1
|
Qureshi F, Guimond AJ, Delaney S, Boehm JK, Kubzansky LD. Who Benefits and How: Five Dimensions of Adolescent Psychological Well-Being and Their Relative Impact on Cardiometabolic Health in Adulthood. J Adolesc Health 2024; 75:85-93. [PMID: 38493401 PMCID: PMC11180584 DOI: 10.1016/j.jadohealth.2024.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 01/22/2024] [Accepted: 02/12/2024] [Indexed: 03/18/2024]
Abstract
PURPOSE Positive dimensions of psychological well-being in adolescence may help youth preserve cardiometabolic health (CMH) as they age, but little is known about which aspects of well-being matter most and for whom. This study examines the differential impact of five dimensions of adolescent psychological well-being on CMH maintenance in adulthood and considers social patterning in both their distribution and respective health benefits. METHODS Data were from the National Longitudinal Study of Adolescent Health (N = 3,464), five dimensions of psychological well-being were identified at baseline (1994-1995; mean age = 15 years): happiness, optimism, self-esteem, belonging, and feeling loved. CMH was measured using seven biomarkers related to chronic disease risk in 2008 (mean age = 28 years) and 2016-2018 (mean age = 38 years): high-density lipoprotein cholesterol, non-high-density lipoprotein cholesterol, systolic blood pressure, diastolic blood pressure, hemoglobin A1c, C-reactive protein, and body mass index. CMH maintenance in adulthood was characterized as having healthy levels of ≥6 biomarkers at each follow-up. RESULTS Youth who reported higher levels of belonging in the teen years were more likely to maintain CMH across young adulthood than those who reported lower levels, regardless of one's social standing (ORper 1-standard deviation = 1.23, 95% CI = 1.03-1.46). Associations with other dimensions of well-being were heterogeneous by sex and race and ethnicity, while differences by socioeconomic factors were less apparent. DISCUSSION Fostering belonging through supportive social environments may help set youth on positive health trajectories and prevent chronic disease across the lifespan.
Collapse
Affiliation(s)
- Farah Qureshi
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
| | - Anne-Josee Guimond
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts; Lee Kum Sheung Center for Health and Happiness, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Scott Delaney
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| | - Julia K Boehm
- Department of Psychology, Chapman University, Orange, California
| | - Laura D Kubzansky
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, Massachusetts
| |
Collapse
|
2
|
Bravo LG, Ford JD, Giscombe CW, Cooke AN, Stein GL, Gonzalez-Guarda RM, Jones CB, Briggs EC. Service utilization among adolescents seeking trauma-related care: Differences by risk for suicide and ethnoracial background. Res Nurs Health 2024; 47:161-171. [PMID: 38521980 DOI: 10.1002/nur.22380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 02/14/2024] [Accepted: 03/01/2024] [Indexed: 03/25/2024]
Abstract
Adolescents from ethnoracially minoritized backgrounds increasingly report high rates of attempted suicide, trauma exposure, and limited access to mental healthcare services. However, less is known regarding their use of services across different youth-serving systems. This study examines the associations and interactions between self-injurious thoughts and behaviors (SITBs), race/ethnicity, and service sector utilization (mental healthcare, general healthcare, school, and social services) among a sample of trauma-exposed and treatment-seeking adolescents. Participants were treatment-seeking adolescents (N = 4406) ages 12-17 from the National Child Traumatic Stress Network Core Data Set who had available data for SITBs, race/ethnicity, services utilized, and other key variables. Mixed effects logistic regression was used to examine main and interactive effects for whether adolescents' race/ethnicity and SITBs were associated with service utilization in each of the identified service sectors. SITBs were associated with adolescents' utilization of mental healthcare (OR = 1.38 p < 0.001), general healthcare (OR = 2.30; p < 0.001), and school services (OR = 1.38 p < 0.001). NH Black adolescents reporting SITBs were less likely to use mental health services than other NH Black youths (OR = 0.53; p = 0.004). Hispanic adolescents reporting SITBs were more likely to utilize healthcare services than other Hispanic youths (OR = 1.51; p = 0.039). Trauma-exposed adolescents reporting SITBs are more likely to utilize mental healthcare, general healthcare, and school-based services than other trauma-exposed adolescents. However, NH Black adolescents experiencing SITBs may face additional barriers to utilizing mental healthcare services. Findings can be used to develop nursing practices and policies to address barriers faced by adolescents reporting SITBs.
