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Campens S, Claes L, Vanderhaegen J, Van Laere E, Prikken S, Lemiere J, Uyttebroeck A, Luyckx K. Nonsuicidal Self-Injury in Adolescent and Emerging Adult Childhood Cancer Survivors: A First Exploration. J Adolesc Young Adult Oncol 2024. [PMID: 38963773 DOI: 10.1089/jayao.2024.0061] [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: 07/06/2024] Open
Abstract
Purpose: This study examines nonsuicidal self-injury (NSSI) in adolescent and emerging adult survivors of childhood cancer, aiming to gain a first understanding of the phenomenon, its relation to general and cancer-specific functioning, and the stability of NSSI engagement over time. Methods: Dutch-speaking survivors (n = 125, age range = 14-25 years) participated in the first three annual waves of the Longitudinal Identity Study of Childhood Cancer Survivors study. Descriptive characteristics of lifetime NSSI were calculated. Multivariate analysis of variance (MANOVA) and χ2-analyses were performed to examine differences in demographic and clinical characteristics between survivors with and without lifetime NSSI. To assess differences in general and cancer-specific functioning between survivors with and without lifetime NSSI, two MANOVA analyses were performed. Finally, prevalence rates of current NSSI across the three waves were calculated, followed by χ2-analyses to explore differences in current NSSI over time. Results: The prevalence and characteristics of lifetime NSSI engagement resembled those in the general population. Although demographic and clinical characteristics were unrelated to NSSI engagement, several meaningful differences were found in both general and cancer-specific functioning between survivors with and without NSSI. Survivors with lifetime NSSI experienced more depressive symptoms and difficulties with identity formation (i.e., lower levels of identity synthesis and higher levels of identity confusion). In addition, they experienced more post-traumatic stress symptoms and cancer-related worries, and identified less as a "cancer patient." Conclusions: This study provides a first understanding of NSSI engagement in survivors of childhood cancer, mapping the characteristics of NSSI and its associations with both general and cancer-specific functioning.
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Affiliation(s)
- Sara Campens
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Antwerp, Belgium
| | - Janne Vanderhaegen
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Elise Van Laere
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Sofie Prikken
- Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Jurgen Lemiere
- Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Anne Uyttebroeck
- Department of Pediatric Hematology and Oncology, University Hospitals Leuven, Leuven, Belgium
- Department of Oncology, Pediatric Oncology, KU Leuven, Leuven, Belgium
| | - Koen Luyckx
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- UNIBS, University of the Free State, Bloemfontein, South Africa
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Zhang Y, Gong L, Feng Q, Hu K, Liu C, Jiang T, Zhang Q. Association between negative life events through mental health and non-suicidal self-injury with young adults: evidence for sex moderate correlation. BMC Psychiatry 2024; 24:466. [PMID: 38914977 PMCID: PMC11197180 DOI: 10.1186/s12888-024-05880-3] [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: 09/22/2023] [Accepted: 05/31/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) has exhibited an increasing trend in recent years and is now globally recognized as a major public health problem among adolescents and young adults. Negative life events (NLEs) are positively associated with NSSI. We sought to explore (1) whether sex plays a role in the risk of NLEs leading to NSSI and (2) the role played by mental health (MH). METHODS We adopted a multi-stage cluster sampling method to select college students across four grades from May to June 2022. Generalized linear models were used to evaluate the relationships between NLEs, sex, MH and NSSI, presented as incidence-rate ratios (RRs) with 95% confidence intervals (CIs). We examined the complex relationship between these variables using the PROCESS method for moderation analysis. RESULTS Following the exclusion of data that did not meet the study requirements, data from 3,578 students (mean age: 20.53 [± 1.65] years) were included. Poisson regression results indicate that high-level NLEs (RR = 0.110, 95%CI: 0.047-0.173) are associated with increased NSSI. Furthermore, interaction effects were observed among sex, NLEs and NSSI. MH and sex moderated the relationship between NLEs and NSSI. CONCLUSION Identifying risk factors for NSSI is also important when exploring the interaction between NLEs and MH given the potential for NSSI to significantly increase the risk of later psychopathological symptoms and substance abuse problems. In addition, the significance of sex differences in risk factors for NSSI should be determined. This study evaluated how the impact of NLEs on NSSI can be reduced among adolescents from multiple perspectives.
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Affiliation(s)
- Yi Zhang
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Li Gong
- Wuxi Huishan District People's Hospital, Wuxi, Jiangsu, 214187, China
| | - Qing Feng
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China
| | - Keyan Hu
- The First Affiliated Hospital, College of Clinical Medicine of Henan, University of Science and Technology, Luoyang, Henan, 471003, China
| | - Chao Liu
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China
| | - Tian Jiang
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China.
| | - Qiu Zhang
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China.
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Chan SKW, Zhou LF, Cai J, Liao Y, Huang Y, Deng ZY, Liu YJ, Chen XC, Gao R, Zhang XF, Tao YQ, Zhou L, Deng XP, Liu B, Ran MS. Risk factors of non-suicidal self-injury of youth students at different developmental stages during COVID-19 pandemic in Jingzhou China. J Affect Disord 2024; 355:57-65. [PMID: 38518855 DOI: 10.1016/j.jad.2024.03.099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 03/14/2024] [Accepted: 03/19/2024] [Indexed: 03/24/2024]
Affiliation(s)
- Sherry Kit Wa Chan
- Department of Psychiatry, School of Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong; The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong
| | - Li-Fang Zhou
- Jingzhou Mental Health Center, Mental Health Institute of Yangtze University, Jingzhou, Hubei 434000, China
| | - Jia Cai
- Mental Health Center, Institute of Psychiatry, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Yingqi Liao
- Department of Psychiatry, School of Medicine, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Yi Huang
- Mental Health Center, Institute of Psychiatry, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Zhong-Yue Deng
- Mental Health Center, Institute of Psychiatry, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Yu-Jun Liu
- Department of Social Work and Social Policy, School of Social and Behavioral Sciences, Nanjing University, Nanjing, Jiangsu 210023, China
| | - Xiao-Chuan Chen
- Ya'an Fourth People's Hospital, Ya'an, Sichuan 625000, China
| | - Ru Gao
- Wenjiang People's Hospital, Chengdu, Sichuan 610037, China
| | - Xin-Feng Zhang
- Jingzhou Mental Health Center, Mental Health Institute of Yangtze University, Jingzhou, Hubei 434000, China
| | - Yan-Qing Tao
- Jingzhou Mental Health Center, Mental Health Institute of Yangtze University, Jingzhou, Hubei 434000, China
| | - Lie Zhou
- Jingzhou Mental Health Center, Mental Health Institute of Yangtze University, Jingzhou, Hubei 434000, China
| | - Xiao-Peng Deng
- Jingzhou Mental Health Center, Mental Health Institute of Yangtze University, Jingzhou, Hubei 434000, China
| | - Bo Liu
- Jingzhou Mental Health Center, Mental Health Institute of Yangtze University, Jingzhou, Hubei 434000, China.
| | - Mao-Sheng Ran
- Mental Health Center, Institute of Psychiatry, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
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Reichl C, Schär S, Lerch S, Hedinger N, Brunner R, Koenig J, Kaess M. Two-year course of non-suicidal self-injury in an adolescent clinical cohort: The role of childhood adversity in interaction with cortisol secretion. Psychoneuroendocrinology 2024; 167:107093. [PMID: 38889567 DOI: 10.1016/j.psyneuen.2024.107093] [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: 01/27/2024] [Revised: 04/28/2024] [Accepted: 06/05/2024] [Indexed: 06/20/2024]
Abstract
AIM Non-suicidal self-injury (NSSI) is a highly prevalent phenomenon during adolescence. Nonetheless, research on predictors of the clinical course of NSSI over time is still scarce. The present study aimed at investigating the impact of adverse childhood experiences (ACE) and hypothalamus-pituitary-adrenal (HPA) axis functioning on the longitudinal course of NSSI. METHODS In a sample of n = 51 help-seeking adolescents engaging in NSSI, diurnal cortisol secretion (CAR, cortisol awakening response; DSL, diurnal slope), hair cortisol concentrations and ACE were assessed at baseline. Clinical outcome was defined by change in the frequency of NSSI in the past 6 months measured 12 and 24 months after the baseline assessments. Mixed-effects linear regression models were used to test for effects of ACE and HPA axis functioning on the course of NSSI. RESULTS ACE and HPA axis functioning did not show main but interaction effects in the prediction of NSSI frequency over time: Adolescents with a low severity of ACE and either an increased CAR or a flattened DSL showed a steep decline of NSSI frequency in the first year followed by a subsequent increase of NSSI frequency in the second year. CONCLUSIONS Our findings could be interpreted in the sense of high diurnal cortisol concentrations in the absence of ACE being favorable for clinical improvement on the short-term but bearing a risk of allostatic load and subsequent increase of NSSI frequency. In contrast, adolescents with severe ACE may benefit from elevated cortisol concentrations leading to slower but lasting decreases of NSSI frequency.
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Affiliation(s)
- Corinna Reichl
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Selina Schär
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Stefan Lerch
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Nicole Hedinger
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland
| | - Romuald Brunner
- Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Germany
| | - Julian Koenig
- Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Cologne, Germany
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland; Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University of Heidelberg, Germany.
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Yu C, Cai Y, Pan M. Correlation Analysis of Non-Suicidal Self-Injury Behavior with Childhood Abuse, Peer Victimization, and Psychological Resilience in Adolescents with Depression. ACTAS ESPANOLAS DE PSIQUIATRIA 2024; 52:289-300. [PMID: 38863041 PMCID: PMC11190448 DOI: 10.62641/aep.v52i3.1650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
BACKGROUND In recent years, the number of adolescents with depression has been increasing annually, with individuals often exhibiting non-suicidal self-injury (NSSI) behavior. The purpose of this study is to investigate the family (childhood abuse), school (peer victimization), and individual (psychological resilience) factors of adolescents with depression with or without NSSI (the Chinese version of the Functional Assessment of Self-Mutilation [C-FASM] scale), and to analyze the correlation between the above psychological and social factors and the frequency of NSSI, to provide a basis for NSSI prevention and intervention in adolescents with depression. METHODS We recruited 355 adolescents with depressive symptoms to participate in this study and divided them into Group NSSI (N = 227) and Group no-NSSI (n-NSSI) (N = 128) based on the C-FASM scale. The Short-Form Childhood Trauma Questionnaire (CTQ-SF), Multidimensional Peer Visualization Scale (MPVS), and Resilience Scale for Chinese Adolescents (RISC) scores were compared between two groups of adolescents. Pearson correlation coefficient was used to analyze the correlation between NSSI frequency and the above scores. RESULTS Emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect, and total CTQ-SF score in Group NSSI were significantly higher than those in Group n-NSSI (all p < 0.001). Physical victimization, verbal victimization, social manipulation, attacks on property, and total MPVS score in Group NSSI were significantly higher than those in Group n-NSSI (p < 0.001, p < 0.001, p = 0.009, p < 0.001, p < 0.001). Goal concentration, emotion regulation, positive perception, family support, interpersonal assistance, and total RISC score in Group NSSI were significantly lower than those in Group n-NSSI (all p < 0.001). The frequency of NSSI was significantly positively correlated with emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect, and total CTQ-SF score (r = 0.366, p < 0.001; r = 0.411, p < 0.001; r = 0.554, p < 0.001; r = 0.220, p = 0.001; r = 0.255, p < 0.001; r = 0.673, p < 0.001). The frequency of NSSI was significantly positively correlated with physical victimization, verbal victimization, social manipulation, attacks on property, and total MPVS score (r = 0.418, p < 0.001; r = 0.455, p < 0.001; r = 0.447, p < 0.001; r = 0.555, p = 0.001; r = 0.704, p < 0.001). The frequency of NSSI was significantly negatively correlated with goal concentration, emotion regulation, positive perception, family support, interpersonal assistance, and total RISC score (r = -0.393, p < 0.001; r = -0.341, p < 0.001; r = -0.465, p < 0.001; r = -0.272, p = 0.001; r = -0.160, p = 0.016; r = -0.540, p < 0.001). CONCLUSIONS Our findings highlight the importance of family (childhood abuse), school (peer victimization), and individual (psychological resilience) factors for NSSI in depressed adolescents, and these factors are closely related to NSSI frequency. IMPLICATIONS FOR PRACTICE Maintaining a good family environment, solving the problem of peer victimization at school, and developing corresponding measures to improve psychological resilience are of great significance for improving the mental health of depressed adolescents and reducing the risk of NSSI.
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Affiliation(s)
- Chunlan Yu
- General Practice, Xinchang County People's Hospital, 312500 Xinchang, Zhejiang, China
| | - Youhong Cai
- Outpatient Department of Psychological Counseling, Xinchang County People's Hospital, 312500 Xinchang, Zhejiang, China
| | - Meifang Pan
- Department of Five Senses, Xinchang County People's Hospital, 312500 Xinchang, Zhejiang, China
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Chen Q, Gong L, Song Y, Zhang J, Han X, Zhou Y, Li L, Jiang X, Hao Y, Zhou H, Lou X, Wang X. Associations between multiple sleep dimensions and suicide and non-suicidal self-injury: a cross-sectional study of 3828 Chinese young people. Soc Psychiatry Psychiatr Epidemiol 2024:10.1007/s00127-024-02689-z. [PMID: 38780778 DOI: 10.1007/s00127-024-02689-z] [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: 01/09/2023] [Accepted: 05/17/2024] [Indexed: 05/25/2024]
Abstract
PURPOSE Suicide and non-suicidal self-injury (NSSI) are preventable concerns in young people. Suicidal ideation (SI), suicidal plans (SP) and suicidal attempt (SA) are closely related to death. Sleep problems are known risk factors for suicide and NSSI. This study aimed to explore the relationship between sleep, suicidality and NSSI. METHODS Participants were 3,828 middle school and college students aged 11-23 years from urban and rural areas of Henan Province. Sleep, suicidal phenomena and NSSI were assessed by applying self-reported questionnaires. Chi-squared tests were utilized to demonstrate the demographic data and sleep variables. The correlation between sleep, suicidality and NSSI were explored by using binary logistic regression, while adjusting socio-demographic characteristics with multivariate models. RESULTS Sleep variables except mid-sleep time were related to suicidal phenomena (P < 0.05). Greater social jet lag (SJL) [≥ 2 h (h)] was associated with increased risk of SI [Odds ratios (OR) = 1.72, 95% confidence intervals (CI):1.40-2.11], SP (OR = 2.10, 95%CI:1.59-2.79) and SA (OR = 1.50, 95%CI:1.00-2.26). Non-only child participants with SJL (≥ 2 h) had significantly increased odds of SI (OR = 1.75, 95%CI: 1.41-2.18) and SP (OR = 2.25, 95%CI: 1.66-3.05). Eveningness chronotype had the strongest correlation with SI (OR = 3.87, 95%CI:2.78-5.38), SP (OR = 4.72, 95%CI:2.97-7.50), SA (OR = 6.69, 95%CI:3.08-14.52) and NSSI (OR = 1.39, 95%CI:1.02-1.90). CONCLUSION Overlong or short sleep duration, SJL, eveningness chronotype and other sleep abnormalities (e.g., daytime dysfunction, low sleep efficiency) were associated with a higher prevalence of SI, SP and SA. Additionally, eveningness was significantly correlated with NSSI among young people. These findings suggested the importance of assessing and intervening in sleep habits to prevent suicide and NSSI in young people.
