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Bilello D, Townsend E, Broome MR, Armstrong G, Burnett Heyes S. Friendships and peer relationships and self-harm ideation and behaviour among young people: a systematic review and narrative synthesis. Lancet Psychiatry 2024; 11:633-657. [PMID: 39025094 DOI: 10.1016/s2215-0366(24)00170-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 05/03/2024] [Accepted: 05/20/2024] [Indexed: 07/20/2024]
Abstract
Friendships and peer relationships have an important role in the experience of self-harm ideation and behaviour in young people, yet they typically remain overlooked. This systematic review and narrative synthesis explores the extant literature on this topic to identify important relationships between these constructs. We did a keyword search of peer-reviewed empirical articles relating to friendships and peer relationships and self-harm ideation and behaviour in young people (aged 11-25 years). We identified 90 articles with evidence primarily from adolescents aged 11-18 years, including mixed genders and a majority of White individuals. Findings highlight substantive relationships between the key constructs, showing that: characteristics of friends and peers, including their self-harm ideation and behaviour, relate to and predict ego self-harm ideation and behaviour; friends and peers are important sources of support; and evidence on causal mechanisms is scarce but highlights potential peer selection and influence processes. Studies of the friends and peers of young people with self-harm ideation and behaviour highlight that: friends' attitudes to self-harm and suicide influence their responses to peers with self-harm ideation and behaviour; and friends who are bereaved and friend supporters experience negative outcomes such as symptoms of depression, anxiety, PTSD, and grief, alongside difficult emotions. Despite substantial heterogeneity across samples, study designs, and definition or measurement of the primary constructs, this work presents an initial step in organising a complex literature on a crucially important topic, which can help to inform future research and evidence-based interventions.
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Affiliation(s)
- Delfina Bilello
- School of Psychology and Institute for Mental Health, University of Birmingham, Birmingham, UK; Self-Harm Research Group, University of Nottingham, Nottingham, UK.
| | - Ellen Townsend
- Self-Harm Research Group, University of Nottingham, Nottingham, UK
| | - Matthew R Broome
- School of Psychology and Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - Gregory Armstrong
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia
| | - Stephanie Burnett Heyes
- School of Psychology and Institute for Mental Health, University of Birmingham, Birmingham, UK
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Sheehan AE, Salvador PY, Bounoua N, Sadeh N. Impulsive Decision-Making, Affective Experiences, and Parental History of Self-Injurious Thoughts and Behaviors within Parent-Adolescent Dyads. Res Child Adolesc Psychopathol 2024; 52:1209-1220. [PMID: 38647794 PMCID: PMC11289229 DOI: 10.1007/s10802-024-01194-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/29/2024] [Indexed: 04/25/2024]
Abstract
Impulsive decision-making, particularly during states of affective intensity, is associated with greater risk of engagement in self-injurious thoughts and behaviors (SITBs) during adolescence. The proximal (dyadic parent-adolescent affect and impulsivity) and distal (family history of SITBs) risk factors that occur within the family system could be relevant processes at stake in the intergenerational transmission of risk. The current study tests the interdependence of parent-adolescent factors associated with risk for SITBs and probes the extent to which parent-adolescent affective states influence their own (actor-effects) and each other's (partner-effects) impulsive decision-making, and further whether these relationships are moderated by a parent's history of SITBs. Participants included 212 (106 dyads) community parents and their adolescents who completed self-report and behavioral tasks related to positive and negative affective states, impulsive decision-making, and lifetime history of SITBs. Application of the Actor-Partner Interdependence Model (APIM) revealed a partner-effect where greater parent negative affect in the past week was associated with elevated adolescent impulsive decision-making among families with a history of SITBs (Estimate = 0.66, Standard Error = 0.13, p < 0.001). In addition, a significant actor-effect was observed where greater positive affect was associated with decreased impulsive decision-making among adolescents (Estimate = -0.21, Standard Error = 0.10, p = 0.03), however, moderating effects of parent history of SITBs were not detected. Findings from the present study shed light on the interdependence of affect and impulsivity within parent-adolescent dyads, and the extent to which these interactions may be particularly salient for families with known vulnerabilities for SITBs.
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Affiliation(s)
- Ana E Sheehan
- Department of Psychological and Brain Sciences, University of Delaware, 108 Wolf Hall, Newark, DE, 19176, USA.
| | - Paula Yoela Salvador
- Department of Psychological and Brain Sciences, University of Delaware, 108 Wolf Hall, Newark, DE, 19176, USA
| | - Nadia Bounoua
- Department of Psychological and Brain Sciences, University of Delaware, 108 Wolf Hall, Newark, DE, 19176, USA
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Naomi Sadeh
- Department of Psychological and Brain Sciences, University of Delaware, 108 Wolf Hall, Newark, DE, 19176, USA
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He Y, Wei Y, Wang Y, Liang F, Ma T. A cross-sectional study of non-suicidal self-injury in adolescent depression: association with demographic characteristics and physiological indicators. Front Psychiatry 2024; 15:1359400. [PMID: 39119074 PMCID: PMC11306130 DOI: 10.3389/fpsyt.2024.1359400] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 06/18/2024] [Indexed: 08/10/2024] Open
Abstract
Introduction Non-suicidal self-injury (NSSI) is a prevalent concern among adolescents with depression, yet its relationship with demographic characteristics and physiological indicators remains underexplored. This study aimed to investigate these relationships among inpatient adolescents aged 13 to 18 at a hospital affiliated with Guizhou Medical University. Methods A cross-sectional study was conducted involving 222 adolescent inpatients diagnosed with depression. Data on NSSI occurrence, demographic variables (gender, only-child status, age), and physiological indicators (ALT, TSH, FT4, PLR, TG, HDLC, LDLC, FT3, NLR, MLR) were collected and analyzed. Statistical analyses, including correlations and group comparisons, were performed to assess the associations between NSSI and these factors. Results The prevalence of NSSI among the participants was 40.5%. Significant correlations were found between NSSI and several demographic and physiological factors. Specifically, NSSI was significantly associated with female gender, non-only-child status, younger age, lower ALT levels, higher TSH levels, lower FT4 levels, and higher PLR values. However, no significant differences were observed in TG, HDLC, LDLC, FT3, NLR, or MLR between the NSSI and non-NSSI groups. Discussion The findings highlight distinct demographic and physiological profiles associated with NSSI among adolescents with depression. The prevalence rate of NSSI underscores its significance as a behavioral manifestation in this population. Further research should explore the underlying mechanisms linking these factors to better inform targeted interventions and treatment strategies for adolescents experiencing NSSI in the context of depression.
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Affiliation(s)
- Yangliuqing He
- Clinical Medicine College of Guizhou Medical University, Guiyang, China
| | - Yuhan Wei
- Clinical Medicine College of Guizhou Medical University, Guiyang, China
| | - Yiming Wang
- Clinical Medicine College of Guizhou Medical University, Guiyang, China
- Department of Psychiatry, Affiliated Hospital of Guizhou Medical University, Guiyang, China
| | - Fenrong Liang
- Clinical Medicine College of Guizhou Medical University, Guiyang, China
| | - Tianpei Ma
- Clinical Medicine College of Guizhou Medical University, Guiyang, China
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Zheng Q, Zhou HY, Li K, Liu Y, Nan W, Gong J. The effectiveness of mindfulness-based intervention for psychological distress and emotion regulation in college students with non-suicidal self-injury. Appl Psychol Health Well Being 2024. [PMID: 39032127 DOI: 10.1111/aphw.12580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2024] [Accepted: 07/11/2024] [Indexed: 07/22/2024]
Abstract
This study explored the effectiveness of a short-term mindfulness-based intervention (MBI) on psychological distress, mindfulness levels, emotion regulation, and impulsivity among college students with non-suicidal self-injury (NSSI). Participants completed four questionnaires, including the Five Facet Mindfulness Questionnaire, the Depression Anxiety Stress Scale, the Emotion Regulation Questionnaire, and the Brief Barratt Impulsivity Scale, and two behavioral tasks, including an emotion regulation task and a stop signal task (SST), at three time points. Compared with the healthy group, the NSSI group had a significantly greater level of psychological distress and a lower level of mindfulness. Compared with the NSSI control group and the healthy group, the NSSI MBI group had significantly increased mindfulness levels and decreased psychological distress after the intervention. In the NSSI MBI group, regardless of which emotion regulation strategy was adopted when viewing negative pictures, the intensity of negative emotions during the emotion regulation task was significantly reduced. Moreover, in the NSSI MBI group, the effectiveness of the MBI on the mindfulness level, stress level, and emotion regulation process was maintained at the follow-up. The present study provided empirical support that short-term MBI has the potential to help individuals with NSSI by enhancing their emotion regulation.
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Affiliation(s)
- Qiongjuan Zheng
- Department of Psychology and Center for Brain and Cognitive Sciences, School of Education, Guangzhou Higher Education Mega Center, Guangzhou University, Guangzhou, China
| | - Han-Yu Zhou
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
- Shanghai Changning Mental Health Centre, Shanghai, China
| | - Keshuang Li
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Yaohong Liu
- Department of Psychology and Center for Brain and Cognitive Sciences, School of Education, Guangzhou Higher Education Mega Center, Guangzhou University, Guangzhou, China
| | - Weizhi Nan
- Department of Psychology and Center for Brain and Cognitive Sciences, School of Education, Guangzhou Higher Education Mega Center, Guangzhou University, Guangzhou, China
| | - Jingbo Gong
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
- Shanghai Changning Mental Health Centre, Shanghai, China
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Yang J, Zhao Y. Examining bidirectional relations between sleep problems and non-suicidal self-injury/suicidal behavior in adolescents: emotion regulation difficulties and externalizing problems as mediators. Eur Child Adolesc Psychiatry 2024; 33:2397-2411. [PMID: 38150149 DOI: 10.1007/s00787-023-02334-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2023] [Accepted: 11/28/2023] [Indexed: 12/28/2023]
Abstract
Based on previous empirical evidences and theoretical framework, sleep problems and non-suicidal self-injury (NSSI)/suicidal behavior may bidirectionally related to one another. However, this still needs to be examined through longitudinal research. Moreover, the mediating mechanisms accounting for their potential bidirectional relations have yet to be fully investigated. This study thus aimed to evaluate whether sleep problems and NSSI/suicidal behavior promoted each other directly or indirectly through the mediating roles of emotion regulation difficulties (ERD) and externalizing problems. A total of 1648 Chinese adolescents (48.12% boys; Mage = 13.69; SD = 0.82; Age range = 11-16 years old at T1) completed self-report measures on 3-time points across 1 year. Cross-lagged panel models were used to examine the focal longitudinal associations. Results revealed a predictive effect of sleep problems on NSSI and a positive bidirectional relation between sleep problems and suicidal behavior. Moreover, sleep problems exerted an indirect effect on NSSI through ERD, and vice versa. Additionally, both ERD and externalizing problems served as mediators in the pathway from suicidal behavior to sleep problems. This study disentangled the differential mediating roles of ERD and externalizing problems in the longitudinal associations between sleep problems and NSSI/suicidal behavior, which may help provide a more holistic theoretical framework through which to precisely identify key targets for early prevention and intervention of sleep problems and NSSI/suicidal behavior in adolescents.
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Affiliation(s)
- Jiaping Yang
- Department of Psychology, Guangzhou University, 230 Wai Huan Xi Rd, 510006, Guangzhou, China.
| | - Yinqiu Zhao
- School of Psychology, South China Normal University, 510631, Guangzhou, People's Republic of China
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Ahmad SI, Hinshaw SP. A Qualitative Analysis of Perspectives on Self-directed Violence in a Prospective Longitudinal Study of Young Women With and Without Childhood ADHD. J Atten Disord 2024; 28:1255-1266. [PMID: 38294171 PMCID: PMC11168017 DOI: 10.1177/10870547231221729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
OBJECTIVE Non-suicidal self-directed violence (NSSDV) is a significant and growing youth public health crisis. Girls with ADHD are at increased risk of engaging in NSSDV, yet qualitative studies with this population-to better understand manifestations, motivations, and developmental course-are lacking. METHOD We conducted semi-structured, qualitative interviews with a sub-sample of 57 young women (32 with childhood ADHD, 25 neurotypical comparisons; mean age of 27 years, part of a larger prospective longitudinal study) regarding histories and manifestations of NSSDV. RESULTS Inductive and deductive analysis revealed several key themes, including self-perceived reasons for engaging in NSSDV (affect regulation, attention seeking, self-punishment, asserting control), impulsivity, secretiveness, and in some cases motivations for desistance. CONCLUSION Findings underscore the importance of early education and screening, especially among high-risk clinical populations. Increased resources and supports for professionals, parents, and peers are indicated, along with countering the persistent stigma associated with ADHD and NSSDV.
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Affiliation(s)
| | - Stephen P. Hinshaw
- University of California, San Francisco, USA
- University of California, Berkeley, USA
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Zhang C, Li Y, Wang W, Jiang Z, Liu C, Kong Y, Li D, Ran L, Kuang L. Gender Differences of Antioxidant System and Thyroid Function in Depressed Adolescents with Non-Suicidal Self-Injury. Neuropsychiatr Dis Treat 2024; 20:1309-1319. [PMID: 38933097 PMCID: PMC11199165 DOI: 10.2147/ndt.s452643] [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: 12/02/2023] [Accepted: 06/04/2024] [Indexed: 06/28/2024] Open
Abstract
Purpose The aim of our study was to explore the relation between serum levels of non-enzymatic antioxidants, thyroid function with the risk of non-suicidal self-injury (NSSI) in depressed adolescents. Patients and Methods We retrospected the electronic records of 454 hospitalized patients aged 13-17 years old with a diagnosis of major depressive disorder (239 patients with NSSI and 215 subjects without NSSI), and collected their demographic and clinical information, including serum levels of total bilirubin (Tbil), uric acid (UA), free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH). Results The incidence of NSSI was 52.6% among depressed adolescents aged 13-17, 57.1% in female and 38.5% in male. After using the propensity scoring method to exclude the influence of age between the two groups, it was found that patients with NSSI showed lower levels of Tbil (P=0.046) and UA (P=0.015) compared with those without NSSI. Logistic regression results showed that serum UA was associated with NSSI behavior in female patients (OR=0.995, 95% CI: 0.991-0.999, P=0.014), and TSH was associated with NSSI in male participants (OR=0.499, 95% CI: 0.267-0.932, P=0.029). Conclusion Female and male may have different pathological mechanisms of NSSI. NSSI is more likely to be related to antioxidant reaction in female adolescent patients, while more likely to be related to thyroid function in male depressed adolescent patients.