Collapse
Affiliation(s)
- Lilian G Bravo
- Division of General Internal Medicine & Health Services Research, University of California, Los Angeles School of Medicine, Los Angeles, CA, USA
- University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, NC, USA
| | - Julian D Ford
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | | | - Alison N Cooke
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Gabriela Livas Stein
- Department of Human Development and Family Sciences, University of Texas at Austin School of Human Ecology, Austin, TX, USA
| | | | - Cheryl B Jones
- University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, NC, USA
| | - Ernestine C Briggs
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| |
Collapse
|
3
|
Martin F, Ferrey A, Hobbs L, Lascelles K, van Even S, Oliver T. Understanding the impact of children's and young people's self-harm on parental well-being: a systematic literature review of qualitative and quantitative findings. Child Adolesc Ment Health 2024. [PMID: 38362819 DOI: 10.1111/camh.12692] [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] [Accepted: 11/07/2023] [Indexed: 02/17/2024]
Abstract
BACKGROUND Self-harm in children and young people is increasing. Parents are vital in supporting young people; however, parents may experience distress linked to the self-harm. Previous reviews have highlighted the emotional impact and need for information and support, however, have not elucidated the relationships between these themes, nor examined the quantitative data examining parents' well-being. METHODS We conducted a mixed methods review, with qualitative meta-synthesis focusing on links between themes and quantitative synthesis of parental well-being findings, including pooled means. PsycInfo, Medline, EMBASE, AMED, CINHAL and Web of Science were searched to identify relevant records. References of included studies were also searched. Every abstract was screened by two authors. Data were extracted by one author and checked by another. RESULTS We identified 39 reports of 32 studies: 16 with qualitative data and 17 with quantitative data (one had both). Qualitative findings showed how parents' emotions were associated to their knowledge and beliefs about self-harm. Parents' emotions often evidenced the need to self-care, but emotions of guilt reduced engagement in self-care. How parents supported their young person was linked to their knowledge, and the management of their own emotions, and influenced if they could engage in self-care. Quantitative findings were mixed, however suggested poor general mental health amongst these parents. CONCLUSIONS Further good quality quantitative studies are needed, with measurement of psychological mechanisms that may underpin parental distress. Current evidence supports peer-support and interventions that go beyond information provision to address the connected factors of knowledge, emotion, self-care, and parenting behaviours.
Collapse
Affiliation(s)
- Faith Martin
- School of Psychology, Cardiff University, Cardiff, UK
| | - Anne Ferrey
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Laura Hobbs
- School of Applied Sciences, University of the West of England, Bristol, UK
| | | | | | - Thomas Oliver
- School of Social Sciences, University of the West of England, Bristol, UK
| |
Collapse
|
4
|
Meza JI, Folk J, Hoskins D, Kemp K, Tolou-Shams M. Risk and Protective Factors Associated with Self-Cutting Behavior Among Adolescents at First Contact with the Juvenile Court. J Youth Adolesc 2023; 52:2494-2508. [PMID: 37592194 PMCID: PMC10522515 DOI: 10.1007/s10964-023-01839-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 07/25/2023] [Indexed: 08/19/2023]
Abstract
Adolescents involved in juvenile legal system are at increased risk for self-cutting behavior, however, correlates associated with elevated risk remain underresearched, particularly among youth with first involvement with the court. This study utilized an epidemiological two-year longitudinal study involving 401 adolescents at first contact with the court (Mage = 14.47; SDage = 1.94 years; 43% female; 42% Latinx/Hispanic) and an involved caregiver. Study aims examined key prospective psychosocial correlates of self-cutting behavior. Baseline assessments captured individual and family level risk and protective factors; self-cutting behavior was assessed longitudinally every four months post-baseline for 24 months. Psychosocial correlates of self-cutting behavior included adolescent affect dysregulation, post-traumatic stress disorder symptoms, impulsive decision making, anxiety and depression symptoms. Significant protective factors included positive communication with caregiver and family, higher self-esteem, and having a caring and supportive family. These findings suggest that internalizing symptoms as well as difficulties with emotion regulation and impulsive decision making are correlated with heightened risk for self-cutting behavior among adolescents involved in the juvenile legal system. The findings also suggest that individual and family level protective factors, like positive communication and a supportive family, are associated with decreased risk for self-cutting behavior among adolescents at first contact with the court.
