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Masud S, Hyder AA, Khan UR, Khan NU, Raheem A, Petrucka P. Epidemiology of unintentional injuries among 15-24-year-old vocational school youth from Peshawar Pakistan: A cross-sectional survey. RESEARCH SQUARE 2024:rs.3.rs-2603081. [PMID: 36945639 PMCID: PMC10029088 DOI: 10.21203/rs.3.rs-2603081/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/23/2023]
Abstract
Background The burden of unintentional injuries among youth (15-24 years) is high. There is paucity of data on unintentional injuries in youth working in Vocational Training Institutes. Objective To determine the incidence, characteristics, and risk factors of unintentional injuries among youth. Methods Design:: A retrospective cross-sectional survey was conducted among select vocational school youth in Peshawar, Pakistan between February 2022 to October 2022.Participants:: A total of 547 study participants participated in the survey, 356 were males while 191 were females. Data were collected on using the World Health Organization community survey guide for injuries and violence. Multilevel Negative Binomial Regression model was used to report incidence rate ratios of all unitentional injuries. Results A total of 503 injuries were reported by the youth, with road traffic injuries being the most common (n=197, 39%), followed by burns (n=89, 18%), falls (n=79, 16%) and poisonings (n=15, 3%), drownings (n=23, 7.1%). Occupational injuries reported during vocational training were (n=95, 18%). Males had a higher incidence rates of RTI 3.24[2.35-5.3], falls 1.30 [0.74-2.27], poisonings 2.14 [0.57-7.58] and drownings 2.46(0.84-7.21), while females had a higher incidence rate of burns 2.19 [1.785-3.46].Lack of education 4.6 [1.12 -18.91] (p=0.034), smoking 1.25 [1.05 -2.69] (p=0.049), lack of fathers education 4.71 [2.12 -10.49] (p=<0.001), carrying a gun 6.59 [2.54 -17.11] (p=<0.001), crowded families 3.59 [3.11 -5.07] (p=<0.001), lower family income 2.04 [1.04 -4.02](p=0.039*), lack of helmet use 4.54 [2.12 -9.76] (p=<0.001) and lack of seat belt use 1.3 [1.14 -1.69] (p= <0.001) were significant risk factors for unintentional injuries in youth. Conclusion Added value of the study This study is one of the first research studies conducted in vocational school youth in Pakistan. It provides the recent rate of unintentional injuries among the youth of Pakistan. High occupational injuries among vocational school youth were reported which needs further research.
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Yu H, Mu Q, Li K. Effects of physical exercise on non-suicidal self-injury in adolescents: the chain mediating role of perceived social support and self-concept. Front Psychiatry 2023; 14:1201863. [PMID: 37876620 PMCID: PMC10591106 DOI: 10.3389/fpsyt.2023.1201863] [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: 04/07/2023] [Accepted: 09/21/2023] [Indexed: 10/26/2023] Open
Abstract
Objective To study the effect of physical exercise on non-suicidal self-injury in adolescents and to verify the chain mediating role of perceived social support and self-concept. Methods: A survey study was conducted on 1,426 adolescents in Chengdu, Sichuan Province. A chain mediation model was used to verify whether perceived social support and self-concept played a mediating role. Results Physical exercise was significantly negatively associated with non-suicidal self-injury in adolescents (β = -0.53, p < 0.01) and significantly positively associated with perceived social support and self-concept (β = 0.52, 0.54, p < 0.01), and perceived social support and self-concept were significantly negatively associated with non-suicidal self-injury (β = -0.59, p < 0.01; β = -0.64, p < 0.01), and perceived social support was able to significantly and positively associate self-concept (β = 0.76, p < 0.01). Conclusion Perceived social support and self-concept play a chain mediating role in the effect of physical exercise on non-suicidal self-injury in adolescents, and it is recommended that the development of perceived social support and self-concept be emphasized during adolescents' development, which has the potential to reduce the incidence of non-suicidal self-injurious behaviors in adolescents.
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Affiliation(s)
- Haoran Yu
- Institute of Sports Training, Chengdu Sport University, Chengdu, Sichuan, China
| | - Qinglei Mu
- Institute of Physical Education, Chengdu University, Chengdu, Sichuan, China
| | - Ke Li
- Institute of Sports Training, Chengdu Sport University, Chengdu, Sichuan, China
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Xu P, Hao X, Luo D, Lai M, Sun X, Xu J. Problematic internet gaming and non-suicidal self-injury in Chinese adolescents: Moderating and mediating roles of anxiety. Compr Psychiatry 2023; 125:152398. [PMID: 37421849 DOI: 10.1016/j.comppsych.2023.152398] [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: 10/27/2022] [Revised: 05/04/2023] [Accepted: 07/02/2023] [Indexed: 07/10/2023] Open
Abstract
INTRODUCTION Despite consistent reports of the association between problematic internet gaming (PIG) and non-suicidal self-injury (NSSI), an increase in PIG does not necessarily lead to increased NSSI. This apparent paradox indicates the presence of other mediators and moderators in the PIG-NSSI association. This study aimed to investigate the role of anxiety as a potential moderating and mediating factor of the PIG-NSSI association in Chinese adolescents. METHODS A cross-sectional study was conducted among 10,479 Chinese adolescents (50.5% male; age range, 9-18 years). Standardized self-report questionnaires were used to assess the severity of PIG, anxiety, and NSSI. Spearman correlation and multiple linear regression were applied to examine the relationships among PIG, anxiety, and NSSI. Both moderating and mediating effects of anxiety were assessed using Hayes' methods. RESULTS PIG, anxiety symptoms, and NSSI significantly correlated with one another. Anxiety significantly moderated the relationship between PIG and NSSI [B = 0.002, standard error (SE) = 0.000, p < 0.001], and it partially mediated the PIG-NSSI association [B = 0.017, SE = 0.001, 95% confidence interval (CI) 0.014-0.021]. Social concern and concentration were the two dimensions of anxiety that exerted the strongest mediation effect (B = 0.017, SE = 0.002, 95% CI 0.014-0.020). CONCLUSIONS Adolescents with PIG and high anxiety are likely to suffer more severe NSSI and may benefit from interventions to reduce anxiety symptoms.
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Affiliation(s)
- Peiwei Xu
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu 610000, China
| | - Xiaoting Hao
- Department of Neurology, West China Hospital of Sichuan University, Chengdu 610000, China
| | - Dan Luo
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu 610000, China
| | - Mingfeng Lai
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu 610000, China
| | - Xueli Sun
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu 610000, China
| | - Jiajun Xu
- Department of Psychiatry, West China Hospital of Sichuan University, Chengdu 610000, China.
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Mettler J, Cho S, Stern M, Heath NL. Negative and Positive Emotional Reactivity in Women With and Without a History of Self-Injury. Psychol Rep 2023:332941231180118. [PMID: 37247614 DOI: 10.1177/00332941231180118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
In trying to better understand why certain individuals self-injure, researchers have proposed high emotional reactivity for negative emotions may influence vulnerabilities and predispose individuals to react to stressful situations in a dysregulated manner, thus engaging in non-suicidal self-injury (NSSI). However, the role of emotional reactivity for positive emotions in those with a history of NSSI is still unclear. Thus, the present study sought to examine group differences in the reactivity of (a) negative and (b) positive emotions in young adults with and without a history of NSSI engagement, and (c) to evaluate whether the reactivity of positive emotions could predict NSSI engagement when controlling for reactivity of negative emotions. The sample consisted of 96 female students who reported engaging in NSSI within the past 2 years (Mage = 20.28 years, SD = 1.65) and an age-matched female comparison group with no NSSI history (Mage = 20.43 years, SD = 1.76). Results from separate MANOVAs indicated individuals with a history of NSSI reported higher negative reactivity across all aspects (emotional intensity, sensitivity, and persistence) than the comparison group, Wilk's λ = .86, F (3,188) = 10.65, p < .001, partial η2 = .145; however, no significant differences emerged for positive reactivity, Wilk's λ = .99, F (3,188) = 0.52, p = .669. Moreover, a logistic regression revealed that persistence of negative emotions was the only significant predictor of NSSI, Wald χ2 (1) = 4.54, p = .03. The present results highlight the importance of the persistence of negative emotions for individuals who engage in NSSI. Furthermore, the current study provides the first suggestion of no significant differences in positive emotional reactivity between individuals with and without NSSI; underlining the importance of focusing on negative emotional reactivity in clinical practice as well as using positive emotions to "undo" the effect of negative emotions.
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Affiliation(s)
- Jessica Mettler
- Faculty of Education, Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
| | - Sohyun Cho
- Faculty of Education, Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
| | - Melissa Stern
- Grey Zone Psychology & Wellness Centre, Montreal, Quebec, Canada
| | - Nancy L Heath
- Faculty of Education, Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada
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He H, Hong L, Jin W, Xu Y, Kang W, Liu J, Song J, Zheng T, Chen H, Zhao K. Heterogeneity of non-suicidal self-injury behavior in adolescents with depression: latent class analysis. BMC Psychiatry 2023; 23:301. [PMID: 37127584 PMCID: PMC10152699 DOI: 10.1186/s12888-023-04808-7] [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: 10/10/2022] [Accepted: 04/20/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) by adolescent patients with depression has become a serious public health problem. This cross-sectional study aims to identify subgroups of adolescents based on NSSI and explore the factors related to these subgroups. METHODS The study recruited 326 in- and out-patient adolescents (263 girls and 63 boys) aged 12 to 18 years (mean = 14.7, SD = 1.6) who had self-injured in the past year. Latent class indicators included 12 NSSI variables, as well as suicidal ideation. Logistic regression examined associations between identified classes and related factors. RESULTS In this study, two distinct subgroups were identified: a "high suicidal ideation NSSI group" (n = 129, 39.6%) and a "low suicidal ideation NSSI group" (n = 197, 60.4%). Depression (OR = 1.10; 95% CI, 1.05-1.16), female (OR = 2.01; 95% CI, 1.09-3.69), left-behind experience (OR = 2.08; 95% CI, 1.17-3.71), single-parent family (OR = 1.84; 95% CI, 1.11-3.04) and peer victimization (OR = 1.04; 95% CI, 1.02-1.05) increases the probability of belonging to the "high suicidal ideation NSSI group". A high level of perceived social support (OR = 0.99; 95% CI, 0.97-0.99) was a protective factor towards NSSI. CONCLUSIONS This study identifies two subgroups of NSSI and the factors associated with each subgroup. The early identification of high-risk groups for major NSSI in adolescents diagnosed with depression is possible due to the identification of correlating factors. Different treatment plans can be developed for different subtypes of NSSI to improve the effectiveness of prevention and intervention, promoting the healthy physical and mental development of adolescents with depression.