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Affiliation(s)
- Chenyu Zhang
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, 401331, People’s Republic of China
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China
| | - Yalan Li
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, 401331, People’s Republic of China
| | - Wo Wang
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, 401331, People’s Republic of China
| | - Zhenghao Jiang
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, 401331, People’s Republic of China
| | - Chuan Liu
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, 401331, People’s Republic of China
| | - Yiting Kong
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China
| | - Daqi Li
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, 401331, People’s Republic of China
| | - Liuyi Ran
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, 401331, People’s Republic of China
| | - Li Kuang
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, 401331, People’s Republic of China
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, People’s Republic of China
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Ward JH, Becker K, Smith J, Price A, Newlove-Delgado T. Patient, supporter and primary healthcare professional perspectives on health risks in over 16s with attention deficit hyperactivity disorder (ADHD) in England: a national survey study. BMC Health Serv Res 2024; 24:751. [PMID: 38898441 PMCID: PMC11188530 DOI: 10.1186/s12913-024-11188-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Accepted: 06/10/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Current research suggests that people with attention deficit hyperactivity disorder (ADHD) are at higher risk of physical and mental health disorders. This study aimed to explore these health risks in ADHD from the perspectives of multiple stakeholders. METHODS This study forms part of the 'Managing young people with ADHD in Primary care (MAP) study'. A survey developed by the study team was distributed to over 16 year olds with ADHD, their supporters, primary healthcare professionals and health commissioners across England, via social media and through patient/clinical networks (September-October 2022). This survey contained two questions on health risks. Question one asked about views on health risks in ADHD (free text). Question two asked about advice given (options list and free text). Descriptive statistics summarised responses to questions one and two, and qualitative analysis (reflexive thematic analysis) was used to explore free text responses from question one. RESULTS 782 participants responded to the MAP survey. Of these, 206 healthcare professionals, 157 people with ADHD and 88 supporters answered question one. The most mentioned perceived risks were substance misuse, sleep disorders, weight management and smoking. More people with ADHD reported disordered eating as a health risk (n = 32) than healthcare professionals (n = 5). Generated themes included perceived health risks, impact of living with ADHD, lack of adequate healthcare, and need for ADHD awareness. In respect to advice given (question two), based on responses from 258 professionals, 162 people with ADHD and 100 supporters, the most common advice discussed in consultation was mental health (n = 149, n = 50 and n = 17 respectively). High numbers of respondents reported not giving/receiving advice on wider health (n = 38, n = 88 and n = 61 respectively). CONCLUSIONS Findings demonstrate that respondents perceived a range of physical and mental health risks posed by ADHD. These related to difficulties with activities of daily living, as well as healthcare interactions and the impact of core features of ADHD (e.g. impulsivity, emotional dysregulation). These risks are not currently explicitly addressed in United Kingdom national guidance on ADHD. More work is needed to examine and address the broader health outcomes of people with ADHD.
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Affiliation(s)
- John H Ward
- University of Exeter Medical School, 2.05 South Cloisters, St Luke's Campus, Heavitree Road, Exeter, UK.
- Department of Psychiatry, University of Oxford, Oxford, UK.
- Royal Devon University Hospital NHS Foundation Trust, Devon, UK.
- Oxford Health NHS Foundation Trust, Oxford, UK.
| | - Kieran Becker
- University of Exeter Medical School, 2.05 South Cloisters, St Luke's Campus, Heavitree Road, Exeter, UK
| | - Jane Smith
- University of Exeter Medical School, 2.05 South Cloisters, St Luke's Campus, Heavitree Road, Exeter, UK
| | - Anna Price
- University of Exeter Medical School, 2.05 South Cloisters, St Luke's Campus, Heavitree Road, Exeter, UK
| | - Tamsin Newlove-Delgado
- University of Exeter Medical School, 2.05 South Cloisters, St Luke's Campus, Heavitree Road, Exeter, UK
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Cheng J, Guan M, Peng C, Hu J, Rong F, Wang Y, Zhang N, Xu Z, Yu Y. Self-injury and suicidal ideation among Chinese adolescents involved in different subtypes of aggression: The role of gender. J Affect Disord 2024; 355:371-377. [PMID: 38537758 DOI: 10.1016/j.jad.2024.03.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/21/2024] [Accepted: 03/23/2024] [Indexed: 04/07/2024]
Abstract
BACKGROUND Although aggression associated self-injury and suicidal ideation, but the specific impact of different subtypes of aggression is unclear. Therefore, the current study aims to quantify the associations between five subtypes of aggression, self-injury, and suicidal ideation in Chinese adolescents. METHOD A total of 18,532 students were recruited in grades 7 to 12 using a stratified cluster sampling across five representative provinces in China. The Functional Assessment of Self-Mutilation (CH-FASM) and Buss and Warren's Aggression Questionnaire (BWAQ) assess self-injury and aggression, respectively. RESULTS During the last year, the proportion of self-injury, suicidal ideation, and self-injury plus suicidal ideation (SSI) were 13.4 %, 10.0 %, 12.4 %, respectively. Multivariate logistic regression indicated that hostility was associated with self-injury-only (OR = 1.033, 95 % CI = 1.021-1.044), suicidal ideation-only (OR = 1.075, 95 % CI = 1.061-1.088), and SSI (OR = 1.100, 95 % CI = 1.087-1.114) (all P < 0.001) across five subtypes of aggression. In gender stratification, physical aggression was risk factor for self-injury-only, suicidal ideation-only, and SSI (OR = 1.028, 95 % CI = 1.018-1.037, P < 0.001) in females. While anger was association with self-injury-only and suicidal ideation-only in males (P < 0.05). LIMITATIONS This study was a cross-sectional design and self-reported questionnaire. CONCLUSION Hostility is a strong predictor of self-injury and suicidal ideation across five subtypes of aggression. There are gender differences in relationships. Prevention programs for adolescents' self-injury and suicidal ideation should consider different subtypes of aggression and gender differences.
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Affiliation(s)
- Junhan Cheng
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Meiqi Guan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Chang Peng
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jie Hu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Fajuan Rong
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yan Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Nan Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Zixuan Xu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yizhen Yu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China.
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Gao Y, Liu J, Liu X, Wang Y, Qiu S. Dimensions of family stress and repetitive nonsuicidal self-injury in adolescence: Examining the interactive effects of impulsivity and emotion dysregulation. CHILD ABUSE & NEGLECT 2024; 152:106804. [PMID: 38636157 DOI: 10.1016/j.chiabu.2024.106804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 10/16/2023] [Accepted: 04/12/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Repetitive non-suicidal self-injury (R-NSSI) in adolescence represents a significant risk factor for suicide. Although exposure to family stress is robustly associated with the risk of non-suicidal self-injury (NSSI), studies have not examined the potential mechanisms linking different forms of family stress and R-NSSI. OBJECTIVE This study examined how unique dimensions of family stress (threat and deprivation) relate to R-NSSI via interactions between impulsivity and emotion dysregulation. PARTICIPANTS AND SETTING The current sample included 3801 middle-school adolescents (42.2 % girls, Mage = 13.21 years). METHODS We conducted a two-wave study with 6-month intervals. Participants completed self-report measures assessing family stress, impulsivity, emotion dysregulation, and NSSI. RESULTS Moderate mediation analyses showed that threat was indirectly associated with NSSI frequency through the interaction of impulsivity and emotion dysregulation in the R-NSSI group and indirectly through impulsivity in the occasional NSSI (O-NSSI) group. Deprivation did not predict subsequent NSSI frequency in either group. CONCLUSIONS These findings lend empirical support to dimensional models of adversity and suggest that adolescents who experience threat-related family stress may have greater impulsivity and are more likely to report R-NSSI in the context of emotion dysregulation.
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Affiliation(s)
- Yemiao Gao
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Jinmeng Liu
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Xia Liu
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China.
| | - Yumeng Wang
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Shaojie Qiu
- Faculty of Psychology, Beijing Normal University, Beijing, China
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French B, Nalbant G, Wright H, Sayal K, Daley D, Groom MJ, Cassidy S, Hall CL. The impacts associated with having ADHD: an umbrella review. Front Psychiatry 2024; 15:1343314. [PMID: 38840946 PMCID: PMC11151783 DOI: 10.3389/fpsyt.2024.1343314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Accepted: 03/14/2024] [Indexed: 06/07/2024] Open
Abstract
Introduction Attention Deficit Hyperactivity Disorder (ADHD) affects up to 5% of the population and is characterised by symptoms of impulsivity, hyperactivity and inattention. These symptoms are significantly impairing and carry additional risks for children and adults with ADHD, including negative mental health (e.g. depression), physical health (e.g. obesity) and societal outcomes (e.g. imprisonment, divorce). Very few studies have attempted to synthesise these risks in one publication due to the breadth of evidence published on the adverse outcomes of ADHD. Methods An umbrella review was performed to identify reviews (systematic, meta-analysis and narrative) that investigate the risks arising from having ADHD. We conducted a narrative synthesis of the findings and conducted a quality review of the included publications. Results Upon searching five databases, 16,675 records were identified. Of these, 125 reviews met the criteria for inclusion. A narrative synthesis of these findings highlighted three key domains of risks associated with ADHD: mental health, physical health, social and lifestyle. Most reviews were of good and moderate quality. Discussion This review highlights the many risks associated with having ADHD, beyond its three key symptom domains and the impact of the condition on daily functioning. Registration International Prospective Register of Systematic Reviews (PROSPERO CRD42023404073).
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Affiliation(s)
- Blandine French
- NIHR MindTech MedTech Cooperative, Nottingham National Institute of Health Research Biomedical Research Center (NIHR BRC), Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
- School of Psychology, University of Nottingham, Nottingham, United Kingdom
| | - Gamze Nalbant
- Lifespan and Population Health Unit, University of Nottingham, Nottingham, United Kingdom
| | - Hannah Wright
- NIHR MindTech MedTech Cooperative, Nottingham National Institute of Health Research Biomedical Research Center (NIHR BRC), Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Kapil Sayal
- NIHR MindTech MedTech Cooperative, Nottingham National Institute of Health Research Biomedical Research Center (NIHR BRC), Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - David Daley
- Nottingham Trent University (NTU) Psychology, School of Social Science, Nottingham Trent University, Nottingham, United Kingdom
| | - Madeleine J. Groom
- NIHR MindTech MedTech Cooperative, Nottingham National Institute of Health Research Biomedical Research Center (NIHR BRC), Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
| | - Sarah Cassidy
- School of Psychology, University of Nottingham, Nottingham, United Kingdom
| | - Charlotte L. Hall
- NIHR MindTech MedTech Cooperative, Nottingham National Institute of Health Research Biomedical Research Center (NIHR BRC), Institute of Mental Health, School of Medicine, University of Nottingham, Nottingham, United Kingdom
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Rasmussen S, Martin B, Cramer RJ. Multidimensional Impulsivity and Suicidal Behaviour: A Partial Test of the Integrated Motivational-Volitional (IMV) Model of Suicide. Arch Suicide Res 2024:1-19. [PMID: 38411534 DOI: 10.1080/13811118.2024.2322118] [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: 02/28/2024]
Abstract
OBJECTIVE Suicide remains a public health problem within the United Kingdom (UK) and globally. Impulsivity is a key risk factor within the Integrated Motivational-Volitional Model (IMV) of Suicide warranting further study. The current study applied a multi-dimensional impulsivity framework (UPPS-P) to differentiate suicidality subgroups within an IMV framework (i.e., no suicidal behavior, suicidal ideation only, and suicide attempt). Impulsivity subscales were evaluated as moderators of the suicidal ideation-future suicide attempt link. METHOD Adults living in the UK (N = 1027) completed an online survey addressing demographics, impulsivity, psychological distress, and lifetime suicidal behavior. We used analysis of variance (ANOVA) and linear regression with simple slopes analyses to investigate study objectives. RESULTS Data analyses revealed that: (1) four impulsivity subtypes (negative urgency, positive urgency, lack of premeditation, sensation-seeking) differentially distinguished suicidal behavior groups; (b) negative urgency, positive urgency, and lack of premeditation were meaningfully associated with suicide outcomes, and (c) negative urgency served as a moderator of the suicidal ideation-future attempt link. CONCLUSIONS Urgency, regardless of positive or negative valence, is important for understanding differences in lifetime suicidal behavior. Sensation-seeking may play a protective role for direct suicidal behavior. Negative urgency may be the most prominent aspect of impulsivity when considered as an IMV moderator. Findings are contextualized with respect to impulsivity and IMV frameworks. Clinical implications involve accounting for negative urgency in suicide risk assessment and intervention.
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13
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Salles J, Stephan F, Molière F, Bennabi D, Haffen E, Bouvard A, Walter M, Allauze E, Llorca PM, Genty JB, Leboyer M, Holtzmann J, Nguon AS, D'Amato T, Rey R, Horn M, Vaiva G, Fond G, Richieri R, Hennion V, Etain B, El-Hage W, Camus V, Courtet P, Aouizerate B, Yrondi A. Indirect effect of impulsivity on suicide risk through self-esteem and depressive symptoms in a population with treatment-resistant depression: A FACE-DR study. J Affect Disord 2024; 347:306-313. [PMID: 37992775 DOI: 10.1016/j.jad.2023.11.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 11/15/2023] [Accepted: 11/17/2023] [Indexed: 11/24/2023]
Abstract
INTRODUCTION Suicide is a major health issue. Its prevalence is particularly high in subjects presenting major depression disorder (MDD), making this a key suicide-related risk factor. Suicide attempts in severe forms of MDD were assumed to be linked to impulsivity and loss of control. Nevertheless, we failed to find data specifically investigating the link between impulsivity and suicide risk in treatment-resistant depression (TRD). This study seeks to review this relationship. METHOD Patients were recruited for a prospective cohort. Suicide risk and impulsivity were assessed using the International Neuropsychiatric Interview and Barratt Impulsiveness Scale, Version 10, respectively, while the severity of depressive symptoms was assessed using the Montgomery-Asberg Depression Rating Scale, anxiety with the State-Trait Anxiety Inventory and childhood maltreatment using the Childhood Trauma Questionnaire. RESULTS 220 TRD patients were enrolled in the study. The impulsivity score was correlated with self-esteem, marital status, professional status and anxiety. There was no direct link to suicide risk. However, impulsivity was associated with self-esteem (coefficient: -0.24; p value 0.043) and depressive symptom severity (coefficient: 0.; p value 0.045). The suicide risk was significantly correlated with depressive symptom severity (coefficient = 0.38, p < 0.001) and self-esteem (coefficient = -0.34, p = 0.01). Considering these correlations, we postulated that the effect of impulsivity on suicide risk could be mediated by self-esteem in terms of depressive symptom severity and we finally found a relevant mediation model within impulsivity having an indirect effect on suicide risk by impacting self-esteem and depressive symptoms with anxiety also playing a significant role as a covariable. CONCLUSION We found that impulsivity could play an indirect role with the involvement of self-esteem and depressive symptoms and the contributing role of anxiety.