Collapse
Affiliation(s)
- Jocelyn I Meza
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, USA.
| | - Johanna Folk
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, USA
| | - David Hoskins
- Pediatric Psychology Program, UCSF Benioff Children's Hospital, San Francisco, USA
| | - Kathleen Kemp
- Department of Psychiatry and Human Behavior, Brown University, Warren Alpert Medical School, Providence, USA
- Department of Child and Adolescent Psychiatry and Bradley Hasbro Children's Research Center, Rhode Island Hospital, Providence, USA
| | - Marina Tolou-Shams
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, USA
| |
Collapse
|
5
|
McEvoy D, Brannigan R, Cooke L, Butler E, Walsh C, Arensman E, Clarke M. Risk and protective factors for self-harm in adolescents and young adults: An umbrella review of systematic reviews. J Psychiatr Res 2023; 168:353-380. [PMID: 37972513 DOI: 10.1016/j.jpsychires.2023.10.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 09/13/2023] [Accepted: 10/13/2023] [Indexed: 11/19/2023]
Abstract
We conducted an umbrella review to synthesise the evidence from systematic reviews and meta-analyses that examined the risk and protective factors for self-harm in young people. We searched six different databases and used the AMSTAR-2 checklist for quality assessment. The importance of each risk and protective factor was determined based on (1) the number of times it was identified by general reviews examining any risk or protective factor, and (2) the effect sizes from meta-analyses. There were 61 systematic reviews included in this review. The most frequently identified risk factors for self-harm in young people included childhood abuse, depression/anxiety, bullying, trauma, psychiatric illnesses, substance use/abuse, parental divorce, poor family relationships, lack of friends, and exposure to self-harm behaviour in others. The risk factors with the strongest evidence for an association with self-harm were behavioural disorders, personality disorders and depression or anxiety. There was a dearth of systematic reviews examining protective factors but good family/friend relationships were most frequently identified. There was also evidence to show that non-suicidal and suicidal self-harm shared many of the same risk factors. Clinicians and other professionals who work with young people should be particularly cognisant of the psychiatric and adverse life event risk factors as well as the substance use, education-related and individual-level (e.g. being LGB) risk factors for self-harm. Knowledge of risk factors for self-harm can potentially be used to inform the design and implementation of prevention measures and further research is needed on the protective factors for self-harm.
Collapse
Affiliation(s)
- David McEvoy
- School of Population Health, Royal College of Surgeons Ireland (RCSI), Beaux Lane House, Mercer Street Lower, Dublin, 2, Ireland.
| | - Ross Brannigan
- School of Population Health, Royal College of Surgeons Ireland (RCSI), Beaux Lane House, Mercer Street Lower, Dublin, 2, Ireland.
| | - Lorcan Cooke
- School of Medicine, Royal College of Surgeons Ireland (RCSI), Dublin, 2, Ireland.
| | - Emma Butler
- School of Population Health, Royal College of Surgeons Ireland (RCSI), Beaux Lane House, Mercer Street Lower, Dublin, 2, Ireland.
| | - Cathal Walsh
- Health Research Institute, University of Limerick, Limerick, Ireland.
| | - Ella Arensman
- School of Public Health, University College Cork, 4th Floor, Western Gateway Building, Western Road, Cork, Ireland; National Suicide Research Foundation (NSRF), Western Gateway Building, University College Cork, Ireland.
| | - Mary Clarke
- School of Population Health, Royal College of Surgeons Ireland (RCSI), Beaux Lane House, Mercer Street Lower, Dublin, 2, Ireland; Department of Psychiatry, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland.