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Affiliation(s)
- He He
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Lan Hong
- The Third Hospital of QuZhou, Quzhou, 324003, China
| | - Wei Jin
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Yao Xu
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Wei Kang
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Jie Liu
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Jingyao Song
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Tiansheng Zheng
- The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, China
| | - Hong Chen
- Department of Psychiatry, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ke Zhao
- Lishui Second People's Hospital Affiliated to Wenzhou Medical University, Lishui, China.
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, Wenzhou, China.
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James KM, Balderrama-Durbin C, Kobezak HM, Recchia N, Foster CE, Gibb BE. Dynamics of Affective Reactivity during Mother-Daughter Interactions: The Impact of Adolescent Non-Suicidal Self-Injury. Res Child Adolesc Psychopathol 2023; 51:597-611. [PMID: 36607473 DOI: 10.1007/s10802-022-01011-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2022] [Indexed: 01/07/2023]
Abstract
Non-suicidal self-injury (NSSI) is an alarming public health concern that is particularly widespread among adolescents. The current study examined affective responses during mother-daughter interactions in adolescent girls with and without a history of NSSI. Participants were 60 girls aged 13-17 with (n = 27) and without (n = 33) a history of NSSI and their mothers. Adolescents and their mothers completed two interaction tasks: one positive and one negative. During these interactions, facial affect was assessed via electromyography (EMG). Results of Actor-Partner Interdependence Modeling (APIM) revealed several intra- and interpersonal disruptions in affect during both tasks among dyads in which the adolescent had an NSSI history. Findings suggest deficits in both self- and co-regulation of facial affect during mother-daughter interactions involving dyads in which the adolescents reports NSSI. Ultimately, if replicated and extended in longitudinal research, these disruptions may prove to be promising targets of intervention to reduce risk for future NSSI in adolescent girls.
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Affiliation(s)
- Kiera M James
- Department of Psychology, Binghamton University (SUNY), Binghamton, NY, 13902, USA. .,Department of Psychology, University of Pittsburgh, Pittsburgh, PA, 15260, USA.
| | | | - Holly M Kobezak
- Department of Psychology, Binghamton University (SUNY), Binghamton, NY, 13902, USA
| | - Nicolette Recchia
- Department of Psychology, Binghamton University (SUNY), Binghamton, NY, 13902, USA
| | - Claire E Foster
- Department of Psychology, Binghamton University (SUNY), Binghamton, NY, 13902, USA
| | - Brandon E Gibb
- Department of Psychology, Binghamton University (SUNY), Binghamton, NY, 13902, USA
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Wang YJ, Li X, Ng CH, Xu DW, Hu S, Yuan TF. Risk factors for non-suicidal self-injury (NSSI) in adolescents: A meta-analysis. EClinicalMedicine 2022; 46:101350. [PMID: 35330803 PMCID: PMC8938878 DOI: 10.1016/j.eclinm.2022.101350] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 02/10/2022] [Accepted: 02/28/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) in adolescents is a significant mental health problem around the world. Here, we performed a meta-analysis to systematically delineate the risk factors for NSSI. METHOD We searched Medline, Embase, Web of Science and Cochrane for relevant articles and abstracts published prior to 12 November 2021. Pooled odds ratios (ORs) and 95% confident intervals (CIs) were used to assess various risk factors, and publication bias was assessed by Egger's test, the trim and fill method and meta-regression. This study is registered with PROSPERO, CRD42021265885. RESULTS A total of 25 articles were eventually included in the analysis. Eighty risk factors were identified and classified into 7 categories: mental disorders (ORs, 1·89; 95% CI, 1·60-2·24), bullying (ORs, 1·98; 95% CI, 1·32-2·95), low health literacy (ORs, 2·20; 95% CI, 1·63-2·96), problem behaviours (ORs, 2·36; 95% CI, 2·00-2·77), adverse childhood experiences (ORs, 2·49; 95% CI, 1·85-3.34), physical symptoms (ORs, 2·85; 95% CI, 1·36-5·97) and the female gender (ORs, 2·89; 95% CI, 2·43-3·43). The range of heterogeneity (I2) was from 20·3% to 99·2%. CONCLUSION This meta-analysis found that mental disorders, low health literacy, adverse childhood experiences, bullying, problem behaviours, the female gender and physical symptoms appear to be risk factors for NSSI.
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Affiliation(s)
- Yu-Jing Wang
- Zhejiang Provincial Clinical Research Center for Mental Disorders, School of Mental Health and The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
| | - Xi Li
- Zhejiang Provincial Clinical Research Center for Mental Disorders, School of Mental Health and The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
| | - Chee H. Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, VIC, SA
| | - Dong-Wu Xu
- Zhejiang Provincial Clinical Research Center for Mental Disorders, School of Mental Health and The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
- Corresponding author.
| | - Shaohua Hu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- The Key Laboratory of Mental Disorders Management in Zhejiang Province, Hangzhou, China
- Brain Research Institute of Zhejiang University, Hangzhou, China
- Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, China
- MOE Frontier Science Center for Brain Science and Brain-Machine Integration, Zhejiang University, Hangzhou, China
- Corresponding author at: The Key Laboratory of Mental Disorders’ Management in Zhejiang Province, Hangzhou, 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
- Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China
- Corresponding author at: Shanghai Key Laboratory of Psychotic disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Oppenheimer CW, Glenn CR, Miller AB. Future Directions in Suicide and Self-Injury Revisited: Integrating a Developmental Psychopathology Perspective. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2022; 51:242-260. [PMID: 35380885 PMCID: PMC9840868 DOI: 10.1080/15374416.2022.2051526] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
The recent rise in suicide rates among children and adolescents has made suicide prevention in youth a major focus of government agencies and mental health organizations. In 2012, Nock presented future directions in the study of self-injurious thoughts and behavior (SITBs), highlighting the need to better examine which risk factors are associated with "each part of the pathway" to suicidal and non-suicidal self-injury in order to inform prevention and intervention efforts. Over the past decade, we have made important advances in understanding the development of SITBs and effective interventions. However, there are still major gaps of knowledge in our understanding of how to prevent suicide. Researchers have recently called for more studies focusing particularly on the pathway from suicidal ideation to suicidal behavior. However, we caution against prioritizing only a part of the suicide risk continuum (e.g., the transition from suicidal ideation to suicidal behavior) while minimizing research focusing on earlier developmental points of the pathway to suicide (e.g., the first development of suicidal ideation). We emphasize that childhood and adolescence represent a critical opportunity to intervene and prevent SITBs by altering developmental trajectories toward persistent and escalating SITBs over time. We advocate for integrating a developmental psychopathology perspective into future youth suicide research that focuses on how and when risk for SITBs first emerges and develops across childhood into emerging adulthood. This research is critical for informing interventions aimed at bending developmental pathways away from all SITBs. Here, we describe the need for future research that integrates key developmental psychopathology principles on 1) the identification of the continuum from developmentally typical to atypical as SITBs first emerge and develop, particularly among young children in early to middle childhood, 2) the way in which expressions of and risk for SITBs change across development, 3) how SITBs dynamically move along a continuum from typical to atypical over time, and 4) suicide prevention efforts. We also offer recommendations for future directions that focus on identifying disparities in SITBs occurring among minoritized youth within a developmental psychopathology perspective.
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Affiliation(s)
- Caroline W Oppenheimer
- RTI International, Mental Health Risk and Resilience Program, Research Triangle Park, North Carolina, USA
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Catherine R Glenn
- Department of Psychology, Virginia Consortium Program in Clinical Psychology, Old Dominion University, Norfolk, Virginia, USA
| | - Adam Bryant Miller
- RTI International, Mental Health Risk and Resilience Program, Research Triangle Park, North Carolina, USA
- Department of Psychology and Neuroscience, University of North Carolina, Chapel Hill, North Carolina, USA
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Cipriano A, Aprea C, Bellone L, Cotrufo P, Cella S. Non-Suicidal Self-Injury: A School-Based Peer Education Program for Adolescents During COVID-19 Pandemic. Front Psychiatry 2022; 12:737544. [PMID: 35095587 PMCID: PMC8793799 DOI: 10.3389/fpsyt.2021.737544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 12/13/2021] [Indexed: 12/21/2022] Open
Abstract
Introduction: Non-suicidal self-injury (NSSI) constitutes a major health concern among youth. However, less is known about the useful ways to prevent NSSI. As such, the NSSI- Peer Education Program (NSSI-PEP) aims to intervene on the vulnerability factors that predispose to NSSI by applying a peer education approach. The NSSI-PEP is grounded on the psychoanalytic tradition's tenets, implementing modules targeting four crucial risk factors for NSSI: pubertal transformation, body image, self-esteem, and emotion regulation. Methods: Selected 8th grade students were trained to serve as peer educators and held a peer-education intervention for 6th and 7th grade students. Pre- and post-intervention assessments were conducted in order to evaluate the program's effectiveness. Results: Results revealed preliminary support for the program's feasibility, as students reported greater emotion regulation abilities (p = 0.038) and significant changes in self-esteem (p<0.001), personal alienation (p = 0.005), body image (p < 0.001), and maturity fear (p < 0.001). Also, NSSI-PEP was positively evaluated by participants. Discussion: Our pilot study provides preliminary empirical support for the NSSI-PEP, representing a promising way to address areas of vulnerability for NSSI onset. Findings may also help current policies to promote targeted preventive activities and produce sizable benefits to society.