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Affiliation(s)
- Juliette Salles
- Fondation FondaMental (FondaMental Foundation), Créteil, France; Service des urgences psychiatriques, Infinity (Infinity, Department of Emergency Psychiatry), INSERM UMR1291, CNRS UMR5051, Centre Hospitalier Universitaire de Toulouse (Toulouse University Hospital), Toulouse, France
| | - Florian Stephan
- Fondation FondaMental (FondaMental Foundation), Créteil, France; Service Hospitalo-Universitaire de Psychiatrie Générale et de Réhabilitation Psycho Sociale 29G01 et 29G02 (University Hospital Department of General Psychiatry and Psycho-Social Rehabilitation 29G01 and 29G02), Centre Expert Depression Résistante FondaMental (Fondaental Expert Centre for Resistant Depression), EA 7479, CHRU de Brest (Brest Regional University Hospital), Hôpital de Bohars (Bohars Hospital), Brest, France
| | - Fanny Molière
- Fondation FondaMental (FondaMental Foundation), Créteil, France; Department of Emergency Psychiatry and Acute Care, CHU Montpellier (Montpellier University Hospital), INSERM U1061, Montpellier University, Montpellier, France
| | - Djamila Bennabi
- Fondation FondaMental (FondaMental Foundation), Créteil, France; Service de Psychiatrie (Department of Psychiatry), Centre Expert Dépression Résistante FondaMental (FondaMental Expert Centre for Resistant Depression), CIC-1431 INSERM, CHU de Besançon (Besançon University Hospital), EA 481 Neurosciences, Université de Bourgogne Franche Comté, Besançon, France
| | - Emmanuel Haffen
- Fondation FondaMental (FondaMental Foundation), Créteil, France; Service de Psychiatrie (Department of Psychiatry), Centre Expert Dépression Résistante FondaMental (FondaMental Expert Centre for Resistant Depression), CIC-1431 INSERM, CHU de Besançon (Besançon University Hospital), EA 481 Neurosciences, Université de Bourgogne Franche Comté, Besançon, France
| | - Alexandra Bouvard
- Fondation FondaMental (FondaMental Foundation), Créteil, France; Pôle de Psychiatrie Générale et Universitaire (General and University Psychiatry Unit), Centre de référence régional des pathologies anxieuses et de la dépression (Regional Reference Centre for Anxiety and Depression-Related Disorders), Centre Expert Dépression Résistante FondaMental, CH Charles Perrens, Bordeaux, Laboratoire Nutrition et Neurobiologie intégrée (Integrated Nutrition and Neurobiology Laboratory) (UMR INRAE 1286), Université de Bordeaux, Bordeaux, France
| | - Michel Walter
- Fondation FondaMental (FondaMental Foundation), Créteil, France; Service Hospitalo-Universitaire de Psychiatrie Générale et de Réhabilitation Psycho Sociale 29G01 et 29G02 (University Hospital Department of General Psychiatry and Psycho-Social Rehabilitation 29G01 and 29G02), Centre Expert Depression Résistante FondaMental (Fondaental Expert Centre for Resistant Depression), EA 7479, CHRU de Brest (Brest Regional University Hospital), Hôpital de Bohars (Bohars Hospital), Brest, France
| | - Etienne Allauze
- Fondation FondaMental (FondaMental Foundation), Créteil, France; Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, EA 7280 Clermont-Ferrand, France
| | - Pierre Michel Llorca
- Fondation FondaMental (FondaMental Foundation), Créteil, France; Department of Psychiatry, CHU Clermont-Ferrand, University of Clermont Auvergne, EA 7280 Clermont-Ferrand, France
| | - Jean Baptiste Genty
- Fondation FondaMental (FondaMental Foundation), Créteil, France; Université Paris-Est, UMR_S955, UPEC, Créteil, France Inserm, U955, Equipe 15 Psychiatrie génétique (Team 15 Genetic Psychiatry), Créteil, France AP-HP, Hôpital H. Mondor-A. Chenevier, Pôle de psychiatrie (Psychiatry Unit), Créteil, France Fondation FondaMental, Fondation de Cooperation Scientifique (Foundation for Scientific Cooperation), Créteil, France
| | - Marion Leboyer
- Fondation FondaMental (FondaMental Foundation), Créteil, France; Université Paris-Est, UMR_S955, UPEC, Créteil, France Inserm, U955, Equipe 15 Psychiatrie génétique (Team 15 Genetic Psychiatry), Créteil, France AP-HP, Hôpital H. Mondor-A. Chenevier, Pôle de psychiatrie (Psychiatry Unit), Créteil, France Fondation FondaMental, Fondation de Cooperation Scientifique (Foundation for Scientific Cooperation), Créteil, France
| | - Jérôme Holtzmann
- Fondation FondaMental (FondaMental Foundation), Créteil, France; Service de Psychiatrie de l'adulte (Department of Adult Psychiatry), Centre Expert Dépression Résistante FondaMental, CHU de Grenoble-Alpes, Hôpital Nord, Grenoble, CS 10217, France
| | - Anne Sophie Nguon
- Fondation FondaMental (FondaMental Foundation), Créteil, France; Service de Psychiatrie de l'adulte (Department of Adult Psychiatry), Centre Expert Dépression Résistante FondaMental, CHU de Grenoble-Alpes, Hôpital Nord, Grenoble, CS 10217, France
| | - Thierry D'Amato
- Fondation FondaMental (FondaMental Foundation), Créteil, France; INSERM U1028, CNRS UMR5292, University Lyon 1, Lyon Neuroscience Research Centre, Psychiatric Disorders: from Resistance to Response ΨR2 Team, Centre Hospitalier Le Vinatier, Bron, France
| | - Romain Rey
- Fondation FondaMental (FondaMental Foundation), Créteil, France; INSERM U1028, CNRS UMR5292, University Lyon 1, Lyon Neuroscience Research Centre, Psychiatric Disorders: from Resistance to Response ΨR2 Team, Centre Hospitalier Le Vinatier, Bron, France
| | - Mathilde Horn
- Fondation FondaMental (FondaMental Foundation), Créteil, France; Service de Psychiatrie adulte (Department of Adult Psychiatry), Centre Expert Dépression Résistante FondaMental, CHRU de Lille, Hôpital Fontan 1, Lille, France
| | - Guillaume Vaiva
- Fondation FondaMental (FondaMental Foundation), Créteil, France; Service de Psychiatrie adulte (Department of Adult Psychiatry), Centre Expert Dépression Résistante FondaMental, CHRU de Lille, Hôpital Fontan 1, Lille, France; Centre National de Ressources et Résilience pour les psychotraumatismes (National Psychological Trauma Resource and Resilience Centre) (Cn2r Lille Paris), Lille, France
| | - Guillaume Fond
- Fondation FondaMental (FondaMental Foundation), Créteil, France; Faculté de Médecine (Faculty of Medicine), Marseille Univ, EA 3279, Service d'Épidémiologie et d'Économie de la Santé (Department of Epidemiology and Health Economics), Marseille, France
| | - Raphaelle Richieri
- Fondation FondaMental (FondaMental Foundation), Créteil, France; Pôle Psychiatrie (Psychiatry Unit), Centre Expert Dépression Résistante FondaMental, CHU La Conception, Marseille, France
| | - Vincent Hennion
- Fondation FondaMental (FondaMental Foundation), Créteil, France; Département de Psychiatrie et de Médecine Addictologique (Department of Psychiatry and Addiction Medicine), Lariboisière-Fernand Widal GHU APHP Nord Université Paris cité Paris, France
| | - Bruno Etain
- Fondation FondaMental (FondaMental Foundation), Créteil, France; Département de Psychiatrie et de Médecine Addictologique (Department of Psychiatry and Addiction Medicine), Lariboisière-Fernand Widal GHU APHP Nord Université Paris cité Paris, France; Université Paris Cité, INSERM UMR-S 1144, Optimisation Thérapeutique en Neurospsychopharmacologie (Therapeutic Optimisation in Neuropsychopharmacology), OTeN, F-75006 Paris, France
| | - Wissam El-Hage
- Fondation FondaMental (FondaMental Foundation), Créteil, France; U1253, iBrain, CIC1415, Inserm, Pôle psychiatrie-Addictologie, (Psychiatry-Addiction Unit) CHRU de Tours, Université de Tours, Tours, France
| | - Vincent Camus
- Fondation FondaMental (FondaMental Foundation), Créteil, France; U1253, iBrain, CIC1415, Inserm, Pôle psychiatrie-Addictologie, (Psychiatry-Addiction Unit) CHRU de Tours, Université de Tours, Tours, France
| | - Philippe Courtet
- Fondation FondaMental (FondaMental Foundation), Créteil, France; Department of Emergency Psychiatry and Acute Care, CHU Montpellier (Montpellier University Hospital), INSERM U1061, Montpellier University, Montpellier, France
| | - Bruno Aouizerate
- Fondation FondaMental (FondaMental Foundation), Créteil, France; Pôle de Psychiatrie Générale et Universitaire (General and University Psychiatry Unit), Centre de référence régional des pathologies anxieuses et de la dépression (Regional Reference Centre for Anxiety and Depression-Related Disorders), Centre Expert Dépression Résistante FondaMental, CH Charles Perrens, Bordeaux, Laboratoire Nutrition et Neurobiologie intégrée (Integrated Nutrition and Neurobiology Laboratory) (UMR INRAE 1286), Université de Bordeaux, Bordeaux, France
| | - Antoine Yrondi
- Fondation FondaMental (FondaMental Foundation), Créteil, France; Service de Psychiatrie et de Psychologie Médicale (Department of Psychiatry and Medical Psychology), Centre Expert Dépression Résistante FondaMental, CHU de Toulouse, Hôpital Purpan, ToNIC Toulouse NeuroImaging Centre, Université de Toulouse, INSERM, UPS, Toulouse, France.
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14
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Bilello D, Townsend E, Broome MR, Burnett Heyes S. Friendship and self-harm: a retrospective qualitative study of young adults' experiences of supporting a friend who self-harmed during adolescence. Front Psychol 2024; 14:1221661. [PMID: 38370107 PMCID: PMC10869467 DOI: 10.3389/fpsyg.2023.1221661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 12/11/2023] [Indexed: 02/20/2024] Open
Abstract
Introduction Self-harm amongst young people is becoming increasingly prevalent. Understanding, responding to, and supporting young people who self-harm is vital. Friends are typically the first and sometimes the only source of support sought by adolescents who self-harm. Despite their important role as confidants, friends' perspectives and experiences remain poorly understood. Methods We conducted retrospective qualitative semi-structured interviews, prompted by an adapted version of the Card Sort Task for Self-Harm (CaTS-FF), about the experiences of nine female young adults (18-20 years old) who supported a friend who self-harmed during adolescence. Data were analyzed using thematic analysis. Results Four themes were developed: (1) "I did not realize my friend was on the road to self-harm": Friends' reactions to self-harm; (2) "That's what friends do": the role of friends; (3) The impact of supporting a friend who self-harms; and (4) "They were quite formative years": reflecting on growth through the experience. Discussion The present findings highlight the complex experiences of young people supporting a friend who self-harms. Despite being willing to take on the role of a supporter, participants experienced a range of difficult emotions and consequences. The temporal transition running through the four themes reflects the evolving nature of participants' attitudes, knowledge, and friendships. Overall, results highlight the unmet needs of adolescents supporting young people who self-harm, as well as identifying potential pathways to "support the supporters" toward resilience.
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Affiliation(s)
- Delfina Bilello
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
| | - Ellen Townsend
- Self-Harm Research Group, School of Psychology, University Park, The University of Nottingham, Nottingham, United Kingdom
| | - Matthew R. Broome
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
| | - Stephanie Burnett Heyes
- School of Psychology, University of Birmingham, Birmingham, United Kingdom
- Institute for Mental Health, University of Birmingham, Birmingham, United Kingdom
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15
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Pears KC, Tiberio SS, Kim HK. Reducing Suicidal Ideation in Preadolescents With a History of Foster Care by Promoting School Readiness in Early Childhood. CHILD MALTREATMENT 2024; 29:165-175. [PMID: 35835729 DOI: 10.1177/10775595221115209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Preadolescents with a history of foster care placement report suicidal ideation (SI) at higher rates than their peers, which increases their risk for suicide attempts in adolescence. Despite these increased risks, few interventions have been shown to reduce SI in these youth. This study examined the main and mediated long-term effects of a program to increase school readiness in children in foster care at age 5 years on SI when the children were ages 9-11 years, 4-6 years after the intervention ended. Children who received the intervention were less likely to report SI, although the difference did not reach statistical significance. The intervention reduced SI indirectly through its positive effect on children's self-esteem at age 9 years. Implications for programming to reduce SI and subsequent suicide attempts in youth with a history of foster care are discussed.
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Affiliation(s)
- Katherine C Pears
- Oregon Social Learning Center, Eugene, OR, USA
- OSLC Developments, Inc, Eugene, OR, USA
| | | | - Hyoun K Kim
- Department of Child & Family Studies, Yonsei University, Seodaemun-gu, Korea
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16
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Meza JI, Folk J, Hoskins D, Kemp K, Tolou-Shams M. Risk and Protective Factors Associated with Self-Cutting Behavior Among Adolescents at First Contact with the Juvenile Court. J Youth Adolesc 2023; 52:2494-2508. [PMID: 37592194 PMCID: PMC10522515 DOI: 10.1007/s10964-023-01839-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 07/25/2023] [Indexed: 08/19/2023]
Abstract
Adolescents involved in juvenile legal system are at increased risk for self-cutting behavior, however, correlates associated with elevated risk remain underresearched, particularly among youth with first involvement with the court. This study utilized an epidemiological two-year longitudinal study involving 401 adolescents at first contact with the court (Mage = 14.47; SDage = 1.94 years; 43% female; 42% Latinx/Hispanic) and an involved caregiver. Study aims examined key prospective psychosocial correlates of self-cutting behavior. Baseline assessments captured individual and family level risk and protective factors; self-cutting behavior was assessed longitudinally every four months post-baseline for 24 months. Psychosocial correlates of self-cutting behavior included adolescent affect dysregulation, post-traumatic stress disorder symptoms, impulsive decision making, anxiety and depression symptoms. Significant protective factors included positive communication with caregiver and family, higher self-esteem, and having a caring and supportive family. These findings suggest that internalizing symptoms as well as difficulties with emotion regulation and impulsive decision making are correlated with heightened risk for self-cutting behavior among adolescents involved in the juvenile legal system. The findings also suggest that individual and family level protective factors, like positive communication and a supportive family, are associated with decreased risk for self-cutting behavior among adolescents at first contact with the court.
