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Du Y, Liu J, Lin R, Chattun MR, Gong W, Hua L, Tang H, Han Y, Lu Q, Yao Z. The mediating role of family functioning between childhood trauma and depression severity in major depressive disorder and bipolar disorder. J Affect Disord 2024; 365:443-450. [PMID: 39187177 DOI: 10.1016/j.jad.2024.08.155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2024] [Revised: 08/18/2024] [Accepted: 08/23/2024] [Indexed: 08/28/2024]
Abstract
BACKGROUND Childhood trauma (CT) and family functioning exert significant influences on the course and long-term outcome of major depressive disorder (MDD) and bipolar disorder (BD) patients. Hence, we examined the intricate relationship between CT, family function, and the severity of depressive episodes in MDD and BD patients. METHODS 562 patients with depressive episodes (336 MDD and 226 BD) and 204 healthy controls (HCs) were included in this retrospective study. The 17-item Hamilton Depression Rating Scale (HAMD-17), Childhood Trauma Questionnaire (CTQ), and Family Adaptability and Cohesion Evaluation Scale (FACES II-CV) were assessed. Pearson correlation analysis and mediation analysis were performed. RESULTS CT had both a direct and indirect impact on depression severity in MDD and BD groups. In MDD, family adaptability mediated the impact of all CT subtypes on depression severity (Effect = 0.113, [0.030, 0.208]). In BD, family cohesion played a mediating role between emotional neglect (EN) and HAMD-17 scores (Effect = 0.169, [0.008, 0.344]). Notable differences were observed in onset age, illness duration, episode frequency, family history, and CT subtypes between MDD and BD (P < 0.05). LIMITATIONS This study has several limitations including recall bias, lack of objective family functioning measures, small sample size, and cross-sectional design. CONCLUSIONS Family functioning mediated the impact of CT on depressive symptoms severity in MDD and BD patients. MDD patients with a history of CT exhibited reduced family adaptability, while BD patients with a history of EN had weaker familial emotional bonds. Our findings highlighted the importance of family-focused preventive interventions in mitigating the long-term effects of CT.
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Affiliation(s)
- Yishan Du
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Jiayu Liu
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Ran Lin
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Mohammad Ridwan Chattun
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Wenyue Gong
- Nanjing Brain Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Nanjing 210029, China
| | - Lingling Hua
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Hao Tang
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China
| | - Yinglin Han
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China.
| | - Qing Lu
- School of Biological Sciences & Medical Engineering, Southeast University, Nanjing 210029, China; Child Development and Learning Science, Key Laboratory of Ministry of Education, Southeast University, Nanjing 210029, China.
| | - Zhijian Yao
- Department of Psychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing 210029, China; School of Biological Sciences & Medical Engineering, Southeast University, Nanjing 210029, China; Nanjing Brain Hospital, Clinical Teaching Hospital of Medical School, Nanjing University, Nanjing 210029, China.
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Wang L, Zou HO, Liu J, Hong JF. Prevalence of Adverse Childhood Experiences and Their Associations with Non-Suicidal Self-Injury Among Chinese Adolescents with Depression. Child Psychiatry Hum Dev 2024; 55:1441-1451. [PMID: 36811752 DOI: 10.1007/s10578-023-01508-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/09/2023] [Indexed: 02/24/2023]
Abstract
The presence of adverse childhood experiences (ACEs) in adolescents diagnosed with depression has been associated with an extensive range of mental health issues, including non-suicidal self-injury (NSSI). However, there has been a dearth of research into the prevalence of ACEs and their associations with NSSI among depressed adolescent populations in China. This study aimed to investigate the prevalence of different types of ACEs and their associations with NSSI in depressed Chinese adolescents. Utilizing Chi-squared tests, latent class analysis (LCA), and multinomial logistic regression, the prevalence of different types of ACEs and their associations with NSSI were determined in a sample of 562 adolescents with depression. Among depressed adolescents. 92.9% of depressed adolescents reported ACEs, and the prevalence of emotional neglect, physical abuse, caregiver treated violently, and bullying was relatively high. ACEs, including sexual abuse (OR = 5.645), physical abuse (OR = 3.603), emotional neglect (OR = 3.096), emotional abuse (OR = 2.701), caregiver divorce/family separation (OR = 2.5), caregiver treated violently (OR = 2.221), and caregiver substance abuser (OR = 2.117), were associated with increased odds of exposure among depressed adolescents with NSSI. The high ACEs class (19%), the moderate ACEs class (40%), and the low ACEs class (41%) were identified as latent classes. NSSI was more prevalent in the high/moderate ACEs class compared to the low ACEs class, particularly in the high ACEs class. The situation of the prevalence of ACEs among adolescents with depression was unsatisfactory, and certain types of ACEs were associated with NSSI. Eliminating potential risk factors for NSSI requires the early prevention and targeted intervention of ACEs. Moreover, additional large-scale longitudinal studies are necessary to assess the different development trajectories associated with ACEs, such as the relationships between the different development periods of ACEs and NSSI, and to ensure the adoption of evidence-based prevention and intervention strategies.
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Affiliation(s)
- Lu Wang
- School of Nursing, Anhui Medical University, No. 81 Mei Shan Road, Shu Shan District, He Fei, 230032, Anhui Province, China
| | - Hai-Ou Zou
- School of Nursing, Peking Union Medical College, No. 33 Ba Da Chu Road, Shi Jing Shan District, 100144, Beijing, China
| | - Jun Liu
- Department of Nursing, Beijing Anding Hospital, Capital Medical University, No. 5 An Kang Hutong, Xi Cheng District, 100088, Beijing, China
| | - Jing-Fang Hong
- School of Nursing, Anhui Medical University, No. 81 Mei Shan Road, Shu Shan District, He Fei, 230032, Anhui Province, China.
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Chu M, Lee CY, Huang S, Zhang X, Wang L, Chen T, Chiang YC. Improving responsible Media Reporting on Student Suicide to Reduce Negative Public Opinion: Text Mining Based on Sina Weibo in China. OMEGA-JOURNAL OF DEATH AND DYING 2024:302228241240945. [PMID: 39049160 DOI: 10.1177/00302228241240945] [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: 07/27/2024]
Abstract
The aims of this study were to explore whether student suicide reporting is consistent with media recommendations for suicide reporting; analyze public opinion and sentiments toward student suicide reports. A keyword search was performed on the WeiboReach platform. This study included 113 student suicide report posts and 176,262 readers' comments on suicide news reports. Hierarchical generalized linear modeling was used to analyze the relationships between adherence to reporting recommendations and negative emotions in readers' comments. None of the media reporting of student suicide was consistent with all of the media recommendations for suicide reporting. Netizens were less likely to post negative comments when the reports describe the suicide method used (OR 1.169, 95% CI 1.022∼1.337), and not specifying the cause of suicide was a protective factor for public negative emotion (OR 0.799, 95% CI 0.707, 0.905). The findings suggest improving responsible media reporting on student suicide to reduce negative public emotion.
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Affiliation(s)
- Meijie Chu
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University, Xiamen, China
| | - Chun-Yang Lee
- School of International Business, China Merchants, Economic and Technological Development Zone, Xiamen University Tan Kah Kee College, Zhangzhou, China
| | - Shiling Huang
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University, Xiamen, China
| | - Xiaoke Zhang
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University, Xiamen, China
- MSD R&D (China) Co., Ltd., China
| | - Lijie Wang
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University, Xiamen, China
| | - Tianmu Chen
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University, Xiamen, China
| | - Yi-Chen Chiang
- State Key Laboratory of Vaccines for Infectious Diseases, Xiang An Biomedicine Laboratory, State Key Laboratory of Molecular Vaccinology and Molecular Diagnostics, National Innovation Platform for Industry-Education Integration in Vaccine Research, School of Public Health, Xiamen University, Xiamen, China
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Liu Y, Fang Y, Chen Y, Qin F, Li X, Feng R, Luo X, Wen J, Chen Y, Teng Z, Zeng Y. Relationship between childhood trauma and non-suicidal self-injury in high school students: the mediating role of the stress perception and the moderating role of teacher-student relationship. BMC Psychol 2024; 12:379. [PMID: 38978110 PMCID: PMC11232308 DOI: 10.1186/s40359-024-01883-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 07/02/2024] [Indexed: 07/10/2024] Open
Abstract
This study delves into the correlation between childhood trauma and non-suicidal self-injury (NSSI) behaviors among high school students. Additionally, it examines the mediating role of stress perception and the moderating role of the teacher-student relationship in this association. A questionnaire survey was administered to 1,329 high school students in Yunnan Province to assess childhood trauma, NSSI behaviors, and stress perception. Firstly, the survey revealed a 12% prevalence of NSSI, with girls exhibiting a higher occurrence compared to boys (OR = 0.413, 95% CI: 0.280-0.609). Secondly, childhood trauma emerged as a significant predictor of NSSI behavior, irrespective of gender or whether the individual was an only child (r = 0.17, P < 0.01). Thirdly, stress perception functioned as a mediator in the relationship between childhood trauma and NSSI among high school students (t = 4.65, P < 0.01). The mediation effect occupies 26.56% of the total effect. Furthermore, the teacher-student relationship moderated the mediating effect of stress perception on the link between childhood trauma and NSSI (β = 0.0736, P < 0.01). Notably, individuals with strong teacher-student relationships exhibited a significant elevation in stress perception upon exposure to childhood trauma. The findings of this study support a moderated mediation model in the association between childhood trauma and NSSI, suggesting profound implications for the development of targeted interventions and prevention strategies among high school students.
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Affiliation(s)
- Yilin Liu
- The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Yuan Fang
- The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Yuanling Chen
- School of Public Health and Health Management, Qujing Medical College, Qujing, Yunnan, China
| | - Fuyi Qin
- The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Xinrui Li
- The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Ruibin Feng
- The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Xinyu Luo
- The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Jia Wen
- The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Yatang Chen
- Central Laboratory, Chongqing University Central Hospital, Chongqing, China
| | - Zhaowei Teng
- The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China.
| | - Yong Zeng
- The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China.
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Ayhan F. The Association Between Witnessing Interparental Violence and Adolescents' Anger Expression Styles. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:1649-1675. [PMID: 37919952 DOI: 10.1177/08862605231209993] [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: 11/04/2023]
Abstract
The purpose of this research was to determine the association between witnessing interparental violence and anger expression styles in adolescents. Previous studies have generally focused on the attitudes to violence of individuals witnessing it. However, the present research specifically investigated the association between witnessing interparental violence and anger. The research was performed as a descriptive and correlational study. The research sample consisted of 1,000 adolescents aged 15 to 19 contacted via social media platforms using the convenience sample method. An online data collection form containing questions was prepared to determine adolescents' sociodemographic characteristics and contained questions from the Witnessing Interparental Violence Scale and Trait Anger Expression Inventory. Statistical analysis was performed on SPSS 21.0 software. In all, 446 (44.6%) adolescents had witnessed interparental violence. Trait, externalized, and internalized anger scores were higher among adolescents who had witnessed interparental violence compared to those who had not. This research shows that witnessing interparental violence has significant effects on the individual's trait anger and anger expression styles. We recommend that the effects of exposure to violence and witnessing interparental violence be compared and that witnessing violence in different cultural environments be evaluated in future studies.
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Affiliation(s)
- Fatma Ayhan
- Division of Psychiatric Nursing, Department of Nursing, Faculty of Health Science, Batman University, Batman, Türkiye
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Moon DS, Chung US, Kwack YS, Kim BN, Kang NR. Analyzing Co-Occurrence of Non-Suicidal Self-Injury With Suicidal Ideation and Related Factors Among Adolescents in Jeju Island. Soa Chongsonyon Chongsin Uihak 2024; 35:119-126. [PMID: 38601107 PMCID: PMC11001503 DOI: 10.5765/jkacap.230054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 09/26/2023] [Accepted: 12/13/2023] [Indexed: 04/12/2024] Open
Abstract
Objectives Non-suicidal self-injury (NSSI) and suicidal behavior, including suicidal ideation (SI) and suicide attempts, are important predictors of suicide in adolescents. This study aimed to investigate the associations between NSSI, SI, NSSI+SI, mental health problems, and family factors in Korean adolescents in Jeju Island, with an emphasis on key findings. Methods A total of 561 adolescents completed self-report questionnaires regarding demographics, NSSI, SI, suicidal behavior, perceived family functioning, and mental health problems, which were assessed using Center for Epidemiological Studies Depression Scale for Children, Screen for Children Anxiety-Related Disorders (SCARED), and Youth Self-Report (YSR). Data were analyzed using descriptive statistics, one-way analysis of variance, chi-square test, post-hoc analyses, and multivariate logistic regression. Results In this study, 22.3% of adolescents reported either NSSI or SI, with 5.5% reporting NSSI and 20.7% reporting SI. Combined (NSSI+SI) group showed a significantly higher SCARED score, anxiety/depression, thought problems, attention problem, and rule breaking on YSR than did the SI only group. Higher level of depression and anxiety were significantly associated with NSSI and SI. Female sex and perceived family dissatisfaction were significantly associated factors for SI, but not for NSSI in multivariate logistic regression. Conclusion This study provides insights into the clinical characteristics and associated factors among adolescents with NSSI, SI, and NSSI+SI in Jeju Island. Identifying these results can inform the development of targeted prevention and intervention strategies to mitigate the negative consequences of these behaviors and contribute to a better understanding of the role of family in this context.