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Affiliation(s)
- Qiuyuan Chen
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China
| | - Lu Gong
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China
| | - Yalin Song
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China
| | - Jiangtao Zhang
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China
| | - Xinke Han
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China
| | - Yuhang Zhou
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China
| | - Lijie Li
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China
| | - Xili Jiang
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China
| | - Yudan Hao
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China
| | - Huijun Zhou
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China
| | - Xiaomin Lou
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China
| | - Xian Wang
- College of Public Health, Zhengzhou University, No. 100 Science Avenue, Zhengzhou, Henan, 450001, PR China.
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Chen W, Yuan T, Pan Y, Ma Y, Sun B, Yu M, Lin X, He H, Zhang J. Borderline personality traits mediate the relationship between negative life events and nonsuicidal self-injury in a clinical sample with youth depression. BMC Psychiatry 2024; 24:370. [PMID: 38755597 PMCID: PMC11100148 DOI: 10.1186/s12888-024-05821-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 05/07/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Borderline personality traits play a significant role in nonsuicidal self-injury (NSSI), particularly in depressed youths. NSSI is also highly correlated with negative life events. This research aimed to explore the connections between negative life events, borderline personality traits, and NSSI. METHODS The study included 338 depressed youth aged 13 to 25 years. Self-reported measures and clinical interviews were utilized to evaluate the depressive symptoms, borderline personality traits, negative life events, and NSSI behaviours of these participants. Identifying variables linked to NSSI was the aim of our analysis, and we also conducted a mediation analysis to look into the influence of borderline traits on the connection between negative life events and NSSI. RESULTS Of the 338 depressed youth, approximately 59.47% (201/338) displayed NSSI, which was associated with greater clinical severity. Borderline traits had an independent influence on NSSI and it partially explained the connection between negative life events and NSSI, even when accounting for depression symptoms. Depressed youth who were more vulnerable to NSSI behaviours often experienced negative life events such as interpersonal relationships, academic pressure, being punished, and loss. CONCLUSIONS Our research suggests that depressed youth who experience more negative life events are more likely to experience NSSI, and negative life events indirectly influence nonsuicidal self-injury through borderline personality traits. Implementing interventions focused on mitigating borderline symptoms could be a promising therapeutic approach for addressing NSSI in young people.
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Affiliation(s)
- Wangni Chen
- Department of Psychosomatic Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Liwan District, Guangzhou, Guangdong, 510370, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
- Guangzhou Medical University, Guangzhou, 510000, China
| | - Ting Yuan
- Department of Psychosomatic Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Liwan District, Guangzhou, Guangdong, 510370, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
- Guangzhou Medical University, Guangzhou, 510000, China
| | - Yuwen Pan
- Department of Psychosomatic Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Liwan District, Guangzhou, Guangdong, 510370, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
- Guangzhou Medical University, Guangzhou, 510000, China
| | - Yarong Ma
- Department of Psychosomatic Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Liwan District, Guangzhou, Guangdong, 510370, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Bin Sun
- Department of Psychosomatic Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Liwan District, Guangzhou, Guangdong, 510370, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Min Yu
- Department of Psychosomatic Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Liwan District, Guangzhou, Guangdong, 510370, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Xiaoming Lin
- Department of Psychosomatic Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Liwan District, Guangzhou, Guangdong, 510370, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China
| | - Hongbo He
- Guangdong Mental Health Center, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, Guangdong, 519041, China.
| | - Jie Zhang
- Department of Psychosomatic Medicine, The Affiliated Brain Hospital of Guangzhou Medical University, 36 Mingxin Road, Liwan District, Guangzhou, Guangdong, 510370, China.
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, China.
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8
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Çobanoğlu Osmanlı C. Child Exhibits Throat-Squeezing Behavior for 5 Years Following Trauma. Psychiatry 2024:1-5. [PMID: 38739375 DOI: 10.1080/00332747.2024.2346941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
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9
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de Neve-Enthoven NGM, Ringoot AP, Jongerling J, Boersma N, Berges LM, Meijnckens D, Hoogendijk WJG, Grootendorst-van Mil NH. Adolescent Nonsuicidal Self-Injury and Suicidality: A Latent Class Analysis and Associations with Clinical Characteristics in an At-Risk Cohort. J Youth Adolesc 2024; 53:1197-1213. [PMID: 38112847 PMCID: PMC10980641 DOI: 10.1007/s10964-023-01922-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/27/2023] [Indexed: 12/21/2023]
Abstract
Nonsuicidal self-injury (NSSI) is frequently encountered in adolescents, but its predictive value for suicidality or other clinical characteristics is challenging due to its heterogeneous nature. This study used latent class analysis to identify subgroups of NSSI and compared these on sociodemographic characteristics, adverse outcomes and protective factors. The study included 966 high-risk adolescents, Mage 14.9 y, SD 0.9 y, 51.8% female. Four classes emerged: (1) "Low NSSI-Low suicidality", (2) "Moderate NSSI-Low suicidality", (3) "Moderate NSSI-High suicidality", and (4) "High NSSI-High suicidality". Girls predominated in the high suicidality classes. Generally, Class 4 had the poorest outcomes: more internalizing and externalizing problems, less social support from friends and families and worst self-esteem. These findings emphasize the need for interventions tailored to specific phenotypes of adolescents engaging in NSSI.
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Affiliation(s)
- N G M de Neve-Enthoven
- Department of Psychiatry, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - A P Ringoot
- Department of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, the Netherlands
- Department of Psychology, Educational and Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - J Jongerling
- Tilburg School of Social and Behavioral Sciences, Department of Methodology, Tilburg University, Tilburg, the Netherlands
| | - N Boersma
- Clinical Psychologist at Yulius, Dordrecht, the Netherlands
| | - L M Berges
- Department of Psychiatry, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - D Meijnckens
- MIND Platform, Utrecht, the Netherlands
- Stichting Zelfbeschadiging (Self-harm Foundation), Utrecht, the Netherlands
| | - W J G Hoogendijk
- Department of Psychiatry, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - N H Grootendorst-van Mil
- Department of Psychiatry, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
- Epidemiological and Social Psychiatric Research Institute (ESPRi), Erasmus MC University Medical Center, Rotterdam, the Netherlands.
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Li L, Liang Z, Li G, Xu H, Yang X, Liu X, Zhang X, Wang J, Zhang Z, Zhou Y. Unveiling convergent and divergent intrinsic brain network alternations in depressed adolescents engaged in non-suicidal self-injurious behaviors with and without suicide attempts. CNS Neurosci Ther 2024; 30:e14684. [PMID: 38739217 PMCID: PMC11090151 DOI: 10.1111/cns.14684] [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: 12/11/2023] [Revised: 01/28/2024] [Accepted: 02/19/2024] [Indexed: 05/14/2024] Open
Abstract
AIMS Limited understanding exists regarding the neurobiological mechanisms underlying non-suicidal self-injury (NSSI) and suicide attempts (SA) in depressed adolescents. The maturation of brain network is crucial during adolescence, yet the abnormal alternations in depressed adolescents with NSSI or NSSI+SA remain poorly understood. METHODS Resting-state functional magnetic resonance imaging data were collected from 114 depressed adolescents, classified into three groups: clinical control (non-self-harm), NSSI only, and NSSI+SA based on self-harm history. The alternations of resting-state functional connectivity (RSFC) were identified through support vector machine-based classification. RESULTS Convergent alterations in NSSI and NSSI+SA predominantly centered on the inter-network RSFC between the Limbic network and the three core neurocognitive networks (SalVAttn, Control, and Default networks). Divergent alterations in the NSSI+SA group primarily focused on the Visual, Limbic, and Subcortical networks. Additionally, the severity of depressive symptoms only showed a significant correlation with altered RSFCs between Limbic and DorsAttn or Visual networks, strengthening the fact that increased depression severity alone does not fully explain observed FC alternations in the NSSI+SA group. CONCLUSION Convergent alterations suggest a shared neurobiological mechanism along the self-destructiveness continuum. Divergent alterations may indicate biomarkers differentiating risk for SA, informing neurobiologically guided interventions.
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Affiliation(s)
- Linling Li
- Guangdong Provincial Key Laboratory of Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, International Health Science Innovation Center, Shenzhen University Medical School, Shenzhen University, Shenzhen, China
| | - Zhen Liang
- Guangdong Provincial Key Laboratory of Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, International Health Science Innovation Center, Shenzhen University Medical School, Shenzhen University, Shenzhen, China
| | - Guohua Li
- Department of Psychiatric Rehabilitation, Shenzhen Mental Health Center/Shenzhen Kangning Hospital, Shenzhen, China
| | - Hong Xu
- Department of Psychiatric Rehabilitation, Shenzhen Mental Health Center/Shenzhen Kangning Hospital, Shenzhen, China
| | - Xing Yang
- Department of Psychiatric Rehabilitation, Shenzhen Mental Health Center/Shenzhen Kangning Hospital, Shenzhen, China
| | - Xia Liu
- Department of Psychiatric Rehabilitation, Shenzhen Mental Health Center/Shenzhen Kangning Hospital, Shenzhen, China
| | - Xin Zhang
- Department of Psychiatric Rehabilitation, Shenzhen Mental Health Center/Shenzhen Kangning Hospital, Shenzhen, China
| | - Jianhong Wang
- Department of Psychiatric Rehabilitation, Shenzhen Mental Health Center/Shenzhen Kangning Hospital, Shenzhen, China
| | - Zhiguo Zhang
- Department of Computer Science and Technology, Harbin Institute of Technology, Peng Cheng Laboratory, Shenzhen, China
| | - Yongjie Zhou
- Department of Psychiatric Rehabilitation, Shenzhen Mental Health Center/Shenzhen Kangning Hospital, Shenzhen, China
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Zhou SC, Zhou Z, Tang Q, Yu P, Zou H, Liu Q, Wang XQ, Jiang J, Zhou Y, Liu L, Yang BX, Luo D. Prediction of non-suicidal self-injury in adolescents at the family level using regression methods and machine learning. J Affect Disord 2024; 352:67-75. [PMID: 38360362 DOI: 10.1016/j.jad.2024.02.039] [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: 10/07/2022] [Revised: 02/07/2024] [Accepted: 02/12/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Adolescent non-suicidal self-injury (NSSI) is a major public health issue. Family factors are significantly associated with NSSI in adolescents, while studies on forecasting NSSI at the family level are still limited. In addition to regression methods, machine learning (ML) techniques have been recommended to improve the accuracy of family-level risk prediction for NSSI. METHODS Using a dataset of 7967 students and their primary caregivers from a cross-sectional study, logistic regression model and random forest model were used to test the forecasting accuracy of NSSI predictions at the family level. Cross-validation was used to assess model prediction performance, including the area under the receiver operator curve (AUC), precision, Brier score, accuracy, sensitivity, specificity, positive predictive value and negative predictive value. RESULTS The top three important family-related predictors within the random forest algorithm included family function (importance:42.66), family conflict (importance:42.18), and parental depression (importance:27.21). The most significant family-related risk predictors and protective predictors identified by the logistic regression model were family history of mental illness (OR:2.25) and help-seeking behaviors of mental distress from parents (OR:0.65), respectively. The AUCs of the two models, logistic regression and random forest, were 0.852 and 0.835, respectively. LIMITATIONS The key limitation is that this cross-sectional survey only enabled the authors to examine predictors that were considered to be proximal rather than distal. CONCLUSIONS These findings highlight the significance of family-related factors in forecasting NSSI in adolescents. Combining both conventional statistical methods and ML methods to improve risk assessment of NSSI at the family level deserves attention.
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Affiliation(s)
- Si Chen Zhou
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China
| | - Zhaohe Zhou
- School of Basic Medical Sciences, Chengdu University, Chengdu, China
| | - Qi Tang
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China
| | - Ping Yu
- Wuhan Mental Health Center, Wuhan, China; Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Huijing Zou
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China
| | - Qian Liu
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China
| | - Xiao Qin Wang
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China
| | - Jianmei Jiang
- The Central Hospital of Enshi Tujia Autonomous Prefecture, Enshi, China
| | - Yang Zhou
- Wuhan Mental Health Center, Wuhan, China; Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Lianzhong Liu
- Wuhan Mental Health Center, Wuhan, China; Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Bing Xiang Yang
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China; Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China.
| | - Dan Luo
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China; Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China.
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Carreiras D, Castilho P, Cunha M. Does self-compassion protect adolescents with non-suicidal self-injury from developing borderline features? A two-wave longitudinal study. J Child Adolesc Ment Health 2024:1-12. [PMID: 38638074 DOI: 10.2989/17280583.2023.2289607] [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: 04/20/2024]
Abstract
Background: Adolescence is a vulnerable developmental stage for the onset of non-suicidal self-injury (NSSI) and borderline features, which are related psychological phenomena. Self-compassion reflects a sensitivity to own suffering and a motivation to relieve it, consisting of a more positive and beneficial self-to-self relationship. The aim of the present study was to test the effect of self-compassion between borderline features at baseline and six months with a sample of adolescents with a history of NSSI.Methods: At assessment wave one, participants were 139 Portuguese adolescents with an NSSI history (mean age = 15.52 years, SD = 0.87). Of these, 87 were re-assessed six months later (mean age = 15.46 years, SD = 0.86). Data were analysed through SPSS and PROCESS Macro.Results: The moderation model explained 56% of borderline features six months later, and the interaction between initial borderline features and the low and medium levels of self-compassion was significant. Youth with lower initial borderline features presented higher borderline features six months later if they had low self-compassion.Conclusions: These findings suggest that among adolescents with a history of NSSI, those with lower levels of self-compassion tend to exhibit higher borderline features in six-month when compared to their peers with higher levels of self-compassion. This observation emphasises the potential beneficial effect of self-compassion within this population.