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Affiliation(s)
- Jocelyn I Meza
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA.
| | - Johanna Folk
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, USA
| | - David Hoskins
- Pediatric Psychology Program, UCSF Benioff Children's Hospital, San Francisco, USA
| | - Kathleen Kemp
- Department of Psychiatry and Human Behavior, Brown University, Warren Alpert Medical School, Providence, USA
- Department of Child and Adolescent Psychiatry and Bradley Hasbro Children's Research Center, Rhode Island Hospital, Providence, USA
| | - Marina Tolou-Shams
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, USA
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17
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McEvoy D, Brannigan R, Cooke L, Butler E, Walsh C, Arensman E, Clarke M. Risk and protective factors for self-harm in adolescents and young adults: An umbrella review of systematic reviews. J Psychiatr Res 2023; 168:353-380. [PMID: 37972513 DOI: 10.1016/j.jpsychires.2023.10.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 09/13/2023] [Accepted: 10/13/2023] [Indexed: 11/19/2023]
Abstract
We conducted an umbrella review to synthesise the evidence from systematic reviews and meta-analyses that examined the risk and protective factors for self-harm in young people. We searched six different databases and used the AMSTAR-2 checklist for quality assessment. The importance of each risk and protective factor was determined based on (1) the number of times it was identified by general reviews examining any risk or protective factor, and (2) the effect sizes from meta-analyses. There were 61 systematic reviews included in this review. The most frequently identified risk factors for self-harm in young people included childhood abuse, depression/anxiety, bullying, trauma, psychiatric illnesses, substance use/abuse, parental divorce, poor family relationships, lack of friends, and exposure to self-harm behaviour in others. The risk factors with the strongest evidence for an association with self-harm were behavioural disorders, personality disorders and depression or anxiety. There was a dearth of systematic reviews examining protective factors but good family/friend relationships were most frequently identified. There was also evidence to show that non-suicidal and suicidal self-harm shared many of the same risk factors. Clinicians and other professionals who work with young people should be particularly cognisant of the psychiatric and adverse life event risk factors as well as the substance use, education-related and individual-level (e.g. being LGB) risk factors for self-harm. Knowledge of risk factors for self-harm can potentially be used to inform the design and implementation of prevention measures and further research is needed on the protective factors for self-harm.
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Affiliation(s)
- David McEvoy
- School of Population Health, Royal College of Surgeons Ireland (RCSI), Beaux Lane House, Mercer Street Lower, Dublin, 2, Ireland.
| | - Ross Brannigan
- School of Population Health, Royal College of Surgeons Ireland (RCSI), Beaux Lane House, Mercer Street Lower, Dublin, 2, Ireland.
| | - Lorcan Cooke
- School of Medicine, Royal College of Surgeons Ireland (RCSI), Dublin, 2, Ireland.
| | - Emma Butler
- School of Population Health, Royal College of Surgeons Ireland (RCSI), Beaux Lane House, Mercer Street Lower, Dublin, 2, Ireland.
| | - Cathal Walsh
- Health Research Institute, University of Limerick, Limerick, Ireland.
| | - Ella Arensman
- School of Public Health, University College Cork, 4th Floor, Western Gateway Building, Western Road, Cork, Ireland; National Suicide Research Foundation (NSRF), Western Gateway Building, University College Cork, Ireland.
| | - Mary Clarke
- School of Population Health, Royal College of Surgeons Ireland (RCSI), Beaux Lane House, Mercer Street Lower, Dublin, 2, Ireland; Department of Psychiatry, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.
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18
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Esposito C, Dragone M, Affuso G, Amodeo AL, Bacchini D. Prevalence of engagement and frequency of non-suicidal self-injury behaviors in adolescence: an investigation of the longitudinal course and the role of temperamental effortful control. Eur Child Adolesc Psychiatry 2023; 32:2399-2414. [PMID: 36123505 PMCID: PMC10682258 DOI: 10.1007/s00787-022-02083-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 09/10/2022] [Indexed: 11/30/2022]
Abstract
Non-suicidal self-injury (NSSI) is among the most frequent maladaptive behaviors reported in adolescence, with prevalence rates around 18-22% in community samples worldwide. The onset of NSSI typically occurs between early and middle adolescence, with a peak during middle adolescence (14-15 years) and a subsequent decline during late adolescence. This study investigated the growth curves of NSSI across four years during adolescence, analyzing simultaneously the probability of engagement in NSSI at least once (i.e., prevalence) and the frequency of engagement once initiated (i.e., severity). Furthermore, the study examined the predicting role of effortful control on NSSI over time (time-varying effects), net of other key risk factors for NSSI, such as anxiety-depression and bullying victimization. A sample of 430 Italian adolescents enrolled in Grade 9 at baseline was involved in the study. Based on the Latent Growth Curve Zero-inflated Poisson methodology, the results indicated a negative quadratic trend of both NSSI prevalence, with an increase between T1 and T3 followed by a decrease in the subsequent wave, and NSSI frequency once initiated, with a peak at T2 followed by a decline over time. The results also showed that adolescents who reported low effortful control abilities had a heightened probability of involvement in NSSI at each time point, whereas no significant association was found with NSSI frequency once initiated. Findings from this study offer important insights into the developmental course of NSSI and point out the need for future in-depth investigations of the mechanisms that might underlie NSSI prevalence and severity throughout adolescence.
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Affiliation(s)
- Concetta Esposito
- Department of Humanities, University of Naples "Federico II", Naples, Italy.
| | - Mirella Dragone
- Department of Humanities, University of Naples "Federico II", Naples, Italy
| | - Gaetana Affuso
- Department of Psychology, University of Campania "L. Vanvitelli", Caserta, Italy
| | - Anna Lisa Amodeo
- Department of Humanities, University of Naples "Federico II", Naples, Italy
| | - Dario Bacchini
- Department of Humanities, University of Naples "Federico II", Naples, Italy
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19
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Dawe-Lane E, Flouri E. Parenting in the early years and self-harm in adolescence: The role of control and reward systems in childhood. J Affect Disord 2023; 339:788-798. [PMID: 37474012 PMCID: PMC11139656 DOI: 10.1016/j.jad.2023.07.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 07/10/2023] [Accepted: 07/11/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND Research suggests that early parenting may contribute to the development of self-harm but this has not been examined longitudinally. In this study, we explored the relationship between early parenting and self-harm in adolescence and considered whether (1) emotion regulation and (2) decision-making in childhood mediate the relationship between early parenting and self-harm. METHOD Using longitudinal data from the Millennium Cohort Study (MCS), we tested mediation models exploring the relationship between early parenting and self-harm in adolescence via emotion regulation and decision-making. Parenting was assessed at age 3 with measures of conflict, closeness and discipline. The trajectories of independence & self-regulation and emotional dysregulation were modelled from ages 3 to 7 years through latent growth curve analysis, with individual predicted slope and intercept values used in the mediation models. Decision-making (deliberation time, total time, delay aversion, quality of decision making, risk adjustment, risk-taking) was assessed using the Cambridge Gambling Task (CGT) at age 11. RESULTS In our sample (n = 11,145), we found no evidence of a direct association between early parenting and self-harm in adolescence. However, there were indirect effects of parenting (conflict and closeness) on self-harm via the slope of emotional dysregulation. Furthermore, delay aversion was positively associated with self-harm in adolescence. LIMITATIONS It must be acknowledged that we cannot determine causality and that self-report measures of parenting are vulnerable to several biases. CONCLUSION The findings support early identification and interventions for children exhibiting chronic emotional dysregulation and decision-making characterised by a bias for smaller, immediate over larger, delayed rewards.
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Affiliation(s)
- E Dawe-Lane
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom.
| | - E Flouri
- Institute of Education, Psychology and Human Development, University College London, London, United Kingdom
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20
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Wallace GT, Henry KL, Barrett KC, Conner BT. Personality and emotion dysregulation profiles predict differential engagement in a wide range of health-risk behaviors. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:1740-1752. [PMID: 34243687 DOI: 10.1080/07448481.2021.1947302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 03/13/2021] [Accepted: 06/08/2021] [Indexed: 06/13/2023]
Abstract
OBJECTIVE Health-risk behaviors have an unclear etiology and college students have elevated risk for engagement. Emotion dysregulation and several personality dimensions have been implicated in health-risk behaviors, but these constructs have rarely been studied together. Further, it is unknown if different types of health-risk behaviors have distinct etiologies. PARTICIPANTS 2077 college students completed a cross-sectional survey. METHODS Latent profile analysis discerned classes of participants from emotion dysregulation and personality dimensions. Differential engagement in self-injury, suicidality, disordered eating, substance misuse, and unprotected sex was evaluated across classes. RESULTS Three classes were identified, which were primarily distinguished by emotion dysregulation, urgency, and neuroticism. Health-risk behaviors generally increased across classes with increasing emotion-related constructs. Self-injury and suicidality demonstrated different patterns than other health-risk behaviors. CONCLUSIONS Results elucidate heterogeneity in health-risk behavior engagement. Focusing on emotional difficulties may be more important for reducing self-injury and suicidality than disordered eating, substance misuse, and risky sex.
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Affiliation(s)
- Gemma T Wallace
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
| | - Kimberly L Henry
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
| | - Karen C Barrett
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, Colorado, USA
| | - Bradley T Conner
- Department of Psychology, Colorado State University, Fort Collins, Colorado, USA
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21
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Wang LJZ, Lan Y, Liu SJ, Yan WS. Impact of the COVID-19 and psychological risk factors on non-suicidal self-injury behavior among high school students: a one-year follow-up study. BMC Psychiatry 2023; 23:512. [PMID: 37452290 PMCID: PMC10349405 DOI: 10.1186/s12888-023-05021-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Accepted: 07/12/2023] [Indexed: 07/18/2023] Open
Abstract
OBJECTIVES Non-suicidal self-injury (NSSI) behavior is a severe public health issue in adolescents. This study investigated the possible impact of the coronavirus disease 2019 (COVID-19) and analyzed psychological risk factors on adolescent NSSI. METHODS A one-year follow-up study was conducted in September 2019 (Time 1) and September 2020 (Time 2) among 3588 high school students. The completed follow-up participants (N = 2527) were classified into no NSSI (negative at both time points), emerging NSSI (negative at Time 1 but positive at Time 2), and sustained NSSI (positive at both time points) subgroups according to their NSSI behaviors before and during the COVID-19 pandemic. Perceived family functioning, perceived school climate, negative life events, personality traits (neuroticism, impulsivity, and self-control) were assessed using self-report scales. RESULTS The data indicated an increase (10.3%) in the incidence of NSSI. Compared to no NSSI subjects, the emerging NSSI and sustained NSSI subgroups had lower perceived family functioning, higher neuroticism, higher impulse-system but lower self-control scores, and more negative life events. Logistic regressions revealed that after controlling for demographics, neuroticism and impulse-system levels at Time 1 positively predicted emerging NSSI behavior, and similarly, higher neuroticism and impulsivity and lower self-control at Time 1 predicted sustained NSSI behavior. CONCLUSIONS These findings highlighted the aggravated impact of the COVID-19 on NSSI, and suggested that individual neuroticism, impulsivity, and self-control traits might be crucial for the development of NSSI behavior among adolescent students.
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Affiliation(s)
- Lu-Jiao-Zi Wang
- Department of Psychology, School of Medical Humanitarians, Guizhou Medical University, 9 Beijing Road, Yunyan District, Guiyang, 550004, China
| | - Yan Lan
- Department of Psychology, School of Medical Humanitarians, Guizhou Medical University, 9 Beijing Road, Yunyan District, Guiyang, 550004, China
| | - Su-Jiao Liu
- Department of Psychology, School of Medical Humanitarians, Guizhou Medical University, 9 Beijing Road, Yunyan District, Guiyang, 550004, China
| | - Wan-Sen Yan
- Department of Psychology, School of Medical Humanitarians, Guizhou Medical University, 9 Beijing Road, Yunyan District, Guiyang, 550004, China.
- Guizhou Research Institute for Health Development, Guizhou Medical University, Guiyang, China.
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22
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Thomas D, Bonnaire C. Non-Suicidal Self-Injury and Emotional Dysregulation in Male and Female Young Adults: A Qualitative Study. Soa Chongsonyon Chongsin Uihak 2023; 34:159-168. [PMID: 37426830 PMCID: PMC10326353 DOI: 10.5765/jkacap.230033] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 06/09/2023] [Accepted: 06/21/2023] [Indexed: 07/11/2023] Open
Abstract
Objectives Non-suicidal self-injury (NSSI) has been theoretically, clinically, and empirically associated with emotional dysregulation. NSSI is a means of regulating emotional states, particularly negative emotions. However, empirical studies on this topic are scarce and the literature lacks qualitative research on individuals' perceptions and comprehension of the function of self-injury. Thus, this qualitative study aimed to provide novel insights into the relationship between NSSI and emotional dysregulation in young adults. Methods Twelve participants (mean age=22.7 years, 9 females and 3 males) from different support groups and a healthcare center participated in semi-structured interviews on NSSI-related emotional processes. Three aspects were investigated: reasons for NSSI, function of NSSI, and emotions. Each interview was voice recorded and typically lasted between 20 and 40 minutes. All responses were analyzed using thematic analysis. Results Four major themes were identified. The results showed that NSSI had both intrapersonal and interpersonal functions, within which emotional regulation played a significant role. NSSI was also used to regulate positive emotions. The results also showed a sequence of emotions among the participants, going from feeling overwhelmed to feeling relatively calm but guilty. Conclusion NSSI has several functions for the same individual. Thus, it would be interesting to provide integrative therapy, such as emotion-focused therapy, which focus on improving intrapersonal and interpersonal emotion regulation skills and strategies.
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Affiliation(s)
| | - Celine Bonnaire
- Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, Boulogne Billancourt, France
- Centre de Soins d'Accompagnement et de Prévention en Addictologie Pierre Nicole, Paris, France
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23
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Yang L, Jia FF, Lu XY, Jia CX. Internalizing and externalizing problems mediate the relationship between maltreatment and self-harm among UK adolescents. J Affect Disord 2023; 333:240-248. [PMID: 37084976 DOI: 10.1016/j.jad.2023.04.046] [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: 02/26/2023] [Revised: 03/30/2023] [Accepted: 04/14/2023] [Indexed: 04/23/2023]
Abstract
BACKGROUND Maltreatment is a significant predictive factor for self-harm in adolescents. Internalizing and externalizing problems are both common psychopathological issues in adolescents. This study aimed to look into the link between maltreatment and self-harm in a large sample of adolescents in the UK, as well as the mediating effects that internalizing and externalizing problems play in this link. METHODS Data were pulled from the UK Millennium Cohort Study, and a total of 8894 adolescents were included in this analysis. All variables were assessed by Questionnaires. Path analysis was performed to assess the mediating effects of internalizing and externalizing problems in the link between maltreatment and self-harm. RESULTS 23.4 % of samples reported self-harm incidents during the preceding 12 months. Emotional abuse and physical abuse were significantly related to self-harm, and adolescents who had experienced multiple forms of maltreatment were more prone to self-harm. Mediation analysis revealed that internalizing problems were the primary mediator in the link between emotional abuse and self-harm, with the mediation effect size being 0.29. Internalizing and externalizing problems performed similarly in the link between physical abuse and self-harm, with mediation effect sizes of 0.23 and 0.19, respectively. LIMITATIONS The majority of the data was gathered through self-reporting. CONCLUSIONS Emotional abuse and physical abuse were significant predictors of self-harm, and their links with self-harm were partially mediated via internalizing and externalizing problems. Better supervision of maltreatment, and timely intervention for both internalizing and externalizing problems, are critical in preventing self-harm among adolescents.