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Affiliation(s)
- Duk-Soo Moon
- Department of Psychiatry, Jeju National University Hospital, Jeju, Korea
- Department of Psychiatry, Jeju National University School of Medicine, Jeju, Korea
| | - Un-Sun Chung
- Department of Psychiatry, Kyungpook National University Children’s Hospital, Daegu, Korea
| | - Young Sook Kwack
- Mental Health Research Institute, National Center for Mental Health, Seoul, Korea
| | - Bung-Nyun Kim
- Department of Psychiatry, Seoul National University School of Medicine, Seoul, Korea
| | - Na Ri Kang
- Department of Psychiatry, Jeju National University Hospital, Jeju, Korea
- Department of Psychiatry, Jeju National University School of Medicine, Jeju, Korea
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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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Zhou HY, Luo YH, Shi LJ, Gong J. Exploring psychological and psychosocial correlates of non-suicidal self-injury and suicide in college students using network analysis. J Affect Disord 2023:S0165-0327(23)00734-6. [PMID: 37257782 DOI: 10.1016/j.jad.2023.05.089] [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: 03/07/2023] [Revised: 05/23/2023] [Accepted: 05/24/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) and suicide are a serious health concern in young people. Remarkable progress has been made in understanding the correlates and risk factors for suicidality. However, it remains unclear the complex interplay between different factors and which factors are most saliently associated with NSSI and suicide risk and should be targeted for interventions. METHODS This study utilized network analysis to examine the interrelationship between NSSI, suicide and a variety of psychological (e.g., depression, psychotic-like experiences) and psychosocial (e.g., childhood maltreatment, family dysfunction, being bullied and social support) correlates in a sample of Chinese first year college students (n = 2328). RESULTS The severity of depressive symptoms was the only factor connected to both NSSI and suicide. Other psychiatric factors like psychotic experiences could only act in an indirect way via the bridging effect of depression. Emotional abuse, compared with other forms of childhood adversities, was found to be the most influential maltreatment form associated with suicidal ideation and attempts. Finally, social support showed the potential to lower the risk of self-injury and suicide in young people. LIMITATIONS Only a subset of risk and resilience factors of NSSI and suicide were included. Causal inference was impossible due to the cross-sectional design. CONCLUSIONS Our findings highlighted the importance of identifying risk groups with mental illnesses or negative childhood events, and providing additional support during the key time of transitioning into higher education.
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Affiliation(s)
- Han-Yu Zhou
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai, China; Shanghai Changning Mental Health Centre, Shanghai, China
| | - Yan-Hong Luo
- Department of Applied Psychology, Hunan university of Chinese medicine, Changsha, Hunan, China
| | - Li-Juan Shi
- School of Education, Hunan University of Science and Technology, Xiangtan, Hunan, China
| | - Jingbo Gong
- Shanghai Changning Mental Health Centre, Shanghai, China.
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Guo Z, Liu Y, Wang C, Li S, Yu L, Wu W, You X, Zhang Y, Teng Z, Zeng Y. Exploring the association of addiction-related genetic factors with non-suicidal self-injury in adolescents. Front Psychiatry 2023; 14:1126615. [PMID: 37065902 PMCID: PMC10102595 DOI: 10.3389/fpsyt.2023.1126615] [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: 12/18/2022] [Accepted: 03/08/2023] [Indexed: 04/18/2023] Open
Abstract
Background Non-suicidal self-injury (NSSI) is self-injurious behavior without suicidal intent commonly seen in the adolescent population and poses a serious threat to the life safety of adolescents. Related researches suggest a possible correlation between addiction and the occurrence of NSSI. This study aimed to explore the correlation between addiction and NSSI from a molecular biological perspective by analyzing the differential expression of addiction-related genes in NSSI patients. Methods (1) The association between addiction and non-suicidal self-injury in a Chinese adolescent population was verified with the help of questionnaires on substance and non-substance addictions and non-suicidal self-injury among 1,329 adolescents in China, (2) Screening for key genes associated with addiction by bioinformatics analysis, and (3) RT-qPCR experiment was performed to validate key genes and Receiver Operating Characteristic curves were plotted for target genes. Results (1) Substance and non-substance addictions were all significantly correlated with non-suicidal self-injury, (2) Four target genes: SERPINA3, SLC14A1, RPS6 and RPS3A were screened by bioinformatics technique, and (3) Relative quantitative analysis by RT-qPCR revealed that the expression levels of SLC14A1 (p < 0.01), RPS6 (p < 0.05) and RPS3A (p < 0.01) were significantly higher in NSSI patients than in healthy controls. Conclusion (1) The significant association between addiction and NSSI exists in the Chinese adolescent population and (2) Addiction-related genes SLC14A1, RPS6, and RPS3A are differentially expressed in adolescents with NSSI. The genes have the potential to become biological markers for the diagnosis of NSSI.
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Affiliation(s)
- Zhichao Guo
- The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yilin Liu
- The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Chengjuan Wang
- The Third Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Shujun Li
- The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Lei Yu
- The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Wenzhi Wu
- The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Xu You
- Honghe Second People's Hospital, Honghe, China
| | | | - Zhaowei Teng
- The Second Affiliated Hospital of Kunming Medical University, Kunming, China
| | - Yong Zeng
- The Second Affiliated Hospital of Kunming Medical University, Kunming, China
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Yu L, Zhao J, Zhao T, Xiao Y, Ou Q, He J, Luo J, Zhong Y, Cen Y, Luo W, Yang J, Deng Y, Zhang J, Luo J. Multicenter analysis on the non-suicidal self-injury behaviors and related influencing factors-A case study of left-behind children in northeastern Sichuan. J Affect Disord 2023; 320:161-168. [PMID: 36162662 DOI: 10.1016/j.jad.2022.09.081] [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: 12/12/2021] [Revised: 08/29/2022] [Accepted: 09/20/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Few studies have been conducted focusing on the non-suicidal self-injury (NSSI) incidence rate and influencing factors among left-behind children in northeastern Sichuan, China. In this study, we investigated the incidence rate of the NSSI behaviors, levels of anxiety and depression in left-behind children in northeastern Sichuan, and relevant sociodemographic factors. METHODS The NSSI behaviors were identified using the Ottawa Self-injury Inventory (Chinese version). Its incidence rate and related influencing factors were evaluated by Cluster sampling; the Depression Anxiety Stress Scale-21 Items (DASS-21) was adopted to assess the levels of anxiety, depression, and stress. RESULTS A total of 9450 adolescents met the inclusion criteria, including 543 with NSSI behaviors, and the prevalence of NSSI was 5.7 %. There were 3596 left-behind children, and 243 of them had NSSI behaviors, the NSSI incidence in left-behind children was 6.8 %. There were 5854 non-left-behind children, and the NSSI incidence in non-left-behind children was 5.1 %. Left-behind children's NSSI behaviors were remarkably correlated with five risk factors: being female (OR = 2.411, 95%CI = 1.773-3.279), parents' divorce (OR = 1.742, 95%CI = 1.262-2.404), elder age (OR = 1.120, 95%CI = 1.028-1.219), severe depression (OR = 1.212, 95%CI = 1.148-1.281), and high anxiety (OR = 1.170, 95%CI = 1.093-1.251). LIMITATIONS This is a cross-sectional study, we cannot probe into the causality between NSSI behaviors and corresponding risk factors. Reporting and recalling biases may be unavoidable as questionnaires are performed by self-rating scales and retrospective reports. CONCLUSION The NSSI behaviors are common in left-behind children in northeastern Sichuan. This study proposes that prevention and intervention measures are necessary for the healthy growth of such children.
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Affiliation(s)
- Ling Yu
- Mental Health Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, China; School of Psychiatry, North Sichuan Medical College, Nanchong, China; Department of Psychiatry, Nanchong Psychosomatic Hospital, Nanchong, China
| | - Jiayu Zhao
- Department of Neurology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Ting Zhao
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Yun Xiao
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Qin Ou
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - JinLong He
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Jing Luo
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Yunling Zhong
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Yu Cen
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Wenxiu Luo
- Mental Health Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, China; School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - JiaMing Yang
- Department of Neurology, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
| | - Ya Deng
- Department of Basic Medicine, Dazhou Vocational College of Chinese Medicine, Dazhou, China
| | - Jiazhu Zhang
- Nanyang Centre for Public Administration, Nanyang Technological University, Singapore
| | - Jiaming Luo
- Mental Health Center, Affiliated Hospital of North Sichuan Medical College, Nanchong, China; School of Psychiatry, North Sichuan Medical College, Nanchong, China.
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11
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Patra BN, Sen MS, Sagar R, Bhargava R. Deliberate self-harm in adolescents: A review of literature. Ind Psychiatry J 2023; 32:9-14. [PMID: 37274564 PMCID: PMC10236686 DOI: 10.4103/ipj.ipj_215_21] [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: 10/14/2021] [Revised: 01/11/2022] [Accepted: 01/17/2022] [Indexed: 11/11/2022] Open
Abstract
Deliberate self-harm is a rising epidemic in the youth. This review examined the different self-harm behavior, approach to treatment, and the implication of such behaviors in the adolescent population in the academic literature. Using the PubMed database, we searched for specific terms related to different self-harm behaviors in Adolescents. The bibliography of the articles found relevant for the review was also screened. Each study's findings were taken with reference to our topic and findings were summarized. After reviewing the literature, we found that the prevalence of suicidal attempts was as high as 18% in the past year While the nonsuicidal attempts were as high as 31%. Risk factors associated with higher levels of suicide were bullying, loneliness and anxiety, tobacco and alcohol use, and weak family and social relationships. While the factors playing a protective role are being connected to school, having good social support, and attending school. There are very few studies focused on interventions related to suicide prevention in Adolescent and postvention programs. Out of the evidence available, the interventions are not focused on the target individuals and lack replicability. Self-harm is a major public health concern which needs to be understood holistically. The interventions aimed at preventing and managing self-harm behavior still need to be more targeted and precise. Other targets may include interventions suited to different phases of development, stopping the progression of the behavior to adulthood, including the varied population in such intervention, etc.
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Affiliation(s)
- Bichitra Nanda Patra
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Mahadev Singh Sen
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Rajesh Sagar
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Rachna Bhargava
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
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12
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Yang M, Sheng X, Ge M, Zhang L, Huang C, Cui S, Yuan Q, Ye M, Zhou R, Cao P, Peng R, Zhou X, Zhang K. Childhood trauma and psychological sub-health among Chinese adolescents: the mediating effect of Internet addiction. BMC Psychiatry 2022; 22:762. [PMID: 36471293 PMCID: PMC9721004 DOI: 10.1186/s12888-022-04384-2] [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: 07/26/2022] [Accepted: 11/11/2022] [Indexed: 12/09/2022] Open
Abstract
BACKGROUND The factors related to psychological sub-health (PSH) have been widely described, but the research on the mechanism behind the complex relationship between childhood trauma and PSH is limited. This study investigated the current situation and risk factors of PSH among Chinese adolescents. And further, explore whether Internet addiction (IA) plays a potential mediating effect in childhood trauma and PSH. METHODS The study was conducted in October 2020 in Anhui Province, China. The PSH state of 866 adolescents was investigated, including demographic information such as gender, age, and grade. Childhood trauma, IA, and PSH were measured by the Childhood Trauma Questionnaire Short Form (CTQ-SF), Young's Internet Addiction Test (IAT), and the Multidimensional Sub-health Questionnaire of Adolescents (MSQA). The mediating effect is further verified by the structural equation model (SEM). RESULTS In this study, 866 adolescents were selected as subjects, and the proportion of male and female is roughly equal. The prevalence of PSH in adolescents was 25.8%, and left-behind children, boarding, or adolescents who have had non-suicidal self-injury (NSSI) are more likely to have PSH. Through the mediation test, the direct effect of childhood trauma on PSH was 0.23 (95% CI [4.91,9.00],p <0.001), and the mediating effect of IA on childhood trauma and PSH was 0.07 (95% CI [1.42, 3.32],p <0.001). and the proportion of them is 75.14% and 24.86% respectively. CONCLUSIONS Childhood trauma has direct and indirect effects on PSH, and IA plays a mediating effect in the indirect effect. Therefore, clarifying these relationships helps formulate and implement effective interventions to improve psychological health (PH) in Chinese adolescents.