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Affiliation(s)
- Diogo Carreiras
- Center for Research in Neuropsychology and Cognitive and Behavioural Intervention, University Coimbra, Coimbra, Portugal
| | - Paula Castilho
- Center for Research in Neuropsychology and Cognitive and Behavioural Intervention, University Coimbra, Coimbra, Portugal
| | - Marina Cunha
- Center for Research in Neuropsychology and Cognitive and Behavioural Intervention, University Coimbra, Coimbra, Portugal
- Instituto Superior Miguel Torga, Coimbra, Portugal
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Fu W, Li X, Ji S, Yang T, Chen L, Guo Y, He K. The Relationship Between Childhood Trauma and Non-Suicidal Self-Injury Behavior in Adolescents with Depression: The Mediating Role of Rumination. Psychol Res Behav Manag 2024; 17:1477-1485. [PMID: 38606089 PMCID: PMC11007121 DOI: 10.2147/prbm.s448248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Accepted: 03/21/2024] [Indexed: 04/13/2024] Open
Abstract
Objective Non-suicidal self-injury (NSSI) behavior is very common in adolescents with depression, and childhood trauma is considered one of the distal risk factors for its exacerbation. Rumination caused by adverse traumatic experiences, which can be transferred through NSSI behavior, can alleviate symptoms of depression in adolescents. The current research focuses on the relationship between the three, further exploring whether rumination is a mediator in the relationship between childhood trauma and NSSI behavior on the basis of previous studies, and provides some suggestions for future early intervention for adolescents with depression. Methods A total of 833 adolescent patients with depression who met the DSM-5 criteria for depressive episode were recruited from 12 hospitals in China. The Chinese version of the Function Assessment of Self-mutilation, Childhood Trauma Questionnaire, and Rumination Inventory were used as research tools. Results The scores of childhood trauma and rumination in adolescents with depression in the NSSI group were higher than those in the non-NSSI group. A Pearson's correlation analysis showed that childhood trauma was positively correlated with rumination (r=0.165, P<0.01), different types of childhood trauma were significantly positively correlated with rumination and its three factors, and these results were statistically significant. Rumination partially mediated the relationship between childhood trauma and NSSI behavior in depressed adolescent patients (effect size=0.002), and the effect in female participants (effect size=0.003), was greater than that in male participants (effect size=0.002). Conclusion Childhood trauma and rumination were key factors for NSSI behavior in adolescents with depression. Childhood trauma not only has a direct effect on NSSI behavior in adolescent depression, but also plays an indirect effect on NSSI behavior through rumination.
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Affiliation(s)
- Wenxian Fu
- Affiliated Psychological Hospital of Anhui Medical University, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Psychiatry Department, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
| | - Xinyi Li
- Affiliated Psychological Hospital of Anhui Medical University, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Psychiatry Department, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
| | - Sifan Ji
- Affiliated Psychological Hospital of Anhui Medical University, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Psychiatry Department, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
| | - Tingting Yang
- Affiliated Psychological Hospital of Anhui Medical University, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Psychiatry Department, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Psychological Counseling department, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
| | - Lu Chen
- Affiliated Psychological Hospital of Anhui Medical University, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Psychiatry Department, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Psychological Counseling department, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
| | - Yaru Guo
- Affiliated Psychological Hospital of Anhui Medical University, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Psychiatry Department, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Psychological Counseling department, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
| | - Kongliang He
- Affiliated Psychological Hospital of Anhui Medical University, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230022, People’s Republic of China
- Anhui Mental Health Center, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Psychiatry Department, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
- Psychological Counseling department, Hefei Fourth People’s Hospital, Hefei, 230022, People’s Republic of China
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Cao P, Peng R, Yuan Q, Zhou R, Ye M, Zhou X. Predictors of non-suicidal self-injury in adolescents with depressive disorder: the role of alexithymia, childhood trauma, and body investment. Front Psychol 2024; 15:1336631. [PMID: 38638510 PMCID: PMC11024233 DOI: 10.3389/fpsyg.2024.1336631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 02/27/2024] [Indexed: 04/20/2024] Open
Abstract
Purpose This study analyzes the relationship of alexithymia, childhood trauma, and body investment to non-suicidal self-injury (NSSI) behaviors in adolescents with depressive disorder and whether they have predictive and diagnostic value for non-suicidal self-injury (NSSI) behaviors in adolescents with depressive disorder. Patients and methods A total of 225 patients with a diagnosis of adolescent depressive disorder were included in the study and were divided into two groups according to the DSM-5 criteria: 98 cases without NSSI and 127 cases with NSSI. Compare the demographic data, 24-item Hamilton Depression Scale (HAMD-24), 20-item Toronto Alexithymia Scale (TAS-20), Childhood Trauma Questionnaire-Short Form (CTQ-SF), and Body Investment Scale (BIS) scores between two groups. Binary logistic regression was used to analyze the independent risk factors contributing to NSSI behaviors in adolescents with depression, and establish four predictive models. Based on the models' predictive probability, the ROC curves were plotted to calculate the value of the predictive diagnostic effect. Results The group without NSSI had lower scores than the group with NSSI on HAMD-24 total score, TAS-20 total score, difficulty identifying feelings, difficulty describing feelings, and externally focused thinking, as well as lower scores on CTQ-SF total score, physical neglect, emotional neglect, physical abuse, and emotional abuse. In contrast, the BIS total score, body image feelings and attitudes, body care, and body protection factor scores were higher for the group without NSSI. The BIS body care factor score and the CTQ-SF emotional abuse factor score were significantly linked with adolescents diagnosed with depressive disorder who exhibited NSSI behaviors. These results provide a good diagnostic model for adolescents with depressive disorder. Conclusion Low levels of body care and childhood emotional abuse may independently contribute to the implementation of NSSI in adolescents with depressive disorder. Body investment and childhood trauma are valuable in diagnosing and predicting NSSI behaviors and should be considered as potentially important factors in clinical treatment.
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Affiliation(s)
- Panpan Cao
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Anhui Psychiatric Center, Hefei, China
| | - Ran Peng
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Anhui Psychiatric Center, Hefei, China
| | - Qiuyu Yuan
- Bengbu Mental Health Center, Anhui Veterans Hospital, Anmin Hospital Affiliated to Bengbu Medical College, Bengbu, China
| | - Ruochen Zhou
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Anhui Psychiatric Center, Hefei, China
| | - Mengting Ye
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Anhui Psychiatric Center, Hefei, China
| | - Xiaoqin Zhou
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Anhui Psychiatric Center, Hefei, China
- Department of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
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Godfrey DA, Kaufman EA, Crowell SE. Non-suicidal Self-injury History Moderates the Association Between Maternal Emotional Support and Adolescent Affect During Conflict. Child Psychiatry Hum Dev 2024; 55:415-425. [PMID: 36028639 DOI: 10.1007/s10578-022-01417-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/17/2022] [Indexed: 11/24/2022]
Abstract
Onset of non-suicidal self-injury (NSSI) is most frequent during adolescence. Etiological models indicate that abnormal affective reactivity and regulation within interpersonal contexts is related to heightened NSSI risk. The current study examined the effects of maternal emotional support on adolescent sympathetic nervous system (SNS) activity and observed anger during a conflict discussion among 56 mother-daughter dyads consisting of healthy adolescents and adolescents with a history of self-injury. During the conflict discussion task, maternal emotional support and adolescent anger were coded from behavior, and cardiovascular pre-ejection period was used to index SNS responding. Results demonstrated that maternal emotional support was negatively associated with adolescent anger and SNS activity during the conflict. However, these associations were not significant among adolescents with heightened NSSI history. Maternal emotional support may serve as an interpersonal mechanism for adolescent physiological and behavioral regulation, yet may function differently among adolescents with more frequent NSSI.
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Affiliation(s)
- Donald A Godfrey
- Department of Psychology, University of Houston, 4505 Cullen Blvd, Houston, TX, 77204, USA
| | - Erin A Kaufman
- Department of Psychology, University of Western Ontario, 361 Windermere Road, London, ON, N6A 3K7, Canada.
| | - Sheila E Crowell
- Department of Psychology, University of Utah, 380 S. 1530 E. BEH S. 502, Salt Lake City, UT, 84112, USA
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Lindquist EG, West AE. What Do My (Online) Friends Think? A Topic Modeling Approach to Identifying Patterns of Response to Self-Injurious Behaviors on Reddit. Arch Suicide Res 2024; 28:537-553. [PMID: 36998237 DOI: 10.1080/13811118.2023.2193594] [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] [Indexed: 04/01/2023]
Abstract
OBJECTIVE Approximately 17% of adolescents and young adults will engage in non-suicidal self-injury (NSSI) at least once in their lifetime, leading the World Health Organization to identify self-injury as one of the top five public health concerns for adolescents. Despite the widespread prevalence of this behavior, NSSI continues to be heavily stigmatized in both medical and community settings, deterring many engaged in NSSI from seeking informal support from friends and family as well as formal psychological or psychiatric treatment. In contrast to the low rates of in-person help-seeking for NSSI, online support groups are highly utilized by those engaged in NSSI. Thus, an empirical study of responses to frequent, voluntary disclosure of NSSI on social media is needed to better understand how these communities meet the needs of those who self-injure. METHOD The current project used latent Dirichlet allocation to identify frequent and favored themes in response to self-injury content in the largest self-injury group on Reddit (over 100,000 members). Reddit, the 9th most visited website in the world, is a chat-based social media platform that has 430+ million active users and billions of site visits, with current estimates suggesting that ∼63% of the U.S. population are Reddit users. RESULTS Identified themes included: (1) recovery encouragement; (2) provision of social and instrumental support; and (3) daily realities of living with NSSI. Responses that encouraged recovery received more upvotes on Reddit than any other type of comment. CONCLUSION These results can inform evidence-based, person-centered, dimensional treatments for NSSI.
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Guan M, Liu J, Li X, Cai M, Bi J, Zhou P, Wang Z, Wu S, Guo L, Wang H. The impact of depressive and anxious symptoms on non-suicidal self-injury behavior in adolescents: a network analysis. BMC Psychiatry 2024; 24:229. [PMID: 38532354 DOI: 10.1186/s12888-024-05599-1] [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: 11/06/2023] [Accepted: 02/08/2024] [Indexed: 03/28/2024] Open
Abstract
PURPOSE Conceptualizing adolescent NSSI and emotional symptoms as a system of causal elements could provide valuable insights into the development of non-suicidal self-injury (NSSI) in adolescent. This study aimed to explore the intricate relationship between NSSI, depressive symptoms, and anxious symptoms in adolescents, identifying key symptoms to establish a theoretical foundation for targeted and effective interventions addressing NSSI behaviors in this population. METHODS A total of 412 adolescents with NSSI behaviors were selected from outpatients. Generalized anxious disorder scale (GAD-7) and patient health questionnaire (PHQ-9) were employed to measure anxious symptoms and depressive symptoms, respectively. The adolescent non-suicidal self-injury assessment questionnaire (ANSSIAQ) was used to evaluate NSSI of adolescent. Using network analysis, the NSSI、depressive symptoms and anxious symptoms network were constructed to identify the most central symptoms and the bridge symptoms within the networks. RESULTS The findings revealed that the NSSI functional nodes "coping with sadness and disappointment" and "relieving stress or anxious" exhibited the strongest correlation, with a regularized partial correlation coefficient was 0.401. The symptoms "having a desire to harm oneself and unable to stop" and the node "depressive symptoms" had the highest strength centrality in the network, and their strength centrality indices were 1.267 and 1.263, respectively. The bridge nodes were "having a desire to harm oneself and unable to stop" and "expressing one's despair and hopelessness", with expected impact indices of 0.389 and 0.396, respectively. CONCLUSION In adolescents, the network revealed a closer connection between NSSI and depressive symptoms. "The desire to not stop hurting oneself" is not only broadly connected to other nodes but also could activate other nodes to maintain NSSI behavior. In light of these findings, precise targets for pharmacological treatment, psychotherapy, physical therapy, etc., are identified for adolescents with NSSI. Targeting this specific aspect in interventions may contribute to preventing and reducing NSSI behavior in adolescents.
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Affiliation(s)
- Muzhen Guan
- Department of Mental Health, Xi'an Medical College, 710021, Xi'an, China
- Department of psychiatry, the first affiliated hospital, Air Force Medical University, 710032, Xi'an, China
| | - Junchang Liu
- Department of psychiatry, the first affiliated hospital, Air Force Medical University, 710032, Xi'an, China
| | - Xinhong Li
- Department of General Practice, Tangdu Hospital, Air Force Medical University, Xi'an, China
| | - Min Cai
- Department of psychiatry, the first affiliated hospital, Air Force Medical University, 710032, Xi'an, China
| | - Jing Bi
- Department of science, Xi'an Guanmiao primary school, 710086, Xi'an, China
| | - Ping Zhou
- Department of psychiatry, the first affiliated hospital, Air Force Medical University, 710032, Xi'an, China
| | - Zhongheng Wang
- Department of psychiatry, the first affiliated hospital, Air Force Medical University, 710032, Xi'an, China
| | - Songwen Wu
- Department of Mental Health, Xi'an Medical College, 710021, Xi'an, China.
| | - Li Guo
- Department of psychiatry, the first affiliated hospital, Air Force Medical University, 710032, Xi'an, China.
| | - Huaning Wang
- Department of psychiatry, the first affiliated hospital, Air Force Medical University, 710032, Xi'an, China.
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Wang Y, Chen X, Song C, Wu Y, Liu L, Yang L, Hao X. A qualitative internet-based study of parental experiences of adolescents suffering from affective disorders with non-suicidal self-injury during the COVID-19 pandemic. Front Psychiatry 2024; 15:1361144. [PMID: 38596632 PMCID: PMC11002897 DOI: 10.3389/fpsyt.2024.1361144] [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: 12/25/2023] [Accepted: 03/12/2024] [Indexed: 04/11/2024] Open
Abstract
Objective Non-suicidal self-injury (NSSI) behaviors of adolescents with affective disorders can directly deteriorate parents' internal experiences, and negative parental experiences can exacerbate or even worsen NSSI behaviors. This study investigates the impact of NSSI behaviors exhibited by adolescents with affective disorders on the internal experiences of parents. Specifically, our research focuses on the inner experiences of parents when their children engage in NSSI behaviors during social isolation of the COVID-19, offering insights for addressing parental mental health issues related to NSSI and developing positive parental behavioral models to optimize adolescent behavior during major public health events. Methods Semi-structured interviews were conducted with 21 parents of adolescents with affective disorders displaying NSSI behaviors during the COVID-19 pandemic. The Colaizzi 7-step analysis was employed to refine and categorize emerging themes. Results Our study revealed that parents of adolescents facing NSSI during the COVID-19 pandemic underwent different internal experiences, which could be classified into four themes: negative experience, high caregiving burden, lack of caregiving capacity, and resilience. Conclusion This Internet-based research is the first to explore the internal experiences of parents of adolescents with affective disorders experiencing NSSI during the COVID-19 pandemic. It sheds light on how parents, in response to their children's NSSI behaviors, undergo resilience following negative experiences, explore more open and supportive family model. Despite these positive outcomes, parents express a need for increased knowledge about NSSI illness care and a desire for professional assistance.