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Affiliation(s)
- Li Yang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Fei-Fei Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
| | - Xin-Yi Lu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
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24
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Wang M, Eaton NR. Linking non-suicidal self-injury to psychopathology: The utility of transdiagnostic and DSM-based models. J Affect Disord 2023; 332:55-63. [PMID: 37004904 DOI: 10.1016/j.jad.2023.03.075] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 03/02/2023] [Accepted: 03/24/2023] [Indexed: 04/04/2023]
Abstract
Non-suicidal self-injury (NSSI) is a significant public health concern, and its primary formal link to the universe of psychopathology content in DSM diagnoses has been mostly through borderline personality disorder (BPD). Recent research has produced ample evidence of weaknesses of diagnoses relative to transdiagnostic psychopathology dimensions, and found that NSSI-related variables like suicidality are best predicted by transdiagnostic versus diagnosis-based variables. These findings suggest a need to characterize how NSSI may relate to different forms of psychopathology classification constructs. We examined how transdiagnostic dimensions of psychopathology relate to NSSI, focusing on how transdiagnostic (shared) variance of dimensional psychopathology spectra might differentially explained the variance in NSSI relative to traditional DSM diagnoses. In two nationally representative United States samples (Ns = 34,653 and 36,309), we modeled the common distress-fear-externalizing transdiagnostic comorbidity model and investigated questions of predictive utility of these dimensional and categorical psychopathology structures. Transdiagnostic dimensions were superior in predicting NSSI compared to common DSM-IV and DSM-5 diagnoses. These dimensions accounted for 33.6-38.7 % of NSSI variance across all analyses in both samples. DSM-IV/DSM-5 diagnoses, however, demonstrated only modest incremental prediction of NSSI over and above the transdiagnostic dimensions. These results support a transdiagnostic reconceptualization of NSSI's links with psychopathology and highlight the importance of transdiagnostic dimensions for predicting clinical outcomes relating to self-injurious behaviors. Implications for research and clinical practice are discussed.
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Affiliation(s)
- Mengxing Wang
- Department of Psychology, Stony Brook University, United States of America.
| | - Nicholas R Eaton
- Department of Psychology, Stony Brook University, United States of America
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25
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Arnold S, Correll CU, Jaite C. Frequency and correlates of lifetime suicidal ideation and suicide attempts among consecutively hospitalized youth with anorexia nervosa and bulimia nervosa: results from a retrospective chart review. Borderline Personal Disord Emot Dysregul 2023; 10:10. [PMID: 36998054 PMCID: PMC10064676 DOI: 10.1186/s40479-023-00216-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 02/25/2023] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Youth with eating disorders (EDs) face an increased risk of a premature suicide death. Precursors of completed suicide are suicidal ideation and suicide attempts, which need to be well understood to prevent suicide. However, epidemiological data on the lifetime prevalence and clinical correlates of suicidal ideation and suicide attempts (i.e., "suicidality") are lacking for the vulnerable group of inpatient ED youth. METHODS This retrospective chart review was conducted at a psychiatric child and adolescent inpatient department, covering a 25-year period. Consecutively hospitalized youth with an ICD-10 diagnosis of anorexia nervosa (AN), restricting type (AN-R), binge-purging type (AN-BP), and bulimia nervosa (BN) were included. Data extraction and coding were standardized with trained raters extracting information from patient records according to a procedural manual and using a piloted data extraction template. The lifetime prevalence of suicidal ideation and suicide attempts was calculated for each ED subgroup, and clinical correlates of suicidality were analyzed via multivariable regression analyses. RESULTS In the sample of 382 inpatients aged 9-18 years (median age = 15.6, females = 97.1%; AN-R: n = 242, BN: n = 84, AN-BP: n = 56), 30.6% of patients had lifetime suicidal ideation (BN:52.4% ≈ AN-BP:44.6% > AN-R:19.8%, χ2(2,382) = 37.2, p < 0.001, Φ = 0.31), and 3.4% of patients reported a history of suicide attempts (AN-BP:8.9% ≈ BN:4.8% > AN-R:1.7%, χ2(2,382) = 7.9, p = 0.019, Φ = 0.14). Independent clinical correlates of suicidality were i) for AN-R a higher number of psychiatric comorbidities (OR = 3.02 [1.90, 4.81], p < 0.001), and body weight < 1st BMI percentile at hospital admission (OR = 1.25 [1.07,1.47], p = 0.005) (r2 = 0.20); ii) for AN-BP patients a higher number of psychiatric comorbidities (OR = 3.68 [1.50, 9.04], p = 0.004) and history of childhood abuse (OR = 0.16 [0.03, 0.96], p = 0.045) (r2 = 0.36), and iii) for BN patients a higher prevalence of non-suicidal self-injury (NSSI)(OR = 3.06 [1.37, 6.83], p = 0.006) (r2 = 0.13). CONCLUSIONS About half of youth inpatients with AN-BP and BN had lifetime suicidal ideation, and one-tenth of patients with AN-BP had attempted suicide. Treatment programs need to address specific clinical correlates of suicidality, namely, low body weight, psychiatric comorbidities, history of childhood abuse, and NSSI. TRIAL REGISTRATION This study was not a clinical trial but a retrospective chart review based on routinely assessed clinical parameters. The study includes data from human participants; however: (1) no intervention and no prospective assignment to interventions were performed, and (2) no evaluation of intervention in participants was accomplished.
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Affiliation(s)
- Sabine Arnold
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité - Universitaetsmedizin Berlin, corporate member of Freie Universitaet Berlin, Humboldt Universitaet zu Berlin, and Berlin Institute of Health, Berlin, Germany.
| | - Christoph U Correll
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité - Universitaetsmedizin Berlin, corporate member of Freie Universitaet Berlin, Humboldt Universitaet zu Berlin, and Berlin Institute of Health, Berlin, Germany
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Charlotte Jaite
- Department of Child and Adolescent Psychiatry, Psychosomatic Medicine and Psychotherapy, Charité - Universitaetsmedizin Berlin, corporate member of Freie Universitaet Berlin, Humboldt Universitaet zu Berlin, and Berlin Institute of Health, Berlin, Germany
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26
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Berlin J, Wallinius M, Nilsson T, Karlén MH, Delfin C. Exploring the psychometric properties of the externalizing spectrum inventory-brief form in a Swedish forensic psychiatric inpatient sample. BMC Psychiatry 2023; 23:184. [PMID: 36944949 PMCID: PMC10031895 DOI: 10.1186/s12888-023-04609-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 02/13/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND The Externalizing Spectrum Inventory-Brief Form (ESI-BF) [1] is a 160-item self-report instrument designed for the assessment of externalizing psychopathology, yet few studies to date have evaluated its psychometric properties, structural fit, and criterion validity in forensic psychiatric settings. METHODS Here, we investigated these aspects in a sample of forensic psychiatric inpatients (n = 77) from a maximum-security forensic psychiatric hospital in Sweden. We firstly investigated the reliability. Secondly, using confirmatory factor analysis, the structure of the ESI-BF. And thirdly, using a Bayesian approach, assessed how the three ESI-BF subfactors relate to criterion measures of antisocial behaviors, substance use, and lifetime externalizing spectrum diagnoses. RESULTS The ESI-BF demonstrated good to adequate reliability and internal consistency, with all but four facet scales exhibiting α and ω values ≥ 0.80. Average inter-item correlations for the facet scales ranged from 0.31 to 0.74. However, all structural models exhibited poor to mediocre fit, with model fit values for the CFI being 0.66, 0.79 and 0.87 and RMSEA values of 0.14, 0.12 and 0.09. for the unidimensional correlated factors and bifactor model, respectively. Regarding criterion validity, all subscales of the item-based ESI-BF three-factor model exhibited robust correlations with the Life History of Aggression total, aggression and antisocial/consequences subscales, with correlations ranging from 0.29 to 0.55. All ESI-BF subfactors demonstrated robust associations, yet with different externalizing outcomes, lending tentative support to its criterion validity. CONCLUSION Despite remaining ambiguities regarding its structural fit, the ESI-BF may be promising for assessing externalizing psychopathology in forensic psychiatric populations. However, further investigation of the ESI-BF is needed before any firm conclusions can be drawn about its appropriateness in forensic psychiatric settings.
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Affiliation(s)
- Johan Berlin
- Lund Clinical Research on Externalizing and Developmental Psychopathology (LU-CRED), Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund University, Lund, Sweden.
- Centre of Ethics, Law and Mental Health (CELAM), Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden.
- Research Department, Regional Forensic Psychiatric Clinic, Växjö, Sweden.
- Rättspsykiatriska regionkliniken, Box 1223, 351 12, Växjö, Sweden.
| | - Märta Wallinius
- Lund Clinical Research on Externalizing and Developmental Psychopathology (LU-CRED), Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund University, Lund, Sweden
- Centre of Ethics, Law and Mental Health (CELAM), Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Research Department, Regional Forensic Psychiatric Clinic, Växjö, Sweden
| | - Thomas Nilsson
- Centre of Ethics, Law and Mental Health (CELAM), Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Department for Forensic Psychiatry, The National Board of Forensic Medicine, Gothenburg, Sweden
- Sahlgrenska University Hospital, University of Gothenburg, Gothenburg, Sweden
| | - Malin Hildebrand Karlén
- Centre of Ethics, Law and Mental Health (CELAM), Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Department for Forensic Psychiatry, The National Board of Forensic Medicine, Gothenburg, Sweden
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
- Institute for Globally Distributed Open Research and Education (IGDORE), Gothenburg, Sweden
| | - Carl Delfin
- Lund Clinical Research on Externalizing and Developmental Psychopathology (LU-CRED), Department of Clinical Sciences Lund, Child and Adolescent Psychiatry, Lund University, Lund, Sweden
- Centre of Ethics, Law and Mental Health (CELAM), Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden
- Research Department, Regional Forensic Psychiatric Clinic, Växjö, Sweden
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27
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Piarulli FM, Margari A, Margari F, Matera E, Croce F, Furente F, Gabellone A, Petruzzelli MG. Do Cortisol and Dehydroepiandrosterone Influence Motivational Factors for Non-Suicidal Self-Injury in Female Adolescents? J Clin Med 2023; 12:jcm12051924. [PMID: 36902709 PMCID: PMC10003553 DOI: 10.3390/jcm12051924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 02/26/2023] [Accepted: 02/27/2023] [Indexed: 03/06/2023] Open
Abstract
Non-suicidal self-injury (NSSI) is a significant public health issue that particularly affects female adolescents usually emerging during puberty, with a subsequent reduction and even remission in the phenomenon later in life. The dysregulation of the hormonal stress response, particularly cortisol and dehydroepiandrosterone sulfate (DHEA-S), whose levels increase markedly during pubertal adrenarche, has been associated with the development and maintenance of a wide range of emotional disorders. Our study aims to investigate whether different cortisol-DHEA-S response patterns could be associated with the main motivational moderators to engage NSSI as well as with urgency and motivation to stop NSSI in a sample of female adolescents. We found significant correlations between stress hormones and several factors that support and sustain NSSI, specifically: cortisol levels and distressing/upsetting urge (r = 0.39 and a p = 8.94 × 10-3) and sensation seeking (r = -0.32 and a p = 0.04), as well as cortisol/DHEA-s ratio and external emotion regulation (r = 0.40 and a p = 0.01) and desire to stop NSSI (r = 0.40 and a p = 0.01). Cortisol and DHEA-S may play a role in NSSI through the regulation of stress responses and affective states. Such results could have implications for the development of new and improved treatment and prevention plans for NSSI.
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Affiliation(s)
- Francesco Maria Piarulli
- Department of Translational Biomedicine and Neurosciences (DiBraiN), University “A. Moro”, 7016 Bari, Italy
| | - Anna Margari
- Department of Translational Biomedicine and Neurosciences (DiBraiN), University “A. Moro”, 7016 Bari, Italy
| | - Francesco Margari
- Department of Translational Biomedicine and Neurosciences (DiBraiN), University “A. Moro”, 7016 Bari, Italy
| | - Emilia Matera
- Department of Precision and Regenerative Medicine and Ionian Area (DiMePRe-J), University “A. Moro”, 7016 Bari, Italy
- Correspondence:
| | - Federica Croce
- Department of Translational Biomedicine and Neurosciences (DiBraiN), University “A. Moro”, 7016 Bari, Italy
| | - Flora Furente
- Department of Translational Biomedicine and Neurosciences (DiBraiN), University “A. Moro”, 7016 Bari, Italy
| | - Alessandra Gabellone
- Department of Translational Biomedicine and Neurosciences (DiBraiN), University “A. Moro”, 7016 Bari, Italy
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28
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Moore F, Allott C, O'Connor R. Impulsivity, aggression, and impulsive aggression in suicidality. PERSONALITY AND INDIVIDUAL DIFFERENCES 2023. [DOI: 10.1016/j.paid.2022.111971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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29
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Macía L, Estévez A, Jáuregui P. Gambling: Exploring the Role of Gambling Motives, Attachment and Addictive Behaviours Among Adolescents and Young Women. J Gambl Stud 2023; 39:183-201. [PMID: 35579778 PMCID: PMC9981506 DOI: 10.1007/s10899-022-10124-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/06/2022] [Indexed: 11/28/2022]
Abstract
There is a growing body of research that seeks to understand the aetiology, consequences and risk factors associated with addictive behaviours in youths. However, research examining the specific profile of adolescent females is very limited. Therefore, the objectives of the present study were, firstly, to explore the differences between attachment, gambling motives (social enhancement and coping), positive and negative affect, and addictive behaviours (gambling, drugs, spending, alcohol and video games) in female adolescents with and without risk of gambling problems. Secondly, the relationships between attachment, gambling motives, positive and negative affect and addictive behaviours were analysed in the subsample of female adolescents with problem gambling Thirdly, we examine the predictive role of positive and negative affect, gambling motives, and attachment in the aforementioned addictive behaviours. The sample was composed of 351 adolescents and young women, of which 312 had no risk of gambling and 39 had gambling problems. The results obtained revealed higher scores in drugs, spending, maternal attachment, and all gambling motives in the group of gambling problems. Likewise, analyses showed that the relevance of the predictor variables (attachment, gambling motives, and affect) varied according to the addiction that was taken as a reference point (i.e., gambling, drugs, spending, alcohol and video games).Consequently, the identification of the possible vulnerability factors for each addiction could be useful in the design of prevention and treatment approaches. In addition, the need for integrated and holistic health- and social- care programmes are suggested in terms of sex and age.