| |
Collapse
|
6
|
Burke TA, Bettis AH, Walsh RFL, Levin RY, Lawrence HR, Sheehan AE, Turnamian MR, Liu RT. Nonsuicidal Self-Injury in Preadolescents. Pediatrics 2023; 152:e2023063918. [PMID: 37916265 PMCID: PMC10657775 DOI: 10.1542/peds.2023-063918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 11/03/2023] Open
Abstract
OBJECTIVES There is a dearth of literature on the prevalence and predictors of nonsuicidal self-injury (NSSI) history and onset among preadolescent youth. This gap in the literature is significant given evidence suggesting that NSSI is a robust predictor of negative mental health outcomes, and that early onset NSSI may be associated with a more severe course of self-injurious thoughts and behaviors. This study aimed to evaluate sociodemographic characteristics, psychiatric disorders, and suicidal ideation (SI) in relation to NSSI onset and history in preadolescents. METHODS Data were drawn from the Adolescent Brain and Cognitive Development (ABCD) study, which recruited a diverse sample of 11 875 youth aged 9 to 10 years. The primary outcome measures were lifetime history and recent onset of NSSI. Measures included sociodemographics and the K-SADS diagnostic interview assessing psychopathology and SI. RESULTS Female sex and identifying as Black were associated with lower odds of lifetime NSSI. Identifying as a sexual minority, having unmarried parents, and a low family income were associated with higher odds of lifetime NSSI. Although depression was most predictive of NSSI history and onset, a range of internalizing and externalizing disorders, greater comorbidity, and SI also were predictive. CONCLUSIONS Given that NSSI was associated with a range of mental health disorders and comorbidity, it may be best conceptualized as a transdiagnostic phenomenon. Findings highlight key sociodemographic and diagnostic factors that may help to direct screening efforts in preadolescents, particularly sexual minority status and depression.
Collapse
Affiliation(s)
- Taylor A. Burke
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Alexandra H. Bettis
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Rachel Y. Levin
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | | | - Ana E. Sheehan
- Department of Psychological and Brain Sciences, University of Delaware, Newark, Delaware
| | | | - Richard T. Liu
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
7
|
Meisler S, Sleman S, Orgler M, Tossman I, Hamdan S. Examining the relationship between non-suicidal self-injury and mental health among female Arab minority students: the role of identity conflict and acculturation stress. Front Psychiatry 2023; 14:1247175. [PMID: 38025473 PMCID: PMC10669148 DOI: 10.3389/fpsyt.2023.1247175] [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: 06/25/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Background and objective Research suggests that individuals from minority backgrounds, including immigrants and ethnic minorities, may be at a higher risk for non-suicidal self-injury (NSSI). The aim of the present research is to examine the relationship between non-suicidal self-injury (NSSI) and identity conflict and acculturation stress, depression, and risk behaviors among female Arab minority students. Methods The sample analyzed consisted of 1,529 female Arab students (85.8% B.A. students, 14% M.A. students) aged 21-54 (M = 23, SD = 4.17). The participants completed self-reported questionnaires assessing NSSI engagement, identity conflict and acculturation stress, depression, and risky substance use behavior. Results As expected, we found a significant positive association between NSSI and identity crisis. In addition, an identity conflict and acculturation stress impact the effect of depression and risky substance use behaviors in engaging in self-injury. Namely, participants were more likely to engage in NSSI when they also experienced identity conflict and acculturation stress and exhibited depressive symptoms and tended to display risky substance use behavior. Conclusion These findings provide evidence that the relationship between depression, risky substance use behavior, and NSSI may be stronger among individuals who experience higher levels of identity conflict and acculturation stress. Implications for intervention and future research are briefly presented.