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Affiliation(s)
- Yongna Wang
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, China
| | - Xueqiu Chen
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, China
| | - Chun Song
- Xinjiang Key Laboratory of Neurological Disorder Research, The Second Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Yan Wu
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, China
| | - Lihua Liu
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, China
| | - Lili Yang
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, China
| | - Xuege Hao
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, China
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Jiang XZ, Li HH, Yu ZZ, Wang C. Deliberate self-harm among pediatric psychiatric inpatients in China: A single-center retrospective study. World J Psychiatry 2024; 14:398-408. [PMID: 38617980 PMCID: PMC11008394 DOI: 10.5498/wjp.v14.i3.398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Revised: 01/22/2024] [Accepted: 02/25/2024] [Indexed: 03/19/2024] Open
Abstract
BACKGROUND For children and adolescents, deliberate self-harm (DSH) is becoming a mental health problem of concern. Despite several studies on the prevalence and factors of DSH in the world, there is little information on DSH among children and adolescents in China. This study explores the prevalence, types, associated risk factors and tendency of DSH in pediatric psychiatric inpatients in China. AIM To understand the situation of DSH among hospitalized children and adolescents and its related factors. METHODS In this study, we retrospectively studied 1414 hospitalized children and adolescents with mental illness at Xiamen Mental Health Center from 2014 to 2019, extracted the demographic and clinical data of all patients, and analyzed clinical risk factors of DSH. RESULTS A total of 239 (16.90%) patients engaged in at least one type of DSH in our study. Cutting (n = 115, 48.12%) was the most common type of DSH. Females (n = 171, 71.55%) were more likely to engage in DSH than males (n = 68, 28.45%). DSH was positively associated with depressive disorders [OR = 3.845 (2.196-6.732); P < 0.01], female [OR = 2.536 (1.815-3.542); P < 0.01], parental marital status [OR = 5.387 (2.254-12.875); P < 0.01] and negative family history of psychiatric illness [OR = 7.767 (2.952-20.433); P < 0.01], but not with occupation, substance use and history of physical abuse. CONCLUSION Our findings suggest that for patients with depression, females, an abnormal marriage of parents, and no history of mental illness, attention should be paid to the occurrence of DSH.
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Affiliation(s)
- Xing-Zhi Jiang
- Department of Child and Adolescent Psychiatry, Shenzhen Kangning Hospital, Shenzhen Mental Health Center, Shenzhen Key Laboratory for Psychological Healthcare and Shenzhen Institute of Mental Health, Shenzhen 518020, Guangdong Province, China
- Department of Psychiatry, Xiamen Xianyue Hospital, Xiamen 361012, Fujian Province, China
| | - Huan-Huan Li
- Department of Geriatric Medicine, Dalian Medical University, Dalian 116000, Liaoning Province, China
| | - Zhen-Zhen Yu
- Department of Neurology, The Second Affiliated Hospital of Xiamen Medical College, Xiamen 361000, Fujian Province, China
| | - Chen Wang
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen 361000, Fujian Province, China
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20
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Gu H, Chen W, Cheng Y. Longitudinal relationship between harsh parenting and adolescent non-suicidal self-injury: The roles of basic psychological needs frustration and self-concept clarity. CHILD ABUSE & NEGLECT 2024; 149:106697. [PMID: 38412590 DOI: 10.1016/j.chiabu.2024.106697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 02/05/2024] [Accepted: 02/08/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND Harsh parenting has been shown to be associated with adolescents' non-suicidal self-injury (NSSI) behavior. However, less is known about the mechanism underlying the association. OBJECTIVE The aim of this study was to use a one-year longitudinal design to investigate the mediating role of basic psychological needs frustration and the moderating role of self-concept clarity in the association between harsh parenting and NSSI. METHODS Three waves of data (called T1, T2 and T3) were collected 6 months apart, between April 2021 and 2022, in a sample of 786 Chinese adolescents (52.0 % girls; Mage at Wave 1 = 13.27 years). Structural equation model was used to test a longitudinal moderated mediation model, with gender, age and baseline NSSI as covariates. RESULTS The results showed process of mediation in which T1 harsh parenting was longitudinally and positively associated with T3 NSSI through T2 basic psychological needs frustration. Furthermore, moderated mediation analyses revealed that T2 self-concept clarity buffered the adverse impact of T2 needs frustration on T3 NSSI, thereby mitigating the mediation process. CONCLUSIONS The findings support the self-determination theory, and suggest that fostering adolescents' self-concept clarity and satisfying their psychological needs may be useful in programs designed to lower the risk of NSSI.
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Affiliation(s)
- Honglei Gu
- Department of Psychology, Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China.
| | - Wanqin Chen
- Institute of Special Education, Faculty of Education, Beijing Normal University, Beijing, China; School of Education Science, Hunan Normal University, Changsha, China
| | - Yufang Cheng
- Department of Psychology, Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China
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21
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Bahali K, Durcan G, Topal M, Önal BS, Bilgiç A, Tanıdır C, Aytemiz T, Yazgan Y. Parental attachment and childhood trauma in adolescents engaged in non-suicidal self-injury. Early Interv Psychiatry 2024; 18:173-180. [PMID: 37438893 DOI: 10.1111/eip.13452] [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: 12/13/2022] [Revised: 06/06/2023] [Accepted: 07/02/2023] [Indexed: 07/14/2023]
Abstract
AIM In this study, it was aimed to compare parental attachment and childhood traumas in adolescents with NSSI with healthy peers. METHODS Fifty adolescents aged 14-18 years with lifetime NSSI and 56 healthy peers were included in the study. Inventory of Statements About Self-injury (ISAS), The Parental Bonding Instrument (PBI) and Child Trauma Questionnaire (CTQ-28) scales were used. RESULTS Eighty-two percentage of the NSSI group and 70% of the control group were girls. The mean age was 15.6 ± 1.1 years in the NSSI group and 15.3 ± 0.9 years in the control group. There was no significant difference between the groups in terms of age and gender. The NSSI group had more negative scores than the control group in terms of childhood traumas and attachment characteristics to both mother and father. The analyses showed that mother PBI care/control and sexual abuse score had a relationship with both ISAS Autonomic Functions and ISAS Social Functions scores. CONCLUSIONS These results suggest that secure attachment with the mother may be protective for both the autonomic and social functions of the NSSI. Therefore, interventions for dysfunctional parental attachment may prevent the development of NSSI.
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Affiliation(s)
- Kayhan Bahali
- Department of Psychology, Istanbul Gelisim University, Istanbul, Turkey
| | - Gizem Durcan
- Department of Child and Adolescent Psychiatry, Medical Faculty of Cerrahpasa, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Melike Topal
- Department of Child and Adolescent Psychiatry, University of Health Sciences, Basaksehir Cam ve Sakura Research and Training Hospital, Istanbul, Turkey
| | - Bedia Sultan Önal
- Department of Child and Adolescent Psychiatry, Medical Faculty, Giresun University, Giresun, Turkey
| | - Ayhan Bilgiç
- Faculty of Medicine, Izmir University of Economics, İzmir, Turkey
| | - Canan Tanıdır
- Department of Psychology, Istanbul Gelisim University, Istanbul, Turkey
| | - Tuğçe Aytemiz
- Child and Adolescent Psychology Laboratory, University of Health Sciences, Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
| | - Yankı Yazgan
- Department of Child and Adolescent Psychiatry, Güzel Günler Clinic, Istanbul, Turkey
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
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22
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Sherif Y, Fattah Azman AZ, Said SM, Siddiqah Alimuddin A, Awang H, Mohammadzadeh M. Effect of online intervention based on life skills for mental health, self-efficacy and coping skills among Arab adolescents in the Klang Valley, Malaysia: A cluster randomised controlled trial protocol. PLoS One 2024; 19:e0298627. [PMID: 38394185 PMCID: PMC10889627 DOI: 10.1371/journal.pone.0298627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 01/25/2024] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Migrant children and adolescents face a significantly increased risk of mental health issues. Focusing on this population's mental health issues is fundamental and requires more attention to detect and reduce these burdens in adulthood. Nevertheless, life skills intervention can improve mental health. Its effects on Arab migrant adolescents have not been tested. Here, an evaluation protocol of the effect of an online life skills-based intervention for improving depression, anxiety, stress, self-efficacy, and coping skills among Arab adolescents in Malaysia will be examined. MATERIAL AND METHODS This cluster randomised controlled trial (RCT) will involve 207 Arab students (14-18 years old) from 12 Arabic schools in the Klang Valley. The schools will be assigned randomly to an intervention (online life skills programme) or control group at a 1:1 ratio. The researcher will deliver eight one-hour sessions to the intervention group weekly. The control group will receive the intervention at the evaluation end. Both groups will complete assessments at baseline, and immediately and three months after the intervention. The primary outcome is anxiety, depression, and stress [Depression Anxiety and Stress Scale-21 (DASS-21)]. The secondary outcomes are self-efficacy (General Self-Efficacy Scale) and coping skills (Brief COPE Inventory). Data analysis will involve the Generalised Estimation Equation with a 95% confidence interval. P < .05 will indicate significant inter- and intra-group differences. DISCUSSION This will be the first cluster RCT of an online life skills education programme involving Arab adolescent migrants in Malaysia. The results could support programme effectiveness for improving the participants' mental health problems (depression, anxiety, stress), increasing their self-efficacy, and enhancing their coping skills. The evidence could transform approaches for ameliorating migrant children and adolescents' mental well-being. TRIAL REGISTRATION The study is registered with the Clinical Trial Registry (Identifier: NCT05370443).
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Affiliation(s)
- Yosra Sherif
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Ahmad Zaid Fattah Azman
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Salmiah Md Said
- Department of Community Health, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Aishah Siddiqah Alimuddin
- Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Hamidin Awang
- Psychiatry Unit, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia (USIM), Nilai, Negeri Sembilan, Malaysia
| | - Marjan Mohammadzadeh
- Institute of Health and Nursing Science, Charité–Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
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23
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Millon EM, Alqueza KL, Kamath RA, Marsh R, Pagliaccio D, Blumberg HP, Stewart JG, Auerbach RP. Non-suicidal Self-injurious Thoughts and Behaviors Among Adolescent Inpatients. Child Psychiatry Hum Dev 2024; 55:48-59. [PMID: 35727385 PMCID: PMC9782727 DOI: 10.1007/s10578-022-01380-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/19/2022] [Indexed: 01/07/2023]
Abstract
Non-suicidal self-injury (NSSI) is a serious public health concern that typically onsets during early adolescence. Adolescents (N = 980, ages 12-19 years) admitted for acute, residential psychiatric treatment completed baseline clinical interviews assessing mental disorders and questionnaires measuring demographics, early life adversity, and symptom severity. Prevalence rates of NSSI for lifetime (thoughts: 78%; behaviors: 72%), past year (thoughts: 74%; behaviors: 65%), and past month (thoughts: 68%; behaviors: 51%) were high. Although effect sizes were modest, the presence of a lifetime depressive disorder, sexual abuse, and comorbidity (i.e., three or more current disorders) were significant correlates of experiencing NSSI thoughts and behaviors. Furthermore, lifetime depressive disorder, current anxiety disorder, and comorbidity were associated with a greater odds of persistent NSSI thoughts and/or behaviors. Longitudinal studies are needed to determine whether targeting these factors reduces the persistence of NSSI thoughts and behaviors.
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Affiliation(s)
- Emma M Millon
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA
| | - Kira L Alqueza
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA
| | - Rahil A Kamath
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA
| | - Rachel Marsh
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA
| | - David Pagliaccio
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA
| | - Hilary P Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Jeremy G Stewart
- Department of Psychology and Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA.
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA.
- Division of Clinical Developmental Neuroscience, Sackler Institute, New York, NY, USA.
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24
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Andersson H, Svensson E, Magnusson A, Holmqvist R, Zetterqvist M. Young adults looking back at their experiences of treatment and care for nonsuicidal self-injury during adolescence: a qualitative study. Child Adolesc Psychiatry Ment Health 2024; 18:16. [PMID: 38245758 PMCID: PMC10800066 DOI: 10.1186/s13034-024-00706-2] [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: 11/06/2023] [Accepted: 01/05/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Nonsuicidal self-injury (NSSI) is associated with stigma, and negative attitudes among healthcare professionals toward NSSI have been reported. A person-centered approach that focuses on how individuals with lived experience of NSSI perceive the treatment and care they receive is invaluable in reducing barriers to help-seeking and improving treatment and mental healthcare services. The aim of the current qualitative study was to explore the perceptions of young adults when they look back upon their experiences of psychiatric treatment for NSSI during adolescence. METHODS Twenty-six individuals with lived experience of NSSI who were in contact with child and adolescent psychiatry during adolescence were interviewed. The interviews were analyzed using thematic analysis. RESULTS Three main themes were developed: Changed perceptions in retrospect, The importance of a collaborative conceptualization and Lasting impression of the relationship. Participants' perception of themselves as well as the treatment changed over time. The importance of a joint understanding of NSSI and an agreed-upon treatment focus was emphasized. The relationship to the mental health professionals, and experiences of how NSSI was communicated, were salient several years later. CONCLUSIONS Healthcare professionals need to communicate about NSSI in a respectful manner and include the perspective of the adolescent with lived experience of NSSI in a joint conceptualization of NSSI and treatment focus.
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Affiliation(s)
- H Andersson
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping university, Linköping, Sweden
| | - E Svensson
- Department of Behavioural Sciences and Learning, Linköping university, Linköping, Sweden
| | - A Magnusson
- Department of Behavioural Sciences and Learning, Linköping university, Linköping, Sweden
| | - R Holmqvist
- Department of Behavioural Sciences and Learning, Linköping university, Linköping, Sweden
| | - M Zetterqvist
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping university, Linköping, Sweden.
- Department of Child and Adolescent Psychiatry, Region Östergötland, Linköping, Sweden.