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Affiliation(s)
| | | | | | | | - Stefania Cella
- Observatory on Eating Disorders, Department of Psychology, University of Campania “Luigi Vanvitelli”, Caserta, Italy
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10
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Tang WC, Lin MP, You J, Wu JYW, Chen KC. Prevalence and psychosocial risk factors of nonsuicidal self-injury among adolescents during the COVID-19 outbreak. CURRENT PSYCHOLOGY 2021; 42:1-10. [PMID: 34092987 PMCID: PMC8167308 DOI: 10.1007/s12144-021-01931-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2021] [Indexed: 11/30/2022]
Abstract
The research investigated the prevalence of nonsuicidal self-injury (NSSI) during the COVID-19 outbreak and identified the psychosocial risk factors among junior high school students in Taiwan. Cross-sectional design was applied and 1,060 participants (Mage = 14.66, SD = 0.86 years) were recruited into the study. The prevalence of NSSI was found to be 40.9% (95% confidence interval, 37.9%-43.9%) during the COVID-19 outbreak. The results suggested that the self-injurers group were mostly female, and scored significantly higher in neuroticism, depression, impulsivity, alexithymia, virtual social support, dissatisfaction with academic performance, and lower in subjective wellbeing, self-esteem, actual social support, and family function than the non-injurers group. In addition, high neuroticism, low self-esteem, high virtual social support, high impulsivity, and high alexithymia were independently predictive in the logistic regression analysis. The principal results of this study suggested that NSSI was extremely prevalent among adolescents during the COVID-19 outbreak, and in particularly, personality and virtual environment risk factors and enhancing self-esteem should be the focus of NSSI preventive strategies when targeting this age population. Our results provide a reference towards designing NSSI prevention programs geared toward the high school population during the COVID-19 pandemic.
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Affiliation(s)
- Wen-Ching Tang
- Department of Educational Psychology and Counseling, National Taiwan Normal University, No.162, Sec. 1, Heping E. Rd., Da-an District, Taipei City, 106 Taiwan
| | - Min-Pei Lin
- Department of Educational Psychology and Counseling, National Taiwan Normal University, No.162, Sec. 1, Heping E. Rd., Da-an District, Taipei City, 106 Taiwan
| | - Jianing You
- Center for Studies of Psychological Application & School of Psychology, South China Normal University, No. 155 Zhongshan W. Rd, Tianhe District, Guangzhou, China
| | - Jo Yung-Wei Wu
- Good-Day Psychology Clinic, 5F., No. 167, Xialin Rd., South District, Tainan City, 702 Taiwan
| | - Kuan-Chu Chen
- Department of Educational Psychology and Counseling, National Taiwan Normal University, No.162, Sec. 1, Heping E. Rd., Da-an District, Taipei City, 106 Taiwan
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Costa LCR, Gabriel IM, Oliveira WAD, Hortense P, Dicastillo OLD, Carlos DM. NON-SUICIDAL SELF-INJURY EXPERIENCES FOR ADOLESCENTS WHO SELF-INJURED - CONTRIBUTIONS OF WINNICOTT’S PSYCHOANALYTIC THEORY. TEXTO & CONTEXTO ENFERMAGEM 2021. [DOI: 10.1590/1980-265x-tce-2019-0382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to identify and analyze the elements present in non-suicidal self-injury experiences by adolescents who self-injured. Method: a qualitative research, with data collection conducted from August to October 2019 through individual therapeutic consultations, mediated by the dialogical resource Drawing-Story with Theme Procedure. Participants were eight adolescents who reported self-injury in a school of a municipality in the countryside of São Paulo, Brazil. Thematic analysis was developed from data anchored in Winnicott’s psychoanalytic theory. Results: two thematic categories were identified: “I think nobody cares about me” and “I do not see the colors I used to see before”. The elements present in adolescents’ experiences on non-suicidal self-injury highlighted the importance of a physical and relational environment that offers holding and is able to integrate characteristics of the adolescence process itself. The importance of a family and peer support network, as well as the need for family, school and health professionals to be involved in coping with and preventing non-suicidal self-injury stands out. Conclusion: non-suicidal self-injury is a multiple phenomenon, closely related to the environment, which deserves attention and care in the field of child and adolescent health. The issues present in the process of becoming an adolescent emerge as essential elements for understanding and coping with non-suicidal self-injury. Due to their multiple characteristics, coping and prevention policies should include several areas, such as health, education, and social assistance. The presence of mental health programs in schools is fundamental.
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Prospective Interpersonal and Intrapersonal Predictors of Initiation and Cessation of Non-Suicidal Self-Injury among Chinese Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249454. [PMID: 33348636 PMCID: PMC7766568 DOI: 10.3390/ijerph17249454] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/05/2020] [Accepted: 12/11/2020] [Indexed: 12/18/2022]
Abstract
(1) Purpose: Non-suicidal self-injury (NSSI) possibly emerges as well as remits in adolescence. To explore the development and transition of NSSI, this study examined the association between a wide range of interpersonal and intrapersonal predictors of NSSI initiation and cessation. (2) Methods: Chinese adolescents (N = 913) completed self-reported surveys at baseline and at a six-month follow-up. The sample included 625 adolescents who reported no NSSI and 288 adolescents who reported engagement in NSSI at baseline. (3) Results: Among the adolescents without NSSI at baseline, 24.3% engaged in NSSI at follow-up (NSSI initiation group). Among the adolescents with NSSI at baseline, 33.3% reported no NSSI at follow-up (NSSI cessation group). Loneliness, beliefs about adversity, problem behavior, and prosocial behavior were the significant factors in predicting subsequent NSSI initiation. None of the potential predicting factors were associated with subsequent NSSI cessation. (4) Conclusions: These results indicate the importance of intrapersonal factors in Chinese culture, which could be used to identify at-risk adolescents and to design interventions.
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Cipriano A, Cella S, Cotrufo P. Non-Suicidal Self-Injury Among Italian Adolescents: The Role of Parental Rejection, Self-Concept, Anger Expression, and Body Investment. CLINICAL NEUROPSYCHIATRY 2020; 17:330-338. [PMID: 34909011 PMCID: PMC8629071 DOI: 10.36131/cnfioritieditore20200602] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Objective Parental rejection, poor self-concept, anger expression, and negative body investment have often been associated with non-suicidal self-injury (NSSI). However, research has investigated each factor separately. To address this shortcoming, the main aim of the study was to integrate these factors and test a hierarchical regression to examine the impact of each factor above and beyond the others. Method A cross-sectional sample of 481 Italian high school students aged 13-19 (Mage=15.48; SD=1.46) were screened by self-report measures that assess parental rejection, self-concept, anger expression, body emotional investment, and NSSI. A semi-structured interview was administered in order to assess the characteristics of self-injurious behaviors. Results After the interview, twenty-three (4.8%) students reported having engaged in NSSI (Mage =12.63; SD=1.58). Neither gender nor age differences were found. The hierarchical regression revealed the NSSI was associated with the inward expression of anger (ORs=1.1–1.7) and the negative body investment (ORs=.037–.281). Conclusions These findings point out that the expression of anger inwardly and the emotional investment in the body may be salient factors to consider in understanding the occurrence of NSSI among adolescents. The clinical relevance of these findings was discussed.
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Affiliation(s)
- Annarosa Cipriano
- Observatory on eating disorders, Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, 81100 Caserta, CE, Italy
| | - Stefania Cella
- Observatory on eating disorders, Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, 81100 Caserta, CE, Italy
| | - Paolo Cotrufo
- Observatory on eating disorders, Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, 81100 Caserta, CE, Italy
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Moreira ÉDS, Vale RRMD, Caixeta CC, Teixeira RAG. Automutilação em adolescentes: revisão integrativa da literatura. CIENCIA & SAUDE COLETIVA 2020; 25:3945-3954. [DOI: 10.1590/1413-812320202510.31362018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 01/22/2019] [Indexed: 11/22/2022] Open
Abstract
Resumo Trata-se de uma revisão integrativa da literatura acerca dos conhecimentos produzidos pela comunidade científica sobre automutilação em adolescentes no período de janeiro de 2012 a junho de 2017. A busca foi realizada nas bases de dados SCIELO e Portal CAPES, em português, inglês e espanhol com amostra final de 71 artigos. Este estudo mostrou grande número de publicações a nível internacional, com destaque para artigos epidemiológicos e fragilidade na publicação de estudos de intervenção que investiguem a eficácia de terapias e programas de prevenção.
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Wan Y, Chen R, Wang S, Clifford A, Zhang S, Orton S. Associations of coping styles with nonsuicidal self-injury in adolescents: Do they vary with gender and adverse childhood experiences? CHILD ABUSE & NEGLECT 2020; 104:104470. [PMID: 32234639 DOI: 10.1016/j.chiabu.2020.104470] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 03/11/2020] [Accepted: 03/17/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The impact of positive coping style on non-suicidal self-injury in adolescents remains unclear, while negative coping style increases the risk of non-suicidal self-injury (NSSI). There is less investigation on gender differences in the impacts of positive coping style and negative coping style on NSSI. It is unknown whether the impacts vary with different levels of adverse childhood experiences (ACEs). AIMS To identify gender differences in the impacts of positive coping style and negative coping style on NSSI, and investigate the impacts at different levels of ACEs. METHOD An adolescent health survey was conducted in 15 schools in China between November 2013 and January 2014. 9704 students aged 11-19 years completed standard questionnaires to record the details of coping style, NSSI and ACEs. RESULTS 38.5 % of adolescents had ≥1 NSSI over the past 12 months. NSSI was significantly increased with the low positive coping style in girls with ≥3 ACEs, but not with 0 and 1-2 ACEs, and not in boys with any levels of ACEs. NSSI was increased with high negative coping style in both girls and boys across all ACEs. The negative coping style impact was stronger in girls than in boys (odds ratio 1.66, p < 0.05), especially in those with 1-2 ACEs. CONCLUSIONS Adolescents at high risk of NSSI in relation to coping styles should be targeted accordingly. Reducing negative coping style in girls and boys and improving positive coping style in girls who have high ACEs could help prevent NSSI in adolescents.