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Affiliation(s)
- Meng Yang
- grid.186775.a0000 0000 9490 772XSchool of Mental Health and Psychological Sciences, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032 Anhui China ,grid.186775.a0000 0000 9490 772XDepartment of Psychiatry, Chaohu Hospital, Anhui Medical University, No. 64 Chaohubei Road, Hefei, 238006 Anhui China ,grid.186775.a0000 0000 9490 772XAnhui Psychiatric Center, Anhui Medical University, No. 64 Chaohubei Road, Hefei, 238006 Anhui China
| | - Xuanlian Sheng
- grid.186775.a0000 0000 9490 772XSchool of Mental Health and Psychological Sciences, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032 Anhui China ,grid.186775.a0000 0000 9490 772XDepartment of Psychiatry, Chaohu Hospital, Anhui Medical University, No. 64 Chaohubei Road, Hefei, 238006 Anhui China ,grid.186775.a0000 0000 9490 772XAnhui Psychiatric Center, Anhui Medical University, No. 64 Chaohubei Road, Hefei, 238006 Anhui China
| | - Menglin Ge
- grid.186775.a0000 0000 9490 772XSchool of Mental Health and Psychological Sciences, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032 Anhui China ,grid.186775.a0000 0000 9490 772XDepartment of Psychiatry, Chaohu Hospital, Anhui Medical University, No. 64 Chaohubei Road, Hefei, 238006 Anhui China ,grid.186775.a0000 0000 9490 772XAnhui Psychiatric Center, Anhui Medical University, No. 64 Chaohubei Road, Hefei, 238006 Anhui China
| | - Ling Zhang
- grid.186775.a0000 0000 9490 772XDepartment of Psychiatry, Chaohu Hospital, Anhui Medical University, No. 64 Chaohubei Road, Hefei, 238006 Anhui China ,grid.186775.a0000 0000 9490 772XAnhui Psychiatric Center, Anhui Medical University, No. 64 Chaohubei Road, Hefei, 238006 Anhui China
| | - Cui Huang
- grid.186775.a0000 0000 9490 772XSchool of Mental Health and Psychological Sciences, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032 Anhui China ,grid.186775.a0000 0000 9490 772XDepartment of Psychiatry, Chaohu Hospital, Anhui Medical University, No. 64 Chaohubei Road, Hefei, 238006 Anhui China ,grid.186775.a0000 0000 9490 772XAnhui Psychiatric Center, Anhui Medical University, No. 64 Chaohubei Road, Hefei, 238006 Anhui China
| | - Shu Cui
- grid.186775.a0000 0000 9490 772XSchool of Mental Health and Psychological Sciences, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032 Anhui China ,grid.186775.a0000 0000 9490 772XDepartment of Psychiatry, Chaohu Hospital, Anhui Medical University, No. 64 Chaohubei Road, Hefei, 238006 Anhui China ,grid.186775.a0000 0000 9490 772XAnhui Psychiatric Center, Anhui Medical University, No. 64 Chaohubei Road, Hefei, 238006 Anhui China
| | - Qiuyu Yuan
- grid.186775.a0000 0000 9490 772XSchool of Mental Health and Psychological Sciences, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032 Anhui China ,grid.186775.a0000 0000 9490 772XDepartment of Psychiatry, Chaohu Hospital, Anhui Medical University, No. 64 Chaohubei Road, Hefei, 238006 Anhui China ,grid.186775.a0000 0000 9490 772XAnhui Psychiatric Center, Anhui Medical University, No. 64 Chaohubei Road, Hefei, 238006 Anhui China
| | - Mengting Ye
- grid.186775.a0000 0000 9490 772XSchool of Mental Health and Psychological Sciences, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032 Anhui China ,grid.186775.a0000 0000 9490 772XDepartment of Psychiatry, Chaohu Hospital, Anhui Medical University, No. 64 Chaohubei Road, Hefei, 238006 Anhui China ,grid.186775.a0000 0000 9490 772XAnhui Psychiatric Center, Anhui Medical University, No. 64 Chaohubei Road, Hefei, 238006 Anhui China
| | - Ruochen Zhou
- grid.186775.a0000 0000 9490 772XSchool of Mental Health and Psychological Sciences, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032 Anhui China ,grid.186775.a0000 0000 9490 772XDepartment of Psychiatry, Chaohu Hospital, Anhui Medical University, No. 64 Chaohubei Road, Hefei, 238006 Anhui China ,grid.186775.a0000 0000 9490 772XAnhui Psychiatric Center, Anhui Medical University, No. 64 Chaohubei Road, Hefei, 238006 Anhui China
| | - Panpan Cao
- grid.186775.a0000 0000 9490 772XSchool of Mental Health and Psychological Sciences, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032 Anhui China ,grid.186775.a0000 0000 9490 772XDepartment of Psychiatry, Chaohu Hospital, Anhui Medical University, No. 64 Chaohubei Road, Hefei, 238006 Anhui China ,grid.186775.a0000 0000 9490 772XAnhui Psychiatric Center, Anhui Medical University, No. 64 Chaohubei Road, Hefei, 238006 Anhui China
| | - Ran Peng
- grid.186775.a0000 0000 9490 772XSchool of Mental Health and Psychological Sciences, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032 Anhui China ,grid.186775.a0000 0000 9490 772XDepartment of Psychiatry, Chaohu Hospital, Anhui Medical University, No. 64 Chaohubei Road, Hefei, 238006 Anhui China ,grid.186775.a0000 0000 9490 772XAnhui Psychiatric Center, Anhui Medical University, No. 64 Chaohubei Road, Hefei, 238006 Anhui China
| | - Xiaoqin Zhou
- School of Mental Health and Psychological Sciences, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China. .,Department of Psychiatry, Chaohu Hospital, Anhui Medical University, No. 64 Chaohubei Road, Hefei, 238006, Anhui, China. .,Anhui Psychiatric Center, Anhui Medical University, No. 64 Chaohubei Road, Hefei, 238006, Anhui, China.
| | - Kai Zhang
- School of Mental Health and Psychological Sciences, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China. .,Department of Psychiatry, Chaohu Hospital, Anhui Medical University, No. 64 Chaohubei Road, Hefei, 238006, Anhui, China. .,Anhui Psychiatric Center, Anhui Medical University, No. 64 Chaohubei Road, Hefei, 238006, Anhui, China.
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13
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Lan Z, Pau K, Yusof HM, Zhao Q, Liang F, Huang X. Influence of adolescents’ tendency to catastrophise on non-suicidal self-injury behaviour: A moderated mediation model. Front Psychol 2022; 13:936286. [DOI: 10.3389/fpsyg.2022.936286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Accepted: 10/26/2022] [Indexed: 11/18/2022] Open
Abstract
Adolescence is the peak period of non-suicidal self-injury (NSSI) behaviour, and it is also a period when the prevention and intervention in NSSI are frequently required. To explore the relationship between catastrophising and NSSI and its mechanism, the mediating effects of parental support and negative emotions on catastrophising and NSSI were analysed. A questionnaire was administered to 401 middle school students with a history of NSSI behaviour from 12 schools in Guangxi. (1) Adolescents’ catastrophising tendencies positively predicted their NSSI status through negative emotions (B = 0.274, P < 0.001). The more severe the adolescents’ catastrophising tendency, the more likely they were to have stronger negative emotions and thus show an increased NSSI level. (2) Parental support played a positive moderating role between the tendency to catastrophise and negative emotions (B = −0.101, t = −2.694, P < 0.01), and it had a protective effect on adolescents’ NSSI. Catastrophising was less likely to induce the NSSI behaviour by reducing adolescents’ negative emotions (B = −0.104, t = −2.313, P < 0.05); however, it should be noted that only parental affective support, informative support, and instrumental support played a significant mediating role. Parental support of adolescents has positive effects on the tendency to catastrophise, negative emotions, and NSSI, and it has some implications for the prevention and intervention of adolescents’ NSSI.
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14
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Xiao Q, Song X, Huang L, Hou D, Huang X. Global prevalence and characteristics of non-suicidal self-injury between 2010 and 2021 among a non-clinical sample of adolescents: A meta-analysis. Front Psychiatry 2022; 13:912441. [PMID: 36032224 PMCID: PMC9399519 DOI: 10.3389/fpsyt.2022.912441] [Citation(s) in RCA: 38] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Adolescents with immature mind and unstable emotional control are high-risk groups of non-suicidal self-injury (NSSI) behavior. We meta-analyzed the global prevalence of NSSI and prevalence of NSSI characteristics in a non-clinical sample of adolescents between 2010 and 2021. Methods A systematic search for relevant articles published from January 1, 2010 to June 30, 2021 was performed within the scholarly database search engines of CBM, CNKI, VIP, Wanfang, PubMed, Web of Science, PsycINFO, and Embase. Eligibility criteria were as follows: provided cross-sectional data on the prevalence of NSSI; the subjects were non-clinical sample adolescents; and a clear definition of NSSI was reported. We used the following definiton of NSSI as our standard: the deliberate, self-inflicted destruction of body tissue, such as cutting, burning, and biting, without attempted suicide. The quality evaluation tool for cross-sectional studies recommended by the JBI was used. The global prevalence of NSSI was calculated based on the random-effects model by Comprehensive Meta-analysis version 3.0. Subgroup analyses were performed to compare the prevalence according to sex, living place, smoking or drinking history, and family structure. Results Sixty-two studies involving 264,638 adolescents were included. The aggregate prevalence of NSSI among a non-clinical sample of adolescents was similar between over a lifetime (22.0%, 95% CI 17.9-26.6) and during a 12-month period (23.2%, 95% CI 20.2-26.5). Repetitive NSSI was more common than episodic NSSI (20.3% vs. 8.3%) but the frequency of mild injury (12.6%) was similar to that of moderate injury (11.6%). Multiple-method NSSI occurred slightly more often compared than one-method NSSI (16.0% vs. 11.1%). The top three types of NSSI in adolescents were banging/hitting (12.0%, 95% CI 8.9-15.9), pinching (10.0%, 95% CI 6.7-14.8), and pulling hair (9.8%, 95% CI 8.3-11.5), and the least common type was swallowing drugs/toxic substances/chemicals (1.0%, 95% CI 0.5-2.2). Subgroup analyses showed that being female, smoking, drinking, having siblings, and belonging to a single-parent family may be linked to higher prevalence of NSSI. Conclusion This meta-analysis found a high prevalence of NSSI in non-clinical sample of adolescents, but there are some changes in severity, methods, and reasons. Based on the current evidence, adolescents in modern society are more inclined to implement NSSI behavior by a variety of ways, which usually are repetitive, and moderate and severe injuries are gradually increasing. It is also worth noting that adolescents with siblings or in single-parent families are relatively more likely to implement NSSI behavior due to maladjustment to the new family model. Future research needs to continue to elucidate the features and risk factors of NSSI so as to intervene in a targeted way. Limitation The limitation of this study is that the heterogeneity among the included studies is not low, and it is mainly related to Chinese and English studies. The results of this study should be used with caution. Systematic review registration [www.crd.york.ac.uk/prospero/], identifier [CRD42022283217].
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Affiliation(s)
- Qingqing Xiao
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Xiaozhen Song
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Lijuan Huang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Dandan Hou
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Xuehua Huang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
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15
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Depression and suicide attempts in Chinese adolescents with mood disorders: the mediating role of rumination. Eur Arch Psychiatry Clin Neurosci 2022:10.1007/s00406-022-01444-2. [PMID: 35763221 DOI: 10.1007/s00406-022-01444-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 05/29/2022] [Indexed: 11/03/2022]
Abstract
Mood disorders (MD) are often associated with a higher incidence of suicidal behavior, especially in adolescent patients. However, the mechanisms by which depression affects suicide attempts in adolescents with MD remain poorly elucidated. Therefore, the purpose of this study was to determine the incidence, risk factors, and clinical correlates of suicide attempts in Chinese adolescent patients with MD, as well as the inter-relationship between depressive symptoms, rumination, and suicide attempts, and the role of rumination in mediating depression and suicide attempts. A total of 331 MD adolescent patients aged 11 ~ 18 years were recruited from a psychiatric hospital. Suicide attempts were assessed with the MINI Suicide Scale. Depressed symptoms were measured with the Patient Health Questionnaire-9 (PHQ-9). To assess rumination, we used the 21-item Chinese version of the Ruminative Responses Scale (RRS). Overall, the percentage of suicide attempts among MD adolescents was 51.96%, with a higher percentage of females (58.62%) than males (36.36%). Compared to non-suicide attempters, suicide attempters had higher scores on PHQ-9, RRS, depression-related, brooding, and reflective pondering. Gender and RRS were independently associated with suicide attempts. Rumination played a fully mediating role between depression and suicide attempts. In addition, the mediating effect of depression between rumination and suicide attempts was not significant. The incidence of suicide attempts was higher in MD adolescents than in general adolescents. Gender and rumination were associated with suicide attempts in MD adolescents. Moreover, rumination mediated the correlation between depressive symptoms and suicide attempts, suggesting that rumination may be an important intervention component for clinical staff to prevent suicidal behavior in adolescents with MD.
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16
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Liu CR, Wan LP, Liu BP, Jia CX, Liu X. Depressive symptoms mediate the association between maternal authoritarian parenting and non-suicidal self-injury among Chinese adolescents. J Affect Disord 2022; 305:213-219. [PMID: 35278486 DOI: 10.1016/j.jad.2022.03.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/03/2022] [Accepted: 03/07/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) is a significant public health concern. Authoritarian parenting is a common parenting style in China. Authoritarian parenting is associated with NSSI in adolescents. Little is known about the mechanism underlying this association. This study was to investigate the mediating effect of depressive symptoms on the association between maternal authoritarian parenting and NSSI among Chinese adolescents. METHODS A total of 7072 adolescents who participated in the 1-year follow-up of Shandong Adolescent Behavior & Health Cohort (SABHC) were included for the analysis. A self-administered questionnaire was used to assess authoritarian parenting, depressive symptoms, non-suicidal self-injury, and family demographics in November-December in 2015. One year later, a follow-up survey was carried out to assess participants' depressive symptoms and NSSI. RESULTS Of the sample, mean age was 14.58 (SD = 1.46) and 3536 (50%) were female at baseline. 19.4% adolescents reported having ever NSSI over the past 12 months at baseline, and 8.8% reported having ever NSSI at 1-year follow-up. The association of maternal authoritarian parenting with subsequent NSSI was at least partially mediated by depressive symptoms. Mediation analyses showed that effect size was 0.194 in the entire sample, 0.192 in females and 0.193 in males, respectively. LIMITATION All variables were measured based on self-report. CONCLUSIONS Maternal authoritarian parenting style is a significant predictor of NSSI and its association with NSSI is partially mediated by depressive symptoms among Chinese adolescents. It may be important to intervene poor parenting styles and depression to reduce the risk of NSSI in Chinese adolescents.
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Affiliation(s)
- Cai-Rui Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University and Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China
| | - Li-Peng Wan
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University and Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China
| | - Bao-Peng Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University and Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University and Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China.
| | - Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, USA
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Liang K, Zhao L, Lei Y, Zou K, Ji S, Wang R, Huang X. Nonsuicidal self-injury behaviour in a city of China and its association with family environment, media use and psychopathology. Compr Psychiatry 2022; 115:152311. [PMID: 35395465 DOI: 10.1016/j.comppsych.2022.152311] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/01/2022] [Accepted: 03/22/2022] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION It is not clear whether there are differences in the risk factors for nonsuicidal self-injury (NSSI) between children and early adolescents. Clarifying this question is crucial for identifying actionable prevention strategies for NSSI in these two age groups. METHOD The study, comprising 8611 children and early adolescents (4409 (51.2%) children, 4202 (48.8%) early adolescents), was based on the baseline data of the Chengdu Positive Child Development (CPCD) in China. NSSI behaviours, emotional and behavioural problems and family environment were assessed and obtained via self-reports and parent reports. RESULTS Overall, 2520 (29.26%) participants reported having ever engaged in NSSI. There was a higher lifetime NSSI rate in males than in females during childhood, contrasting with higher NSSI rates in females than in males during early adolescence. Furthermore, NSSI shared similar risk factors, including major family conflict and poor relationships with caregivers, in both age groups. Specifically, in children, the risk of NSSI increased along with thought and attention problems (OR, 95% CI: 1.194, 1.106-1.288 and 1.114, 1.028-1.207, respectively), whereas in early adolescents, it increased with anxiety and depressive problems (OR, 95% CI: 1.259, 1.116-1.422). CONCLUSIONS The findings suggested the need for difference in preventive strategies for NSSI in the two age groups. It may be more efficacious to screen for NSSI in children with thought and attention problems and in early adolescents with anxiety and depressive problems.