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25
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Hach I, Bertsch T, Nonell P. The prevalence of off-label use and supratherapeutic blood levels of outpatient psychotropic medication in suicidal adolescents. Front Psychiatry 2024; 14:1240681. [PMID: 38298931 PMCID: PMC10827976 DOI: 10.3389/fpsyt.2023.1240681] [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: 06/17/2023] [Accepted: 12/20/2023] [Indexed: 02/02/2024] Open
Abstract
Introduction Adolescents with mental disorders show an increased risk of suicidal phenomena. Vice versa, suicidality is a serious adverse event of psychotropic drug therapy in adolescents. There are only a few new psychotropic agents approved for this young age group. We evaluated the (pre-pandemic) prevalence of off-label use as well as detailed blood concentrations of outpatient psychotropic medication and sex differences in a clinical population of suicidal adolescents. Methods The urine presence and serum levels of psychotropic substances of adolescents hospitalized due to their acute suicidality but without a known actual suicide attempt (i.e., no acute intoxication or serious self-injuries) were investigated routinely between 01.03.2017 and 31.01.2018. Urine (N = 205) and blood samples (N = 193) were taken at the beginning of closed inpatient admission, i.e., the results of the laboratory analysis reflect outpatient drug intake. The serum levels of psychopharmacological medication and OTC medication were measured. Results Our sample consists of 231 cases (boys: N = 54; girls: N = 177, ratio: 1:3.3), aged 12-17 years (average age: 15,4 years). The most prevalent psychiatric diagnoses were depressive episodes (54%) and adjustment disorders (25%), and girls were more often diagnosed with depressive disorders than boys (boy/girl ratio: 1:9.5, p < 0.0001). More than half of adolescents (56%) used at least one prescribed psychotropic drug at admission (24.8% ≥ two psychotropic drugs). Off-label use of second-generation antipsychotics was significantly more frequent than off-label use of antidepressants (85% vs. 31%, p < 0.01). Adolescents suffering from depressive disorders were significantly more often on-label treated than adolescents with neurotic or stress-related disorders (56% vs. 10%). Female cases with prescribed psychotropic drug use showed significantly more frequent supratherapeutic drug levels than male cases (5% vs. 27%, p < 0.05). Conclusion Female adolescents may have an increased risk of supratherapeutic blood levels, especially when outpatient prescribed psychotropic drugs are off-label used. Measurement of blood levels of outpatient-prescribed psychotropic drugs could be used to enhance the safety and efficacy of the individual psychopharmacological treatment of adolescent suicidal patients. There is an urgent need for more real-world evidence on the effective treatment of adolescents with psychotropic drugs.
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Affiliation(s)
- Isabel Hach
- Department of Education and Science, Klinikum Nürnberg, Paracelsus Medical University Nürnberg, Nürnberg, Germany
| | - Thomas Bertsch
- Institute of Clinical Chemistry, Laboratory Medicine and Transfusion Medicine, Klinikum Nürnberg, Paracelsus Medical University Nürnberg, Nürnberg, Germany
| | - Patrick Nonell
- Clinic of Child and Adolescent Psychiatry and Psychotherapy, Klinikum Nürnberg, Paracelsus Medical University Nürnberg, Nürnberg, Germany
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Liu Z, Wei Y, Yang Y, Kong L. Unveiling a novel clinical risk assessment model for identifying non-suicidal self-injury risks in depressed Chinese adolescents amidst the COVID-19 pandemic: insights from low self-esteem, internet use, and sleep disturbance. Front Psychiatry 2024; 14:1259909. [PMID: 38250260 PMCID: PMC10797052 DOI: 10.3389/fpsyt.2023.1259909] [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: 07/17/2023] [Accepted: 12/14/2023] [Indexed: 01/23/2024] Open
Abstract
Background Non-suicidal self-injury (NSSI) is a highly prevalent behavioral problem among depression adolescent patients that can result in numerous adverse outcomes. This study endeavors to bridge this knowledge gap by creating a comprehensive model that incorporates multiple aspects of NSSI to accurately evaluate its risk in adolescents with depression, thereby enhancing our ability to prevent and address this challenging issue. Method Using a cross-sectional design, we recruited 302 adolescents with depressive disorders who visited or were hospitalized at Shandong Mental Health Center from December 2021 to June 2022. The participants completed several self-report questionnaires, including the Chinese version of the Internet Addiction Test, the Pittsburgh Sleep Quality Index questionnaire, the Defeat Scale, the Social Avoidance and Distress Scale and the Children's Depression Inventory. Logistic regression analysis was performed to identify the diagnostic factors, which were further used to establish clinical risk assessment models. A receiver operating characteristic curve (ROC) to identify the best model. An external validating team was introduced to verify the assessing efficiency. Results Based on a logistic regression analysis, three variables have been identified as significant risk factors. Specifically, adolescents with depression who experience low self-esteem, internet use, or suffer from sleep disturbance face an increased risk of NSSI. An integrated risk index for NSSI exhibits excellent accuracy in identifying depressed adolescents at risk of NSSI (area under the curve = 0.86, sensitivity = 0.88, specificity = 0.69). In the validation cohort, the identification performance remains strong (area under the curve = 0.84, sensitivity = 0.72, specificity = 0.81). Conclusion This study highlighted the role of self-esteem, internet use and sleep disturbance in the development of NSSI. The risk index diagnosing NSSI onset may help to guide the design and application of novel interventions to minimize this risky behavior in future depressed adolescents.
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Affiliation(s)
- Zhongyi Liu
- Department of Psychiatry, School of Clinical Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
- Childhood Psychiatry Unit, Shandong Mental Health Center, Jinan, China
| | - Yuhuan Wei
- Childhood Psychiatry Unit, Shandong Mental Health Center, Jinan, China
- School of Mental Health, Jining Medical University, Jining, China
| | - Ying Yang
- Department of Psychiatry, School of Clinical Medicine, Cheeloo College of Medicine, Shandong University, Jinan, China
- Childhood Psychiatry Unit, Shandong Mental Health Center, Jinan, China
- School of Mental Health, Jining Medical University, Jining, China
| | - Linghua Kong
- School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, China
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Long Q, Huang B, Tang Y, Wu J, Yu J, Qiu J, Huang Y, Huang G. Peer victimization and non-suicidal self-injury among high school students: the mediating role of social anxiety, mobile phone addiction, and sex differences. BMC Psychiatry 2024; 24:25. [PMID: 38178004 PMCID: PMC10768228 DOI: 10.1186/s12888-024-05495-8] [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: 08/02/2023] [Accepted: 01/02/2024] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Peer victimization (PV) is one of the major causes of non-suicidal self-injury. Non-suicidal self-injury (NSSI), peer victimization, social anxiety, and mobile phone addiction are significantly related; however, the interaction mechanism and effect of sex differences remain to be determined. OBJECTIVE Herein, we investigated the relationship between peer victimization and NSSI among Chinese high school students. We also explored the chain mediating roles of social anxiety and mobile phone addiction and the regulatory role of sex. The findings of this study provide insights for theoretical interventions based on internal mechanisms. METHOD A self-reported survey of 14,666 high school students from Sichuan County was conducted using a peer victimization scale, NSSI scale, social anxiety scale, and mobile phone addiction scale. A self-administered questionnaire was used to capture sociodemographic information. RESULTS Peer victimization, social anxiety, and mobile phone addiction were positively correlated with NSSI. Peer victimization had significant direct predictive effects on NSSI (95% CI: 0.341, 0.385) and significant indirect predictive effects on NSSI through social anxiety (95% CI: 0.008, 0.019) or mobile phone addiction (95% CI: 0.036, 0.053). Peer victimization had significant indirect predictive effects on NSSI through social anxiety as well as mobile phone addiction (95% CI: 0.009, 0.014). The first stage (predicting the effect of peer victimization on NSSI) and the third stage (predicting the effect of mobile phone addiction on NSSI) were both moderated by sex. CONCLUSIONS Peer victimization could directly predict NSSI and indirectly predict NSSI through social anxiety and mobile phone addiction. Thus, social anxiety and mobile phone addiction exhibited chain mediating effects between peer victimization and NSSI in high school students; moreover, sex might be involved in the regulation of the mediation process.
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Affiliation(s)
- Qianmei Long
- Department of Psychiatry, North Sichuan Medical College, 637000, Nanchong, China
| | - Bin Huang
- Department of Psychiatry, North Sichuan Medical College, 637000, Nanchong, China
| | - Yiyu Tang
- Department of Psychiatry, North Sichuan Medical College, 637000, Nanchong, China
| | - Junlin Wu
- The Third Hospital of Mianyang, Sichuan Mental Health Center, 621000, Mianyang, China
| | - Jia Yu
- The Third Hospital of Panzhihua, Panzhihua Mental Health Center, 617061, Panzhihua, China
| | - Junlin Qiu
- Department of Psychiatry, North Sichuan Medical College, 637000, Nanchong, China
| | - Yanqing Huang
- Department of Psychiatry, North Sichuan Medical College, 637000, Nanchong, China
| | - Guoping Huang
- Department of Psychiatry, North Sichuan Medical College, 637000, Nanchong, China.
- The Third Hospital of Mianyang, Sichuan Mental Health Center, 621000, Mianyang, China.
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Eggart V, Mortazavi M, Kirchner SK, Keeser D, Brandstetter L, Hasan A, Wagner E. Association of Four Medication Classes and Non-suicidal Self-injury in Adolescents with Affective Disorders - A Retrospective Chart Review. PHARMACOPSYCHIATRY 2024; 57:4-12. [PMID: 37722411 DOI: 10.1055/a-2153-4370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) behaviour is frequently observed in children and adolescents with psychiatric conditions. Affected individuals are regularly treated with psychotropic drugs, although the impact of these agents on NSSI behaviour remains elusive. METHODS We performed a retrospective chart review from clinical routine data in a large cohort (N=1140) of adolescent inpatients with primary affective and non-affective psychiatric disorders according to ICD-10 (mean age=15.3±1.3 years; 72.6% female). Four separate mixed regression models compared the frequency of NSSI between treatment periods without any medication and four medication categories (benzodiazepines, selective serotonin reuptake inhibitors (SSRIs), high- and low-potency antipsychotics). RESULTS In those individuals with affective disorders as the primary diagnosis, periods without medication were associated with significantly lower NSSI/day compared to all four other medication conditions (benzodiazepines p<10-8, antidepressants/SSRIs p=0.0004, high-potency antipsychotics p=0.0009, low-potency antipsychotics p<10 -4). In individuals with a primary diagnosis other than an affective disorder, NSSI was significantly lower during the period without medication compared to the treatment periods with benzodiazepines (p=0.005) and antidepressants/SSRIs (p=0.01). However, NSSI rates in the no-medication condition were comparable to NSSI rates under high-potency (p=0.89) and low-potency antipsychotics (p=0.53). CONCLUSIONS The occurrence of NSSI correlates with the treatment with a psychotropic drug in children and adolescents with psychiatric disorders. Due to the retrospective design, it remains elusive to what extent psychotropic drugs might alter the frequency of NSSI in adolescents or if NSSI might indicate a transdiagnostic feature of more pronounced disease severity.
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Affiliation(s)
- Vincent Eggart
- Department Rottmannshöhe, Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, KBO-Heckscher-Klinikum gGmbH, Munich, Germany
| | - Matin Mortazavi
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Sophie-Kathrin Kirchner
- Department of Psychiatry, Psychotherapy and Psychosomatics of the University Augsburg, Bezirkskrankenhaus Augsburg, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Lisa Brandstetter
- Department Rottmannshöhe, Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, KBO-Heckscher-Klinikum gGmbH, Munich, Germany
| | - Alkomiet Hasan
- Department of Psychiatry, Psychotherapy and Psychosomatics of the University Augsburg, Bezirkskrankenhaus Augsburg, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Elias Wagner
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
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Conway-Jones R, James A, Goldacre MJ, Seminog OO. Risk of self-harm in patients with eating disorders: English population-based national record-linkage study, 1999-2021. Int J Eat Disord 2024; 57:162-172. [PMID: 37949682 DOI: 10.1002/eat.24091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 10/29/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023]
Abstract
OBJECTIVE Anorexia nervosa (AN) and bulimia nervosa (BN) are eating disorders associated with high rates of self-harm (SH). This is the first national study in England to quantify this association in a hospital population. METHOD A retrospective cohort study using a linked national dataset of Hospital Episode Statistics for 1999-2021. The exposure cohort included individuals aged <35 years admitted to hospital with a diagnosis of AN or BN. The reference cohort included hospital controls. We calculated the rate ratio (RR) of SH in each cohort. The individuals in the two cohorts were matched on multiple socio-demographic indicators. The main outcome was a subsequent hospitalization or death record with an SH diagnosis. RESULTS We identified 15,004 females and 1411 males with AN, and 6055 females and 741 males with BN. The RR with 95% confidence intervals (95%CI) for a subsequent admission with intentional self-harm after admission with AN was 4.9 (95%CI 4.7-5.1) in females and 4.8 (95%CI 3.9-5.8) in males. For BN it was 9.0 (95%CI 8.4-9.6) in females and 9.8 (95%CI 7.7-12.2) in males. There were strong associations between AN and BN and other SH. DISCUSSION Women and men admitted to English hospitals with AN or BN have a very high risk of a subsequent admission with SH. For some SH behaviors, such as alcohol intoxication, the RR was >10-fold elevated. The magnitude of risk was higher for BN than for AN. Clinicians should be aware of the scale of risk increase. Providing those at risk with appropriate support is required. PUBLIC SIGNIFICANCE This study is the first national study in an English hospital population that confirms and quantifies the association between eating disorders and self-harm. We have found that both women and men admitted to hospital with anorexia nervosa or bulimia nervosa are at an increased risk of subsequent admission with self-harm. It is important that clinicians are aware of this increased risk to support those at highest risk of self-harm.
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Affiliation(s)
| | - A James
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - M J Goldacre
- Big Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - O O Seminog
- Big Data Institute, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Evseev VD, Bokhan NA, Mandel AI, Kadochnikova SV. [Prevalence and risk factors of non-suicidal self-injury behavior]. Zh Nevrol Psikhiatr Im S S Korsakova 2024; 124:13-19. [PMID: 38465806 DOI: 10.17116/jnevro202412402113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
The prevalence of non-suicidal self-injury (NSSI) behavior in adolescents has increased significantly in the early 21st century. The phenomenon of NSSI behavior has become one of the key health problems in the field of adolescent psychiatry and psychology over the past decade worldwide. However, the social characteristics and factors influencing NSSI are very different in different regions of the world. Studies of self-harming behavior indicate that the upward trend is almost equally relevant for developing and developed countries. To date, the methodological basis for the diagnosis of NSSI has not been sufficiently developed in the Russian Federation, there are only some studies of NSSI both from an empirical perspective and in the context of the search for risk factors, causes and functions, models of comorbidity with mental disorders.