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Affiliation(s)
- Yuhui Wan
- Department of Maternal, Child& Adolescent Health, School of Public Health, Anhui Medical University, China; Anhui Provincial Key Laboratory of Population Health &Aristogenics, 81 Meishan Road, Hefei, 230032, Anhui, China; Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, UK
| | - Ruoling Chen
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, UK.
| | - Shanshan Wang
- Department of Maternal, Child& Adolescent Health, School of Public Health, Anhui Medical University, China; Anhui Provincial Key Laboratory of Population Health &Aristogenics, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Angela Clifford
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, UK
| | - Shichen Zhang
- Department of Maternal, Child& Adolescent Health, School of Public Health, Anhui Medical University, China; Anhui Provincial Key Laboratory of Population Health &Aristogenics, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Sophie Orton
- Division of Primary Care, School of Medicine, University of Nottingham, UK
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Buser JK, Buser TJ, Pertuit T. Nonsuicidal Self‐Injury and Attachment to God or a Higher Power. COUNSELING AND VALUES 2020. [DOI: 10.1002/cvj.12123] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Juleen K. Buser
- Department of Graduate Education, Leadership, and CounselingRider University
| | - Trevor J. Buser
- Department of Graduate Education, Leadership, and CounselingRider University
- Now at the Graduate School of Counseling and PsychologyNaropa University
| | - Terry Pertuit
- Department of Graduate Education, Leadership, and CounselingRider University
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Life Events Predicting the First Onset of Adolescent Direct Self-Injurious Behavior-A Prospective Multicenter Study. J Adolesc Health 2020; 66:195-201. [PMID: 31677986 DOI: 10.1016/j.jadohealth.2019.08.018] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 08/02/2019] [Accepted: 08/02/2019] [Indexed: 11/21/2022]
Abstract
PURPOSE Self-injurious behavior is a frequent phenomenon in adolescence. The present study prospectively examined life events as risk factors for the first onset of direct self-injurious behavior (D-SIB) in the Saving and Empowering Young Lives in Europe school-based multicenter sample. METHODS Longitudinal assessments with an interval of 1 year were performed within a sample of 1,933 adolescents (51.47% females; mean age 14.84 ± .9 years) from 10 European countries and Israel. RESULTS The number of life events during the past 6 months predicted the first onset of D-SIB in the following year. Gender neither predicted the onset of D-SIB nor moderated the association with life events. Moreover, analyses of individual events identified a range of mainly interpersonal events within both family and peer group as proximal risk factors for first episode D-SIB. CONCLUSIONS The results support the critical role of interpersonal life events in the development of D-SIB for both genders and refine the conceptualization of proximal risk factors in terms of accumulated stressors and interpersonal events.
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Moraes DX, Moreira ÉDS, Sousa JM, Vale RRMD, Pinho ES, Dias PCDS, Caixeta CC. “The pen is the blade, my skin the paper”: risk factors for self-injury in adolescents. Rev Bras Enferm 2020; 73:e20200578. [DOI: 10.1590/0034-7167-2020-0578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 09/13/2020] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Objective: to describe the risk factors that influence the self-injury behavior of adolescents assisted at a Psychosocial Care Center for Children and Adolescents, according to subjects’ own perceptions. Method: a descriptive, exploratory, qualitative study carried out through medical records and a focus group with 07 adolescents. The statements were submitted to thematic content analysis. Results: in the risk factors category, four subcategories emerged: Family adversity factors; Social contagion; Adverse life events; Personal characteristics. Conflicts, lack of support, drug use in the family, meeting someone who cuts themselves, social networks, religiosity, history of sexual violence and bullying were identified as risk factors that influence self-injury. Final Considerations: adolescents pointed out the need for prejudice-free dialogues in schools, in health and family devices, configuring protective factors to avoid this practice that comes from several negative events throughout life.
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Case JAC, Burke TA, Siegel DM, Piccirillo ML, Alloy LB, Olino TM. Functions of Non-Suicidal Self-Injury in Late Adolescence: A Latent Class Analysis. Arch Suicide Res 2020; 24:S165-S186. [PMID: 30856362 PMCID: PMC6739178 DOI: 10.1080/13811118.2019.1586607] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This study employed latent class analysis utilizing an array of features of non-suicidal self-injury (NSSI) in order to identify distinct subgroups of self-injurers. Participants were 359 undergraduates with NSSI history. Indicator variables were lifetime and last year frequency rates, number of methods, scarring, pain during self-injury, and functions of NSSI. Analyses yielded mild/experimental NSSI, moderate NSSI, moderate multiple functions NSSI, and severe NSSI groups, endorsing low, moderate, moderate multiple functions, and high frequencies of self-injury and presence of functions, respectively. Following class assignment, groups differed on self-esteem, social support and belongingness, internalizing symptoms, suicidal ideation and behaviors, and additional NSSI constructs. These subtype analyses emphasize matching phenotypes of NSSI to specific interventions considering dimensions of clinical functioning.
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Palmer C, Connor C, Channa S, Lavis A, Leung N, Parsons N, Birchwood M. The Development of First-Episode Direct Self-Injurious Behavior and Association with Difficulties in Emotional Regulation in Adolescence. Suicide Life Threat Behav 2019; 49:1266-1280. [PMID: 30178563 DOI: 10.1111/sltb.12512] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Accepted: 07/18/2018] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Self-harm remains a serious public health concern; however, identifying adolescents at risk is challenging. While self-harm has been linked with difficulties in emotional regulation postinjury, comparatively little is known about how such difficulties may impact on the future development of self-harm behavior. METHODS A total of 318 pupils aged 14-15 years completed measures on history of direct self-injurious behavior (D-SIB), emotional regulation, depression, and anxiety at two time points across a six-month period. RESULTS Of 13% (42) of participants reported their first episode of D-SIB over the six-month period and reported increased difficulties with emotional regulation prior to initial D-SIB. Regression analyses found significant associations for emotional regulation and specifically lack of emotional clarity prior to first episode of D-SIB. Lack of emotional awareness and difficulties with impulse control was significantly associated in those with ongoing D-SIB. CONCLUSIONS Prior to first episode of D-SIB, young people may experience difficulty regulating emotions, a difficulty which appears less pronounced following their engagement with D-SIB. Our findings implicate difficulties in the early evaluation and understanding of emotions which may later impair attempts at emotion modulation and increase risk of D-SIB. Such findings might help inform early identification of adolescents at risk of initial D-SIB.
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Affiliation(s)
- Colin Palmer
- Mental Health & Well-being, University of Warwick Medical School, Coventry, UK
| | - Charlotte Connor
- Mental Health & Well-being, University of Warwick Medical School, Coventry, UK
| | - Sunita Channa
- Mental Health & Well-being, University of Warwick Medical School, Coventry, UK
| | - Anna Lavis
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
| | - Newman Leung
- Birmingham & Solihull Mental Health Foundation Trust, Birmingham, UK
| | - Nick Parsons
- Mental Health & Well-being, University of Warwick Medical School, Coventry, UK
| | - Max Birchwood
- Mental Health & Well-being, University of Warwick Medical School, Coventry, UK
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Adrian M, Zeman J, Erdley C, Whitlock K, Sim L. Trajectories of non-suicidal self-injury in adolescent girls following inpatient hospitalization. Clin Child Psychol Psychiatry 2019; 24:831-846. [PMID: 30947520 DOI: 10.1177/1359104519839732] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
This study explored the growth of non-suicidal self-injury (NSSI) frequency over 2.5 years in a clinical sample of adolescent girls. Following a functional model of NSSI, the contribution of emotion dysregulation, peer victimization, and psychological maladjustment were evaluated as the predictors of NSSI trajectories. Participants of 99 girls (Mage = 16.03 years) were admitted for psychiatric hospitalization, who responded to questionnaires assessing NSSI, emotion dysregulation, relational and overt peer victimization, and internalizing and externalizing symptoms. NSSI was also assessed at 6 months and 2.5 years following the baseline assessment. Linear mixed modeling estimated NSSI frequency over time. The findings highlight the stable nature of NSSI and the contribution of emotion dysregulation and internalizing symptoms to NSSI patterns. Peer victimization and externalizing behavior problems were not the significant predictors. Developing interventions targeting these NSSI predictors early in girls' development may prevent the emergence and maintenance of NSSI.
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Affiliation(s)
- Molly Adrian
- Department of Psychiatry and Child Health Institute, University of Washington, USA
| | - Janice Zeman
- Department of Psychology, College of William & Mary, USA
| | | | - Kathryn Whitlock
- Center for Child Health, Behavior and Development, Seattle Children's Research Institute, USA
| | - Leslie Sim
- Department of Psychiatry and Psychology, Mayo Clinic, USA
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Turner BJ, Baglole JS, Chapman AL, Gratz KL. Experiencing and Resisting Nonsuicidal Self-injury Thoughts and Urges in Everyday Life. Suicide Life Threat Behav 2019; 49:1332-1346. [PMID: 30152181 DOI: 10.1111/sltb.12510] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2017] [Accepted: 07/30/2018] [Indexed: 12/01/2022]
Abstract
OBJECTIVE We used a daily diary to examine (1) the frequency of three types of NSSI thoughts and urges (fleeting thoughts, persistent thoughts, and intense urges), (2) the correlates of NSSI thought and urges within and across days, (3) strategies that aid in resisting NSSI thoughts and urges, and (4) the prospective association of daily NSSI thoughts and urges with NSSI behavior over 12 months. METHOD Sixty adults (aged 18-35) completed a two-week daily diary and follow-ups every 3 months for one year. RESULTS Fleeting NSSI thoughts were reported on 48% of days, whereas persistent thoughts (11%) and intense urges (17%) were less common. Within days, earlier stress predicted more persistent NSSI thoughts, whereas earlier perceived support predicted less intense NSSI urges. Furthermore, NSSI thoughts and urges were positively associated with same-day stress and avoidant coping. Problem-focused coping was associated with greater success resisting same-day fleeting thoughts and intense urges, as well as success resisting next-day persistent thoughts. Perceived support was associated with less intense same-day urges, but also less success resisting these urges. Over the follow-up, persistent thoughts predicted less frequent NSSI, whereas intense urges predicted more frequent NSSI. CONCLUSIONS NSSI thoughts and urges are commonly experienced and deserve further attention.
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Affiliation(s)
- Brianna J Turner
- Department of Psychology, University of Victoria, Victoria, BC, Canada
| | | | | | - Kim L Gratz
- Department of Psychology, University of Toledo, Toledo, OH, USA
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Chavez K, Palfai TP. Feasibility of a Mobile Messaging-Enhanced Brief Intervention for High Risk Heavy Drinking MSM: A Pre-Pilot Study. ALCOHOLISM TREATMENT QUARTERLY 2019; 38:87-105. [PMID: 32982032 PMCID: PMC7518379 DOI: 10.1080/07347324.2019.1653240] [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] [Indexed: 10/26/2022]
Abstract
The purpose of this project was to assess the feasibility of an in-person session + mobile messaging intervention approach to reduce heavy drinking and condomless anal intercourse among heavy drinking men who have sex with men at high risk for HIV. Participant (n = 8) engagement rates, retention and satisfaction ratings were used to measure feasibility and acceptability of the 4-week intervention. Paired t-tests were used to assess additional secondary outcomes. Results support the feasibility and acceptability of this novel treatment approach among this population. Pre-post intervention effect sizes on alcohol, sex risk and process variable secondary outcomes are discussed.