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Affiliation(s)
- Kaili Liang
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China; Department of Health Policy and Management, West China School of Public Health, West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Li Zhao
- Department of Health Policy and Management, West China School of Public Health, West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Yalin Lei
- Department of Health-Related Social and Behavioural Sciences, West China School of Public Health, West China Fourth Hospital, Sichuan University, Chengdu 610041, Sichuan, China
| | - Kun Zou
- Department of Child, Adolescent and Maternal Health, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, China; West China Research Center for Rural Health Development, Sichuan University, Chengdu, Sichuan 610041, China; Institute for Healthy Cities, Sichuan University, Chengdu, Sichuan 610041, China
| | - Shuming Ji
- Department of Health Policy and Management, West China School of Public Health, West China Fourth Hospital, Sichuan University, Chengdu 610041, China
| | - Ruiou Wang
- West China School of Public Health, West China Fourth Hospital, Sichuan University, Chengdu, Sichuan 610041, China
| | - Xiaoqi Huang
- Huaxi MR Research Center (HMRRC), Functional and Molecular Imaging Key Laboratory of Sichuan Province, Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China.
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Meng L, Qu D, Bu H, Huo L, Qi L, Yang J, Zheng T, Du X, He K, Wang Y, Zhou Y. The Psychosocial Correlates of Non-suicidal Self-Injury Within a Sample of Adolescents With Mood Disorder. Front Public Health 2022; 10:768400. [PMID: 35273935 PMCID: PMC8902037 DOI: 10.3389/fpubh.2022.768400] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 01/10/2022] [Indexed: 11/13/2022] Open
Abstract
Background According to the integrated theoretical model, adolescents' behaviors were the outcome of the complex interplay between multiple levels. Non-suicidal self-injury (NSSI) is a serious and high prevalent problem among adolescents with mood disorders. However, a systematic perspective on psychosocial correlates among Chinese clinical adolescents is still rare. Method The impact of several factors at the individual (i.e., sex, age, self-esteem, and psychological distress), family (i.e., family structure, family income, and family support), and social level (i.e., living environment, peer support, and teacher support) on the frequency of NSSI behaviors were investigated in the current study. This research included 621 Chinese adolescents with mood disorders from 20 hospitals. Results Three-steps hierarchical regression analyses indicated that lower levels of psychological distress and higher levels of self-esteem were most associated with less frequency of NSSI behaviors. In addition, family support was negatively associated with the frequency of NSSI behaviors. After controlling the factors at individual and family levels, no significant association was found between the factors at the social level and the frequency of NSSI behaviors. Conclusion These findings provide preliminary support for the notion that adolescent self-esteem and family support may effectively shield them from problematic behavior; nevertheless, adolescents suffering from more emotional pain can be even riskier. Thus, further intervention strategies should consider the non-independence of individual capacities, co-combinatory effects of mood disorder, and family environment in treating those vulnerable Chinese adolescents.
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Affiliation(s)
| | - Diyang Qu
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - He Bu
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Lijuan Huo
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ling Qi
- School of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | - Jiezhi Yang
- Shenzhen Health Development Research Center, Shenzhen, China
| | - Tiansheng Zheng
- Kangning Hospital Affiliated to Wenzhou Medical University, Wenzhou, China
| | - Xiangdong Du
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | | | - Yanni Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Lanzhou, China
| | - Yongjie Zhou
- Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, China
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19
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Chen PJ, Mackes N, Sacchi C, Lawrence AJ, Ma X, Pollard R, Matter M, Morgan C, Harding S, Schumann G, Pariante C, Mehta MA, Montana G, Nosarti C, Dazzan P. Parental education and youth suicidal behaviours: a systematic review and meta-analysis. Epidemiol Psychiatr Sci 2022; 31:e19. [PMID: 35352676 PMCID: PMC8967699 DOI: 10.1017/s204579602200004x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 02/04/2022] [Accepted: 02/07/2022] [Indexed: 01/04/2023] Open
Abstract
AIMS Lower parental education has been linked to adverse youth mental health outcomes. However, the relationship between parental education and youth suicidal behaviours remains unclear. We explored the association between parental education and youth suicidal ideation and attempts, and examined whether sociocultural contexts moderate such associations. METHODS We conducted a systematic review and meta-analysis with a systematic literature search in PubMed, PsycINFO, Medline and Embase from 1900 to December 2020 for studies with participants aged 0-18, and provided quantitative data on the association between parental education and youth suicidal ideation and attempts (death included). Only articles published in English in peer-reviewed journals were considered. Two authors independently assessed eligibility of the articles. One author extracted data [e.g. number of cases and non-cases in each parental education level, effect sizes in forms of odds ratios (ORs) or beta coefficients]. We then calculated pooled ORs using a random-effects model and used moderator analysis to investigate heterogeneity. RESULTS We included a total of 59 articles (63 study samples, totalling 2 738 374 subjects) in the meta-analysis. Lower parental education was associated with youth suicidal attempts [OR = 1.12, 95% Confidence Interval (CI) = 1.04-1.21] but not with suicidal ideation (OR = 1.05, 95% CI = 0.98-1.12). Geographical region and country income level moderated the associations. Lower parental education was associated with an increased risk of youth suicidal attempts in Northern America (OR = 1.26, 95% CI = 1.10-1.45), but with a decreased risk in Eastern and South-Eastern Asia (OR = 0.72, 95% CI = 0.54-0.96). An association of lower parental education and increased risk of youth suicidal ideation was present in high- income countries (HICs) (OR = 1.14, 95% CI = 1.05-1.25), and absent in low- and middle-income countries (LMICs) (OR = 0.91, 95% CI = 0.77-1.08). CONCLUSIONS The association between youth suicidal behaviours and parental education seems to differ across geographical and economical contexts, suggesting that cultural, psychosocial or biological factors may play a role in explaining this association. Although there was high heterogeneity in the studies reviewed, this evidence suggests that the role of familial sociodemographic characteristics in youth suicidality may not be universal. This highlights the need to consider cultural, as well as familial factors in the clinical assessment and management of youth's suicidal behaviours in our increasingly multicultural societies, as well as in developing prevention and intervention strategies for youth suicide.
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Affiliation(s)
- P. J. Chen
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- Department of Psychiatry, Chang Gung Memorial Hospital at Taoyuan and Chang Gung University, Taoyuan, Taiwan
| | - N. Mackes
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - C. Sacchi
- Department of Developmental Psychology and Socialisation, University of Padova, Padua, Italy
| | - A. J. Lawrence
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - X. Ma
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - R. Pollard
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - M. Matter
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - C. Morgan
- Health Service & Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - S. Harding
- Division of Diabetes and Nutritional Sciences, King's College London, London, UK
| | - G. Schumann
- Biological Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - C. Pariante
- Biological Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - M. A. Mehta
- Department of Neuroimaging & Psychopharmacology, Centre of Neuroimaging Sciences, King's College London, London, UK
| | - G. Montana
- Department of Data Science, University of Warwick, Coventry, UK
| | - C. Nosarti
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
- Centre for the Developing Brain, Department of Perinatal Imaging & Health, School of Biomedical Engineering & Imaging Sciences, King's College London, London, UK
| | - P. Dazzan
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
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20
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Poudel A, Lamichhane A, Magar KR, Khanal GP. Non suicidal self injury and suicidal behavior among adolescents: co-occurrence and associated risk factors. BMC Psychiatry 2022; 22:96. [PMID: 35139825 PMCID: PMC8827284 DOI: 10.1186/s12888-022-03763-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 02/04/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) and suicidal behavior (SB) are the major public health problems in adolescents. Despite the increased focus on these phenomena, there exist no reliable data in Nepal. This study aimed to determine the prevalence of NSSI and SB among adolescents. Furthermore the study identified the relationship between these two behaviors and assessed demographic, behavioral, and psychological risk factors of NSSI and SB in Nepalese adolescents in a representative sample of the general population. METHODS The study was conducted among 730 adolescents studying in grade 9 to 12 of public and private schools of Pokhara Metropolitan city, Nepal. Data were collected through self administered standard tools- Functional Assessment of Self Mutilation (FASM) tool, Suicidal Behaviors Questionnaire-Revised (SBQ-R), Rosenberg self-esteem scale (RSES) and Beck Depression Inventory (BDI). Descriptive statistical measures such as frequency, percentage, mean, standard deviation, range were used to assess demographic characteristics and adolescent's behavior regarding NSSI and suicide. For inferential analysis chi-square and one way ANOVA test was used. Furthermore, to determine the predictors of NSSI and SB, multiple logistic regression analysis was used. RESULTS Regarding behavioral characteristics, nearly half of the sample 327 (44.8%) reported a history of NSSI in past 1 year. Furthermore, 25.8% (n = 188) of the overall sample engaged in minor NSSI only and 3.42% (n = 25) engaged in at least one act of moderate/severe NSSI. The mean number of type of NSSI performed was 2.63 ± 1.71. The most common type of NSSI method used were picking at wound (27.3%), biting self (20.3%), pulling hair out (11.8%), cutting self (11.1%). Boys (52.6%) were more likely to be engaged in NSSI than girls (47.4%) (χ2 = 10.298, p = 0.002). Furthermore, among 730 adolescents who completed the SBQ-R questionnaire, 131 (17.9%) had suicidal behaviors (SB) (as defined by SBQ-R a total score ≥ 7). Regarding sex differences female were significantly higher in life time prevalence of suicidal behavior than male (χ2 = 30.26, p = 0.001). Simple Chi-square tests indicated that NSSI was significantly associated with SB (χ2 = 58.16, P < .001). Logistic regressions identified the four significant predictors of NSSI behavior: male, low-level of self-esteem (SE), moderate to severe form of depression and SB. Similarly, significant predictors of SB were: female, low-level of SE, moderate to severe form of depression and NSSI behavior. CONCLUSION The prevalence of both NSSI and SB is high in adolescents. Despite the differences between NSSI and SB a significant number of adolescents reported a history of both behaviors. Lower level of SE and moderate to severe depression were the significant predictors of both NSSI and SB. Furthermore, male and adolescents with the history of SB were at risk of NSSI behavior whereas female sex and adolescents with the history of NSSI were at risk of SB.
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Affiliation(s)
- Anju Poudel
- Tribhuvan University, Institute of Medicine, Pokhara Nursing Campus, Pokhara, Nepal.
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21
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Zhou J, Zhang J, Huang Y, Zhao J, Xiao Y, Zhang S, Li Y, Zhao T, Ma J, Ou N, Wang S, Ou Q, Luo J. Associations between coping styles, gender, their interaction and non-suicidal self-injury among middle school students in rural west China: A multicentre cross-sectional study. Front Psychiatry 2022; 13:861917. [PMID: 36016979 PMCID: PMC9395723 DOI: 10.3389/fpsyt.2022.861917] [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: 01/25/2022] [Accepted: 07/13/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND To investigate the association between coping styles, gender, their interactions and non-suicidal self-injurious (NSSI) behaviors among middle school students in rural western China under COVID-19. METHODS A multicentre cross-sectional study method was used to conduct an online survey of 8,361 students from 23 middle schools in the northern Sichuan region by clustering sampling, using the General Information Questionnaire, the Ottawa Self-Injury Inventory, and the Coping Style Scale for Middle School Students. RESULTS The past year prevalence of NSSI among middle school students in rural west China was 5.7%. The differences in scores between those with and without NSSI on all dimensions of coping styles were statistically significant (p < 0.001). Multivariate logistic regression analysis revealed that vocational high school (OR = 1.67), girls (OR = 2.5), single parent with divorced parents (OR = 1.89), remarriage with divorced parents (OR = 1.81), and tolerance (OR = 1.17), venting emotions (OR = 1.15) and fantasy/denial (OR = 1.07) in coping styles may increase the risk of NSSI among middle school students, while problem solving (OR = 0.9) and seeking social support (OR = 0.9) among coping styles may reduce the risk of NSSI among middle school students. The interaction results show that gender has a moderating role in the process of endurance, avoidance, venting of emotions, and fantasy/denial influencing non-suicidal self-injury in middle school students. CONCLUSION There is an association between coping styles and self-injury among middle school students in rural areas in western China, with gender playing a moderating role. Active attention should be paid to students' coping styles and encouraging them to adopt positive coping styles as well as avoid negative coping styles, especially in the case of girls, which can help prevent self-injury.