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Affiliation(s)
- L. Macía
- Faculty of Health Sciences, Psychology Department, University of Deusto, Apartado 1, 48080 Bilbao, Spain
| | - A. Estévez
- Faculty of Health Sciences, Psychology Department, University of Deusto, Apartado 1, 48080 Bilbao, Spain
| | - P. Jáuregui
- Faculty of Health Sciences, Psychology Department, University of Deusto, Apartado 1, 48080 Bilbao, Spain
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30
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Malejko K, Hafner S, Brown RC, Plener PL, Grön G, Graf H, Abler B. Neural Signatures of Error Processing in Depressed Adolescents with Comorbid Non-Suicidal Self-Injury (NSSI). Biomedicines 2022; 10:biomedicines10123188. [PMID: 36551944 PMCID: PMC9775576 DOI: 10.3390/biomedicines10123188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/24/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022] Open
Abstract
Non-suicidal self-injury (NSSI), as a highly prevalent psychiatric symptom in adolescents and young adults, is defined as the deliberate destruction of body tissue without suicidal intent. Impulsivity and dysfunctional response inhibition have been suggested to play a central role in adolescents' vulnerability to self-harm. To investigate the potentially distinct neurobiology of NSSI, we used a well-established Go/No Go task in which activation of the inferior frontal gyrus (IFG) and dorsal anterior cingulate cortex (dACC) is interpreted as a neural correlate of processing failed response inhibition. Task-based functional magnetic resonance imaging data were obtained from 14 adolescents with a diagnosis of major depression and a history of NSSI (MD-NSSI), 13 depressed adolescents without NSSI (MD-only), and 14 healthy controls (HC). In line with hypotheses of dysfunctional response inhibition, we observed increased rates of commission errors in MD-NSSI along with significantly reduced error-related activations of the dACC and IFG. Intact response inhibition, as reflected by low commission error rates not different from HC, was observed in MD-only, along with increased activation of the error-processing network. Our findings support the hypothesis of a distinct neurobiological signature of NSSI. Further research on biomarkers of NSSI could focus on behavioral and neural correlates of failed response inhibition.
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Affiliation(s)
- Kathrin Malejko
- Department of Psychiatry and Psychotherapy III, University Hospital Ulm, 89075 Ulm, Germany
- Correspondence: ; Tel.: +49-(0)-731-500-61401
| | - Stefan Hafner
- Department of Psychiatry and Psychotherapy III, University Hospital Ulm, 89075 Ulm, Germany
| | - Rebecca C. Brown
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, 89075 Ulm, Germany
| | - Paul L. Plener
- Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, 89075 Ulm, Germany
- Department of Child and Adolescent Psychiatry, Medical University of Vienna, 1090 Vienna, Austria
| | - Georg Grön
- Department of Psychiatry and Psychotherapy III, University Hospital Ulm, 89075 Ulm, Germany
| | - Heiko Graf
- Department of Psychiatry and Psychotherapy III, University Hospital Ulm, 89075 Ulm, Germany
| | - Birgit Abler
- Department of Psychiatry and Psychotherapy III, University Hospital Ulm, 89075 Ulm, Germany
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Ojala O, Kuja-Halkola R, Bjureberg J, Ohlis A, Cederlöf M, Norén Selinus E, Lichtenstein P, Larsson H, Lundström S, Hellner C. Associations of impulsivity, hyperactivity, and inattention with nonsuicidal self-injury and suicidal behavior: longitudinal cohort study following children at risk for neurodevelopmental disorders into mid-adolescence. BMC Psychiatry 2022; 22:679. [PMID: 36329415 PMCID: PMC9635086 DOI: 10.1186/s12888-022-04311-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 10/13/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND The knowledge of how the separate Attention-Deficit/Hyperactivity Disorder (ADHD) subdimensions (impulsivity, hyperactivity, and inattention) are associated with nonsuicidal self-injury (NSSI) and suicidal behavior (SB) is limited. The objective of this study was to investigate the associations of childhood ADHD subdimensions with NSSI and SB in children at risk of neurodevelopmental disorders (NDDs; including ADHD). METHODS The sample (N = 391) included twin pairs where at least one twin screened positive for at least one NDD or common comorbidity at age 9 or 12. Data on ADHD subdimensions was collected through a telephone interview with a caregiver/legal guardian at age 9 or 12, and data on NSSI and SB was collected through an in-person clinical assessment at age 15. The associations between the ADHD subdimensions and NSSI or SB were tested in three different models: (1) univariable, (2) together with the other ADHD subdimensions, and (3) in a confounder-adjusted model including other NDD symptoms in addition to ADHD subdimensions, for NSSI and SB separately. RESULTS A total of 32 (8.2%) adolescents reported life-time engagement of NSSI, and 18 (4.6%) SB. Childhood impulsivity was associated with SB and childhood inattention with NSSI, in all models. Hyperactivity was not meaningfully associated with any of the outcomes. CONCLUSION Impulsivity and inattention, but not hyperactivity, may be of particular importance in understanding SB and NSSI. Brief screening for impulsivity and inattention in childhood could facilitate detection of children vulnerable to NSSI and SB and indicate valuable information for preventive and intervention strategies.
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Affiliation(s)
- Olivia Ojala
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Norra Stationsgatan 69 7th fl, SE-11364, Stockholm, Sweden.
| | - Ralf Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Johan Bjureberg
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Norra Stationsgatan 69 7th fl, SE-11364, Stockholm, Sweden
- Department of Psychology, Stanford University, Stanford, CA, USA
| | - Anna Ohlis
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Norra Stationsgatan 69 7th fl, SE-11364, Stockholm, Sweden
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Martin Cederlöf
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Norra Stationsgatan 69 7th fl, SE-11364, Stockholm, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Eva Norén Selinus
- Region Vastmanland - Uppsala University, Centre for Clinical Research, Vastmanland Hospital, Vasteras, Sweden
- The Swedish School of Sport and Health Sciences, Stockholm, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Sebastian Lundström
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- Centre for Ethics, Law and Mental health (CELAM), Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Clara Hellner
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, & Stockholm Health Care Services, Norra Stationsgatan 69 7th fl, SE-11364, Stockholm, Sweden
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Greenberg NR, Zhai ZW, Hoff RA, Krishnan-Sarin S, Potenza MN. Difficulties in impulse control in adolescents with problematic use of the internet and self-injurious behaviors. Psychiatry Res 2022; 317:114919. [PMID: 37732862 DOI: 10.1016/j.psychres.2022.114919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 10/14/2022] [Accepted: 10/19/2022] [Indexed: 12/24/2022]
Abstract
Problematic use of the internet (PUI) and self-injurious behaviors (SIB) associate in adolescents and both relate to impulsivity. However, studies have not examined whether difficulties in impulse control are shared in adolescents with PUI and SIB, and how PUI relates to SIB frequency and impairment. Here, exploratory factor analysis was performed on a PUI questionnaire based on the Minnesota Impulse Disorder Interview, using survey data from 2,912 Connecticut high-school students. Regression analyses evaluated relationships between PUI factor scores and correlates of SIB. Moderation analyses examined impulsivity and sensation-seeking in relationship to PUI factors and SIB. Two PUI factors were extracted. The first PUI factor was associated with lifetime SIB, frequency, severity, urges, rising tension, and self-perceived problems with SIB. The second factor was associated with lifetime SIB and attempts to reduce SIB. Impulsivity and sensation-seeking associated with PUI factors and SIB, but did not moderate relationships between PUI and SIB. Findings suggest that PUI and SIB are related by difficulties in impulse control, and poor control over internet use is associated with more impairing SIB in adolescents who self-injure. Further research should investigate possible interventions targeting impulsivity and sensation-seeking to prevent PUI and SIB in youth.
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Affiliation(s)
| | - Zu Wei Zhai
- Program in Neuroscience, Middlebury College, Middlebury, VT, USA
| | - Rani A Hoff
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | | | - Marc N Potenza
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA; Connecticut Mental Health Center, New Haven, CT, USA; Connecticut Council on Problem Gambling, Wethersfield, CT, USA; Child Study Center, Yale School of Medicine, New Haven, CT, USA; Department of Neuroscience, Yale University, New Haven, CT, USA; Wu Tsai Institute, Yale University, New Haven, CT, USA.
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Moore H, Sayal K, Williams AJ, Townsend E. Investigating the relationship between bullying involvement and self-harmful thoughts and behaviour in young people: A systematic review. J Affect Disord 2022; 315:234-258. [PMID: 35908603 DOI: 10.1016/j.jad.2022.07.056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 07/11/2022] [Accepted: 07/22/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND There is a complex and inconsistent relationship between bullying involvement and self-harmful thoughts and behaviour (SHTB) in young people. This novel systematic review aims to establish key interacting, moderating and mediating variables associated with SHTB in young people involved in bullying. METHODS The systematic review was registered with PROSPERO: CRD42020192023. A search was conducted (until February 2021) across databases: PubMed/MEDLINE, EMBASE, PsycINFO (Ovid), Cochrane Library, Scopus (Elsevier), Web of Science, ERIC and CINAHL (EBSCOhost). Observational studies containing quantitative primary or secondary data analyses were included in the review, on the basis that they examined interactions, moderators, or mediators between bullying involvement and SHTB in young people. Versions of the Newcastle-Ottawa Scale were used to assess risk of bias in the included studies. RESULTS A total of 57 studies were included. Overall, 3 studies identified interactions, 25 studies identified moderators and 21 studies identified mediators. 9 studies identified moderator-mediators. The findings were categorised as either self-harmful thoughts or self-harmful behaviours and synthesised under the following themes: socio-demographic; depression; parental; personality/psychological; and social/environmental. LIMITATIONS This review uncovered significant heterogeneity and a paucity of replicated studies in the field, therefore, tentative conclusions have been drawn. CONCLUSIONS This comprehensive review highlights the key role of depression as a mediator between traditional/cyber victimisation and SHTB in young people. The moderating effects of gender on mediation models investigating the role of depression suggest the possibility that females involved in bullying may be at increased suicide risk.
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Affiliation(s)
- Hayley Moore
- Self-Harm Research Group, School of Psychology, University Park, University of Nottingham, Nottingham NG7 2RD, UK.
| | - Kapil Sayal
- Institute of Mental Health, School of Medicine, Jubilee Campus, University of Nottingham, Nottingham NG7 2UH, UK
| | - A Jess Williams
- Self-Harm Research Group, School of Psychology, University Park, University of Nottingham, Nottingham NG7 2RD, UK; Institute of Mental Health, School of Medicine, Jubilee Campus, University of Nottingham, Nottingham NG7 2UH, UK; Department of Informatics, Strand Campus, King's College London, London WC2B 4BG, UK
| | - Ellen Townsend
- Self-Harm Research Group, School of Psychology, University Park, University of Nottingham, Nottingham NG7 2RD, UK
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Lan Z, Pau K, Mohd Yusof H, Huang X. Hierarchical topological model of the factors influencing adolescents' non-suicidal self-injury behavior based on the DEMATEL-TAISM method. Sci Rep 2022; 12:17238. [PMID: 36241902 PMCID: PMC9568609 DOI: 10.1038/s41598-022-21377-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 09/27/2022] [Indexed: 01/06/2023] Open
Abstract
This study analyzed the factors influencing adolescents' non-suicidal self-injury (NSSI) behavior and their interrelationships, and established a total influencing factor model. Through a literature analysis and semi-structured interviews with 87 adolescents and 27 experts in Guangxi Province, China, 13 influencing factors were identified from six aspects: physiological factors, cognitive factors, emotional factors, social support factors, social environment, and NSSI behavior. A system of factors influencing adolescents' NSSI behavior and a model of the factors influencing the comprehensive antagonism multilevel explanatory structure were obtained using a combination of Decision-Making Trial and Evaluation Laboratory technique and Total Adversarial Interpretive Structural Model. In descending order, NSSI, emotional state, self-efficacy, and self-cognition influenced adolescents' NSSI behavior. Social environment, exercise, and recreation had a greater impact on other factors, while NSSI, emotional regulation ability, and emotional state were greatly affected by other factors. Emotion regulation ability, self-cognition, self-efficacy, family support, school support, social support, and sleep were found to be the core factors influencing NSSI behavior of adolescents. These factors could be used to directly intervene in adolescent NSSI behavior. Timely treatment of adolescents' negative emotional states is directly conducive to preventing NSSI behavior and alleviating its severity.
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Affiliation(s)
- Zhensong Lan
- grid.464329.e0000 0004 1798 8991School of Public Administrations, Hechi University, Hechi, 546300 China ,grid.444506.70000 0000 9272 6490Department of Psychology and Counseling, Faculty of Human Development, Sultan Idris Education University, 35900 Tanjong Malim, Perak Malaysia
| | - Kee Pau
- grid.444506.70000 0000 9272 6490Department of Psychology and Counseling, Faculty of Human Development, Sultan Idris Education University, 35900 Tanjong Malim, Perak Malaysia
| | - Hapsah Mohd Yusof
- grid.444506.70000 0000 9272 6490Department of Psychology and Counseling, Faculty of Human Development, Sultan Idris Education University, 35900 Tanjong Malim, Perak Malaysia
| | - Xuefang Huang
- grid.464329.e0000 0004 1798 8991School of Public Administrations, Hechi University, Hechi, 546300 China
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Abstract
BACKGROUND Nonsuicidal self-injury (NSSI) is prevalent among adolescents and research is needed to clarify the mechanisms which contribute to the behavior. Here, the authors relate behavioral neurocognitive measures of impulsivity and compulsivity to repetitive and sporadic NSSI in a community sample of adolescents. METHODS Computerized laboratory tasks (Affective Go/No-Go, Cambridge Gambling Task, and Probabilistic Reversal Task) were used to evaluate cognitive performance. Participants were adolescents aged 15 to 17 with (n = 50) and without (n = 190) NSSI history, sampled from the ROOTS project which recruited adolescents from secondary schools in Cambridgeshire, UK. NSSI was categorized as sporadic (1-3 instances per year) or repetitive (4 or more instances per year). Analyses were carried out in a series of linear and negative binomial regressions, controlling for age, gender, intelligence, and recent depressive symptoms. RESULTS Adolescents with lifetime NSSI, and repetitive NSSI specifically, made significantly more perseverative errors on the Probabilistic Reversal Task and exhibited significantly lower quality of decision making on the Cambridge Gambling Task compared to no-NSSI controls. Those with sporadic NSSI did not significantly differ from no-NSSI controls on task performance. NSSI was not associated with behavioral measures of impulsivity. CONCLUSIONS Repetitive NSSI is associated with increased behavioral compulsivity and disadvantageous decision making, but not with behavioral impulsivity. Future research should continue to investigate how neurocognitive phenotypes contribute to the onset and maintenance of NSSI, and determine whether compulsivity and addictive features of NSSI are potential targets for treatment.