Collapse
Affiliation(s)
| | | | | | | | - Sami Hamdan
- The School of Behavioral Sciences, The Academic College of Tel Aviv-Yafo, Tel Aviv-Yafo, Israel
| |
Collapse
|
8
|
Oladunjoye AF, Li E, Aneni K, Onigu-Otite E. Cannabis use disorder, suicide attempts, and self-harm among adolescents: A national inpatient study across the United States. PLoS One 2023; 18:e0292922. [PMID: 37847698 PMCID: PMC10581466 DOI: 10.1371/journal.pone.0292922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 10/02/2023] [Indexed: 10/19/2023] Open
Abstract
BACKGROUND Suicide is among the top three causes of adolescent mortality. There is a scarcity of research examining cannabis use and suicidal behavior in adolescents. OBJECTIVES To determine the association between cannabis use disorder (CUD) and suicide attempt/self-harm in a hospitalized sample of adolescents. METHODS We conducted a cross-sectional observation study using data from the Nationwide Inpatient Sample collected over four years from January 1, 2016, through December 31, 2019. We included adolescents aged 10-19 hospitalized during the above period (N = 807,105). The primary outcome was suicide attempt/self-harm and the main predictor was CUD. The International Classification of Diseases Tenth Revision (ICD 10) diagnostic codes was used to identify a diagnosis of CUD, suicide attempt/self-harm, and other diagnoses included in the analyses. Adolescents diagnosed with CUD (n = 53,751) were compared to adolescents without CUD (n = 753,354). Univariate and multivariate logistic regressions were conducted to determine the association between CUD and suicide attempts/self-harm. RESULTS 807,105 adolescent hospitalizations were analyzed, of which 6.9% had CUD. Adolescents with CUD were more likely to be older (17 years vs. 15 years), female (52% vs. 48%), have depression (44% vs. 17%), anxiety (32% vs. 13%), an eating disorder (1.9% vs. 1.2%), ADHD (16.3% vs. 9.1%), Conduct Disorder (4.1% vs. 1.3%), Alcohol Use Disorder (11.9% vs. 0.8%), Nicotine Use Disorder (31.1% vs. 4.1%), Cocaine Use Disorder (5.4% vs. 0.2%), Stimulant Use Disorder (0.8% vs. 0.4%) and report suicide attempts/self-harm (2.8% vs. 0.9%) [all ps<0.001]. After adjusting for potential confounders, CUD was associated with a higher risk of suicide attempts/self-harm (OR = 1.4, 95% CI 1.3-1.6, p <0.001). Post-hoc analyses showed the presence of depression moderated the association between CUD and suicide attempts/self-harm in that adolescents with CUD and depression had 2.4 times the odds of suicide attempt/self-harm compared to those with CUD but no depression after controlling for potential confounders (p<0.001). CONCLUSIONS Our study provides evidence for the association between CUD and suicide risk among hospitalized adolescents and underscores the importance of recognizing and addressing co-occurring mental and substance use disorders along with CUD to mitigate suicide risk. Identifying high-risk adolescents in inpatient settings provides an opportunity for intervention.
Collapse
Affiliation(s)
- Adeolu Funso Oladunjoye
- Menninger Department of Psychiatry, Baylor College of Medicine, Houston, Texas, United States of America
| | - Elijah Li
- School of Medicine, Baylor College of Medicine, Houston, Texas, United States of America
| | - Kammarauche Aneni
- Child Study Center, Yale School of Medicine, New Haven, Connecticut, United States of America
| | - Edore Onigu-Otite
- Menninger Department of Psychiatry, Baylor College of Medicine, Houston, Texas, United States of America
- School of Medicine, Baylor College of Medicine, Houston, Texas, United States of America
| |
Collapse
|
9
|
Masland SR, Finch EF, Schnell SE. Effects of Group Psychotherapy for Nonsuicidal Self-Injury: A Meta-Analysis. Int J Group Psychother 2023; 73:183-201. [PMID: 38446601 DOI: 10.1080/00207284.2023.2191683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
Nonsuicidal self-injury (NSSI) is prevalent and concerning among adolescents and adults. Although prior meta-analytic work has considered the efficacy of individual psychotherapy for reducing NSSI, the efficacy of group psychotherapy remains unclear. We conducted a systematic meta-analysis of group psychotherapy studies with NSSI measures. We identified a total of eight studies, including published articles (n = 6) or dissertations (n = 2) with 10 total effect sizes for group interventions. Overall, random-effects meta-analysis suggests that group psychotherapies have a significant small effect on NSSI. However, when corrected for publication bias, the effect is no longer significant. This meta-analysis cautiously suggests that group psychotherapies, which are cost-effective and efficient, hold promise for attenuating NSSI. The field would benefit from further study and treatment refinement, including consideration of what works for whom.