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Affiliation(s)
- Kathryn Chavez
- Boston University, Psychological and Brain Science, 900 Commonwealth Avenue 2 Floor, Boston, 02215, MA, USA
| | - Tibor P. Palfai
- Boston University, Psychological and Brain Science, 900 Commonwealth Avenue 2 Floor, Boston, 02215, MA, USA
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Copeland M, Siennick SE, Feinberg ME, Moody J, Ragan DT. Social Ties Cut Both Ways: Self-Harm and Adolescent Peer Networks. J Youth Adolesc 2019; 48:1506-1518. [PMID: 30989471 DOI: 10.1007/s10964-019-01011-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2019] [Accepted: 02/28/2019] [Indexed: 11/29/2022]
Abstract
Peers play an important role in adolescence, a time when self-harm arises as a major health risk, but little is known about the social networks of adolescents who cut. Peer network positions can affect mental distress related to cutting or provide direct social motivations for self-harm. This study uses PROSPER survey data from U.S. high school students (n = 11,160, 48% male, grades 11 and 12), finding that social networks predict self-cutting net of demographics and depressive symptoms. In final models, bridging peers predicts higher self-cutting, while claiming more friends predicts lower cutting for boys. The findings suggest that researchers and practitioners should consider peer networks both a beneficial resource and source of risk associated with cutting for teens and recognize the sociostructural contexts of self-harm for adolescents more broadly.
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Affiliation(s)
- Molly Copeland
- Department of Sociology, Duke University, Durham, NC, 27708, USA.
| | - Sonja E Siennick
- College of Criminology and Criminal Justice, Florida State University, Tallahassee, FL, 32306, USA
| | - Mark E Feinberg
- Edna Bennett Pierce Prevention Research Center, Pennsylvania State University, 310 BioBehavioral Health, University Park, PA, 16802, USA
| | - James Moody
- Department of Sociology, Duke University, Durham, NC, 27708, USA.,King Abdulaziz University, Jeddah, Saudi Arabia
| | - Daniel T Ragan
- Department of Sociology, University of New Mexico, Albuquerque, NM, 87131, USA
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Taylor PJ, McDonald J, Smith M, Nicholson H, Forrester R. Distinguishing people with current, past, and no history of non-suicidal self-injury: Shame, social comparison, and self-concept integration. J Affect Disord 2019; 246:182-188. [PMID: 30583143 DOI: 10.1016/j.jad.2018.12.033] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 11/06/2018] [Accepted: 12/16/2018] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Non-Suicidal Self-Injury (NSSI) can have a major impact on the lives of individuals and those around them. The way in which a person feels about and perceives themselves (i.e. self-concept) appears central to understanding NSSI. The current study investigates three variables linked to self-concept: shame, social comparison, and self-concept integration. We examine how well these variables differentiate people who report past NSSI, people who report current NSSI, and people who have never engaged in NSSI. DESIGN Cross-sectional. METHOD Individuals reporting NSSI in the past year (n = 51), individuals with a history of NSSI but none in the past year (n = 44), and individuals with no history of NSSI (n = 110) were compared on measures of shame, social comparison, and self-concept integration. RESULTS Shame was elevated in people with a history of NSSI but did not distinguish between past and current NSSI when other variables were controlled for. Self-concept integration was poorer in people reporting current NSSI than people reporting past NSSI, even when controlling for other variables. CONCLUSIONS The results support the role of shame as a general marker for NSSI risk, but suggest self-concept integration may fluctuate more dynamically in relation to the recency of NSSI. The study is limited by a non-matched student control group.
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Affiliation(s)
- Peter J Taylor
- Division of Psychology & Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Sciences Centre, England M13 9PL, United Kingdom.
| | - James McDonald
- Division of Psychology & Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Sciences Centre, England M13 9PL, United Kingdom
| | - Megan Smith
- Division of Psychology & Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Sciences Centre, England M13 9PL, United Kingdom
| | - Hannah Nicholson
- Institute of Psychology, Health & Society, University of Liverpool, Liverpool, England L69 3GB, United Kingdom
| | - Rebecca Forrester
- Springpark Mental Health Resource Centre, NHS Greater Glasgow & Clyde, Glasgow, Scotland G22 5EU, United Kingdom
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Victor SE, Hipwell AE, Stepp SD, Scott LN. Parent and peer relationships as longitudinal predictors of adolescent non-suicidal self-injury onset. Child Adolesc Psychiatry Ment Health 2019; 13:1. [PMID: 30622642 PMCID: PMC6317237 DOI: 10.1186/s13034-018-0261-0] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 12/22/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescence is characterized by developmental changes in social relationships, which may contribute to, or protect against, psychopathology and risky behaviors. Non-suicidal self-injury (NSSI) is one type of risky behavior that typically begins during adolescence and is associated with problems in relationships with family members and peers. Prior research on social factors in adolescent NSSI has been limited, however, by a narrow focus on specific interpersonal domains, cross-sectional methods, retrospective self-report of childhood experiences, and a failure to predict NSSI onset among as-yet-unaffected youth. METHODS We investigated these relationships in 2127 urban-living adolescent girls with no NSSI history at age 13, who were participating in a longitudinal cohort study (Pittsburgh Girls Study). We used discrete-time survival analyses to examine the contribution of time-varying interpersonal risk factors, assessed yearly at ages 13-16, to NSSI onset assessed in the following year (ages 14-17), controlling for relevant covariates, such as depression and race. We considered both behavioral indicators (parental discipline, positive parenting, parental monitoring, peer victimization), and cognitive/affective indicators (quality of attachment to parent, perceptions of peers, and perceptions of one's own social competence and worth in relation to peers) of interpersonal difficulties. RESULTS Parental harsh punishment, low parental monitoring, and poor quality of attachment to parent predicted increased odds of subsequent adolescent NSSI onset, whereas positive parenting behaviors reduced the odds of next year NSSI onset. Youth who reported more frequent peer victimization, poorer social self-worth and self-competence, and more negative perceptions of peers were also at increased risk of NSSI onset in the following year. When tested simultaneously, no single parenting variable showed a unique association with later NSSI onset; in contrast, peer victimization and poor social self-worth each predicted increased odds of later NSSI onset in an omnibus model of peer and parent relationship characteristics. CONCLUSIONS In this urban sample of adolescent girls, both peer and parent factors predicted new onset NSSI, although only peer factors were associated with subsequent NSSI in combined multivariate models. Results further suggest that both behavioral and cognitive/affective indicators of interpersonal problems predict NSSI onset. These findings highlight the relevance of family and peer relationships to NSSI onset, with implications for prevention of NSSI onset among at-risk youth.
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Affiliation(s)
- Sarah E. Victor
- 0000 0004 1936 9000grid.21925.3dDepartment of Psychiatry, University of Pittsburgh, Sterling Plaza Suite 408, Pittsburgh, PA 15213 USA
| | - Alison E. Hipwell
- 0000 0004 1936 9000grid.21925.3dDepartment of Psychiatry, University of Pittsburgh, Sterling Plaza Suite 408, Pittsburgh, PA 15213 USA
| | - Stephanie D. Stepp
- 0000 0004 1936 9000grid.21925.3dDepartment of Psychiatry, University of Pittsburgh, Sterling Plaza Suite 408, Pittsburgh, PA 15213 USA
| | - Lori N. Scott
- 0000 0004 1936 9000grid.21925.3dDepartment of Psychiatry, University of Pittsburgh, Sterling Plaza Suite 408, Pittsburgh, PA 15213 USA
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Zinchuk MS, Avedisova AS, Guekht AB. Nonsuicidal self-injury behavior in non-psychotic disorders: epidemiology, social and clinical risk factors. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:108-119. [DOI: 10.17116/jnevro2019119031108] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Fox AR, Hammond LE, Mezulis AH. Respiratory sinus arrhythmia and adaptive emotion regulation as predictors of nonsuicidal self-injury in young adults. Int J Psychophysiol 2018; 133:1-11. [DOI: 10.1016/j.ijpsycho.2018.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2017] [Revised: 08/23/2018] [Accepted: 09/19/2018] [Indexed: 11/24/2022]
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Driver N, Cready CM. Nativity/language, neighborhoods, and teen pregnancy norms among U.S. Hispanics. Women Health 2018; 59:496-509. [PMID: 30040608 DOI: 10.1080/03630242.2018.1500416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
This study examined the relations of nativity, language, and neighborhood context to pregnancy norms among U.S. Hispanic teens. We used data from a sample of 972 Hispanic females and 960 Hispanic males from Waves I and II (1994-1996) of the National Longitudinal Study of Adolescent to Adult Health (Add Health) collected in eighty high schools and fifty-two middle schools across the country. Results indicated that nativity, language, and neighborhood context were related to Hispanic teen pregnancy norms, although these relationships varied by gender. Specifically, foreign-born, non-English speaking females and those who lived in immigrant neighborhoods held stronger norms against unmarried teen pregnancies compared to English speakers and/or lived elsewhere. Yet, no relationship was demonstrated for males. The results of this study suggest an immigrant advantage related to female teen pregnancy norms, and that context matters in the formation of pregnancy norms for Hispanic females.