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Affiliation(s)
- Jinhui Zhou
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Jiazhu Zhang
- Nanyang Centre for Public Administration, Nanyang Technological University, Singapore, Singapore
| | - Yilin Huang
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Jiayu Zhao
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Yun Xiao
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Shibei Zhang
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Yanfeng Li
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Ting Zhao
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Jinyu Ma
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Nanbing Ou
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Shuyi Wang
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Qing Ou
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Jiaming Luo
- School of Psychiatry, North Sichuan Medical College, Nanchong, China.,Nanchong Psychosomatic Hospital, Nanchong, China
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22
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Xu H, Jiang Z, Li S, Zhang X, Xu S, Wan Y, Tao F. Differences in Influencing Factors Between Non-suicidal Self-Injury and Suicide Attempts in Chinese Adolescents: The Role of Gender. Front Psychiatry 2022; 13:870864. [PMID: 35845460 PMCID: PMC9280144 DOI: 10.3389/fpsyt.2022.870864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 06/01/2022] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Non-suicidal self-injury (NSSI) and suicide attempts (SA) are common in adolescents and are important risk factors for suicide deaths. They are related to various psychosocial, behavioral, and biological factors. We aimed to compare the differences on psychological behavior problem and family environment characteristics between NSSI and SA, and the role of gender. METHODS A multi-center population-based survey was conducted in 29 schools across 4 provinces in China. A total of 14,500 urban and rural adolescents in grades 7-12 completed a structured questionnaire to report their sociodemographic information, psychological and behavioral characteristics, childhood maltreatment, parent-child relationships, NSSI, and SA. Post-hoc tests, pairwise comparisons, and multinomial logistic regression analyses were conducted to explore the differences and similarities between subjects who had engaged in NSSI and SA. RESULTS The prevalence of NSSI and SA were 27.3 and 4.9%, respectively, and the co-occurrence of these two behaviors (NSSI + SA) was reported to 2.8%. The NSSI + SA group scored the highest on all study variables, followed by the SA-only group, the NSSI-only group, and the non-self-harm group (p < 0.001). Compared with the non-self-harm group, adolescents who reported either NSSI or SA scored significantly higher on all study variables (p< 0.0083). The comparison between other self-harm groups, this difference have varied in all research variables. CONCLUSION The current study indicate that psychological, behavioral, and family relationships profiles of Chinese adolescents with SA and NSSI are similar, but the measured problematic characteristics were more severe in suicide attempters. In the future, it's necessary to pay more attention to adolescents with more serious psychological and behavioral problems to prevent and early intervene in their self-harm, and actively explore gender differences.
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Affiliation(s)
- Huiqiong Xu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Anhui Medical University, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China
| | - Zhicheng Jiang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Anhui Medical University, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China
| | - Shuqin Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Anhui Medical University, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China
| | - Xinyu Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Anhui Medical University, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China
| | - Shaojun Xu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Anhui Medical University, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China
| | - Yuhui Wan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Anhui Medical University, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, Hefei, China.,Key Laboratory of Population Health Across Life Cycle, Ministry of Education of the People's Republic of China, Anhui Medical University, Hefei, China.,NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, Hefei, China.,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, China
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23
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Zhang Q, Zhao S, Liu Z, Luo B, Yang Y, Shi Y, Geng F, Xia L, Zhang K, Liu H. Association of thyroid-stimulating hormone and lipid levels with suicide attempts among adolescents with major depressive disorder in China. Front Psychiatry 2022; 13:1031945. [PMID: 36733417 PMCID: PMC9887045 DOI: 10.3389/fpsyt.2022.1031945] [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: 08/30/2022] [Accepted: 12/23/2022] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVES Evidence suggested that thyroid-stimulating hormone (TSH) and lipid levels were associated with major depressive disorder (MDD). However, its role in suicide attempts in adolescents with MDD was unclear. This investigation was to probe into the relationship between TSH, lipid levels, and attempted suicide in adolescents with MDD. METHODS A total of 179 adolescents with MDD were included from January 2021 to January 2022. Socio-demographic data and clinical data were obtained through self-made questionnaires. TSH and lipid levels were analyzed by a recognized laboratory. The Epidemiological Studies Depression Scale (CES-D) was used to assess the severity of depression. Questions about whether there was a behavior of suicide attempts were completed through conversation interviews. RESULTS Results showed that the CES-D total score, TSH, and low-density lipoprotein cholesterol (LDL-C) of suicide attempters were significantly higher than those of non-suicide attempters. Ordinary family relationships were more likely to attempt suicide than good family relationships. The CES-D total score, ordinary family relationships, TSH and LDL-C were still significant in binary logistic regression, with an adjusted odds ratio (OR) of 1.04, 3.42, 5.14, and 1.76, respectively. The area under the receiver operating characteristic (ROC) curve showed that the area under the ROC curve (AUC) ranged from 0.60 to 0.74. CONCLUSION Suicide attempts are common among adolescents with MDD and were associated with CES-D total score, ordinary family relationships, TSH, and LDL-C. Given the association between suicide attempts and TSH and LDL-C, the dynamic changes in TSH and LDL-C levels should be detected regularly.
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Affiliation(s)
- Qing Zhang
- Department of Psychiatry, 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, Anhui Medical University, Hefei, China
| | - Shuyi Zhao
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
| | - Zhichun Liu
- Department of Psychiatry, 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, Anhui Medical University, Hefei, China
| | - Bei Luo
- Department of Psychiatry, 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, Anhui Medical University, Hefei, China
| | - Yingying Yang
- Department of Psychiatry, 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, Anhui Medical University, Hefei, China
| | - Yudong Shi
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
| | - Feng Geng
- Department of Psychiatry, Hefei Fourth People's Hospital, Hefei, China
| | - Lei Xia
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
| | - Kai Zhang
- Department of Psychiatry, 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, Anhui Medical University, Hefei, China
| | - Huanzhong Liu
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China.,Department of Psychiatry, School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, China
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24
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Mannekote Thippaiah S, Shankarapura Nanjappa M, Gude JG, Voyiaziakis E, Patwa S, Birur B, Pandurangi A. Non-suicidal self-injury in developing countries: A review. Int J Soc Psychiatry 2021; 67:472-482. [PMID: 32715834 DOI: 10.1177/0020764020943627] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) may be understood as a physical and behavioral expression of emotional distress. Over the past 70 years, it has been variably formulated as a type of emotional reaction to various stressors. NSSI has complex goals, sometimes implicit, but overall it serves as a transient psychological relief. Many believe that NSSI is a maladaptive behavior and is not related to suicide, with the primary differentiating factor between suicide and NSSI being the 'intention' to die. NSSI is an important mental health problem in current modern societies, and it is part of a trend in current psychiatric and mental health practice to medicalize maladaptive behaviors or psychological distress. AIMS To review the prevalence, associated factors, purpose, and psychological and social significance of NSSI in developing countries. METHOD This article is a narrative review. However, of the total 1,094 articles, 13 articles were included to derive information on the prevalence and methods of NSSI in the developing country. RESULTS NSSI rates are very variable, ranging from 11.5% to as high as 33.8%, depending on the nature of the sample and study design, but data show an increasing trend globally, including in developing countries. CONCLUSION The recent emerging data does not support the notion that it is common in developed Western countries, though the meaning, context and reason for NSSI might differ in developing and developed countries. NSSI is almost equally prevalent in both developing and developed countries.
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Affiliation(s)
- Srinagesh Mannekote Thippaiah
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Glen Oaks, NY, USA.,Department of Psychiatry, Valleywise Behavioral Health Center, Phoenix, AZ, USA
| | | | - Jayasudha G Gude
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Glen Oaks, NY, USA
| | - Emanuel Voyiaziakis
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Glen Oaks, NY, USA
| | - Sohum Patwa
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Glen Oaks, NY, USA
| | - Badari Birur
- Department of Psychiatry and Behavioral Neurobiology, The University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ananda Pandurangi
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
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25
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Matera E, Margari M, Serra M, Petruzzelli MG, Gabellone A, Piarulli FM, Pugliese A, Tassiello AR, Croce F, Renna C, Margari A. Non-Suicidal Self-Injury: An Observational Study in a Sample of Adolescents and Young Adults. Brain Sci 2021; 11:brainsci11080974. [PMID: 34439593 PMCID: PMC8391479 DOI: 10.3390/brainsci11080974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/18/2021] [Accepted: 07/20/2021] [Indexed: 11/16/2022] Open
Abstract
Non-Suicidal Self-Injury (NSSI) is the self-inflicted destruction of body tissues without suicidal intent with a prevalence of 1.5% to 6.7% in the youth population. At present, it is not clear which emotional and behavioral components are specifically associated with it. Therefore, we studied NSSI in a clinical sample of youth using the Ottawa Self-injury Inventory and the Barratt Impulsiveness Scale 11. The Mann-Whitney test was used to compare the numerical responses provided to the tests. We found 54 patients with NSSI, with a mean age of 17 years. Scores were analyzed in the total sample and in four subgroups. In the total sample, Internal Emotion and External Emotion Regulation, Craving, Non-Planning and Total Impulsivity were significantly associated with NSSI. There were statistically significant differences in Craving between patients with multiple NSSI episodes, suicide attempts and multiple injury modes and patients of other corresponding subgroups, in Internal Emotion Regulation, Sensation Seeking and Motor Impulsivity between NSSI patients with suicide attempts and no suicide attempts, and in Cognitive Impulsivity between NSSI patients with multiple injury modes and one injury mode. It is necessary to carefully evaluate the components underlying NSSI in order to activate personalized treatment options.
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Affiliation(s)
- Emilia Matera
- Department of Biomedical Sciences and Human Oncology, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy;
- Correspondence:
| | - Mariella Margari
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (M.M.); (M.S.); (M.G.P.); (F.M.P.); (A.P.); (A.R.T.); (F.C.); (A.M.)
| | - Maria Serra
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (M.M.); (M.S.); (M.G.P.); (F.M.P.); (A.P.); (A.R.T.); (F.C.); (A.M.)
| | - Maria Giuseppina Petruzzelli
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (M.M.); (M.S.); (M.G.P.); (F.M.P.); (A.P.); (A.R.T.); (F.C.); (A.M.)
| | - Alessandra Gabellone
- Department of Biomedical Sciences and Human Oncology, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy;
| | - Francesco Maria Piarulli
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (M.M.); (M.S.); (M.G.P.); (F.M.P.); (A.P.); (A.R.T.); (F.C.); (A.M.)
| | - Assunta Pugliese
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (M.M.); (M.S.); (M.G.P.); (F.M.P.); (A.P.); (A.R.T.); (F.C.); (A.M.)
| | - Anna Rita Tassiello
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (M.M.); (M.S.); (M.G.P.); (F.M.P.); (A.P.); (A.R.T.); (F.C.); (A.M.)
| | - Federica Croce
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (M.M.); (M.S.); (M.G.P.); (F.M.P.); (A.P.); (A.R.T.); (F.C.); (A.M.)
| | - Caterina Renna
- Center for Treatment and Research on Eating Disorders Mental Health Department AL, Via Miglietta 5, 73100 Lecce, Italy;
| | - Anna Margari
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (M.M.); (M.S.); (M.G.P.); (F.M.P.); (A.P.); (A.R.T.); (F.C.); (A.M.)
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Madjar N, Daka D, Zalsman G, Shoval G. Depression symptoms as a mediator between social support, non-suicidal self-injury, and suicidal ideation among Arab adolescents in Israel. SCHOOL PSYCHOLOGY INTERNATIONAL 2021. [DOI: 10.1177/0143034321998741] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The purpose of the current study was to explore whether depression symptoms mediate the relationships between perceptions of social support from three sources; namely parents, teachers, and peers, and non-suicidal self-injury (NSSI) and suicidal ideation. We also tested the interactions between the different sources of support. Focusing on the Arab-Israeli population is unique as it is an ethnic minority characterized with strong familial support, and less access to mental health services compared to the ethnic majority. Adolescents (N = 276; 65.6% girls; mean age 15.1 years) from the Arab minority in northern Israel were sampled (74% response rate). Participants were evaluated using validated scales assessing perceived social support, NSSI and suicidal ideation. Path analysis with Bayesian estimation supported the hypothesized model. Depression symptoms fully mediated the relationships between school-related social support (i.e., teachers and peers) and NSSI, and partially between parents’ support and suicidal ideation. Interactions between the social support sources were not significant, and cluster analysis indicated that each source is independently essential to understand NSSI and suicide ideation. This model emphasizes the importance of school-related factors in adolescents’ particular aspects of mental health, and suggests that one source of social support may not compensate for a lack of another.
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Affiliation(s)
- Nir Madjar
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel; Geha Mental Health Center, Petakh Tikva, Israel
| | - Doaa Daka
- School of Education, Bar-Ilan University, Ramat-Gan, Israel
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel; Geha Mental Health Center, Petakh Tikva, Israel
| | - Gil Zalsman
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel; Geha Mental Health Center, Petakh Tikva, Israel; Department of Psychiatry, Columbia University, New York, USA
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel; Geha Mental Health Center, Petakh Tikva, Israel
| | - Gal Shoval
- Sackler Faculty of Medicine, Tel-Aviv University, Tel Aviv, Israel; Geha Mental Health Center, Petakh Tikva, Israel
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Li L, You D, Ruan T, Xu S, Mi D, Cai T, Han L. The prevalence of suicidal behaviors and their mental risk factors among young adolescents in 46 low- and middle-income countries. J Affect Disord 2021; 281:847-855. [PMID: 33248811 DOI: 10.1016/j.jad.2020.11.050] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 10/21/2020] [Accepted: 11/08/2020] [Indexed: 10/25/2022]
Abstract
BACKGROUND To describe the prevalence of suicidal behaviors (ideation, planning, and attempt) and their associated factors in young adolescents in low- and middle-income countries (LMICs). METHODS We used the latest data from the Global School-Based Health Survey (GSHS) for adolescents aged 12-15 years during 2009-2015. The weighted prevalence and 95% confidential intervals (CIs) of suicidal behaviors were calculated using a random-effects model. The factors associated with suicidal behaviors were examined using logistic regression analysis. RESULTS Data from 130,488 adolescents (48.13% boys) in 46 LMICs were included in the study. Across all countries, the pooled 12-month prevalence of suicidal ideation, planning, and attempt were 14.5%, 14.6%, and 12.7%, respectively. The highest prevalence of suicidal ideation, planning, and attempt were all in Africa (16.7%, 19.3% and 17.0%), and the lowest prevalence were all in South-East Asia (8.2%, 10.5% and 7.4%). The overall prevalence of three suicidal behaviors were higher in girls (all P < 0.001). Suicidal ideation and planning were more common in the 14-15 age group than 12-13 age group (both P < 0.001). The factors associated with suicidal behaviors were being female, older age, loneliness, anxiety, a lack of close friends, and having family supportive (all P < 0.001). LIMITATIONS The GSHS data were obtained from a self-report questionnaire and the participants included in the GSHS were adolescents in school. CONCLUSIONS The prevalence of suicidal behaviors remains high among young adolescents in LMICs, especially in Africa. These countries should be intervention priorities.