Collapse
|
10
|
Baghdadi F, Evans BA, Goodacre S, John PA, Hettiarachchi T, John A, Lyons RA, Porter A, Safari S, Siriwardena AN, Snooks H, Watkins A, Williams J, Khanom A. Building an understanding of Ethnic minority people's Service Use Relating to Emergency care for injuries: the BE SURE study protocol. BMJ Open 2023; 13:e069596. [PMID: 37185177 PMCID: PMC10151843 DOI: 10.1136/bmjopen-2022-069596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023] Open
Abstract
INTRODUCTION Injuries are a major public health problem which can lead to disability or death. However, little is known about the incidence, presentation, management and outcomes of emergency care for patients with injuries among people from ethnic minorities in the UK. The aim of this study is to investigate what may differ for people from ethnic minorities compared with white British people when presenting with injury to ambulance and Emergency Departments (EDs). METHODS AND ANALYSIS This mixed methods study covers eight services, four ambulance services (three in England and one in Scotland) and four hospital EDs, located within each ambulance service. The study has five Work Packages (WP): (WP1) scoping review comparing mortality by ethnicity of people presenting with injury to emergency services; (WP2) retrospective analysis of linked NHS routine data from patients who present to ambulances or EDs with injury over 5 years (2016-2021); (WP3) postal questionnaire survey of 2000 patients (1000 patients from ethnic minorities and 1000 white British patients) who present with injury to ambulances or EDs including self-reported outcomes (measured by Quality of Care Monitor and Health Related Quality of Life measured by SF-12); (WP4) qualitative interviews with patients from ethnic minorities (n=40) and focus groups-four with asylum seekers and refugees and four with care providers and (WP5) a synthesis of quantitative and qualitative findings. ETHICS AND DISSEMINATION This study received a favourable opinion by the Wales Research Ethics Committee (305391). The Health Research Authority has approved the study and, on advice from the Confidentiality Advisory Group, has supported the use of confidential patient information without consent for anonymised data. Results will be shared with ambulance and ED services, government bodies and third-sector organisations through direct communications summarising scientific conference proceedings and publications.
Collapse
Affiliation(s)
| | | | - Steve Goodacre
- School of Health and Health Related Research, University of Sheffield, Sheffield, UK
| | - Paul Anthony John
- Research and Innovation Hub, Scottish Ambulance Service, Edinburgh, UK
| | | | - Ann John
- Medical School, Swansea University, Swansea, UK
| | | | | | - Solmaz Safari
- Public Contributor, c/o Medical School, Swansea University, Swansea, UK
| | | | | | | | - Julia Williams
- School of Health and Social Work, University of Hertfordshire, Hertfordshire, UK
| | | |
Collapse
|
11
|
Vafaei T, Samavi SA, Whisenhunt JL, Najarpourian S. An investigation of self-injury in female adolescents: a qualitative study. QUALITY & QUANTITY 2023; 57:1-24. [PMID: 36816810 PMCID: PMC9923642 DOI: 10.1007/s11135-023-01632-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/03/2023] [Indexed: 02/16/2023]
Abstract
This study aimed to investigate the phenomenon of self-injury among female adolescents. The research was qualitative, and the sampling method was purposive non-random; the sample size was 20 Iranian girl adolescents aged 13-15 years who had experienced non-suicidal self-injury. Data were collected through semi-structured interviews. The data analysis process was performed during three coding steps (open, axial, selective), through which the basic codes and categories were identified. Study results indicate that the main factors in adolescents' self-injury were individual or psychological (thoughts, emotions, and behaviors) and social (peers, family, communication with different gender, communication with others, media/cyberspace, school, and economic). In the former, the role of emotions was remarkable, while in the latter, the family played a key role. Further, results revealed that communication within the family was an important motivating and sustentative factor in adolescents' self-injury. The results can help counselors in working with adolescents who self-injure; results can also be used in the development and implementation of treatment plans.