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Affiliation(s)
- Nichola Driver
- a Clinton School of Public Service , University of Arkansas Clinton , Little Rock , Arkansas , USA
| | - Cynthia M Cready
- b Department of Sociology , University of North Texas , Denton , Texas , USA
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Fraser G, Wilson MS, Garisch JA, Robinson K, Brocklesby M, Kingi T, O'Connell A, Russell L. Non-Suicidal Self-Injury, Sexuality Concerns, and Emotion Regulation among Sexually Diverse Adolescents: A Multiple Mediation Analysis. Arch Suicide Res 2018; 22:432-452. [PMID: 28759324 DOI: 10.1080/13811118.2017.1358224] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Despite increasing interest in the prevalence and correlates of Non-Suicidal Self-Injury (NSSI) in adolescent populations, relatively few studies have examined NSSI among lesbian, gay and bisexual (LGB) adolescents. The current study explored sexuality concerns and elevated emotion dysregulation as potential mechanisms underlying the relationship between sexual orientation and elevated non-suicidal self-injury (NSSI). A community sample of 1,799 adolescents completed a questionnaire assessing NSSI, sexual orientation, sexuality concerns, and emotion regulation. Across the study, 20.6% of adolescents reported a history of NSSI. Adolescents who identify as "mostly heterosexual," "bisexual," and "mostly homosexual" were more likely to engage in NSSI than gay/lesbian, heterosexual, and asexual adolescents. Multiple mediation analysis showed that emotion regulation, but not sexuality concerns, mediated the relationship between sexual orientation and NSSI. The current study tested two theoretical pathways by which sexual orientation could predict NSSI engagement. Findings suggest that literature on general psychological processes, as well as group-specific minority stressors, can shed light on high rates of NSSI among LGB populations. Specifically, the challenges faced by LGB adolescents may undermine the development of emotion regulation. As such, this should be a key target of intervention with LGB adolescents engaging in NSSI.
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Robinson K, Garisch JA, Kingi T, Brocklesby M, O’Connell A, Langlands RL, Russell L, Wilson MS. Reciprocal Risk: the Longitudinal Relationship between Emotion Regulation and Non-suicidal Self-Injury in Adolescents. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2018; 47:325-332. [DOI: 10.1007/s10802-018-0450-6] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Hack J, Martin G. Expressed Emotion, Shame, and Non-Suicidal Self-Injury. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15050890. [PMID: 29710866 PMCID: PMC5981929 DOI: 10.3390/ijerph15050890] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 04/15/2018] [Accepted: 04/26/2018] [Indexed: 11/16/2022]
Abstract
A cross-sectional study examining relationships between perceived family Expressed Emotion and shame, emotional involvement, depression, anxiety, stress and non-suicidal self-injury, in 264 community and online adults (21.6% male). We compared self-injurers with non-self-injurers, and current with past self-injurers. Self-injurers experienced more family Expressed Emotion (EE) than non-injurers (t(254) = −3.24, p = 0.001), linear contrasts explaining 6% of between-groups variability (F(2, 254) = 7.36, p = 0.001, η2 = 0.06). Differences in EE between current and past self-injurers were not significant. Overall shame accounted for 33% of between-groups variance (F(2, 252) = 61.99, p < 0.001, η2 = 0.33), with linear contrasts indicating self-injurers experienced higher levels compared to non-injurers (t(252) = −8.23, p < 0.001). Current self-injurers reported higher overall shame than past self-injurers (t(252) = 6.78, p < 0.001). In further logistic regression, emotional involvement and overall shame were the only significant predictors of self-injury status. With every one-unit increase in emotional involvement, odds of currently engaging in self-injury decreased by a factor of 0.860. Conversely, a one-unit increase in overall shame was associated with an increase in the odds of being a current self-injurer by a factor of 1.05. The findings have important treatment implications for engaging key family members in intervention and prevention efforts.
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Affiliation(s)
- Jessica Hack
- Provisional Psychologist, Newcastle Mental Health Service, Newcastle, NSW 2300, Australia.
| | - Graham Martin
- Department of Psychiatry, The University of Queensland, Royal Brisbane and Women's Hospital, Herston, Brisbane, QLD 4066, Australia.
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Whitlock JL, Baetens I, Lloyd-Richardson E, Hasking P, Hamza C, Lewis S, Franz P, Robinson K. Helping schools support caregivers of youth who self-injure: Considerations and recommendations. SCHOOL PSYCHOLOGY INTERNATIONAL 2018. [DOI: 10.1177/0143034318771415] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Non-suicidal self-injury (NSSI) is a significant international mental health concern, with consequences for not only youth who self-injure, but for their entire family system. Helping caregivers respond productively to their child’s self-injury is a vital part of effectively addressing NSSI. This paper will assist school-based mental health practitioners and other personnel support caregivers of youth who self-injure by reviewing current literature, highlighting common challenges faced by school-based professionals, and providing evidenced-informed recommendations for supporting caregivers of youth who self-injure. We posit that schools can best support caregivers by having clear and well-articulated self-injury protocols and by engaging caregivers early. Once engaged, helping caregivers to navigate first conversations, keep doors open, know what to expect, seek support for themselves and understand and address safety concerns will ultimately benefit youth who self-injure and the school systems that support them. We also review recommendations for working with youth whose caretakers are unwilling or unable to be engaged.
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Affiliation(s)
- Janis L. Whitlock
- Bronfenbrenner Center for Translational Research, Cornell University, USA
| | | | | | | | - Chloe Hamza
- Ontario Institute for Studies in Education at the University of Toronto, Canada
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Valencia-Agudo F, Burcher GC, Ezpeleta L, Kramer T. Nonsuicidal self-injury in community adolescents: A systematic review of prospective predictors, mediators and moderators. J Adolesc 2018. [PMID: 29522914 DOI: 10.1016/j.adolescence.2018.02.012] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Nonsuicidal self-injury (NSSI) usually starts during adolescence and is associated with an array of psychological and psychiatric symptoms and future suicide attempts. The aim of this study is to determine prospective predictors, mediators and moderators of NSSI in adolescent community samples in order to target prevention and treatment strategies. Two team members searched online databases independently. Thirty-nine studies were included in the review. Several variables were seen to prospectively predict NSSI: female gender, family-related variables, peer victimisation, depression, previous NSSI and self-concept. Few studies analysed mediators and moderators. Low self-concept was highlighted as a relevant moderator in the relationship between intra/interpersonal variables and NSSI. Implications of these findings are discussed. The considerable heterogeneity between studies posed a limitation to determine robust predictors of NSSI. Further prospective studies using standardised measures of predictors and outcomes are needed to ascertain the most at risk individuals and develop prevention strategies.
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Affiliation(s)
- Fatima Valencia-Agudo
- Clinical and Health Psychology Department, Autonomous University of Barcelona, Facultat de Psicologia UAB, Departament de Psicologia Clínica i de la Salut, Edifici B1, Campus de la Universitat Autònoma de Barcelona, Carrer de Ca n'Altayó, s/n, 08193, Bellaterra, Barcelona, Spain; Centre for Psychiatry, Imperial College London, 7th Floor Commonwealth Building, Du Cane Road, London, W12 0NN, UK.
| | - Georgina Corbet Burcher
- Centre for Psychiatry, Imperial College London, 7th Floor Commonwealth Building, Du Cane Road, London, W12 0NN, UK
| | - Lourdes Ezpeleta
- Clinical and Health Psychology Department, Autonomous University of Barcelona, Facultat de Psicologia UAB, Departament de Psicologia Clínica i de la Salut, Edifici B1, Campus de la Universitat Autònoma de Barcelona, Carrer de Ca n'Altayó, s/n, 08193, Bellaterra, Barcelona, Spain
| | - Tami Kramer
- Centre for Psychiatry, Imperial College London, 7th Floor Commonwealth Building, Du Cane Road, London, W12 0NN, UK
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Ammerman BA, Jacobucci R, Kleiman EM, Uyeji LL, McCloskey MS. The Relationship Between Nonsuicidal Self-Injury Age of Onset and Severity of Self-Harm. Suicide Life Threat Behav 2018; 48:31-37. [PMID: 28160318 PMCID: PMC5557699 DOI: 10.1111/sltb.12330] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 10/27/2016] [Indexed: 12/01/2022]
Abstract
This study examined how age of nonsuicidal self-injury (NSSI) onset relates to NSSI severity and suicidality using decision tree analyses (nonparametric regression models that recursively partition predictor variables to create groupings). Those with an earlier age of NSSI onset reported greater NSSI frequency, NSSI methods, and NSSI-related hospital visits. No significant splits were found for suicide ideation or attempts, although those with an earlier onset were more likely to have a suicide plan. Overall, findings suggest that onset of NSSI before age 12 is associated with more severe NSSI and may be a crucial age for prevention efforts.
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Ren Y, Lin MP, Liu YH, Zhang X, Wu JYW, Hu WH, Xu S, You J. The mediating role of coping strategy in the association between family functioning and nonsuicidal self-injury among Taiwanese adolescents. J Clin Psychol 2018; 74:1246-1257. [PMID: 29355974 DOI: 10.1002/jclp.22587] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2017] [Revised: 10/28/2017] [Accepted: 11/15/2017] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Nock's (2009) integrated theoretical model suggests that both intrapersonal and interpersonal factors contribute to the development of nonsuicidal self-injury (NSSI). Based on this model, the present study examined the roles of family functioning and coping strategy in predicting NSSI, as well as the mediating effect of coping strategy in the relationship between family functioning and NSSI. Gender differences on the associations of these variables were also examined. METHOD A sample of 1,989 secondary school students (52.0% females) in Taiwan was assessed by self-report measures of perceived family functioning, coping strategy, and NSSI. RESULTS Results showed that both family functioning and avoidance/emotion-focused coping strategy predicted NSSI. Additionally, the association between family functioning and NSSI was mediated by avoidance/emotion-focused coping strategy. Gender differences were not found on the associations among these study variables. CONCLUSIONS These data provided evidences that the Nock's (2009) integrated theoretical model may help to explain how coping strategy mediates the effect of family functioning on NSSI. The implications of the findings for future research and intervention were discussed.