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Affiliation(s)
- Lian Li
- Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, PR China; Department of Global Health, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, Zhejiang, PR China; Department of Epidemiology, Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, PR China
| | - Dingyun You
- School of Public Health, Kunming Medical University, Kunming, PR China
| | - Tiecheng Ruan
- Department of Epidemiology, Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, PR China
| | - Shujun Xu
- Department of Epidemiology, Zhejiang Provincial Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, PR China
| | - Duo Mi
- Ningbo University Mental Health Guidance Center, Ningbo University, Ningbo, Zhejiang, PR China.
| | - Ting Cai
- Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, PR China; Department of Global Health, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, Zhejiang, PR China.
| | - Liyuan Han
- Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, PR China; Department of Global Health, Ningbo Institute of Life and Health Industry, University of Chinese Academy of Sciences, Ningbo, Zhejiang, PR China.
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Hansen A, Slavova D, Cooper G, Zummer J, Costich J. An emergency department medical record review for adolescent intentional self-harm injuries. Inj Epidemiol 2021; 8:3. [PMID: 33413622 PMCID: PMC7791795 DOI: 10.1186/s40621-020-00293-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 11/24/2020] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Non-suicidal self-injury and suicide attempts are increasing problems among American adolescents. This study developed a definition for identifying intentional self-harm (ISH) injuries in emergency department (ED) records coded with International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) codes. The definition is based on the injury-reporting framework proposed by the Centers for Disease Control and Prevention. The study sought to estimate the definition's positive predictive value (PPV), and the proportion of ISH injuries with intent to die (i.e., suicide attempt). METHODS The study definition, based on first-valid external cause-of-injury ICD-10-CM codes X71-X83, T14.91, T36-T65, or T71, captured 207 discharge records for initial encounters for ISH in one Kentucky ED. Medical records were reviewed to confirm provider-documented diagnosis for ISH, and identify intent to die or suicide ideation. The PPV of the study definition for capturing provider-documented ISH injuries was reported with its 95% confidence interval (95% CI). RESULTS The estimated PPV for the study definition to capture ISH injuries was 88.9%, 95% CI (83.8%, 92.8%). The estimated percentage of ISH with intent to die was 45.9, 95% CI (47.1, 61.0%). The ICD-10-CM code "suicide attempt" (T14.91) captured only 7 cases, but coding guidelines restrict assignment of this code to cases in which the mechanism of the suicide attempt is unknown. CONCLUSIONS The proposed case definition supported a robust PPV for ISH injuries. Our findings add to the evidence that the current ICD-10-CM coding system and coding guidelines do not allow identification of ISH with intent to die; modifications are needed to address this issue.
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Affiliation(s)
- Anna Hansen
- Kentucky Injury Prevention and Research Center, University of Kentucky, Lexington, KY, USA
- Department of Sociology, University of Kentucky, Lexington, USA
- College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Dessi Slavova
- College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Gena Cooper
- Department of Emergency Medicine, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Jaryd Zummer
- Department of Emergency Medicine, College of Medicine, University of Kentucky, Lexington, KY, USA
| | - Julia Costich
- Kentucky Injury Prevention and Research Center, University of Kentucky, Lexington, KY, USA.
- Department of Health Management & Policy, College of Public Health, University of Kentucky, 111 Washington Ave, Lexington, KY, 40536-0003, USA.
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Zhou Y, Hu D, Zhang K, Mao J, Teng F, Yu T, Xu K, Tan R, Ding X, Liu Y. The mechanism of family adaptability and cohesion in suicidal ideation among Chinese cancer patients. J Psychosoc Oncol 2020; 38:612-626. [PMID: 32508254 DOI: 10.1080/07347332.2020.1757799] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Yi Zhou
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Deying Hu
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Keke Zhang
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Jing Mao
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Fen Teng
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ting Yu
- School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Ke Xu
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Rong Tan
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Xiaoping Ding
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yilan Liu
- Department of Nursing, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
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Yan P, Ren Y, Li M, Lin MP, Xu S, Liu J, Zhou G, Xu L, You J. The Prevalence and Correlates of Suicidality in a Sample of Adolescents in Guangdong, China. JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY 2020. [DOI: 10.1521/jscp.2020.39.02.77] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background: Suicidality is a public health concern among Chinese adolescents. This study aimed to examine the prevalence and correlates of suicidal ideation and suicide attempts in a large sample of Chinese adolescents. Methods: A total of 30,644 Chinese students (56.7% male; Mage = 14.14 years) completed the questionnaires, and a multinomial logistic regression was conducted to analyze the data. Results: About 17.0% of the participants reported having suicidal ideation and 4.4% reported suicide attempts in the past year. Adolescents with more rumination, more severe depressive symptoms, more communication problems with their parents, and more feelings of burdensomeness were more likely to be suicidal ideators or suicide attempters rather than non-suicidal controls. Additionally, male adolescents, adolescents from incomplete families, adolescents whose parents have lower educational levels, and adolescents with less rumination, more severe depressive symptoms, less communication problems with their parents were more likely to be suicide attempters rather than suicidal ideators. Discussion: Suicidality is prevalent and correlates with various familial and individual factors in Chinese adolescents. Theoretical and clinical implications of the findings were discussed.
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Affiliation(s)
- Pei Yan
- Research Center of Light and Physio-Psychological Health, School of Psychology, South China Normal University, Guangzhou, China
| | - Yaxuan Ren
- Center for Studies of Psychological Application, Research Center for Crisis Intervention and Psychological Service of Guangdong Province, & School of Psychology, South China Normal University, Guangzhou, China
| | - Minyi Li
- Center for Studies of Psychological Application, Research Center for Crisis Intervention and Psychological Service of Guangdong Province, & School of Psychology, South China Normal University, Guangzhou, China
| | - Min-Pei Lin
- Department of Educational Psychology and Counseling, National Taiwan Normal University, Taipei City, Taiwan
| | - Sian Xu
- Center for Studies of Psychological Application, Research Center for Crisis, Intervention and Psychological Service of Guangdong Province, & School of Psychology, South China Normal University, Guangzhou, China
| | - Jiaqi Liu
- Center for Studies of Psychological Application, Research Center for Crisis, Intervention and Psychological Service of Guangdong Province, & School of Psychology, South China Normal University, Guangzhou, China
| | - Guofu Zhou
- Guangdong Provincial Key Laboratory of Optical Information Materials and Technology & Institute of Electronic Paper Displays, South China Academy of Advanced Optoelectronics, South China Normal University, Guangzhou, China
- National Center for International Research on Green Optoelectronics, South China Normal University, Guangzhou, China
- Shenzhen Guohua Optoelectronics Tech. Co. Ltd., Shenzhen, China
| | - Liang Xu
- Guangdong Communication Polytechnic
| | - Jianing You
- Center for Studies of Psychological Application, Research Center for Crisis Intervention and Psychological Service of Guangdong Province, & School of Psychology, South China Normal University, Guangzhou, China
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Mo J, Wang C, Niu X, Jia X, Liu T, Lin L. The relationship between impulsivity and self-injury in Chinese undergraduates: The chain mediating role of stressful life events and negative affect. J Affect Disord 2019; 256:259-266. [PMID: 31200164 DOI: 10.1016/j.jad.2019.05.074] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 05/26/2019] [Accepted: 05/30/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Self-injury is one of the strongest predictors of suicide. Undergraduates have been recognized as one of the populations with the highest incidence of self-injury. A substantial body of literature has documented the important influence of impulsivity on self-injury. However, few studies have focused on the mediating mechanisms underlying this relationship. Based on the stress generation hypothesis and the affect-regulation model of self-injury, this study constructed a chain mediating model to examine whether stressful life events and negative affect mediated the relationship between impulsivity and self-injury among Chinese undergraduates. METHODS A total of 2270 undergraduates (69.8% female, mean age = 19 years) were recruited to participate in this study and completed self-report measures of impulsivity, self-injury, stressful life events and negative affect. RESULTS (1) There were significant positive correlations among impulsivity, stressful life events, negative affect and self-injury. (2) After controlling for the effect of gender, impulsivity still had a significant positive effect on self-injury. (3) Undergraduates' self-injury was affected by impulsivity partly through 3 different pathways: the mediating role of stressful life events, the mediating role of negative affect, and the chain mediating role of both stressful life events and negative affect. CONCLUSIONS These findings contribute to a more comprehensive understanding of the risk factors for self-injury. Impulsivity, stressful life events, and negative affect might increase the occurrence of self-injury. In addition, the chain mediating effect of stressful life events and negative affect plays an important role in the occurrence of self-injury.
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Affiliation(s)
- Juanchan Mo
- Faculty of Psychology, Tianjin Normal University, Tianjin, China
| | - Chenxu Wang
- Faculty of Psychology, Tianjin Normal University, Tianjin, China
| | - Xiaoxiao Niu
- Division of Psychology and Language Sciences, University College London, London, United Kingdom
| | - Xuji Jia
- Faculty of Psychology, Tianjin Normal University, Tianjin, China; Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin, China
| | - Tuo Liu
- Faculty of Psychology, Tianjin Normal University, Tianjin, China; Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin, China
| | - Lin Lin
- Faculty of Psychology, Tianjin Normal University, Tianjin, China; Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin, China.
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Bani M, Travagin G, Monticelli M, Valsecchi M, Truisi E, Zorzi F, Strepparava M, Clerici M, Mazza U, Rezzonico G. Pattern of self-injurious behavior and suicide attempts in Italian custodial inmates: A cluster analysis approach. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2019; 64:1-7. [PMID: 31122619 DOI: 10.1016/j.ijlp.2018.12.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Revised: 12/14/2018] [Accepted: 12/21/2018] [Indexed: 06/09/2023]
Abstract
Self-injurious behaviors and suicide attempts are more frequent in prison settings than in the general population and represent a crucial problem. The aims of this work are to assess the prevalence of self-injurious behaviors and suicide attempts in an Italian prison setting, to determine whether inmates could be differentiated based on profiles of psychological distress and impulsiveness, and to assess the predictive power of the proposed profiles. A sample of 1422 male inmates of a north Italian penitentiary was assessed upon admission with a clinical interview and completed a set of self-report questionnaires to assess psychological distress and impulsiveness; the number of self-injurious behaviors and suicide attempts occurring in the first year of detention was recorded. A cluster analysis approach was used. Prevalence of self-Injurious behaviors and suicide attempts is similar to what has been observed in previous work. Cluster analysis revealed four clusters: dysregulated (high impulsivity and distress), impulsive (high impulsivity and mean distress), mildly distressed (mean impulsivity and moderate distress) and well-balanced (low impulsivity and distress). The four clusters help to discriminate subjects more at risk of self-injurious behaviors and suicide attempts and are confirmed by the inclusion of risk factors such as marital status and relatives'/social support. Clinical implications are discussed.
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Affiliation(s)
- Marco Bani
- Department of Medicine and Surgery, University of Milano - Bicocca, via Cadore 48, 20900 Monza, Italy.
| | - Gabriele Travagin
- Catholic University of Sacred Heart, Department of Psychology, Largo Agostino Gemelli, 1, 20123 Milan, Italy
| | - Michele Monticelli
- Catholic University of Sacred Heart, Department of Education, Largo Agostino Gemelli, 1, 20123 Milan, Italy
| | - Manuela Valsecchi
- Mental Health Department, ASST S. Gerardo Monza, via Pergolesi 33, 20900 Monza, Italy
| | - Emanuele Truisi
- Mental Health Department, ASST S. Gerardo Monza, via Pergolesi 33, 20900 Monza, Italy
| | - Federico Zorzi
- Department of Medicine and Surgery, University of Milano - Bicocca, via Cadore 48, 20900 Monza, Italy
| | - Mariagrazia Strepparava
- Department of Medicine and Surgery, University of Milano - Bicocca, via Cadore 48, 20900 Monza, Italy; Mental Health Department, ASST S. Gerardo Monza, via Pergolesi 33, 20900 Monza, Italy
| | - Massimo Clerici
- Department of Medicine and Surgery, University of Milano - Bicocca, via Cadore 48, 20900 Monza, Italy; Mental Health Department, ASST S. Gerardo Monza, via Pergolesi 33, 20900 Monza, Italy
| | - Umberto Mazza
- Clinical Psychology, Mental Health Department, Niguarda Hospital, piazza Ospedale Maggiore, 3, 20162 Milan, Italy
| | - Giorgio Rezzonico
- Department of Medicine and Surgery, University of Milano - Bicocca, via Cadore 48, 20900 Monza, Italy
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Liu X, Huang Y, Liu Y. Prevalence, distribution, and associated factors of suicide attempts in young adolescents: School-based data from 40 low-income and middle-income countries. PLoS One 2018; 13:e0207823. [PMID: 30566431 PMCID: PMC6300318 DOI: 10.1371/journal.pone.0207823] [Citation(s) in RCA: 62] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 11/05/2018] [Indexed: 02/05/2023] Open
Abstract
Suicide attempts are the most important known predictor of death by suicide. The aim of this study is to examine the prevalence, distribution, and associated factors of suicide attempts among young adolescents in 40 low-income and middle-income countries. We used data from the Global School-Based Student Health Survey (2009–2013) and a nationally representative study in China (2010), which are school-based surveys of students primarily aged 12–18 years that assess health behaviors using an anonymous, standardized, self-reported questionnaire. We calculated the prevalence of suicide attempts in young adolescents from 40 low-income and middle-income countries using the surveys. Multilevel logistic models were used to estimate the associations between suicide attempts and potential risk factors, adjusting for gender, age, school and survey year. Results show that the mean 12-month prevalence of suicide attempts was 17.2%, ranging from 6.7% in Malaysia to 61.2% in Samoa. The overall prevalence of suicide attempts was higher for girls than for boys (18.2% vs 16.2%, P<0.05). Among the suicide attempts, the proportion of suicide attempts with a plan was higher for girls than for boys (62.7% vs 53.2%, P<0.05). Both the prevalence of suicide attempts and the proportion of suicide attempts with a plan increased with age. Factors associated with suicide attempts included poor socioeconomic status, history of bullying, loneliness and anxiety, tobacco and alcohol use, and weak family and social relationships. In conclusion, suicide attempts are frequent among young adolescents in low-income and middle-income countries. Girls and older adolescents tend to make suicide attempts with a plan. The data demonstrate the need to strengthen suicide intervention and prevention programs for young adolescents in low-income and middle-income countries.