Collapse
Affiliation(s)
- Tayebeh Vafaei
- Department of Counseling, University of Hormozgan, Bandar Abbas, Iran
| | | | - Julia L. Whisenhunt
- Department of Counseling, Higher Education, and Speech-Language Pathology, University of West Georgia, Carrollton, GA USA
| | | |
Collapse
|
12
|
Zheng Q, Liu J, Ji Y, Zhang Y, Chen X, Liu B. Elevated levels of monocyte-lymphocyte ratio and platelet-lymphocyte ratio in adolescents with non-suicidal self-injury. BMC Psychiatry 2022; 22:618. [PMID: 36123674 PMCID: PMC9483869 DOI: 10.1186/s12888-022-04260-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2022] [Accepted: 09/14/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), and platelet-lymphocyte ratio (PLR) are blood indicators of systemic inflammation. This study aims to compare the levels of inflammatory indicators derived from blood routine tests between adolescents with non-suicidal self-injury (NSSI) and those with non-NSSI. METHODS A total of 201 adolescents with mood or emotional disorders were enrolled in this study, among which 106 had engaged in NSSI and 95 had never engaged in NSSI. NLR, MLR, and PLR were calculated based on the complete blood cell count. RESULTS There was no significant difference in demographic data between the two groups. The NSSI group exhibited significantly higher MLR (P = 0.001) and PLR (P = 0.007) than the non-NSSI group. Multivariate logistic regression analysis revealed that MLR (OR 1.545, 95%CI [1.087-2.281], P = 0.021) and PLR (OR 1.327, 95%CI [1.215-1.450], P < 0.001) were independently associated with NSSI. Receiver operating characteristic (ROC) curve analyses demonstrated that for differentiating NSSI from non-NSSI, the optimal cut-off value of MLR was 0.135 and the area under curve was 0.638 ([0.561- 0.715], P < 0.001), with a sensitivity of 90.60% and a specificity of 33.70%; the optimal cut-off value of PLR was 127.505 and the area under curve was of 0.611 ([0.533-0.689], P < 0.001), with a sensitivity of 39.60% and a specificity of 81.10%. CONCLUSIONS Systemic inflammation, as indicated by elevated MLR and PLR, was found to be strongly associated with NSSI among adolescents.
Collapse
Affiliation(s)
- Qi Zheng
- Department of Psychology, Xiamen Xianyue Hospital, Xiamen, 361000 Fujian China
| | - Jin Liu
- grid.452708.c0000 0004 1803 0208Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011 Hunan China
| | - YaJuan Ji
- Department of Psychology, Xiamen Xianyue Hospital, Xiamen, 361000 Fujian China
| | - Yan Zhang
- grid.452708.c0000 0004 1803 0208Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011 Hunan China
| | - XinChao Chen
- Department of Psychology, Xiamen Xianyue Hospital, Xiamen, 361000, Fujian, China.
| | - BangShan Liu
- Department of Psychiatry, and National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
| |
Collapse
|
13
|
Kamody RC, Pluhar E, Burton ET, Lois BH, Martin A. Nonsuicidal Self-injury and Barriers to Accessibility of Dialectical Behavior Therapy Among Black Youth. J Am Acad Child Adolesc Psychiatry 2022; 62:389-393. [PMID: 35981668 DOI: 10.1016/j.jaac.2022.08.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 07/28/2022] [Accepted: 08/08/2022] [Indexed: 10/15/2022]
Abstract
Youth in communities of color are disproportionately affected by the current mental health crisis, as highlighted in the recent Declaration of National Emergency by the American Academy of Child and Adolescent Psychiatry (AACAP), the American Academy of Pediatrics (AAP), and the Children's Hospital Association (CHA).1 The structural racism that Black youth encounter is a social determinant of health that contributes to inequitable access to evidence-based mental health services. Black youth in the United States experience inequities in financial hardships, access to educational resources, and the undue burden of the coronavirus disease 2019 (COVID-19) pandemic, further exacerbating an already outsized mental health burden.2.
Collapse
Affiliation(s)
| | - Emily Pluhar
- Boston Children's Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts
| | - E Thomaseo Burton
- University of Tennessee Health Science Center, Memphis, Tennessee; Le Bonheur Children's Hospital, Memphis, Tennessee
| | - Becky H Lois
- Hassenfeld Children's Hospital at NYU Langone, New York
| | | |
Collapse
|
14
|
Mackey ER, Burton ET, Cadieux A, Getzoff E, Santos M, Ward W, Beck AR. Addressing Structural Racism Is Critical for Ameliorating the Childhood Obesity Epidemic in Black Youth. Child Obes 2022; 18:75-83. [PMID: 34491828 DOI: 10.1089/chi.2021.0153] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Racism and childhood obesity are both pervasive factors adversely affecting the health and wellbeing of children and adolescents in the United States. The association between racism and obesity has been touched upon in the literature; yet most work has focused on a few dimensions of intersectionality of these two domains at one time. The renewed focus on structural racism as the primary contributor to distress of Black individuals in the United States has highlighted the urgency of identifying the contributions of racism to the childhood obesity epidemic. The current article is not a complete review of the literature, rather, it is meant to take a broad narrative review of the myriad ways in which racism contributes to the obesity epidemic in Black youth to serve as a call to action for more research, prevention, and intervention. The current article illustrates how a number of mechanisms for the etiology and maintenance of obesity are heavily influenced by racism and how addressing racism is critical for ameliorating the childhood obesity epidemic.