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Affiliation(s)
- Yaxuan Ren
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, Research Center for Crisis Intervention and Psychological Service of Guangdong Province, & School of Psychology, South China Normal University, Guangzhou, People's Republic of China
| | - Min-Pei Lin
- Department of Educational Psychology and Counseling, National Taiwan Normal University, Taipei City, Taiwan
| | - Yin-Han Liu
- Department of Educational Psychology and Counseling, National Taiwan Normal University, Taipei City, Taiwan
| | - Xu Zhang
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, Research Center for Crisis Intervention and Psychological Service of Guangdong Province, & School of Psychology, South China Normal University, Guangzhou, People's Republic of China
| | - Jo Yung-Wei Wu
- Department of Counseling and Guidance, National University of Tainan, Tainan, Taiwan
| | - Wei-Hsuan Hu
- Department of Counseling and Guidance, National University of Tainan, Tainan, Taiwan
| | - Sian Xu
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, Research Center for Crisis Intervention and Psychological Service of Guangdong Province, & School of Psychology, South China Normal University, Guangzhou, People's Republic of China
| | - Jianing You
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, Research Center for Crisis Intervention and Psychological Service of Guangdong Province, & School of Psychology, South China Normal University, Guangzhou, People's Republic of China
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Schreiner MW, Klimes-Dougan B, Mueller BA, Eberly LE, Reigstad KM, Carstedt PA, Thomas KM, Hunt RH, Lim KO, Cullen KR. Multi-modal neuroimaging of adolescents with non-suicidal self-injury: Amygdala functional connectivity. J Affect Disord 2017; 221. [PMID: 28628767 PMCID: PMC5555154 DOI: 10.1016/j.jad.2017.06.004] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) is a significant mental health problem among adolescents. Research is needed to clarify the neurobiology of NSSI and identify candidate neurobiological targets for interventions. Based on prior research implicating heightened negative affect and amygdala hyperactivity in NSSI, we pursued a systems approach to characterize amygdala functional connectivity networks during rest (resting-state functional connectivity [RSFC)]) and a task (task functional connectivity [TFC]) in adolescents with NSSI. METHOD We examined amygdala networks in female adolescents with NSSI and healthy controls (n = 45) using resting-state fMRI and a negative emotion face-matching fMRI task designed to activate the amygdala. Connectivity analyses included amygdala RSFC, amygdala TFC, and psychophysiological interactions (PPI) between amygdala connectivity and task conditions. RESULTS Compared to healthy controls, adolescents with NSSI showed atypical amygdala-frontal connectivity during rest and task; greater amygdala RSFC in supplementary motor area (SMA) and dorsal anterior cingulate; and differential amygdala-occipital connectivity between rest and task. After correcting for depression symptoms, amygdala-SMA RSFC abnormalities, among others, remained significant. LIMITATIONS This study's limitations include its cross-sectional design and its absence of a psychiatric control group. CONCLUSIONS Using a multi-modal approach, we identified widespread amygdala circuitry anomalies in adolescents with NSSI. While deficits in amygdala-frontal connectivity (driven by depression symptoms) replicates prior work in depression, hyperconnectivity between amygdala and SMA (independent of depression symptoms) has not been previously reported. This circuit may represent an important mechanism underlying the link between negative affect and habitual behaviors. These abnormalities may represent intervention targets for adolescents with NSSI.
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Affiliation(s)
| | | | - Bryon A. Mueller
- Department of Psychiatry, University of Minnesota Medical School
| | - Lynn E. Eberly
- Division of Biostatistics, University of Minnesota School of Public Health
| | | | | | - Kathleen M. Thomas
- Institute of Child Development, University of Minnesota College of Education and Human Development
| | - Ruskin H. Hunt
- Institute of Child Development, University of Minnesota College of Education and Human Development
| | - Kelvin O. Lim
- Department of Psychiatry, University of Minnesota Medical School
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Lin MP, You J, Ren Y, Wu JYW, Hu WH, Yen CF, Zhang X. Prevalence of nonsuicidal self-injury and its risk and protective factors among adolescents in Taiwan. Psychiatry Res 2017; 255:119-127. [PMID: 28544943 DOI: 10.1016/j.psychres.2017.05.028] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 03/27/2017] [Accepted: 05/15/2017] [Indexed: 11/18/2022]
Abstract
The present study aimed to investigate the prevalence of nonsuicidal self-injury (NSSI) in a large representative sample of secondary school students and identified the psychosocial risk and protective factors. Using a cross-sectional design, 2170 participants were recruited from senior high schools throughout Taiwan using both stratified and cluster sampling. The one-year prevalence of NSSI was found to be 20.1%. Results suggested that compared to non-injurers, episodic self-injurers reported higher levels of neuroticism and openness, while repetitive self-injurers reported higher levels of neuroticism, openness, avoidance/emotion-focused coping, and virtual social support, and lower levels of self-esteem and cognitive reconstruction/problem-focused coping. Compared to episodic self-injurers, repetitive self-injurers reported a higher level of avoidance/ emotion-focused coping. Additionally, compared to non-injurers, mild self-injurers reported higher levels of neuroticism and openness, while severe self-injurers reported higher levels of neuroticism, openness, avoidance/emotion-focused coping, and virtual social support, and lower levels of self-esteem and cognitive reconstruction/problem-focused coping. Our study found that NSSI is fairly prevalent among secondary school students in Taiwan. Psychosocial risk factors, especially maladaptive coping strategies, should be given special attention when examining adolescents with NSSI. Regarding protective factors, enhancing self-esteem should be the focus of formulating effective intervention strategies for NSSI.
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Affiliation(s)
- Min-Pei Lin
- Department of Educational Psychology and Counseling, National Taiwan Normal University, No.162, Section 1, Heping E. Rd., Da-an District, Taipei City 106, Taiwan.
| | - Jianing You
- Guangdong Key Laboratory of Mental Health and Cognitive Science, Center for Studies of Psychological Application, and School of Psychology, South China Normal University, No. 155 Zhongshan W. Rd, Tianhe District, Guangzhou, China
| | - Yaxuan Ren
- Guangdong Key Laboratory of Mental Health and Cognitive Science, Center for Studies of Psychological Application, and School of Psychology, South China Normal University, No. 155 Zhongshan W. Rd, Tianhe District, Guangzhou, China
| | - Jo Yung-Wei Wu
- Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, No. 1, University Rd, Tainan 701, Taiwan
| | - Wei-Hsuan Hu
- Department of Counseling and Guidance, National University of Tainan, No.33, Section 2, Shu-Lin St., Tainan 700, Taiwan
| | - Cheng-Fang Yen
- Department of Psychiatry, Kaohsiung Medical University Hospital, No.100, Tzyou 1st Road, Kaohsiung 807, Taiwan; Department of Psychiatry, Tainan Municipal Hospital, No.670, Chongde Road, East District, Tainan 701, Taiwan
| | - Xu Zhang
- Guangdong Key Laboratory of Mental Health and Cognitive Science, Center for Studies of Psychological Application, and School of Psychology, South China Normal University, No. 155 Zhongshan W. Rd, Tianhe District, Guangzhou, China
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Castro K, Kirchner T. Coping and Psychopathological Profile in Nonsuicidal Self-Injurious Chilean Adolescents. J Clin Psychol 2017; 74:147-160. [DOI: 10.1002/jclp.22493] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 03/20/2017] [Accepted: 04/16/2017] [Indexed: 11/05/2022]
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Longitudinal Pathways for the Maintenance of Non-Suicidal Self-Injury in Adolescence: The Pernicious Blend of Depressive Symptoms and Self-Criticism. CHILD & YOUTH CARE FORUM 2017. [DOI: 10.1007/s10566-017-9406-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Multi-level Analysis of the Functioning of the Neurobiological Threat System in Adolescents: Implications for Suicide and Nonsuicidal Self-Injury. Curr Behav Neurosci Rep 2017. [DOI: 10.1007/s40473-017-0117-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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A longitudinal investigation of the relation between nonsuicidal self-injury and spirituality/religiosity. Psychiatry Res 2017; 250:106-112. [PMID: 28152395 DOI: 10.1016/j.psychres.2017.01.062] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 01/22/2017] [Indexed: 11/22/2022]
Abstract
Despite increased research on factors that predict engagement in nonsuicidal self-injury (NSSI), one factor that has been neglected is spirituality/religiosity. While some researchers suggest that spiritual/religious beliefs and practice may protect against aversive mental health outcomes, it also is possible that certain aspects of spirituality/religiosity - specifically doubt and questioning - may be distressing. In this study, we examined whether multiple dimensions of spirituality/religiosity, including the often-overlooked experience of doubt/questioning, were associated with engagement in NSSI among university students over time. Participants included 1,132 (70.5% female) first-year undergraduate students (Mean age=19.06, SD=1.05) from a Canadian university who were surveyed first in their freshman year, and again one year later. Auto-regressive cross-lagged analyses revealed a bidirectional relation between doubt/questioning and NSSI, where higher doubt/questioning predicted increased NSSI over time (after controlling for baseline depressive symptoms), and vice versa. There were no longitudinal associations between general spirituality/religiosity (i.e., general beliefs/practice) and NSSI. Our findings suggest questioning and doubt may be distressing for some individuals, and predict increased risk for NSSI as a form of coping. Further, higher NSSI may predict increases in questioning/doubt over time. However, the hypothesis that general spirituality/religiosity may protect against NSSI, was not supported.
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Temperament and character traits in female adolescents with nonsuicidal self-injury disorder with and without comorbid borderline personality disorder. Child Adolesc Psychiatry Ment Health 2017; 11:4. [PMID: 28101133 PMCID: PMC5237331 DOI: 10.1186/s13034-016-0142-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 12/21/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Temperament and character traits of adolescents with nonsuicidal self-injury disorder (NSSI) might differentiate those- with and without comorbid borderline personality disorder (BPD). METHODS Participants were 57 female adolescents with NSSI disorder without BPD (NSSI - BPD), 14 adolescents with NSSI disorder and BPD (NSSI + BPD), 32 clinical controls (CC), and 64 nonclinical controls (NC). Temperament and character traits were assessed with the Junior Temperament and Character Inventory, and impulsivity with the Barratt Impulsiveness Scale and a Go/NoGo task. RESULTS Adolescents with NSSI disorder scored significantly higher on novelty seeking and harm avoidance and lower on persistence, self-directedness, and cooperativeness than CC. The NSSI + BPD group scored even higher than the NSSI - BPD group on novelty seeking and harm avoidance and lower on persistence and cooperativeness (d ≥ 0.72). Adolescents with NSSI reported higher levels of impulsivity than the CC and NC group. However, this difference was not found in a Go/NoGo task. CONCLUSIONS The results provide further evidence for a distinct diagnostic entity of NSSI disorder.