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Affiliation(s)
- V D Evseev
- Mental Health Research Institute - Tomsk National Research Medical Center Russian Academy of Sciences, Tomsk, Russia
| | - N A Bokhan
- Mental Health Research Institute - Tomsk National Research Medical Center Russian Academy of Sciences, Tomsk, Russia
- Siberian State Medical University, Tomsk, Russia
| | - A I Mandel
- Mental Health Research Institute - Tomsk National Research Medical Center Russian Academy of Sciences, Tomsk, Russia
| | - S V Kadochnikova
- Siberian State Medical University, Tomsk, Russia
- Tomsk Clinical Psychiatric Hospital, Tomsk, Russia
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Liu J, Yao Y, Deng X, Xu X, He W. How does emotional abuse affect adolescents' non-suicidal self-injury urges? A moderated chain mediation model. CHILD ABUSE & NEGLECT 2024; 147:106535. [PMID: 37980785 DOI: 10.1016/j.chiabu.2023.106535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 10/24/2023] [Accepted: 11/02/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND Studying non-suicidal self-injury (NSSI) among adolescents has high clinical significance. Its urges have been identified as a potential predictor of NSSI behavior and may serve as a crucial intervention target. OBJECTIVE This study uses a moderated chain mediation model to explore the relationship between emotional abuse and adolescent NSSI urges. Additionally, we examine the mediating roles of ego depletion and self-esteem and the moderating effect of resilience. PARTICIPANTS AND SETTING We recruited 1129 Chinese adolescents (age M = 16.68; SD = 0.78; 49.4 % men) from secondary vocational schools in China. METHODS We assessed emotional abuse, ego depletion, self-esteem, and NSSI urges in a longitudinal investigation across two time points (T1: March 2023, T2: June 2023). RESULTS After controlling for age, sex, NSSI urges and self-esteem at T1, our study validates a moderated chain mediation model and finds that the mediating effect via self-esteem is 0.026 (95%CI = [0.011,0.046]), and the chain mediating effect via ego depletion and self-esteem is 0.031 (95%CI = [0.022,0.045]), whereas the direct effect of emotional abuse T1 on NSSI urges T2 is not significant (DE = 0.082, 95%CI = [-0.002, 0.167]) and the mediating effect via ego depletion is also not significant (IE = -0.003, 95%CI = [-0.022, 0.015]). Resilience moderates the impact of emotional abuse on ego depletion (β = 0.09, p < 0.01). CONCLUSIONS These findings suggest that ego depletion and self-esteem are potential mechanisms related to emotional abuse and adolescents' NSSI urges, whereas resilience can play a moderating role in reducing ego depletion.
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Affiliation(s)
- Jie Liu
- School of Psychology, Shanghai Normal University, Shanghai 200234, China
| | - Yan Yao
- Pinghu Vocational Secondary School, China
| | - Xun Deng
- School of Psychology, Shanghai Normal University, Shanghai 200234, China
| | - Xiongwei Xu
- School of Education, Shanghai Normal University, Shanghai 200234, China.
| | - Wen He
- School of Psychology, Shanghai Normal University, Shanghai 200234, China.
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Liu S, Qi Q, Zeng Z, Hu Y. Cumulative ecological risk and nonsuicidal self-injury in adolescents: The mediation of depression and the moderation of impulsiveness. Child Care Health Dev 2024; 50:e13211. [PMID: 38102970 DOI: 10.1111/cch.13211] [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: 06/14/2023] [Revised: 10/29/2023] [Accepted: 11/17/2023] [Indexed: 12/17/2023]
Abstract
BACKGROUND This study is based on the biosocial model of nonsuicidal self-injury (NSSI), to explore the effects of cumulative ecological risk on adolescents' NSSI, the mediating effect of depression between cumulative ecological risk and adolescents' NSSI, and the moderating role of impulsiveness in this mediating pathway. METHODS A total of 16 508 adolescents, with 7903 males (47.9%), participated in the study and completed the Cumulative Ecological Risk Questionnaire, the Short Form of the Center for Epidemiological Studies Depression Scale, the Impulsiveness assessment, and the Nonsuicidal Self-Injury Scale. RESULTS (1) There was a significant positive correlation between cumulative ecological risk, depression, impulsiveness, and NSSI; (2) cumulative ecological risk significantly predicted adolescents' NSSI; (3) depression had a mediating effect between cumulative ecological risk and adolescents' NSSI; and (4) impulsiveness moderated both the effects of cumulative ecological risk on adolescents' depression and NSSI and the effects of depression on NSSI in adolescents. CONCLUSIONS Impulsiveness and depression are risk factors for adolescent NSSI and play a crucial role between cumulative ecological risk and NSSI in adolescents.
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Affiliation(s)
- Shuangjin Liu
- School of Educational Science, Hunan Normal University, Changsha, China
| | - Qi Qi
- School of Educational Science, Hunan Normal University, Changsha, China
| | - Zihao Zeng
- School of Educational Science, Hunan Normal University, Changsha, China
| | - Yiqiu Hu
- School of Educational Science, Hunan Normal University, Changsha, China
- School of Educational Science, Cognition and Human Behavior Key Laboratory of Hunan Province, Changsha, China
- School of Educational Science, Research Center for Mental Health Education of Hunan Province, Changsha, China
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Karmakar S, Duggal C. Trauma-Informed Approach to Qualitative Interviewing in Non-Suicidal Self-Injury Research. QUALITATIVE HEALTH RESEARCH 2024; 34:33-47. [PMID: 37924212 DOI: 10.1177/10497323231207746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2023]
Abstract
Non-suicidal self-injury (NSSI) is recognized as a public health concern owing to its chronic nature, association with suicide risk, and its growing prevalence rates across the globe. Including individuals living with NSSI in research is crucial as it offers opportunities to give primacy to participant voices and insights, further guiding therapeutic interventions. Research has established an association between history of traumatic events and adverse childhood experiences with subsequent risk of NSSI. When planning a qualitative research study with individuals with potential trauma history, researchers need to be aware of and sensitive to potential re-traumatization and distressing emotions that participants may experience during interviews, as well as complex trauma reactions that may affect individuals after study participation. The article emphasizes that researchers be cognizant of the multifaceted nature of trauma and how it can impact individuals and communities and be sensitive in their approach to interviewing vulnerable groups such as individuals with experiences of NSSI. The authors propose adopting a trauma-informed approach to ethically plan and conduct qualitative interviews exploring NSSI experiences. Trauma-informed recommendations for preparing and carrying out specific steps during different stages of NSSI interviews are detailed.
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Affiliation(s)
- Sushmita Karmakar
- School of Human Ecology, Tata Institute of Social Sciences, Mumbai, India
| | - Chetna Duggal
- School of Human Ecology, Tata Institute of Social Sciences, Mumbai, India
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Liu J, Li JT, Zhou M, Liu HF, Fan YY, Mi S, Tang YL. Non-suicidal self-injury in adolescents with mood disorders and the roles of self-compassion and emotional regulation. Front Psychiatry 2023; 14:1214192. [PMID: 38179248 PMCID: PMC10764550 DOI: 10.3389/fpsyt.2023.1214192] [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: 04/29/2023] [Accepted: 11/30/2023] [Indexed: 01/06/2024] Open
Abstract
Objective We aimed to investigate the characteristics and psychological mechanism of non-suicidal self-injury (NSSI) in adolescents with mood disorders. We examined how self-compassion and emotional regulation affected NSSI and tested the mediating role of self-compassion in the link between emotional regulation and NSSI. Method We recruited outpatient and inpatient adolescent patients with bipolar and related disorders or depressive disorders (DSM-5), with a focus on NSSI. We also recruited healthy controls from the community. We collected demographic and clinical data. The Adolescent Self-injury Questionnaire, Self-compassion Scale (SCS), and Emotion Regulation Questionnaire (ERQ) were used to assess the frequency and severity of NSSI, level of self-compassion, and emotional regulation. Results In total, we recruited 248 adolescent patients with mood disorders (N = 196 with NSSI, and 52 without NSSI) and 212 healthy controls. NSSI was significantly associated with the female sex, lower levels of education and less use of cognitive reappraisal strategies, lower levels of self-warmth, and higher levels of self-coldness. Multivariate analysis of variance showed that there were significant differences in the scores of ERQ, cognitive reassessment score, and the scores of SCS among the three groups, but no statistical differences in expressive suppression score among the three groups. Self-warmth had a mediating effect between cognitive reappraisal and NSSI behavior. Conclusion NSSI is prevalent among adolescent patients with mood disorders in clinical settings, especially among girls and those with lower levels of education and less cognitive reappraisal strategies. More clinical attention is needed. Self-compassion and its factors may mediate the association between emotional regulation and NSSI. Clinical implications and future research directions were discussed.
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Affiliation(s)
- Jing Liu
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Jia-ting Li
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Man Zhou
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Hui-feng Liu
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yang-yang Fan
- Faculty of Economics and Management, East China Normal University, Shanghai, China
| | - Si Mi
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yi-lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
- Mental Health Service Line, Atlanta VA Medical Center, Decatur, GA, United States
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Qin Y, Wu D, Liu J, Peng J, Li C. Perspectives of parents of adolescents with repeated non-suicidal self-injury on sharing their caretaking experiences with peers: a qualitative study. Front Psychiatry 2023; 14:1237436. [PMID: 38148747 PMCID: PMC10750419 DOI: 10.3389/fpsyt.2023.1237436] [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: 06/09/2023] [Accepted: 11/24/2023] [Indexed: 12/28/2023] Open
Abstract
Background The prevalence of non-suicidal self-injury among adolescents has increased over the years. Most parents, however, are poorly informed and confused about this behavior. Sharing caretaking experiences with parents in similar situations seems to be beneficial. Nevertheless, few researchers have explored the views of parents who share their caretaking experiences with peers. Aim This study aimed to investigate the perspectives of parents of adolescents with repeated non-suicidal self-injury on sharing their caretaking experiences with peers as well as the motivations for and barriers to this behavior. Methods This qualitative study adopted a purposive sampling method. Participants (16 mothers and 2 fathers) were recruited from the mental health center of a tertiary hospital in Chengdu, Sichuan, China. A total of 18 semistructured face-to-face individual interviews were conducted. All interviews were audio-recorded and analyzed thematically using NVivo 11. Results Three themes and nine subthemes were identified: (1) sharable caretaking experiences: reflection and transformation, self-emotional management, and diversified support; (2) motivations for sharing: empathy, reciprocity, and meaning; and (3) barriers to sharing: inadequate knowledge, low self-identity, and concerns for children. Conclusion Parents accumulate a wealth of experience during their long-term care of adolescents with repeated non-suicidal self-injury. Although most parents are willing to share their caretaking experiences with peers, there are several barriers. Therefore, in order to increase parents' motivation to share, psychological education is necessary.
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Affiliation(s)
- Yuan Qin
- School of Nursing, Chengdu Medical College, Chengdu, China
- Chongqing Mental Health Center, Chongqing, China
| | - Dongmei Wu
- Department of Nursing, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
- Nursing Key Laboratory of Sichuan Province, Chengdu, China
| | - Jiao Liu
- School of Nursing, Zunyi Medical University, Zunyi, China
| | - Jianyan Peng
- Department of Nursing, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Chunya Li
- Department of Nursing, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
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Esposito C, Dragone M, Affuso G, Amodeo AL, Bacchini D. Prevalence of engagement and frequency of non-suicidal self-injury behaviors in adolescence: an investigation of the longitudinal course and the role of temperamental effortful control. Eur Child Adolesc Psychiatry 2023; 32:2399-2414. [PMID: 36123505 PMCID: PMC10682258 DOI: 10.1007/s00787-022-02083-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 09/10/2022] [Indexed: 11/30/2022]
Abstract
Non-suicidal self-injury (NSSI) is among the most frequent maladaptive behaviors reported in adolescence, with prevalence rates around 18-22% in community samples worldwide. The onset of NSSI typically occurs between early and middle adolescence, with a peak during middle adolescence (14-15 years) and a subsequent decline during late adolescence. This study investigated the growth curves of NSSI across four years during adolescence, analyzing simultaneously the probability of engagement in NSSI at least once (i.e., prevalence) and the frequency of engagement once initiated (i.e., severity). Furthermore, the study examined the predicting role of effortful control on NSSI over time (time-varying effects), net of other key risk factors for NSSI, such as anxiety-depression and bullying victimization. A sample of 430 Italian adolescents enrolled in Grade 9 at baseline was involved in the study. Based on the Latent Growth Curve Zero-inflated Poisson methodology, the results indicated a negative quadratic trend of both NSSI prevalence, with an increase between T1 and T3 followed by a decrease in the subsequent wave, and NSSI frequency once initiated, with a peak at T2 followed by a decline over time. The results also showed that adolescents who reported low effortful control abilities had a heightened probability of involvement in NSSI at each time point, whereas no significant association was found with NSSI frequency once initiated. Findings from this study offer important insights into the developmental course of NSSI and point out the need for future in-depth investigations of the mechanisms that might underlie NSSI prevalence and severity throughout adolescence.
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Affiliation(s)
- Concetta Esposito
- Department of Humanities, University of Naples "Federico II", Naples, Italy.
| | - Mirella Dragone
- Department of Humanities, University of Naples "Federico II", Naples, Italy
| | - Gaetana Affuso
- Department of Psychology, University of Campania "L. Vanvitelli", Caserta, Italy
| | - Anna Lisa Amodeo
- Department of Humanities, University of Naples "Federico II", Naples, Italy
| | - Dario Bacchini
- Department of Humanities, University of Naples "Federico II", Naples, Italy
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Zhao J, Zhao H, Zhou A. Negative Parenting Styles and Psychological Crisis in Adolescents: Testing a Moderated Mediating Model of School Connectedness and Self-Esteem. Behav Sci (Basel) 2023; 13:929. [PMID: 37998676 PMCID: PMC10669031 DOI: 10.3390/bs13110929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 10/28/2023] [Accepted: 11/10/2023] [Indexed: 11/25/2023] Open
Abstract
Little is known about how rejecting and controlling parenting styles may influence adolescent psychological crisis and what conditions may buffer the detrimental effects of psychological crisis. By integrating multiple theories, this study investigated self-esteem as an underlying mediator and school connectedness as a potential moderator to explain the link between negative parenting and the two psychological crises among Chinese adolescents. In this study, the questionnaire method is adopted to examine the combined mechanism of rejecting parenting style and controlling parenting style on the psychological crisis of adolescents. In total, 1863 adolescents were involved in this study, ranging from 13 to 17 years old. The results showed that both the rejecting parenting style and the controlling parenting style can significantly and positively predict the level of psychological crisis of adolescents, but the predictive power of the rejecting parenting style was stronger. Self-esteem partially mediates the relationship between rejecting parenting style, controlling parenting style, and psychological crisis. School connectedness moderates both the effects of rejecting parenting styles on self-esteem and the effects of self-esteem on the psychological crisis. This study identifies the internal mechanisms by which negative parenting styles affect adolescents' psychological crisis, and reveals the mediating and moderating roles of self-esteem and school connectedness, providing additional explanatory paths for the mechanisms of adolescents' psychological crisis.