Collapse
Affiliation(s)
- Eleanor R Mackey
- Children's National Hospital, Center for Translational Research, Washington, DC, USA
- The George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| | - E Thomaseo Burton
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, USA
- Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, TN, USA
| | - Adelle Cadieux
- Department of Behavioral Health, Helen DeVos Children's Hospital, Grand Rapids, MI, USA
- Department of Pediatrics and Human Development, Michigan State University, Lansing MI, USA
| | - Elizabeth Getzoff
- Department of Psychology and Neuropsychology, Mt. Washington Pediatric Hospital, Baltimore, MD, USA
| | - Melissa Santos
- Division of Pediatric Psychology, Connecticut Children's, Hartford, CT, USA
| | - Wendy Ward
- Department of Pediatrics, College of Medicine, University of Arkansas Medical Center, Little Rock, AR, USA
| | - Amy R Beck
- Center for Children's Healthy Lifestyles and Nutrition and Division of Developmental and Behavioral Health, Children's Mercy Kansas City, Kansas City, MO, USA
- Department of Pediatrics, University of Missouri, Kansas City School of Medicine, Kansas City, MO, USA
| |
Collapse
|
15
|
“How deep do I have to cut?“: Non-suicidal self-injury and imagined communities of practice on Tumblr. Soc Sci Med 2022; 296:114760. [DOI: 10.1016/j.socscimed.2022.114760] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 12/09/2021] [Accepted: 01/27/2022] [Indexed: 11/18/2022]
|
16
|
Dobias ML, Schleider JL, Jans L, Fox KR. An online, single-session intervention for adolescent self-injurious thoughts and behaviors: Results from a randomized trial. Behav Res Ther 2021; 147:103983. [PMID: 34688102 DOI: 10.1016/j.brat.2021.103983] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 07/28/2021] [Accepted: 10/03/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Across 50 years of research, existing interventions for self-injurious thoughts and behaviors (SITBs) in adolescents have remained largely ineffective and inaccessible. Single-session interventions, interventions designed to last one session, may be a low-cost and timely resource for adolescents engaging in SITBs who may not otherwise receive treatment. METHOD 565 adolescents (Mage = 14.95 years) endorsing recent engagement in non-suicidal self-injury (NSSI) were randomized to receive a 30-min, web-based, single-session intervention-"Project SAVE"-or an active, attention-matched control program. Proximal outcomes were measured at baseline and immediately post-intervention. Long-term outcomes were measured at baseline and 3-month follow-up. RESULTS Adolescents rated Project SAVE as acceptable; 80% of participants randomized to SAVE completed the intervention. Between-group effects were non-significant for pre-registered outcomes: post-intervention likelihood of future NSSI; 3-month frequencies of NSSI and suicidal ideation at follow-up. Relative to control-group participants, SAVE participants reported short-term improvements in two exploratory outcomes: self-hatred (d = -.35, p<.001) and desire to stop future NSSI (d = .25, p = .003). CONCLUSIONS Project SAVE is an acceptable resource for adolescents engaging in SITBs-with short-term effects on clinically-relevant outcomes. Future research may evaluate SAVE as an easy-to-access, short-term coping resource for youth engaging in SITBs. CLINICAL TRIALS. GOV IDENTIFIER NCT04498143.
Collapse
Affiliation(s)
- Mallory L Dobias
- Department of Psychology, Stony Brook University, Stony Brook, NY, 11794-2500, USA.
| | - Jessica L Schleider
- Department of Psychology, Stony Brook University, Stony Brook, NY, 11794-2500, USA
| | - Laura Jans
- Department of Psychology, University of Denver, Denver, CO, 80208, USA
| | - Kathryn R Fox
- Department of Psychology, University of Denver, Denver, CO, 80208, USA
| |
Collapse
|
17
|
Equitable assessment and treatment of self-harm. THE LANCET CHILD & ADOLESCENT HEALTH 2021; 5:768-769. [PMID: 34555351 PMCID: PMC8452463 DOI: 10.1016/s2352-4642(21)00303-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Accepted: 09/09/2021] [Indexed: 11/23/2022]
|