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Richmond S, Hasking P, Meaney R. Psychological Distress and Non-Suicidal Self-Injury: The Mediating Roles of Rumination, Cognitive Reappraisal, and Expressive Suppression. Arch Suicide Res 2017; 21:62-72. [PMID: 26645313 DOI: 10.1080/13811118.2015.1008160] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study sought to explore the relationships between depression, anxiety, stress, and non-suicidal self-injury (NSSI), and the mediating roles of rumination and emotion regulation in this relationship. The sample comprised 1,586 Australian university students who completed a self-report questionnaire assessing the relevant variables. Of the sample, 8.9% engaged in NSSI in the 4 weeks prior to the survey. Depression, anxiety, and stress each exerted a direct effect on NSSI, and each relationship was mediated by cognitive reappraisal. The relationship between stress and NSSI was also mediated by expressive suppression. The results imply intervention efforts aimed at teaching adaptive emotion regulation strategies for students experiencing high levels of psychological distress may reduce the frequency of NSSI.
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Reigstad B, Kvernmo S. Concurrent adversities and deliberate self-harm among indigenous Sami and majority Norwegian adolescents: the Norwegian Arctic Adolescent Health Study. Scand J Child Adolesc Psychiatr Psychol 2017. [DOI: 10.21307/sjcapp-2017-011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Abstract
Background:
Few studies have investigated proximal relationships between deliberate self-harm (DSH) and concurrent adversities.
Objective:
We aimed to investigate these relationships in a community population of 4881 indigenous Sami and majority Norwegian adolescents, 15 to 16 years old, and related to ethnicity and gender.
Methods:
Youth with and without self-reports of DSH last year were compared on 12 concurrent adversities, on scales measuring family and peer functioning, and on sociodemographic conditions.
Results:
DSH last year was reported by 22.3% of the adolescents, and by more girls (28.8%) than boys (15.9%). All 12 concurrent adversities were related strongly to DSH last year. Deliberate self-harmers reported twice as many concurrent adversities as non-DSHs, and a large effect size (Cohen’s d = 0.80) indicated a strong multiple additive relationship, but among DSHs no ethnic or gender differences were found. Multivariately, among Sami youth sexual abuse [odds ratio (OR), 8.4] was strongly related to DSH, whereas among majority Norwegians sexual abuse (OR, 3.9) and violence (OR, 4.5) were identified as the strongest predictors. Similarly, among boys violence from adults (OR, 8.8) was associated most strongly with DSH, whereas among girls sexual abuse (OR, 4.3) was the most robust predictor. DSHs reported more conflicts with parents, less family support and involvement, and more peer problems than non-DSHs, and DHS girls had more difficulties in these relationships than DHS boys. Only small ethnic differences were found.
Conclusion:
Adolescent DSHs reported twice as many concurrent adversities as non-DSHs, sexual abuse and violence were strongly related to DSH. Ethnic and gender differences in risk factors were found. Clinicians should inquire about traumatic experiences such as sexual and physical abuses, and should have a family, peer, and gender perspective in their work.
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Affiliation(s)
- Bjørn Reigstad
- Department of Research, Division of Research and Patient Safety , Nordlandssykehuset, Bodø , Norway
| | - Siv Kvernmo
- Department of Clinical Medicine, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway , Tromsø , Norway
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Freitas-Rosa M, Gonçalves S, Antunes H. Is being overweight associated with engagement in self-injurious behaviours in adolescence, or do psychological factors have more "weight"? Eat Weight Disord 2016; 21:493-500. [PMID: 26753879 DOI: 10.1007/s40519-015-0251-7] [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: 07/17/2015] [Accepted: 12/22/2015] [Indexed: 10/22/2022] Open
Abstract
INTRODUCTION The purpose of this study was to examine the prevalence of non-suicidal self-injurious behaviours (NSSI) among healthy weight and overweight adolescents and to examine the role of age, gender, weight status, treatment condition for weight control, and psychological variables (psychopathological symptoms and emotional skills) in the prediction of NSSI. METHODS The study had a cross-sectional design, and participants (n = 370) were aged 14-19 years and were divided in three groups: 205 adolescents with normal weight, 82 adolescents from the community with overweight/obesity, and 83 adolescents with overweight/obesity and in outpatient treatment for weight control. RESULTS The prevalence of these behaviours in the overweight community group (25.6 %) and in the overweight clinical group (14.5 %) was similar to their healthy weight peers (19 %). Not attending an outpatient treatment for weight control, higher psychopathology and less ability to regulate emotions predict the presence of NSSI. CONCLUSION Being overweight is not associated with NSSI, but psychosocial variables such as psychopathology, emotional deregulation and the absence of medical care predict these behaviours.
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Affiliation(s)
- Marta Freitas-Rosa
- School of Psychology, University of Minho, Campus Gualtar, 4710, Braga, Portugal.
| | - Sónia Gonçalves
- School of Psychology, University of Minho, Campus Gualtar, 4710, Braga, Portugal
| | - Henedina Antunes
- Pediatric, Gastroenterology, Hepatology and Nutrition Unit of Braga´s Hospital, Braga, Portugal.,Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal.,ICVS/3B's-PT Government Associate Laboratory, Guimarães, Braga, Portugal
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De Riggi ME, Moumne S, Heath NL, Lewis SP. Non-Suicidal Self-Injury in Our Schools: A Review and Research-Informed Guidelines for School Mental Health Professionals. CANADIAN JOURNAL OF SCHOOL PSYCHOLOGY 2016. [DOI: 10.1177/0829573516645563] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Non-suicidal self-injury (NSSI), the immediate and deliberate destruction of one’s own body tissue, without suicidal intent, and not for purposes that are socially accepted, is a critical concern for youth in schools. Despite significant scholarly advances and increasing clinical awareness of NSSI, many school mental health professionals (MHPs) continue to report feeling ill equipped to support students who self-injure, and emphasize a need for formal education about NSSI and its management in schools. Thus, the first part of this article summarizes current NSSI research on prevalence, age of onset, gender differences, functions, risk factors, and associations with suicide. Emerging from this review, the second part offers research-informed recommendations for MHPs managing NSSI in schools, including guidelines for (a) identifying students at elevated risk of self-injury, (b) developing a protocol for school personnel’s initial response to student self-injury, (c) first-level assessment of NSSI, and (d) managing critical issues related to NSSI contagion and online activity.
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Family-based risk factors for non-suicidal self-injury: Considering influences of maltreatment, adverse family-life experiences, and parent-child relational risk. J Adolesc 2016; 49:170-80. [PMID: 27086083 DOI: 10.1016/j.adolescence.2016.03.015] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 03/20/2016] [Accepted: 03/28/2016] [Indexed: 01/11/2023]
Abstract
The current investigation addressed the potential for unique influences of perceived childhood maltreatment, adverse family-life events, and parent-child relational trauma on the lifetime occurrence and addictive features of non-suicidal self-injury (NSSI). Participants included 957 undergraduate students (747 females; M = 20.14 years, SD = 3.88) who completed online questionnaires regarding the key variables under study. Although self-injuring youth reported more experiences with each family-based risk factor, different patterns of association were found when lifetime engagement in NSSI or its addictive features were under study. Perceived parent-child relational trauma was uniquely linked with NSSI behavior after accounting for perceived childhood maltreatment; adverse family-life events had an additional unique association. In contrast, perceived paternal maltreatment was uniquely related with NSSI's addictive features. Findings underline the importance of studying inter-related family-based risk factors of NSSI simultaneously for a comprehensive understanding of familial correlates of NSSI behavior and its underlying features.
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Fox KR, Franklin JC, Ribeiro JD, Kleiman EM, Bentley KH, Nock MK. Meta-analysis of risk factors for nonsuicidal self-injury. Clin Psychol Rev 2015; 42:156-67. [PMID: 26416295 PMCID: PMC4772426 DOI: 10.1016/j.cpr.2015.09.002] [Citation(s) in RCA: 246] [Impact Index Per Article: 27.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Revised: 08/25/2015] [Accepted: 09/10/2015] [Indexed: 11/19/2022]
Abstract
Nonsuicidal self-injury (NSSI) is a prevalent and dangerous phenomenon associated with many negative outcomes, including future suicidal behaviors. Research on these behaviors has primarily focused on correlates; however, an emerging body of research has focused on NSSI risk factors. To provide a summary of current knowledge about NSSI risk factors, we conducted a meta-analysis of published, prospective studies longitudinally predicting NSSI. This included 20 published reports across 5078 unique participants. Results from a random-effects model demonstrated significant, albeit weak, overall prediction of NSSI (OR=1.59; 95% CI: 1.50 to 1.69). Among specific NSSI risk factors, prior history of NSSI, cluster b, and hopelessness yielded the strongest effects (ORs>3.0); all remaining risk factor categories produced ORs near or below 2.0. NSSI measurement, sample type, sample age, and prediction case measurement type (i.e., binary versus continuous) moderated these effects. Additionally, results highlighted several limitations of the existing literature, including idiosyncratic NSSI measurement and few studies among samples with NSSI histories. These findings indicate that few strong NSSI risk factors have been identified, and suggest a need for examination of novel risk factors, standardized NSSI measurement, and study samples with a history of NSSI.
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Affiliation(s)
- Kathryn R Fox
- Department of Psychology, Harvard University, United States.
| | | | - Jessica D Ribeiro
- Department of Psychology, Harvard University, United States; Military Suicide Research Consortium, United States
| | - Evan M Kleiman
- Department of Psychology, Harvard University, United States
| | - Kate H Bentley
- Center for Anxiety and Related Disorders, Boston University, United States
| | - Matthew K Nock
- Department of Psychology, Harvard University, United States
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Tanner AK, Hasking P, Martin G. Effects of rumination and optimism on the relationship between psychological distress and non-suicidal self-injury. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2015; 15:860-8. [PMID: 24249084 DOI: 10.1007/s11121-013-0444-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
In recent years, increasing concern regarding non-suicidal self-injury (NSSI) among adolescents has prompted investigation of factors that may prevent this behavior. This study examined the relationship between psychological distress and NSSI in a community sample of adolescents, and the moderating effect of both optimism and rumination on this association. Two thousand five hundred seventy-two participants (12-18 years) completed self-report questionnaires assessing psychological distress, cognitive, and emotional characteristics, and NSSI history. Ten percent of the sample reported a history of NSSI, and as hypothesized, optimism moderated the relationship between psychological distress and NSSI; the association was only evident when optimism was low. Rumination was not found to moderate the relationship between psychological distress and NSSI. These findings highlight the utility of considering optimism in NSSI prevention and early intervention programs.
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Affiliation(s)
- Alicia K Tanner
- School of Psychology and Psychiatry, Monash University, Clayton, 3800, VIC, Australia
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