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Affiliation(s)
| | | | - Aibao Zhou
- School of Psychology, Northwest Normal University, Lanzhou 730070, China; (J.Z.); (H.Z.)
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Carreiras D, Cunha M, Sharp C, Castilho P. The Clinical Interview for Borderline Personality Disorder for Adolescents (CI-BOR-A): Development, acceptability and expert panel evaluation. Personal Ment Health 2023; 17:377-386. [PMID: 37183381 DOI: 10.1002/pmh.1586] [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] [Received: 03/16/2022] [Revised: 04/02/2023] [Accepted: 05/01/2023] [Indexed: 05/16/2023]
Abstract
Borderline personality disorder (BPD) is a severe mental disorder with marked impulsivity, instability, emotional dysregulation and self-harm. These features tend to develop over time and can be identified in adolescence. Early diagnosis is the first step to prevent the development of these features to a personality disorder. The purpose of this study was to develop the Clinical Interview for BPD for Adolescents (CI-BOR-A), a new instrument based on a sound clinical interview for BPD in youth (CI-BPD). We tested its acceptability with 43 adolescents and its content validity with the quantitative and qualitative evaluation of 23 experts in mental health. The CI-BOR-A is a hybrid semi-structured interview that considers both categorical and dimensional approaches of personality disorders of DSM-5-TR, including 16 items, decision tables for diagnosis, and an appendix to explore self-harm history further. Adolescents accepted the interview, and none refused to complete the assessment. The expert panel considered the interview relevant, clear, accurate and complete. Important feedback was provided in terms of structure and content to improve the CI-BOR-A quality. In general, the CI-BOR-A is a rigorous interview to assess BPD in adolescents and adds an important contribution to early detection in clinical and community settings.
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Affiliation(s)
- Diogo Carreiras
- Faculty of Psychology and Educational Sciences, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal
- Miguel Torga Higher Institute, Coimbra, Portugal
| | - Marina Cunha
- Faculty of Psychology and Educational Sciences, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal
- Miguel Torga Higher Institute, Coimbra, Portugal
| | | | - Paula Castilho
- Faculty of Psychology and Educational Sciences, Center for Research in Neuropsychology and Cognitive and Behavioral Intervention (CINEICC), University of Coimbra, Coimbra, Portugal
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Taliaferro LA, Westers NJ, Matsumiya B, Ingraham K, Muehlenkamp JJ, Hughes CE. Improving capacity to identify, assess, and manage adolescents engaging in non-suicidal self-injury using patient avatars. MEDICAL TEACHER 2023; 45:1283-1289. [PMID: 37232295 DOI: 10.1080/0142159x.2023.2216861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
PURPOSE We developed and evaluated a training comprising a didactic and virtual practice session with human-guided patient avatars to increase pediatric residents' competence to identify and assess non-suicidal self-injury (NSSI) and suicide risk. METHODS Thirty pediatric residents at three children's hospitals in Florida participated in the training and completed pre-, one-month post-, and three-months post-training surveys. One-way repeated measures ANOVA with post-hoc comparisons determined changes in confidence, comfort, behavioral intentions, attitudes, knowledge, and behavior over time. Qualitative responses provided feedback on the training, especially the novel practice session with adolescent patient avatars. RESULTS Three-months post-training residents expressed significantly greater confidence in talking to adolescents who self-injure, applying the SOARS method to assess self-injury, and assessing functions/reasons for self-injury; reported feeling significantly more comfortable asking about self-injury, well-equipped to handle the emotional aspects of self-injury, and comfortable treating adolescents who self-injure; reported greater behavioral intentions to talk to adolescents about self-injury, assess an adolescent's stage of change for stopping self-injury, and provide brief interventions for adolescents who self-injure; and used SOARS to evaluate current NSSI with a greater proportion of adolescent patients. Qualitative feedback expressed positive perceptions, especially related to the virtual-reality role-play session. CONCLUSIONS Incorporating an interactive, human-guided virtual experience using role-playing and feedback with patient avatars represents a viable option comparable to using typical standardized patients to expand the scalability of NSSI trainings for pediatric residents, especially when they occur virtually.
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Affiliation(s)
- Lindsay A Taliaferro
- Department of Population Health Sciences, College of Medicine, University of Central Florida, Orlando, FL, USA
| | | | | | - Kate Ingraham
- College of Community Innovation and Education, University of Central Florida, Orlando, FL, USA
| | | | - Charles E Hughes
- Department of Computer Science, University of Central Florida, Orlando, FL, USA
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Hedén L, Jonsson LS, Fredlund C. The Connection Between Sex as Self-Injury and Sexual Violence. ARCHIVES OF SEXUAL BEHAVIOR 2023; 52:3531-3540. [PMID: 37640887 PMCID: PMC10703980 DOI: 10.1007/s10508-023-02669-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 07/11/2023] [Accepted: 07/17/2023] [Indexed: 08/31/2023]
Abstract
Nonsuicidal self-injury (NSSI) is a suggested diagnosis recognized by DSM-5 as in need of further research. Recent studies conclude that sex as self-injury (SASI) and NSSI share similar functions, such as being used as emotional regulation. SASI has been associated with earlier sexual abuse, but the understanding of the association between sexual violence and SASI is still limited. The aim of this study was to further investigate the connection between sexual violence and the experience of SASI. How could SASI be related to sexual violence? The study used a qualitative design and was based on an anonymous questionnaire published on the websites of Swedish NGOs, providing help and support to women and youths, such as those in women's shelters. In total, 139 informants with a mean age of 27.9 years (range 15-64 years) were included in the study. Three main themes were found: (1) Normalization of sexual violence and a shift in boundaries could be seen as consequences of earlier experiences of sexual violence leading to SASI; (2) SASI could escalate into sexual violence through increased need of emotional regulation, increased risk-taking, and risk of victimization; (3) SASI could be used to regain control of re-experiences, the body, sexuality, and shame after sexual abuse. In conclusion, a complex connection was identified whereby SASI could escalate into sexual violence, and earlier experiences of sexual violence could lead to SASI in a vicious loop. Hence, SASI should be seen as a risk factor for further victimization and sexual abuse.
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Affiliation(s)
- Ludwig Hedén
- Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden
| | - Linda S Jonsson
- Department of Social Sciences, Marie Cederschiöld University, Stockholm, Sweden
| | - Cecilia Fredlund
- Department of Psychiatry in Linköping, and Department of Biomedical and Clinical Sciences, Linköping University, SE-581 83, Linköping, Sweden.
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Gyori D, Farkas BF, Komaromy D, Horvath LO, Kollarovics N, Garas P, Balazs J. The Association between Nonsuicidal Self-Injury and Perfectionism in Adolescence: The Role of Mental Disorders. Eur J Investig Health Psychol Educ 2023; 13:2299-2327. [PMID: 37998053 PMCID: PMC10670610 DOI: 10.3390/ejihpe13110163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/14/2023] [Accepted: 10/18/2023] [Indexed: 11/25/2023] Open
Abstract
Previous evidence has drawn attention to the fact that maladaptive perfectionism is a risk factor for engagement in nonsuicidal self-injury (NSSI). Until now, few studies have examined this topic, especially among community adolescents. The aim of this study was to explore the relationship between perfectionism dimensions and NSSI functions to examine the potential mediating effect of mental disorders. Altogether, 146 Hungarian community adolescents (ages 13-18 years) were involved. All participants completed the Hungarian adaptation of the Inventory of Statements about Self-Injury (ISAS), the Frost Multidimensional Perfectionism Scale (FMPS), and the Mini International Neuropsychiatric Interview Kid. To analyse the interrelationships among NSSI, perfectionism, and mental disorders, we conducted regression and network analysis. Of the 146 adolescents, 90 (61.64%, girls: 71.11%) engaged in NSSI. The Concern over Mistakes and Doubts about Action scales of the FMPS significantly and positively predicted both NSSI intrapersonal and interpersonal motivation, with comparable effect sizes, and this association was fully mediated by anxiety disorders. There was a significant direct negative relationship between the FMPS Organisation dimension and both main NSSI functions. This study draws attention to an increasing trend and the extremely high NSSI prevalence rate among community adolescents. Adolescents with perfectionistic concerns are at heightened risk for anxiety disorders, which can increase their vulnerability to NSSI engagement.
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Affiliation(s)
- Dora Gyori
- Doctoral School of Psychology, Eotvos Lorand University, 1075 Budapest, Hungary
- Institute of Psychology, Eotvos Lorand University, 1075 Budapest, Hungary; (D.K.); (L.O.H.)
| | - Bernadett Frida Farkas
- Mental Health Sciences Doctoral School, Semmelweis University Doctoral School, 1083 Budapest, Hungary; (B.F.F.); (N.K.); (P.G.)
| | - Daniel Komaromy
- Institute of Psychology, Eotvos Lorand University, 1075 Budapest, Hungary; (D.K.); (L.O.H.)
- Department of Behavioural and Movement Sciences, Vrije Universiteit, 1081 HV Amsterdam, The Netherlands
| | - Lili Olga Horvath
- Institute of Psychology, Eotvos Lorand University, 1075 Budapest, Hungary; (D.K.); (L.O.H.)
- Pedagogical Services, 1141 Budapest, Hungary
| | - Nora Kollarovics
- Mental Health Sciences Doctoral School, Semmelweis University Doctoral School, 1083 Budapest, Hungary; (B.F.F.); (N.K.); (P.G.)
| | - Peter Garas
- Mental Health Sciences Doctoral School, Semmelweis University Doctoral School, 1083 Budapest, Hungary; (B.F.F.); (N.K.); (P.G.)
| | - Judit Balazs
- Institute of Psychology, Eotvos Lorand University, 1075 Budapest, Hungary; (D.K.); (L.O.H.)
- Department of Psychology, Oslo New University College, 0456 Oslo, Norway
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Lai J, Chen Z. The relationship between family cohesion and adaptability and non-suicidal self-injury behavior in ethnic minority adolescents: a moderating mediation model. Front Psychol 2023; 14:1206889. [PMID: 37928581 PMCID: PMC10625406 DOI: 10.3389/fpsyg.2023.1206889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2023] [Accepted: 09/13/2023] [Indexed: 11/07/2023] Open
Abstract
To explore the relationship between family cohesion and adaptability and non-suicidal self-injury behavior among ethnic minority adolescents, as well as the mediating effect of depression and the moderating effect of school connectedness, this study adopts the Family Adaptability and Cohesion Scale, the Non-Suicidal Self-Injury Behavior Questionnaire, the Center for Epidemiological Studies Depression Scale, and the School Connectedness Scale to collect behavioral data from 949 ethnic minority middle-school students. Descriptive statistical analysis and correlation analysis, as well as the mediating and moderating effects, were performed using SPSS 25.0 and the PROCESS macro program. We found that family cohesion and adaptability significantly and negatively predicted non-suicidal self-injury in ethnic minority adolescents (β = -0.28, p < 0.001); depression mediated the relationship between family cohesion and adaptability and non-suicidal self-injury in minority adolescents, with a confidence interval (mediating effect size -0.15, and a Bootstrap 95% CI) of [-0.19, -0.12]. School connectedness moderated the second half of the mediating effect (β = -0.08, p < 0.01).
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Affiliation(s)
- Junrong Lai
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Zhiyan Chen
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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De Luca L, Pastore M, Palladino BE, Reime B, Warth P, Menesini E. The development of Non-Suicidal Self-Injury (NSSI) during adolescence: A systematic review and Bayesian meta-analysis. J Affect Disord 2023; 339:648-659. [PMID: 37479039 DOI: 10.1016/j.jad.2023.07.091] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 06/07/2023] [Accepted: 07/16/2023] [Indexed: 07/23/2023]
Abstract
BACKGROUND Despite a surge in research on self-injury in the last decade, a summary of research findings about the development of Non-Suicidal Self-Injury (NSSI) over time in community youth samples is not yet present in the scientific literature. This study aims to summarize the empirical literature on this topic, examining both the occurrence (Study 1) and frequency (Study 2) of NSSI over time, and for this reason, a Systematic Review and Bayesian Meta-Analysis were conducted. METHODS Following the PRISMA guidelines, the longitudinal studies included in the systematic review consisted of 41 papers (Study 1 = 16; Study 2 = 25). Only studies with available data were included in the meta-analysis (Study 1 = 12; Study 2 = 11). RESULTS First, the findings highlight limits related to methodological aspects, the design of the studies, and the availability of data. Meta-analytic results shows that across development, the frequency (i.e., not the occurrence) of NSSI increases for the group of younger adolescents, remains stable in the group of middle adolescents, and it decreases for older adolescents. LIMITATIONS This study highlights some limitations that can be summarized in three different macro categories: the first refers to methodological aspects (e.g., the lifetime prevalence of NSSI), the second to the design of the studies (e.g., not homogeneous cohort; short-term covered), and the third to the availability of data. CONCLUSIONS The current meta-analysis tries to shed light on the longitudinal research on NSSI behavior and how this behavior develops in terms of both occurrence and frequency, providing practical and methodological indications for future research.