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Affiliation(s)
- Xiang Liu
- Department of Health and Social Behavior, School of Public Health, Sichuan University, Chengdu, Sichuan Province, China
| | - Yi Huang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China
| | - Yuanyuan Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Sichuan University, Chengdu, Sichuan Province, China
- * E-mail:
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Liu ZZ, Chen H, Bo QG, Chen RH, Li FW, Lv L, Jia CX, Liu X. Psychological and behavioral characteristics of suicide attempts and non-suicidal self-injury in Chinese adolescents. J Affect Disord 2018; 226:287-293. [PMID: 29024902 DOI: 10.1016/j.jad.2017.10.010] [Citation(s) in RCA: 57] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Revised: 09/24/2017] [Accepted: 10/01/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Suicide attempts (SA) and non-suicidal self-injury (NSSI) are prevalent in adolescents and important risk factors of suicide death. Both SA and NSSI are associated with multiple psychosocial, behavioral, biological and genetic factors. This study examined similarities and differences in psychological vulnerability and internalizing and externalizing problems between adolescents with SA and NSSI. METHODS Participants consisted of 11,831 students and had a mean age of 14.97 (SD = 1.46) years. Students completed a structured questionnaire to report their demographic information, psychological characteristics, internalizing and externalizing problems, SA and NSSI. Based on the history of NSSI and SA in the last year, the sample was divided into four groups: non-self-harm (NSH), NSSI only, SA only, and NSSI+SA. Multivariate analyses of covariance and post-hoc pairwise comparisons were performed for multiple comparisons. RESULTS Compared with NSH group, adolescents with either NSSI or SA scored significantly higher on trait anger, impulsiveness, hopelessness, internalizing and externalizing problems. NSSI+SA group and SA only group scored significantly higher than NSSI only group but both did not score significantly different on most psychological and behavioral variables. LIMITATIONS Limitations include reliance on self-reported measures and cross-sectional survey. CONCLUSIONS Psychological and behavioral profiles between adolescents with SA and NSSI are similar but are more severe in suicide attempters. The findings highlight the necessity of assessing psychological and behavioral problems for prevention and early intervention of adolescent self-harm.
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Affiliation(s)
- Zhen-Zhen Liu
- Department of Epidemiology, Shandong University School of Public Health and Shandong University Center for Suicide Prevention Research, Jinan 250012, China
| | - Hua Chen
- Department of Epidemiology, Shandong University School of Public Health and Shandong University Center for Suicide Prevention Research, Jinan 250012, China
| | - Qi-Gui Bo
- Centers for Disease Control and Prevention of Lijin County, Lijin 257400, China
| | - Ren-Hong Chen
- Centers for Disease Control and Prevention of Yanggu County, Yanggu 252300, China
| | - Feng-Wen Li
- Centers for Disease Control and Prevention of Zoucheng City, Zoucheng 273500, China
| | - Lei Lv
- Education bureau of Yanggu County, Yanggu 252300, China
| | - Cun-Xian Jia
- Department of Epidemiology, Shandong University School of Public Health and Shandong University Center for Suicide Prevention Research, Jinan 250012, China.
| | - Xianchen Liu
- Department of Epidemiology, Shandong University School of Public Health and Shandong University Center for Suicide Prevention Research, Jinan 250012, China; School of Psychology, South China Normal University, Shipai, Guangzhou 510631, China; The University of Tennessee Health Science Center, Memphis, TN 38163, United States.
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Bhola P, Manjula M, Rajappa V, Phillip M. Predictors of non-suicidal and suicidal self-injurious behaviours, among adolescents and young adults in urban India. Asian J Psychiatr 2017; 29:123-128. [PMID: 29061408 DOI: 10.1016/j.ajp.2017.04.024] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 04/19/2017] [Accepted: 04/28/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND The complex intersections between non-suicidal self-injurious (NSSI) behaviours; like cutting, burning or self-hitting, and suicide attempts, are an important domain of enquiry among vulnerable adolescents and young adults. A cross-sectional survey in urban schools and colleges assessed the rates of self-injurious behaviour among Indian adolescents and young adults. Predictors of NSSI and of self-injurious behaviours with associated suicidal intent, were also examined. PARTICIPANTS AND METHODS The sample comprised 1571 male and female students, from 19 private and government aided high schools, pre-university colleges and undergraduate colleges in an urban city in South India. Participants completed the Functional Assessment of Self-Mutilation which assesses the methods, characteristics and functions of self-injurious acts in the past 12 months. The measures of psychopathology included the Youth Self-Report and the Young-Adult Self-Report. RESULTS AND CONCLUSION The results indicated that rate of NSSI was 33.8%, with minor forms of self-injury reported more often (19.4%) than the moderate/severe forms (14.6%). A smaller proportion (6.8%) reported self-injurious acts with associated suicidal intent. Certain self-injury characteristics and levels of internalizing and externalizing problems differentiated self-injuring youth with and without suicidal intent. Logistic regression analyses identified predictors of any self-injurious behaviour and of self-injury associated with suicidal intent. The implications for assessment and intervention frameworks for self-injuring youth are discussed.
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Affiliation(s)
- Poornima Bhola
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bangalore, 560029, India.
| | - Munivenkatappa Manjula
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bangalore, 560029, India
| | - Vanitha Rajappa
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bangalore, 560029, India
| | - Mariamma Phillip
- Department of Biostatistics, National Institute of Mental Health and Neuro Sciences, Bangalore, 560 029, India
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Wong WHS, Lee JCY, Ho FKW, Li TMH, Ip P, Chow CB. Stock Market Fluctuations and Self-Harm among Children and Adolescents in Hong Kong. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14060623. [PMID: 28598378 PMCID: PMC5486309 DOI: 10.3390/ijerph14060623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 05/22/2017] [Accepted: 05/31/2017] [Indexed: 06/07/2023]
Abstract
Although a few studies investigated the impact of stock market fluctuations on population health, the question of whether stock market fluctuations have an impact on self-harm in children and adolescents remain unanswered. This study therefore investigated the association between stock market fluctuations and self-harm among children and adolescents in Hong Kong. Daily self-harm attendance records were retrieved from all 18 local Accident and Emergency Departments (AED) from 2001 to 2012. 4931 children and adolescents who committed self-harm were included. The results indicated positive correlation between daily change in stock market index, Hang Seng Index (∇HSI, per 300 points), and daily self-harm incident risk of children and adolescents, without time lag between the two. The incident risk ratio for ∇HSI was 1.09 (p = 0.0339) in children and 1.06 (p = 0.0246) in adolescents. Importantly, non-trading days were found to impose significant protective effect in both groups against self-harm risk. Our results showed that stock market fluctuations were related to self-harm behaviors in children and adolescents. Parents and professionals should be educated about the potential harm of stock market fluctuations and the importance of effective parenting in reducing self-harm among children and adolescents.
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Affiliation(s)
- Wilfred Hing-Sang Wong
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
| | - James Chun-Yin Lee
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
| | - Frederick Ka-Wing Ho
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
| | - Tim Man-Ho Li
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
| | - Chun-Bong Chow
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
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Aggarwal S, Patton G, Reavley N, Sreenivasan SA, Berk M. Youth self-harm in low- and middle-income countries: Systematic review of the risk and protective factors. Int J Soc Psychiatry 2017; 63:359-375. [PMID: 28351292 DOI: 10.1177/0020764017700175] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Self-harm (defined here as an act of intentionally causing harm to own self, irrespective of the type, motive or suicidal intent) is one of the strongest antecedents of suicide in youth. While there have been a number of studies of youth self-harm in low- and middle-income countries (LMICs), there is currently no systematic review of studies of prevalence rates and risk and protective factors. AIM To systematically review the evidence relating to the prevalence rates and forms of self-harm in youth in LMICs and its relationship to family economic status, family functioning, relationship with the peer group, social relationships and academic performance. METHODS Electronic searches of three databases, MEDLINE, PsycINFO and Scopus, were performed. In total, 27 school-, community- and hospital-based studies evaluating self-harm in LMICs with youth focus (with participants between 12 and 25 years) were included. RESULTS The self-harm was divided into suicidal and non-suicidal depending on the nature of self-harm. The 12-month prevalence rates of non-suicidal self-harm varied from 15.5% to 31.3%, and the range of suicidal behaviour rates was from 3.2% to 4.7%. Banging and hitting were the most common in the community-based studies, followed by cutting, scratching and wound picking. Self-poisoning with pesticides was most commonly reported in hospital-based studies. Risk factors for self-harm were family conflict, peer groups with members indulging in self-harm, truancy and school absenteeism. Protective factors were having an understanding family, having friends and higher school competence. Risk factors for suicidal thoughts and attempts were lack of close friends and history of suicide by a friend. CONCLUSION The 12-month prevalence rates of youth self-harm in LMICs are comparable to high-income countries (HICs). The profile of risk and protective factors suggests that family-based interventions could be useful in treatment and prevention. Future studies should aim for greater consistency in assessment methods and the constructs under evaluation.
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Affiliation(s)
- Shilpa Aggarwal
- 1 IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia
| | - George Patton
- 2 Department of Pediatrics, Royal Children's Hospital, Parkville, VIC, Australia.,3 Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia
| | - Nicola Reavley
- 3 Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia
| | | | - Michael Berk
- 1 IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia.,4 Orygen: The National Centre of Excellence in Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
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Lockwood J, Daley D, Townsend E, Sayal K. Impulsivity and self-harm in adolescence: a systematic review. Eur Child Adolesc Psychiatry 2017; 26:387-402. [PMID: 27815757 PMCID: PMC5364241 DOI: 10.1007/s00787-016-0915-5] [Citation(s) in RCA: 102] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 10/27/2016] [Indexed: 12/20/2022]
Abstract
Research supports an association between impulsivity and self-harm, yet inconsistencies in methodology across studies have complicated understanding of this relationship. This systematic review examines the association between impulsivity and self-harm in community-based adolescents aged 11-25 years and aims to integrate findings according to differing concepts and methods. Electronic searches of EMBASE, MEDLINE, PsychINFO, CINAHL, PubMed and The Cochrane Library, and manual searches of reference lists of relevant reviews identified 4496 articles published up to July 2015, of which 28 met inclusion criteria. Twenty-four of the studies reported an association between broadly specified impulsivity and self-harm. However, findings varied according to the conception and measurement of impulsivity and the precision with which self-harm behaviours were specified. Specifically, lifetime non-suicidal self-injury was most consistently associated with mood-based impulsivity-related traits. However, cognitive facets of impulsivity (relating to difficulties maintaining focus or acting without forethought) differentiated current self-harm from past self-harm. These facets also distinguished those with thoughts of self-harm (ideation) from those who acted on thoughts (enaction). The findings suggested that mood-based impulsivity is related to the initiation of self-harm, while cognitive facets of impulsivity are associated with the maintenance of self-harm. In addition, behavioural impulsivity is most relevant to self-harm under conditions of negative affect. Collectively, the findings indicate that distinct impulsivity facets confer unique risks across the life-course of self-harm. From a clinical perspective, the review suggests that interventions focusing on reducing rash reactivity to emotions or improving self-regulation and decision making may offer most benefit in supporting those who self-harm.
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Affiliation(s)
- Joanna Lockwood
- Division of Psychiatry & Applied Psychology, Institute of Mental Health, University of Nottingham, Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK.
- Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan, (CANDAL) Institute of Mental Health, University of Nottingham, Nottingham, UK.
| | - David Daley
- Division of Psychiatry & Applied Psychology, Institute of Mental Health, University of Nottingham, Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK
- Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan, (CANDAL) Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Ellen Townsend
- School of Psychology, University of Nottingham, Nottingham, UK
| | - Kapil Sayal
- Division of Psychiatry & Applied Psychology, Institute of Mental Health, University of Nottingham, Innovation Park, Triumph Road, Nottingham, NG7 2TU, UK
- Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan, (CANDAL) Institute of Mental Health, University of Nottingham, Nottingham, UK
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Kelada L, Hasking P, Melvin G, Whitlock J, Baetens I. “I Do Want to Stop, At Least I Think I Do”: An International Comparison of Recovery From Nonsuicidal Self-Injury Among Young People. JOURNAL OF ADOLESCENT RESEARCH 2016. [DOI: 10.1177/0743558416684954] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Phenomenological and cultural understandings of recovery from the perspective of individuals who engage in nonsuicidal self-injury (NSSI) are rare. The primary study objective was to understand similarities across three samples in (a) how young people define recovery from NSSI and (b) what they consider helpful approaches taken by parents and professionals to assist their recovery. Using a cross-national sample of young people ( n = 98) from Australia ( n = 48), Belgium ( n = 25) and the United States ( n = 25), we assessed their perspectives on NSSI. Consistent across all samples, young people defined recovery as no longer having the urge to self-injure when distressed, often displayed ambivalence about recovery, and reported it was helpful when parents and professionals were calm and understanding. Acceptance of recovery as a process involving relapses may need to be emphasized in NSSI treatment, to ease the pressure young people often place on themselves to stop the behavior outright.
