “self injury”, “self-mutilation”, “non-suicidal,”, “NSSI”, “self-harm” and time descriptors: 2005-2017
Results: Available tools were divided into three groups: I- scale of self-assessment made by the patient, II- assessment made by the clinician, and III- auxiliary scale.
Conclusions: None of the available scales covers the complexity of the NSSI phenomenon. For the overall NSSI assessment, several NSSI assessment tools are suggested, taking into account both self-assessment scales and clinical evaluation.
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Affiliation(s)
| | - Agata Makarewicz
- I Department of Psychiatry, Psychotherapy and Early Intervention , Medical University of Lublin
| | - Mateusz Walczak
- I Department of Psychiatry, Psychotherapy and Early Intervention , Medical University of Lublin
| | - Aleksandra Walczak
- Department of Dermatology , Venereology and Pediatric Dermatology of Autonomous Public University Hospital No. 1 in Lublin
| | | | - Gustaw Kozak
- I Department of Psychiatry, Psychotherapy and Early Intervention , Medical University of Lublin
| | - Piotr Frończuk
- Non-public Healtcare Centre Mental Health Clinic in Biała Podlaska
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Bo S, Kongerslev M. Self-reported patterns of impairments in mentalization, attachment, and psychopathology among clinically referred adolescents with and without borderline personality pathology. Borderline Personal Disord Emot Dysregul 2017; 4:4. [PMID: 28228967 PMCID: PMC5310093 DOI: 10.1186/s40479-017-0055-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2016] [Accepted: 02/09/2017] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Previous research, which primarily focused on adult samples, suggests that individuals with borderline personality disorder (BPD) display high levels of psychopathology, dysfunctional mentalization and problematic attachment to others. The current study investigated whether impairments in mentalization, attachment, and psychopathology are more severe in outpatient adolescents with BPD than in a clinical comparison group. METHODS Consecutive referrals to a child and adolescent psychiatric clinic were clinically assessed with a battery of self-report instruments to assess mentalization, attachment, and psychopathology. Specifically, in regard to BPD a self-report questionnaire was employed to decide if patients were classified into the BPD or the clinical comparison group. The main outcome variables of adolescents with a primary diagnosis of BPD were then compared with those of a clinical comparison group comprising patients receiving psychiatric diagnoses other than BPD. RESULTS Relative to the clinical group without BPD, and after controlling for sociodemographic variables, the BPD group displayed poorer mentalizing abilities, more problematic attachments to parents and peers, and higher self-reported levels of psychopathology. CONCLUSIONS The results of this study suggest that BPD is a severe mental condition in adolescents and is characterized by poor mentalizing abilities, attachment problems and high levels of psychopathology compared to adolescents with psychiatric disorders other than BPD. Hence, clinicians should consider BPD when conducting diagnostic assessments, and evidence-based treatments for this vulnerable group should be developed.
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Affiliation(s)
- Sune Bo
- Psychiatric Research Unit, Region Zealand Psychiatry, Slagelse, Denmark
- Department of Child and Adolescent Psychiatry, Region Zealand Psychiatry, Roskilde, Denmark
| | - Mickey Kongerslev
- Centre of Excellence on Personality Disorder, Region Zealand Psychiatry, Slagelse, Denmark
- Department of Psychology, University of Southern Denmark, Odense, Denmark
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