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Affiliation(s)
- Lisa De Luca
- Department of Education, Languages, Intercultures, Literatures and Psychology, University of Florence, Italy
| | - Massimiliano Pastore
- Department of Developmental and Socialization Psychology, University of Padua, Italy
| | | | - Birgit Reime
- Department of Health, Safety, and Society, Furtwangen University, Germany
| | - Patrick Warth
- Department of Health, Safety, and Society, Furtwangen University, Germany
| | - Ersilia Menesini
- Department of Education, Languages, Intercultures, Literatures and Psychology, University of Florence, Italy
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Geng S, Wang L, Sun J, Xu M, Zhang L, Yi Z, Ji J, Zhang X. Risk factors and protective factors for nonsuicidal self-injury in adolescents: A hospital- and school-based case-control study. Clin Child Psychol Psychiatry 2023; 28:1321-1332. [PMID: 37038624 DOI: 10.1177/13591045231169087] [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] [Indexed: 04/12/2023]
Abstract
OBJECTIVE Nonsuicidal Self-Injury (NSSI) in China has increasingly interested clinicians, although few studies have investigated its risk and protective factors. This study examined the risk factors of NSSI among Chinese adolescents. METHODS The researchers recruited adolescent participants with NSSI from a hospital outpatient clinic to form a case group and recruited adolescents without NSSI who provided informed consent from the school to form a control group. Participants completed a questionnaire, and data were analyzed using logistic regression. RESULTS A total of 138 cases and 276 controls participated in this study. Binary multivariate logistic regression analysis with adjusting for age and sex showed that domestic violence (OR = 8.615, 95%CI: 3.081-24.091), parental overconcern (OR = 6.995, 95%CI: 3.447-14.192), guilt (OR = 4.949, 95%CI: 2.227-10.996), and school bullying (OR = 21.676, 95%CI: 6.799-69.109) increased the risk of NSSI, while peer support (OR = 0.068, 95%CI: 0.030-0.150) and living in an urban environment (OR = 0.157, 95%CI: 0.056-0.437) decreased the risk of NSSI. CONCLUSION Some psychosocial factors were confirmed to be independent risk and protective factors for NSSI in this study. However, the clinical significance of the results needs to be interpreted with caution due to sample size limitations.
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Affiliation(s)
- Shuo Geng
- Department of Clinical Psychology, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lin Wang
- Sleep Medicine Center, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jinping Sun
- Department of Neurology, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Mingdong Xu
- Department of Clinical Psychology, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Li Zhang
- Department of Psychology, Qingdao University, Qingdao, China
| | - Zhi Yi
- Department of Pediatric Neurology, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jun Ji
- College of Computer Science and Technology, Qingdao University, Qingdao, China
| | - Xu Zhang
- Department of Clinical Psychology, the Affiliated Hospital of Qingdao University, Qingdao, China
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Wang Y, Zhou Y, Li G, Qin P, Wang J, Qi L, Li L, Wang Y, Wang J, Li J, Liang Z, Zhou Y. Executive functions in non-suicidal self-injury comorbid first-episode and drug-naïve depression among adolescents. Psychiatry Res 2023; 328:115476. [PMID: 37708804 DOI: 10.1016/j.psychres.2023.115476] [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: 01/05/2023] [Revised: 09/07/2023] [Accepted: 09/09/2023] [Indexed: 09/16/2023]
Abstract
Executive functions(EFs) may be associated with the emergence of non-suicidal self-injury(NSSI) due to their role as behavior controllers. EFs includes three core cognitive processes: inhibitory control, working memory, and cognitive flexibility(i.e. the ability to selectively alter cognitive strategies to generate appropriate behavior in the changing environment). This study aimed to systematically explore the three core EFs in depressed adolescents with NSSI. The data was obtained from the baseline data of the Chinese adolescent depression Cohort. The adolescents underwent cognitive assessments to yield domain-specific scores in EFs using the Digit Span Backward test(DSB), the Stroop Color-word interference test- color-word condition(Stroop-CW), and the Wisconsin Card Sorting tests(WCST). The significant differences in WCST scores were found between the NSSI group and the non-NSSI group. NSSI frequency was moderately positively correlated with total errors and negatively correlated with the number of categories completed. The number of categories completed in the "≥200″ NSSI frequency group was significantly lower than that in the "≤10″ NSSI group. The current findings suggested that depressed adolescents who had engaged in NSSI have poorer cognitive flexibility performance compared to adolescents without NSSI. As the frequency of NSSI increased, cognitive flexibility might become worse. These results provide evidence of a connection between executive dysfunctions and NSSI in depressed adolescents.
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Affiliation(s)
- Yanni Wang
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Yue Zhou
- School of Public Health, Lanzhou University, Lanzhou, China
| | - Guohua Li
- Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, China
| | - Peiwu Qin
- Tsinghua Shenzhen international graduate school, Shenzhen, China
| | - Jiesi Wang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Ling Qi
- School of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | - Linling Li
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Guangdong Provincial Key Laboratory of Biomedical Measurements and Ultrasound Imaging Shenzhen, China
| | - Yang Wang
- College of Management, Shenzhen University, Shenzhen, China
| | - Jianhong Wang
- Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, China
| | - Junchang Li
- Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, China
| | - Zhen Liang
- School of Biomedical Engineering, Health Science Center, Shenzhen University, Guangdong Provincial Key Laboratory of Biomedical Measurements and Ultrasound Imaging Shenzhen, China
| | - Yongjie Zhou
- Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, China.
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Trovini G, Amici E, Bauco P, Matrone M, Lombardozzi G, Giovanetti V, Kotzalidis GD, De Filippis S. A comprehensive evaluation of adverse childhood experiences, social-emotional impairments, and neurodevelopmental disorders in cannabis-use disorder: Implications for clinical practice. Eur Psychiatry 2023; 66:e77. [PMID: 37702087 PMCID: PMC10594251 DOI: 10.1192/j.eurpsy.2023.2436] [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: 04/12/2023] [Revised: 06/05/2023] [Accepted: 06/29/2023] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Adverse childhood experiences (ACEs), social-emotional impairments (SEIs), and neurodevelopmental disorders (NDs) are frequent in psychiatric disorders, including substance-use disorders. We aimed to determine the prevalence of ACE, SEI, or ND in individuals with cannabis-use disorder (CUD). We compared individuals with preCUD-onset ACE, SEI, or ND to those without. METHODS We crosssectionally studied 323 inpatients or outpatients with a history of past or current CUD, aged 12-35 years (mean age 22.94 ± 4.79), 64.5% of whom were male. The sample was divided into two groups: the non-premorbid (N = 52) and the premorbid ACE/SEI/ND group (N = 271). Within the premorbid group, further subgroups were based on ACEs, SEI, and NDs. We also analyzed other substance use and psychiatric symptoms/diagnoses based on the non-premorbid-premorbid dichotomy in the CUD sample. RESULTS Pre-CUD ACE-SEI-ND had higher prevalence of bipolar, schizoaffective, borderline personality, and attention-deficit/hyperactivity disorders, and a history of agitation, hallucinations, and self-injury. The ACE group had higher rates of agitation, depression, delusions, hallucinations, eating disorders, and use of cocaine, amphetamines, and hallucinogens than the SEI or ND. Patients in the premorbid group initiated cannabis use at an earlier age, experienced the first comorbid psychiatric episode earlier, and were hospitalized earlier than those in the non- premorbid ACE-SEI-ND group. CONCLUSIONS PreCUD-onset ACE, SEI, or ND conditions in individuals with CUDare linked to earlier onset of comorbid mental illness. Furthermore, ACEs contribute to significant and potentially severe clinical symptoms, as well as the use of substances other than cannabis.
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Affiliation(s)
| | | | - Piergiorgio Bauco
- Department of Psychiatry, Università Politecnica delle Marche, Ancona, Italy
| | | | | | | | - Georgios D. Kotzalidis
- Clinica Villa Von Siebenthal, Rome, Italy
- NESMOS Department, Sapienza University of Rome, Faculty of Medicine and Psychology, Rome, Italy
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Quitério A, Mendes Abreu J, Saura A, Borges MI, Corte Real A. A Case Report of Extreme Oral Lesions: A Rare Indicator of Bullying-Associated Non-suicidal Self-Injury. Cureus 2023; 15:e44713. [PMID: 37809120 PMCID: PMC10552680 DOI: 10.7759/cureus.44713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/04/2023] [Indexed: 10/10/2023] Open
Abstract
Bullying has reached epidemic proportions, affecting one in three students worldwide. A pervasive issue that carries profound physical, mental, and social consequences, significantly increasing the risk of non-suicidal self-injury (NSSI) and suicidal behaviors among those who experience this type of harassment and hazing. While physicians and most caregivers are fully aware and competent in identifying signs of self-harming behavior such as scratching, cutting, or burning the skin, oral self-injury is often overlooked as a potential indicator and is associated with unintentional soft tissue biting or specific conditions. We present a rare case of a 14-year-old male who sought medical attention due to severe bilateral tongue ulcers, leading to his admittance to the emergency department (ED) with excruciating pain and feeding difficulties. In the reported case, although the traumatic biting of the tongue emerged as the most probable etiological factor, a specific underlying motive and contextual comprehension were initially absent. It was only after successfully establishing a foundation of trust with the patient, enabling an honest response, that it became evident that the observed lesions represented a manifestation of bullying-induced non-suicidal self-injury. However, patients rarely openly acknowledge intentional self-inflicted lesions and/or their experiences of bullying, underscoring the necessity to maintain vigilance for alternative indicators such as behavioral changes or a noticeable decline in academic productivity. The significance of this case also goes beyond its presentation, highlighting the largely unexplored issue of how a patient's dentofacial features can serve as substantial catalysts for bullying. Therefore, it is only through equally prioritizing awareness of uncommon signs, symptoms, and context that one can expedite early diagnosis and intervention, emphasizing the essential need for comprehensive and timely management of such cases.
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Affiliation(s)
- Anabela Quitério
- Maxilofacial Surgery Department, Clinical and Academic Centre of Coimbra, Coimbra, PRT
| | - João Mendes Abreu
- Stomatology Department, Clinical and Academic Centre of Coimbra, Coimbra, PRT
- Faculty of Medicine, Clinical and Academic Centre of Coimbra, Coimbra, PRT
| | - André Saura
- Maxilofacial Surgery and Stomatology Department, Hospital Santo António - Centro Hospitalar Universitário do Porto, Porto, PRT
| | - Maria Inês Borges
- Stomatology Department, Clinical and Academic Centre of Coimbra, Coimbra, PRT
| | - Ana Corte Real
- Faculty of Medicine, Clinical and Academic Centre of Coimbra, Coimbra, PRT
- Forensic Dentistry Laboratory, University of Coimbra, Coimbra, PRT
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Muskens JB, Ester WA, Klip H, Zinkstok J, van Dongen-Boomsma M, Staal WG. Novel Insights into Somatic Comorbidities in Children and Adolescents Across Psychiatric Diagnoses: An Explorative Study. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01587-w. [PMID: 37656290 DOI: 10.1007/s10578-023-01587-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/08/2023] [Indexed: 09/02/2023]
Abstract
Many children with psychiatric disorders display somatic symptoms, although these are frequently overlooked. As somatic morbidity early in life negatively influences long-term outcomes, it is relevant to assess comorbidity. However, studies of simultaneous psychiatric and somatic assessment in children are lacking. The aim of this study was to assess the prevalence of somatic comorbidities in a clinical sample of children and adolescents with psychiatric disorders in a naturalistic design. Data were assessed from 276 children with various psychiatric disorders (neurodevelopmental disorders, affective disorders, eating disorders and psychosis) aged 6-18 years. These data were collected as part of routine clinical assessment, including physical examination and retrospectively analyzed. For a subsample (n = 97), blood testing on vitamin D3, lipid spectrum, glucose and prolactin was available. Results of this cross-sectional study revealed that food intake problems (43%) and insomnia (66%) were common. On physical examination, 20% of the children were overweight, 12% displayed obesity and 38% had minor physical anomalies. Blood testing (n = 97) highlighted vitamin D3 deficiency (< 50 nmol/L) in 73% of the children. None of the predefined variables (gender, age, medication and socioeconomic factors) contributed significantly to the prevalence of somatic comorbidities. The main somatic comorbidities in this broad child- and adolescent psychiatric population consisted of (1) problems associated with food intake, including obesity and vitamin D3 deficiency and (2) sleeping problems, mainly insomnia. Child and adolescent psychiatrists need to be aware of potential somatic comorbidities and may promote a healthy lifestyle.
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Affiliation(s)
- Jet B Muskens
- Karakter Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, The Netherlands.
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands.
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, The Netherlands.
| | - Wietske A Ester
- Sarr Autism Rotterdam, Youz Child and Adolescence Psychiatry, Dynamostraat 18, Rotterdam, 3083 AK, The Netherlands
- Parnassia Psychiatric Institute, Kiwistraat 30, The Hague, 2552 DH, The Netherlands
- Department of Child and Adolescent Psychiatry, Curium-LUMC, Leiden University Medical Center, Endegeesterstraatweg 27, Oegstgeest, 2342 AK, The Netherlands
| | - Helen Klip
- Karakter Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, The Netherlands
| | - Janneke Zinkstok
- Karakter Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, The Netherlands
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Martine van Dongen-Boomsma
- Karakter Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, The Netherlands
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - Wouter G Staal
- Karakter Child and Adolescent Psychiatry University Centre Nijmegen, Nijmegen, The Netherlands
- Department of Psychiatry, Radboud University Medical Centre, Nijmegen, The Netherlands
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboudumc, Nijmegen, The Netherlands
- Leiden Institute for Brain and Cognition, Leiden, The Netherlands
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Wang L, Zou H, Yang Y, Hong J. Adolescents' attitudes toward non-suicidal self-injury (NSSI) and their perspectives of barriers to seeking professional treatment for NSSI. Arch Psychiatr Nurs 2023; 45:26-35. [PMID: 37544699 DOI: 10.1016/j.apnu.2023.04.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/07/2023] [Accepted: 04/30/2023] [Indexed: 08/08/2023]
Abstract
PURPOSE This study aimed to investigate the attitudes of adolescents toward NSSI, and to explore their perspectives on barriers to seeking professional treatment for NSSI. METHODS A qualitative phenomenological design was used to conduct in-depth interviews with 17 adolescents with NSSI in a psychiatric hospital in Beijing, China. Data from the 17 adolescents were analyzed using Colaizzi's 7-step analysis. RESULTS Two themes were extracted: (1) attitudes toward NSSI (normal, effective, ignorant, disgraceful); (2) subjective/objective barriers to seeking professional treatment (negative attitudes toward NSSI, fear of being regarded as an attention getter, fear of interfering with personal relationships, fear of aggravating the family burden, fear of being criticized by parents, fear of ongoing hospitalization, fear of the side effects of medication, etc.). CONCLUSIONS It is suggested to strengthen the knowledge of NSSI among adolescents, families and society, formulate interventions suitable for Chinese sociocultural backgrounds, and cultivate the specialty literacy of mental health nurses and their abilities to identify the barriers, which are required for eliminating barriers to seeking professional treatment and establishing a system for seeking full coverage of professional treatment.
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Affiliation(s)
- Lu Wang
- School of Nursing, Anhui Medical University, Hefei 230032, Anhui Province, China
| | - Haiou Zou
- School of Nursing, Peking Union Medical College, Beijing 100144, China
| | - Yuan Yang
- Department of Nursing, Beijing An Ding Hospital, Beijing 100088, China
| | - Jingfang Hong
- School of Nursing, Anhui Medical University, Hefei 230032, Anhui Province, China.
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50
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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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