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Raffagnato A, Iannattone S, Fasolato R, Parolin E, Ravaglia B, Biscalchin G, Traverso A, Zanato S, Miscioscia M, Gatta M. A Pre-Adolescent and Adolescent Clinical Sample Study about Suicidal Ideation, Suicide Attempt, and Self-Harming. Eur J Investig Health Psychol Educ 2022; 12:1441-1462. [PMID: 36286085 PMCID: PMC9600697 DOI: 10.3390/ejihpe12100100] [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: 06/29/2022] [Revised: 08/30/2022] [Accepted: 09/19/2022] [Indexed: 11/05/2022] Open
Abstract
Suicide is the second cause of death among adolescents, and nonsuicidal self-injury (NSSI) is one of the main risk factors for suicidal behavior. However, the possible variables specifically associated with suicidal ideation and suicide attempt, as well as the psychopathological characteristics linked to the concomitant presence of suicidal ideation/attempt and NSSI are still under-investigated in youth. The current study aimed to address these issues in a sample of 174 young Italian inpatients (Mage = 14.3 years ± 1.93, 78.2% girls). Sociodemographic and clinical variables were assessed through psycho-diagnostic interviews and ad hoc questionnaires. A binomial logistic regression was performed to identify the predictors of suicidal ideation and suicide attempt. Then, Kruskal-Wallis tests were run to analyze the psychopathological differences between patients with suicidal ideation and suicide attempt considering the coexistence of NSSI. The results highlighted that previous access to child mental health services and general psychopathological problems significantly predicted suicidal ideation, while previous hospitalizations, borderline personality functioning, and affective disorders significantly predicted suicide attempt. In general, inpatients with also NSSI reported higher levels of internalizing, somatic and total problems, impulsiveness, alexithymia, and emotional dysregulation. The clinical implications of our findings in terms of primary and secondary preventive programs are discussed.
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Affiliation(s)
- Alessia Raffagnato
- Department of Woman and Child’s Health, Padua University Hospital, 35128 Padua, Italy
| | - Sara Iannattone
- Department of General Psychology, University of Padua, 35131 Padua, Italy
- Correspondence: ; Tel.: +39-049-827-6918
| | - Rachele Fasolato
- Department of Woman and Child’s Health, Padua University Hospital, 35128 Padua, Italy
| | - Elisa Parolin
- Department of Woman and Child’s Health, Padua University Hospital, 35128 Padua, Italy
| | - Benedetta Ravaglia
- Department of Woman and Child’s Health, Padua University Hospital, 35128 Padua, Italy
| | - Gaia Biscalchin
- Department of Woman and Child’s Health, Padua University Hospital, 35128 Padua, Italy
| | - Annalisa Traverso
- Department of Woman and Child’s Health, Padua University Hospital, 35128 Padua, Italy
| | - Silvia Zanato
- Department of Woman and Child’s Health, Padua University Hospital, 35128 Padua, Italy
| | - Marina Miscioscia
- Department of Woman and Child’s Health, Padua University Hospital, 35128 Padua, Italy
- Department of Developmental Psychology and Socialization, University of Padua, 35131 Padua, Italy
| | - Michela Gatta
- Department of Woman and Child’s Health, Padua University Hospital, 35128 Padua, Italy
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Aghamohammadi S, Mazaheri M, Fata L, Mootabi F. Relationship between Non-Suicidal Self-Injury and Attachment: Protocol for Systematic Review and Meta-Analysis (Preprint). JMIR Res Protoc 2022; 12:e40808. [DOI: 10.2196/40808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 01/28/2023] [Accepted: 03/15/2023] [Indexed: 03/17/2023] Open
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Attygalle UR. A family life cycle perspective on deliberate self-harm among adolescents: an initial qualitative study. ASIA PACIFIC JOURNAL OF COUNSELLING AND PSYCHOTHERAPY 2022. [DOI: 10.1080/21507686.2022.2098349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Beach VL, Gissandaner TD, Schmidt AT. The UPPS Model of Impulsivity and Suicide: A Systematic Literature Review. Arch Suicide Res 2022; 26:985-1006. [PMID: 33650464 DOI: 10.1080/13811118.2021.1892002] [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: 12/24/2022]
Abstract
INTRODUCTION Suicide is a leading cause of death worldwide. Although inconsistent, impulsivity has been identified as a risk factor for suicidal thoughts and behaviors, and these inconsistent findings can largely be attributed to varying operationalizations of impulsivity. As such, the UPPS model of impulsivity provides a clear definition of impulsivity and its associated features that may provide utility in clarifying unreliable findings between impulsivity and suicide. This review aimed to summarize relevant information pertaining to the UPPS model of impulsivity and suicide. METHODS This systematic review followed the a priori guide outlined by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) statement. Articles were gathered from PsycINFO, PsycArticles, Scopus, and PubMed. RESULTS Twenty-eight articles were reviewed and analyzed. Most articles reviewed reported on indirect (i.e., through mediators and moderators) associations between the UPPS dimensions and suicidal behaviors. Additionally, results noted limited between-group differences in UPPS facets among individuals with a history of suicide attempts and those without a history of suicide attempts, those with a history of suicide attempts and individuals with suicide ideation, and those with suicide ideation and those without suicide ideation, with the exception of lack of premeditation. DISCUSSION The results of this review indicate support for the UPPS model of impulsivity as a theoretical starting point when examining the relation between impulsivity and suicide. Further, findings are helpful for clinicians and case conceptualization. Particularly, suicide risk assessment and treatment would be impacted based on impulsivity traits and suicide history.
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Lutz NM, Neufeld SAS, Hook RW, Jones PB, Bullmore ET, Goodyer IM, Ford TJ, Chamberlain SR, Wilkinson PO. Why Is Non-suicidal Self-injury More Common in Women? Mediation and Moderation Analyses of Psychological Distress, Emotion Dysregulation, and Impulsivity. Arch Suicide Res 2022:1-17. [PMID: 35698453 DOI: 10.1080/13811118.2022.2084004] [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] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Non-suicidal self-injury (NSSI) appears to be more common among women than men, though the underlying reasons for this remain unclear. In a community sample of young adults (N = 996, aged 18-33) assessed during the COVID-19 pandemic, we investigated alternative explanation for the NSSI prevalence gap: are women more likely to experience the feelings which lead to NSSI as a coping strategy, or does this prevalence gap result from differences in how men and women respond to distress? METHODS Cross-sectional mediation and moderation analyses tested how self-reported psychological distress (K10), emotion dysregulation (DERS), and impulsivity (UPPS-P) may contribute to a higher prevalence of NSSI among women. RESULTS Women were twice as likely as men to report past-year NSSI (14.47% versus 7.78%, OR = 2.00, 95% CI [1.29, 3.13]). Women reported significantly higher psychological distress and significantly lower sensation seeking and positive urgency than men. Psychological distress partially statistically mediated the relationship between gender and past-year NSSI. Gender did not significantly moderate associations between psychological distress, emotion dysregulation, or impulsivity and past-year NSSI. Past-year NSSI prevalence did not significantly decrease with age and we found no significant age by gender interaction. CONCLUSIONS Greater levels of NSSI in young women are partly explained by their greater levels of psychological distress, but not by differences in how men and women respond to this distress. Given similar levels of psychological distress, emotion dysregulation, and impulsivity, women and men are similarly likely to experience NSSI. HighlightsWomen aged 18-33 were significantly more likely to report past-year NSSI than menWomen's greater psychological distress contributed to their higher NSSI prevalenceVariables investigated here were similarly associated with NSSI in men and women.
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A Person-Centered Approach to Adolescent Nonsuicidal Self-Injury: Predictors and Correlates in a Community Sample. J Youth Adolesc 2022; 51:1760-1773. [PMID: 35590029 PMCID: PMC9279201 DOI: 10.1007/s10964-022-01628-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 05/03/2022] [Indexed: 11/02/2022]
Abstract
Growing incidence of nonsuicidal self-injury (NSSI) and a lack of intensive examination of NSSI variability among adolescents justify identification of latent classes based on the endorsement of different NSSI behaviors. Latent class analysis was used to detect the heterogeneity of past month NSSI among 322 high school students (73.2% female). Two interpretable latent classes emerged. The Severe/Multimethod NSSI class (39%) engaged in almost all forms of NSSI with high intensity and motivated mainly for intrapersonal reasons. The results imply that compared to Mild/Moderate NSSI group (61%), the Severe class is at greater risk for poor mental health, which can exacerbate further NSSI acts. In school settings, identifying adolescents who are vulnerable for more severe NSSI can help to interrupt NSSI trajectories to emerging adulthood.
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Jiao XY, Xu CZ, Chen Y, Peng QL, Ran HL, Che YS, Fang D, Peng JW, Chen L, Wang SF, Xiao YY. Personality traits and self-harm behaviors among Chinese children and adolescents: The mediating effect of psychological resilience. World J Psychiatry 2022; 12:494-504. [PMID: 35433324 PMCID: PMC8968495 DOI: 10.5498/wjp.v12.i3.494] [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: 09/06/2021] [Revised: 01/05/2022] [Accepted: 02/16/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Previous studies have shown that personality traits are associated with self-harm (SH) in adolescents. However, the role of resilience in this association remains unclear. Our research aims to explore the hypothesized mediation effect of resilience in the relationship between personality traits and SH in Chinese children and adolescents.
AIM To evaluate resilience as a mediator of the association between personality traits and SH.
METHODS A population-based cross-sectional survey involving 4471 children and adolescents in Yunnan province in southwestern China was carried out. Relevant data were collected by self-reporting questionnaires. Univariate and multivariate logistic regression models were employed to identify associated factors of SH. A path model was used to assess the mediation effect of resilience with respect to personality traits and SH association.
RESULTS Among the 4471 subjects, 1795 reported SH, with a prevalence of 40.1% (95%CI: 34.4%-46.0%). All dimensions of personality traits were significantly associated with SH prevalence. Resilience significantly mediated the associations between three dimensions of personality (extroversion, neuroticism, psychoticism) and SH, accounting for 21.5%, 4.53%, and 9.65%, respectively, of the total associations. Among all dimensions of resilience, only emotional regulation played a significant mediation role.
CONCLUSION The results of the study suggest that improving emotion regulation ability might be effective in preventing personality-associated SH among Chinese children and adolescents.
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Affiliation(s)
- Xue-Yang Jiao
- School of Public Health, Kunming Medical University, Kunming 650500, Yunnan Province, China
| | - Chuan-Zhi Xu
- School of Public Health, Kunming Medical University, Kunming 650500, Yunnan Province, China
| | - Ying Chen
- School of Public Health, Kunming Medical University, Kunming 650500, Yunnan Province, China
| | - Qing-Lan Peng
- School of Public Health, Kunming Medical University, Kunming 650500, Yunnan Province, China
| | - Hai-Liang Ran
- School of Public Health, Kunming Medical University, Kunming 650500, Yunnan Province, China
| | - Yu-San Che
- School of Public Health, Kunming Medical University, Kunming 650500, Yunnan Province, China
| | - Die Fang
- School of Public Health, Kunming Medical University, Kunming 650500, Yunnan Province, China
| | - Jun-Wei Peng
- School of Public Health, Kunming Medical University, Kunming 650500, Yunnan Province, China
| | - Lin Chen
- School of Public Health, Kunming Medical University, Kunming 650500, Yunnan Province, China
| | - Si-Fan Wang
- School of Public Health, Kunming Medical University, Kunming 650500, Yunnan Province, China
| | - Yuan-Yuan Xiao
- School of Public Health, Kunming Medical University, Kunming 650500, Yunnan Province, China
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Moore FR, Doughty H, Neumann T, McClelland H, Allott C, O'Connor RC. Impulsivity, aggression, and suicidality relationship in adults: A systematic review and meta-analysis. EClinicalMedicine 2022; 45:101307. [PMID: 35243273 PMCID: PMC8860929 DOI: 10.1016/j.eclinm.2022.101307] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/25/2022] [Accepted: 01/28/2022] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND The aim of the study was to crystallize the nature of relationships between impulsivity, aggression, and suicidality. We reviewed studies of adults with published, psychometric measures of impulsivity and aggression, and measures of suicidality. METHODS Our primary data source was Web of Science (from inception to 31st December 2021). Quality of articles was assessed using a Joanna Briggs Appraisal Tool and publication bias using Trim and Fill. We synthesised results using random effects meta-analyses and explored moderation by measure of impulsivity, aggression, and suicidality, and population. FINDINGS 77 studies were included in our analysis. We found weak positive relationships between impulsivity (r = 0·19 [95% CI: 0·15-0·22]), aggression (0·23 ([0·17, 0·29]), and impulsive aggression (0·16 [0·1, 0·22]) with suicidality. Heterogeneity was significant and only partially explained by moderators. Limitations included the lack of studies which assess impulsivity or aggression proximal to suicidality. INTERPRETATION Given small effect sizes and significant heterogeneity, the study suggests that additional studies are needed in the field to analyze the relation between impulsivity and aggression with suicidality. FUNDING None.
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Affiliation(s)
- Fhionna R. Moore
- NHS Highland's Child and Adolescent Mental Health Services, Phoenix Centre, Raigmore Hospital, Inverness, Scotland IV2 3UJ United Kingdom
- Suicidal Behavior Research Laboratory, Institute of Health and Wellbeing, College of Medicine, Veterinary, and Life Sciences, University of Glasgow, Glasgow, Northern Ireland G12 8QQ United Kingdom
- Corresponding author at: NHS Highland's Child and Adolescent Mental Health Services, Phoenix Centre, Raigmore Hospital, Inverness, Scotland IV2 3UJ United Kingdom.
| | - Heather Doughty
- School of Social and Health Science, University of Dundee, Dundee, Northern Ireland DD1 4HN United Kingdom
| | - Tabea Neumann
- School of Social and Health Science, University of Dundee, Dundee, Northern Ireland DD1 4HN United Kingdom
| | - Heather McClelland
- Suicidal Behavior Research Laboratory, Institute of Health and Wellbeing, College of Medicine, Veterinary, and Life Sciences, University of Glasgow, Glasgow, Northern Ireland G12 8QQ United Kingdom
| | - Claire Allott
- NHS Highland's Child and Adolescent Mental Health Services, Phoenix Centre, Raigmore Hospital, Inverness, Scotland IV2 3UJ United Kingdom
| | - Rory C. O'Connor
- Suicidal Behavior Research Laboratory, Institute of Health and Wellbeing, College of Medicine, Veterinary, and Life Sciences, University of Glasgow, Glasgow, Northern Ireland G12 8QQ United Kingdom
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Ran H, Fang D, Che Y, Donald AR, Peng J, Chen L, Wang S, Xiao Y. Resilience mediates the association between impulsivity and self-harm in Chinese adolescents. J Affect Disord 2022; 300:34-40. [PMID: 34952124 DOI: 10.1016/j.jad.2021.12.077] [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: 04/27/2021] [Revised: 10/05/2021] [Accepted: 12/19/2021] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Existing literature is supportive for the positive connection between impulsivity and self-harm (SH), nevertheless, less is known regarding to the role of resilience in this association. This research primarily explored potential mediation of resilience in the association between impulsivity and SH in a large sample of Chinese adolescents. METHOD A population-based cross-sectional survey of 4552 adolescents was conducted in southwest China. A self-administered questionnaire was adopted for data collection from all subjects. The Barratt Impulsiveness Scale (BIS), the Modified version of Adolescents Self-Harm Scale (MASHS) and the Resilience Scale for Chinese Adolescents (RSCA) were used to measure impulsivity, SH, and resilience, respectively. The associations between impulsivity, resilience, and SH were estimated by using stepwise multivariate Logistic regression models. Mediation of resilience in impulsivity and SH association was evaluated by using path model. RESULTS The prevalence of SH was 39.1% (95% CI: 34.0%-45.0%) for surveyed adolescents. Impulsivity and resilience were significantly associated with the prevalence of SH. Prominent dose-response association between impulsivity and SH prevalence was further confirmed. Resilience was a salient mediator which accounted for 42.90% of the total impulsivity-SH association. Among all the five dimensions of resilience, goal concentration (23.98%) and emotion regulation (21.94%) showed the strongest mediation. CONCLUSIONS The findings suggest that resilience building intervention strategies, particularly those focusing on improving goal concentration, emotion regulation, and positive perception, could be effective in reducing impulsivity related SH risk among Chinses adolescents.