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Factores asociados a la conducta suicida en Colombia. Resultados de la Encuesta Nacional de Salud Mental 2015. ACTA ACUST UNITED AC 2016; 45 Suppl 1:68-75. [DOI: 10.1016/j.rcp.2016.03.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Revised: 03/03/2016] [Accepted: 03/25/2016] [Indexed: 11/19/2022]
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Buffering the effects of peer victimization on adolescent non-suicidal self-injury: The role of self-compassion and family cohesion. J Adolesc 2016; 53:107-115. [PMID: 27710776 DOI: 10.1016/j.adolescence.2016.09.005] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Revised: 08/22/2016] [Accepted: 09/16/2016] [Indexed: 11/22/2022]
Abstract
Non-suicidal self-injury (NSSI) is a significant behavioral problem among adolescents all over the world. This study examined the longitudinal relationship between peer victimization and NSSI, as well as the buffering effects of self-compassion and family cohesion on this relationship. Data were collected at two time points from 525 secondary school students (226 girls; Mage = 12.97, SD = 1.02) in China. Results showed that peer victimization (marginally) significantly predicted NSSI over time even after controlling for Wave 1 NSSI. This association was weakened under the condition of high levels of self-compassion. Findings of this study emphasize the buffering effect of self-compassion in the relationship between peer victimization and NSSI, and are informative for prevention and intervention of this behavioral problem.
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Law BMF, Shek DTL. A 6-year Longitudinal Study of Self-harm and Suicidal Behaviors among Chinese Adolescents in Hong Kong. J Pediatr Adolesc Gynecol 2016; 29:S38-48. [PMID: 26461529 DOI: 10.1016/j.jpag.2015.10.007] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
STUDY OBJECTIVE To examine the trajectories of self-harm and suicidal behaviors among Chinese adolescents in Hong Kong and to investigate the related predictors, including gender, family nonintactness, economic disadvantage, positive youth development, and family functioning. DESIGN We used quantitative data from a large sample of adolescent participants. Participants initially joined this study when they were in grade 7 (wave 1), and they were followed from grade 8 (wave 2) to grade 12 (wave 6). SETTING, PARTICIPANTS, AND INTERVENTIONS The participants consisted of 2023 grade 12 students from 28 secondary schools in Hong Kong. A multistage cluster random sampling method was adopted. MAIN OUTCOME MEASURES Self-harm and suicidal behaviors. RESULTS The trajectories of self-harm and suicidal behaviors in general declined from grade 7 to grade 12. Regarding the effect of gender, whereas adolescent girls showed a higher prevalence for self-harm and suicidal behaviors at baseline and other waves, adolescent boys showed a pronounced decline in self-harm rates. Adolescents from nonintact families were more likely to self-harm or engage in suicidal behaviors at wave 6. Economic disadvantage at wave 4 predicted higher suicidal behavior among adolescents but not self-harm at wave 6. Regarding positive youth development, several protective factors that include cognitive-behavioral competencies, prosocial attributes, general positive youth development qualities, and positive identity could help reduce self-harm and suicidal behaviors at different time points. Regarding the role of family functioning, more family conflicts predicted higher suicidality in adolescence (self-harm and suicidal behaviors), and family communication affected self-harming behaviors at wave 6. CONCLUSION The trajectories of self-harm and suicidal behaviors decline from early to late adolescence among Chinese adolescents. Positive youth development and constructive family functioning are critical to help reduce suicidal behaviors. Regarding increased risk, more attention should be paid to adolescent girls and adolescents from nonintact and economic disadvantaged families.
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Affiliation(s)
- Ben M F Law
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, P.R. China.
| | - Daniel T L Shek
- Department of Applied Social Sciences, The Hong Kong Polytechnic University, Hong Kong, P.R. China; Centre for Innovative Programmes for Adolescents and Families, The Hong Kong Polytechnic University, Hong Kong, P.R. China; School of Social Development, East China Normal University, Shanghai, P.R. China; Kiang Wu Nursing College of Macau, Macau, P.R. China; Division of Adolescent Medicine, Department of Pediatrics, Kentucky Children's Hospital, University of Kentucky College of Medicine, Lexington, Kentucky
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Fresán A, Camarena B, González-Castro TB, Tovilla-Zárate CA, Juárez-Rojop IE, López-Narváez L, González-Ramón AE, Hernández-Díaz Y. Risk-factor differences for nonsuicidal self-injury and suicide attempts in Mexican psychiatric patients. Neuropsychiatr Dis Treat 2016; 12:1631-7. [PMID: 27462155 PMCID: PMC4939986 DOI: 10.2147/ndt.s110044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The present study compared sociodemographic characteristics, comorbidities with substance use, and impulsivity features in three groups of psychiatric patients - suicide attempters, nonsuicidal self-injury, and nonsuicidal without self-injury - to determine the predictive factors for nonsuicidal self-injury or suicide behavior. PATIENTS AND METHODS Demographic features and self-reported substance use were assessed in 384 Mexican psychiatric patients. Impulsivity features were evaluated using the Plutchik Impulsivity Scale. Comparison analyses between groups were performed and a logistic regression model used to determine the factors associated with nonsuicidal with self-injury behavior and suicidal behavior. RESULTS Different predictive factors were observed for nonsuicidal self-injury and suicidal behavior. Females were more likely to present nonsuicidal self-injury behaviors (odds ratio [OR] 0.42, 95% confidence interval [CI] 0.18-0.93; P=0.03). For suicide attempters, the factors associated were younger age (OR 0.89, 95% CI 0.85-0.93; P<0.001), less than 6 years of schooling (OR 0.2, 95% CI 0.06-0.6; P=0.004), and higher impulsivity traits, such as self-control (OR 1.19, 95% CI 1.03-1.36; P=0.01), planning of future actions (OR 0.79, 95% CI 0.66-0.95; P=0.01), and physiological behavior (OR 1.34, 95% CI 1.01-1.78; P=0.03). CONCLUSION Our results show that in a Mexican population, impulsivity features are predictors for suicide attempts, but not for self-injury. Other factors related to sociocultural background and individual features (such as personality) may be involved in this behavioral distinction, and should be studied in future research aimed at better understanding of both self-harmful behaviors.
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Affiliation(s)
- Ana Fresán
- Subdirección de Investigaciones Clínicas, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, México City
| | - Beatriz Camarena
- Departamento de Genética Psiquiátrica, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, México City
| | | | | | | | | | - Alicia E González-Ramón
- División Académica Multidisciplinaria de Comalcalco, Universidad Juárez Autónoma de Tabasco, Comalcalco
| | - Yazmín Hernández-Díaz
- División Académica Multidisciplinaria de Jalpa de Méndez, Universidad Juárez Autónoma de Tabasco, Jalpa de Méndez
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Gholamrezaei M, De Stefano J, Heath NL. Nonsuicidal self-injury across cultures and ethnic and racial minorities: A review. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2015; 52:316-326. [PMID: 26644040 DOI: 10.1002/ijop.12230] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 10/01/2015] [Indexed: 11/08/2022]
Abstract
The field of nonsuicidal self-injury (NSSI) is dominated by research conducted with Caucasian-majority samples in Western countries such as United States, Canada, Australia and European countries. This article critically reviewed the empirical research on NSSI in non-Western countries and among ethnic/racial minority individuals who live in the West to give voice to and understand the patterns of NSSI among individuals who do not fall within the dominant Caucasian majority. The study found both similarities and differences between Western and non-Western data in terms of characteristics and functions of NSSI. Differences in gender patterns in regards to prevalence of NSSI and methods used as well as presence of a more relational functionality of NSSI rather than emotion regulation functionality were two points of divergence in the findings of these studies. In addition, the findings seem to indicate that the role of ethnicity/race is mediated by important factors such as socioeconomic status (SES) and gender. Existing gaps in the literature and suggestions for further research are discussed.
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Affiliation(s)
- Maryam Gholamrezaei
- Department of Educational and Counselling Psychology, McGill University, Montreal, Canada
| | - Jack De Stefano
- Department of Educational and Counselling Psychology, McGill University, Montreal, Canada
| | - Nancy L Heath
- Department of Educational and Counselling Psychology, McGill University, Montreal, Canada
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Parents of youth who self-injure: a review of the literature and implications for mental health professionals. Child Adolesc Psychiatry Ment Health 2015; 9:35. [PMID: 26421058 PMCID: PMC4586015 DOI: 10.1186/s13034-015-0066-3] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 06/25/2015] [Indexed: 11/18/2022] Open
Abstract
Non-suicidal self-injury (NSSI) is a common mental health concern among youth, and parents can be valuable supports for these youth. However, youth NSSI can have a significant impact on parents' wellbeing, which may in turn alter parents' ability to support the youth. To date, no single article has consolidated the research on parents of youth who self-injure. This review synthesizes the literature on parent factors implicated in youth NSSI risk, the role of parents in help-seeking and intervention for youth NSSI, and the impact of youth NSSI on parent wellbeing and parenting. Clinical implications for supporting parents as they support the youth are also discussed, and recommendations for future research are outlined.
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Hu J, Dong Y, Chen X, Liu Y, Ma D, Liu X, Zheng R, Mao X, Chen T, He W. Prevalence of suicide attempts among Chinese adolescents: A meta-analysis of cross-sectional studies. Compr Psychiatry 2015; 61:78-89. [PMID: 26005111 DOI: 10.1016/j.comppsych.2015.05.001] [Citation(s) in RCA: 172] [Impact Index Per Article: 19.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 04/10/2015] [Accepted: 05/04/2015] [Indexed: 10/23/2022] Open
Abstract
OBJECTIVE According to World Health Organization, for every committed suicide there were 20 suicide attempts at least. In the last decade, despite the increasing awareness on suicide attempts among adolescents in China, there has been no comprehensive system reporting vital statistics. Consequently, the prevalence of suicide attempts reported in some studies ranged variedly. Therefore, the purpose of this study was to provide the first meta-analysis of cross-sectional studies of suicide attempts to fill this gap. METHODS Two reviewers independently screened potentially relevant cross-sectional studies of suicide attempts through PubMed-Medline, Embase, Wanfang Data, Chongqing VIP and Chinese National Knowledge Infrastructure databases using the core terms 'suicid*'/'suicide attempt*'/'attempted suicide' and 'adolescen*'/'youth'/'child*'/'student*' and 'China'/'Chinese' in the article titles, abstracts and keywords. Chi-square based Q test and I(2) statistic assessed the heterogeneity. Forest plot was used to display results graphically. Potential publication bias was assessed by the funnel plot, Begg's and Egger's test. RESULTS In total, 43 studies with 200,124 participants met the eligibility criteria. The pooled prevalence of suicide attempts among Chinese adolescents was 2.94% (95% CI: 2.53%-3.41%). Substantial heterogeneity in prevalence estimates was revealed. Subgroup analyses showed that the prevalence for males was 2.50% (95% CI: 2.08%-3.01%), and for females was 3.17% (95% CI: 2.56%-3.91%). CONCLUSIONS In sum, abstracting across the literatures, the prevalence of suicide attempts among Chinese adolescents was moderate compared with other countries around the world. Necessary measures should be set out prevent them in the future.
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Affiliation(s)
- Jiande Hu
- Nanhui Mental Health Center, Pudong New Area, Shanghai, 201300, China
| | - Yonghai Dong
- Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, 330029, China.
| | - Xiaodan Chen
- Jiangxi Provincial Cancer Hospital, 519 Beijing East Road, Nanchang 330029, Jiangxi, China
| | - Yun Liu
- Cadre Wards of Neurology Medicine, Jiangxi Provincial People's Hospital, Nanchang, 330006, China
| | - Dongyang Ma
- Nanhui Mental Health Center, Pudong New Area, Shanghai, 201300, China
| | - Xiaoyun Liu
- Cadre Wards of Neurology Medicine, Jiangxi Provincial People's Hospital, Nanchang, 330006, China
| | - Ruizhi Zheng
- School of Public Health, Zhejiang University, Hangzhou, 310058, China
| | - Xiangqun Mao
- Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, 330029, China
| | - Ting Chen
- Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, 330029, China
| | - Wei He
- Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, 330029, China
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Gender differences in socio-demographic, clinical characteristics and psychiatric diagnosis in/of suicide attempters in a Mexican population. Acta Neuropsychiatr 2015; 27:182-8. [PMID: 25686910 DOI: 10.1017/neu.2015.6] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE The aim of the present study was to analyse demographic and clinical characteristics, as well as psychiatric diagnoses to identify gender differences in patients with attempted suicide in a Mexican population. METHODS Between September 2010 and September 2012, 140 suicide attempts were documented in the Department of Psychiatry at the General Hospital of Comalcalco (Hospital General de Comalcalco in Spanish) in Tabasco, Mexico. Diagnoses were established using the DSM-IV questionnaire in which Axis I and II were considered. The Suicide Intent Scale was also applied. RESULTS In our sample, 63.6% were females and 36.4% males. With regard to socio-demographic characteristics, the predominant marital status in males was single, and in females married (χ2=5.93, df=2, p=0.05). In occupation the male group was mainly unemployed and housewife in females (χ2=55.51, df=4, p<0.001). Male subjects were more likely to consume alcohol (χ2=20.40, df=1, p≤0.001), cannabis (χ2=16.62, df=1, p≤0.001) or tobacco. The prevalence of psychiatric diagnosis was significantly different because, the male group was mainly diagnosed with substance-related disorders, whereas female participants showed a prevalence of stress-related disorders (χ2=34.17, gl=4, p=0.0001). CONCLUSION Our results provide evidence that the characteristics of suicide attempt are different by gender in the Mexican population. Interventions are necessary for the development of prevention strategies that may lead to a reduction in suicidal behaviour. These preventive activities should consider the occupation for the female group and consumption of alcohol, cannabis or tobacco in the male group.
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