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Affiliation(s)
- Hailiang Ran
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Die Fang
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Yusan Che
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | | | - Junwei Peng
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Lin Chen
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Sifan Wang
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China
| | - Yuanyuan Xiao
- School of Public Health, Kunming Medical University, Kunming, Yunnan, China.
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Self-Injury in Adolescence Is Associated with Greater Behavioral Risk Avoidance, Not Risk-Taking. J Clin Med 2022; 11:jcm11051288. [PMID: 35268378 PMCID: PMC8911447 DOI: 10.3390/jcm11051288] [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: 12/27/2021] [Revised: 02/18/2022] [Accepted: 02/24/2022] [Indexed: 02/01/2023] Open
Abstract
Strategies to link impulsivity and self-injurious behaviors (SIBs) show highly variable results, and may differ depending on the impulsivity measure used. To better understand this lack of consistency, we investigated correlations between self-report and behavioral impulsivity, inhibitory control, SIBs, and rumination. We included participants aged 13-17 years with either current or remitted psychopathology who have (n = 31) and who do not have (n = 14) a history of SIBs. Participants completed self-report measures of impulsivity, the Rumination Responsiveness Scale (RRS), and two behavioral measures of impulsivity: the Balloon Analogue Risk Task (BART) and Parametric Go/No-Go (PGNG). Lifetime SIBs were positively associated with self-reported impulsivity, specifically positive and negative urgency. However, individuals with greater lifetime SIBs demonstrated greater risk aversion (lower impulsivity) as measured by the BART, whereas there was no relation between lifetime SIBs and PGNG performance. There was no relation between rumination and behavioral impulsivity, although greater rumination was associated with higher negative urgency. Future research examining the role of SIBs in the context of active versus remitted psychopathology is warranted. Because most adolescents were remitted from major depressive disorder at the time of study, follow-up studies can determine if lower risk-taking may aid individuals with more prior SIBs to achieve and maintain a remitted state.
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Ma J, Zhao M, Niu G, Wang Z, Jiang S, Liu Z. Relationship between thyroid hormone and sex hormone levels and non-suicidal self-injury in male adolescents with depression. Front Psychiatry 2022; 13:1071563. [PMID: 36620661 PMCID: PMC9810634 DOI: 10.3389/fpsyt.2022.1071563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Accepted: 12/06/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Non-suicidal self-injury (NSSI) is the intentional and repeated direct injury to one's bodily tissues or organs without the intent to die, which is not socially sanctioned and does not result in death. This study will be the first to explore the relationship between NSSI behavior and thyroid hormone and sex hormone levels in male adolescents with depression. METHODS Among the inpatients in the children's ward of Shandong Mental Health Center, eighty male patients with first-episode depressive disorder were randomly selected. Forty male adolescent depressed patients with NSSI behaviors were set as the NSSI group, and forty male adolescent depressed patients without NSSI behaviors were set as the No-NSSI group. Their thyroid hormones (free triiodothyronine, free thyroxine, and thyroid stimulating hormone) and sex hormones (estradiol, progesterone, and testosterone) were measured, and the severity of self-injury in the NSSI group was assessed using the Adolescent Self-Injury Questionnaire. The NSSI group was tested again after 6 weeks of sertraline treatment for biological indicators and assessed by the Self-Injury Questionnaire to compare the hormonal differences between the NSSI group and the No-NSSI group and compare the differences of each index before and after treatment in the NSSI group. RESULTS T3/T4 (p = 0.001) and FT3 (p = 0.023), TSH levels (p < 0.001) were lower in the NSSI group than in the No-NSSI group before treatment, and FT4 (p = 0.036) and T (p < 0.001) levels were higher than in the No-NSSI group. T3/T4 levels were higher in the NSSI group after treatment (p < 0.001). FT4 (p < 0.001) and T (p = 0.001) levels and self-injury questionnaire scores (p < 0.001) decreased after treatment in the NSSI group. In the NSSI group at baseline, FT4 levels were negatively correlated with self-injury questionnaire scores (r = -0.459, p = 0.003) and testosterone levels were positively correlated with self-injury questionnaire scores (r = 0.383, p = 0.015), and in the NSSI group after treatment, FT4 difference was negatively correlated with self-injury questionnaire score reduction rate (r = -0.037, p = 0.019), and testosterone difference was positively correlated with self-injury questionnaire score reduction rate (r = 0.424, p = 0.006). Logistic regression analysis showed that low TSH and high testosterone levels were independent risk factors for the development of non-suicidal self-harming behaviors in male adolescent depressed patients. CONCLUSION Changes in thyroid hormone and sex hormone levels may be associated with non-suicidal self-injurious behavior in male adolescent depressed patients.
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Affiliation(s)
- Jiahui Ma
- Department of Psychiatry, Jining Medical University, Jining, China
| | - Mingming Zhao
- Department of Psychiatry, Jining Medical University, Jining, China
| | - Gengyun Niu
- Department of Psychiatry, Shandong Mental Health Center, Jinan, China
| | - Zhifei Wang
- Department of Psychiatry, Jining Medical University, Jining, China
| | - Shan Jiang
- Department of Psychiatry, Jining Medical University, Jining, China
| | - Zengxun Liu
- Department of Psychiatry, Shandong Mental Health Center, Jinan, China
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Cheng X, Zhang Y, Zhao D, Yuan TF, Qiu J. Trait Anxiety Mediates Impulsivity and Suicidal Ideation in Depression During COVID-19 Pandemic. Front Psychiatry 2022; 13:892442. [PMID: 35873250 PMCID: PMC9301462 DOI: 10.3389/fpsyt.2022.892442] [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: 03/09/2022] [Accepted: 06/22/2022] [Indexed: 11/13/2022] Open
Abstract
Suicidality in patients with major depressive disorder (MDD) has been an urgent affair during the COVID-19 pandemic. It is well-established that impulsivity and trait anxiety are two risk factors for suicidal ideation. However, literature is still insufficient on the relationships among impulsivity, (state/trait) anxiety and suicidal ideation in individuals with MDD. The present study aims to explore the relationships of these three variables in MDD patients during the COVID-19 pandemic through three scales, including Barrett Impulsivity Scale (BIS), State-Trait Anxiety Scale (STAI) and Self-rating Idea of Suicide Scale (SIOSS). Sixty-three MDD patients (low SIOSS group and high SIOSS group, which were split by the mean score of SIOSS) and twenty-seven well-matched healthy controls were analyzed. Our results showed that the high SIOSS group had higher trait anxiety (p < 0.001, 95% CI = [-19.29, -5.02]) but there was no difference in state anxiety (p = 0.171, 95% CI = [-10.60, 1.25]), compared with the low SIOSS group. And the correlation between impulsivity and suicidal ideation was significant in MDD patients (r = 0.389, p = 0.002), yet it was not significant in healthy controls (r = 0.285, p = 0.167). Further, mediation analysis showed that trait anxiety significantly mediate impulsivity and suicidal ideation in patients with depression (total effect: β = 0.304, p = 0.002, 95% CI = [0.120, 0.489]; direct effect: β = 0.154, p = 0.076, 95% CI = [-0.169, 0.325]), indicating impulsivity influenced suicidal ideation through trait anxiety in MDD patients. In conclusion, our results suggested that trait anxiety might mediate the association of impulsivity and suicidal ideation in MDD patients. Clinicians may use symptoms of trait anxiety and impulsivity for screening when actively evaluating suicidal ideation in MDD patients, especially in the setting of COVID-19 pandemic.
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Affiliation(s)
- Xinyu Cheng
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yi Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Di Zhao
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Ti-Fei Yuan
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Co-innovation Center of Neuroregeneration, Nantong University, Nantong, China
| | - Jianyin Qiu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Garavito DMN, Bjork JM. Impulsivity and Reflective Thinking in Veterans Seeking Care for Substance Use Disorder. Subst Use Misuse 2022; 57:1563-1571. [PMID: 35819091 DOI: 10.1080/10826084.2022.2096237] [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: 10/17/2022]
Abstract
Objective: Substance use disorder (SUD) is a major public health crisis, with increased overdose deaths in the past decade. This has coincided with a tremendous amount of research on those who misuse substances. However, extensive research on SUD vulnerability characteristics such as impulsivity may be complemented by research on theoretically relevant aspects of cognition. The Cognitive Reflection Test (CRT) was designed to measure a person's ability to subdue quick, intuitive decisions to reflect or deliberate. To some decision making theorists, this measure may help explain why some people are better able to inhibit "gut reactions" than others. Methods: We recruited 140 veterans from a Veterans Affairs medical center; 91 of whom were receiving SUD treatment. Participants completed the CRT and a measure of trait impulsivity (the UPPS-P). We ran planned ANCOVAs assessing differences in the number of correct answers on the CRT and the proportion of errors that were intuitive. Results: Participants who were receiving treatment gave significantly fewer correct, reflective answers on the CRT compared to controls. However, there were no significant differences in the proportion of errors that were due to intuitive responses. These findings did not change when controlling for age and/or trait impulsivity. Conclusion: Those suffering from SUD may exhibit cognitive deficits that do not stem from intuitive thinking. These deficits may, in turn, exacerbate issues arising from elevated impulsivity. Additional research which better incorporates decision making theory may be invaluable in providing clinically-relevant results and positive public health outcomes.
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Affiliation(s)
- David M N Garavito
- Department of Veterans Affairs, Mental Health Service, Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia, USA
| | - James M Bjork
- Department of Veterans Affairs, Mental Health Service, Hunter Holmes McGuire Veterans Affairs Medical Center, Richmond, Virginia, USA
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Mancinelli E, Ruocco E, Napolitano S, Salcuni S. A network analysis on self-harming and problematic smartphone use - The role of self-control, internalizing and externalizing problems in a sample of self-harming adolescents. Compr Psychiatry 2022; 112:152285. [PMID: 34798535 DOI: 10.1016/j.comppsych.2021.152285] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 10/13/2021] [Accepted: 10/26/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Research has shown an increased risk for Non-suicidal self-injurious (NSSI) behavior as well as Problematic Smartphone Use (PSU) and particularly in adolescence, a developmental period defined by multi-level changes and still poor self-control capacities associating with risk-taking behaviors. OBJECTIVE The current study was aimed to assess the pattern of mutual relations characterizing NSSI considering self-control, internalizing and externalizing problems, and investigating how PSU fits within the network since NSSI and PSU are here conceptualized as attempts at emotion regulation. Age and gender differences were also assessed. METHOD Participants were Italian adolescents presenting NSSI behavior (N = 155; Mage = 14.68; SD = 1.647; Range = 11-18; 43.2%-females); the sample is based on community recruitment. A Network Analysis was performed to assess the organizational structure of NSSI; age and gender differences were assessed through multivariate rank tests further applying multiplicity control. RESULTS The emerged Network showed the centrality of low self-control and internalizing problems for NSSI. NSSI and PSU were associated through low self-control, and so were PSU and externalizing problems. Significant age differences were observed showing a decrease in NSSI as age increases (stat = -2.86; adj.p = .029). No gender differences have emerged. CONCLUSIONS The current findings provide support for the consideration and investigation of PSU as regards NSSI behavior in adolescence. Moreover, these findings point to the relevance of prevention practices during this peculiar developmental period, particularly sustaining self-control capacities and the use of more adaptive emotion regulation strategies, thereby limiting the accrue of at-risk behaviors.
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Affiliation(s)
- Elisa Mancinelli
- Department of Developmental Psychology and Socialization, University of Padua, Via Venezia 8, Padua, Italy; Digital Health Lab, Centre for Digital Health and Wellbeing, Fondazione Bruno Kessler, Trento, Via Sommarive 18, Povo, Italy.
| | | | - Stefania Napolitano
- The Net-ONLUS, Via degli Scrovegni 7, Padua, Italy; Complex Operating Unit - Childhood Adolescence Family and Consultants, Child Neuropsychiatry, ULSS6 Euganea, Via Enrico degli Scrovegni 14, Padua, Italy
| | - Silvia Salcuni
- Department of Developmental Psychology and Socialization, University of Padua, Via Venezia 8, Padua, Italy.
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Abstract
LEARNING OBJECTIVE After participating in this activity, learners should be better able to:• Discuss and outline the general and overlapping effects of the menstrual cycle on women's mental health. ABSTRACT A growing body of research demonstrates menstrual cycle-dependent fluctuations in psychiatric symptoms; these fluctuations can therefore be considered as prevalent phenomena. Possible mechanisms underlying these fluctuations posit behavioral, psychological, and neuroendocrine influences. Recent reviews document cyclic exacerbation of symptoms and explore these mechanisms in the context of specific and often single disorders. The question remains, however, as to whether there are general and overlapping effects of the menstrual cycle on women's mental health. To address this gap, we synthesized the literature examining the exacerbation of a variety of psychiatric symptoms across the menstrual cycle in adult women. Results show that the premenstrual and menstrual phases are most consistently implicated in transdiagnostic symptom exacerbation. Specifically, strong evidence indicates increases in psychosis, mania, depression, suicide/suicide attempts, and alcohol use during these phases. Anxiety, stress, and binge eating appear to be elevated more generally throughout the luteal phase. The subjective effects of smoking and cocaine use are reduced during the luteal phase, but fewer data are available for other substances. Less consistent patterns are demonstrated for panic disorder, symptoms of posttraumatic stress disorder, and borderline personality disorder, and it is difficult to draw conclusions for symptoms of generalized anxiety disorder, social anxiety disorder, obsessive-compulsive disorder, and trichotillomania because of the limited data. Future research should focus on developing standardized approaches to identifying menstrual cycle phases and adapting pharmacological and behavioral interventions for managing fluctuations in psychiatric symptoms across the menstrual cycle.
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