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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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2
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Lietzau SB, Dardis CM. Unwanted Pursuit Behavior Victimization as a Predictor of Engagement in Nonsuicidal Self-Injury. VIOLENCE AND VICTIMS 2024; 39:425-442. [PMID: 39019568 DOI: 10.1891/vv-2021-0173] [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: 07/19/2024]
Abstract
While prior research has studied associations between child abuse and nonsuicidal self-injury (NSSI), there is limited research assessing unwanted pursuit behavior (UPB) victimization and NSSI. In addition, few studies have assessed the self-reported functions of NSSI among survivors of violence. Among a sample of 18-25-year-old young adults (N = 333), both UPB victimization and child abuse were significantly associated with NSSI frequency. In regression models, UPB victimization was associated with increased use of affect regulation, antidissociation/feeling-generation, self-punishment, and antisuicide functions, while child abuse was associated only with antidissociation/feeling-generation and self-punishment. Affect regulation mediated the association between UPB victimization and NSSI frequency, but not the association between child victimization and NSSI frequency. Implications for research and clinical practice will be discussed.
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Vatanparast A, Shakiba S, Momeni F, Kamrani A. The relationship between childhood maltreatment and self-harm: the mediating roles of alexithymia, dissociation, internalizing and posttraumatic symptoms. Eur J Psychotraumatol 2024; 15:2378642. [PMID: 39028641 PMCID: PMC11262236 DOI: 10.1080/20008066.2024.2378642] [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: 01/17/2024] [Accepted: 07/04/2024] [Indexed: 07/21/2024] Open
Abstract
Background: Although childhood maltreatment is associated with later self-harm, the mechanism through which it might lead to self-harm is not completely understood. The purpose of this study was to examine the roles of alexithymia, dissociation, internalizing and posttraumatic symptoms in the association between exposure to childhood maltreatment and subsequent self-harm.Methods: A total of 360 adolescents were asked to complete the Childhood Trauma Questionnaire, the Toronto Alexithymia Scale, the Dissociative Experience Scale, the Somatoform Dissociation Questionnaire-20, the Posttraumatic Stress Checklist for DSM-5, and the Deliberate Self-Harm Inventory.Results: Results of structural equation modelling analysis revealed the significant mediation effects of alexithymia and dissociative symptoms in the relationship between childhood maltreatment and self-harm, while internalizing and posttraumatic symptoms did not significantly mediate.Conclusion: The findings indicate that alexithymia and dissociative symptoms may be proximal mechanisms linking maltreatment exposure and adolescence self-harm.
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Affiliation(s)
- Amin Vatanparast
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Shima Shakiba
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Fereshte Momeni
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ali Kamrani
- Department of Occupational Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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Wang Q. Childhood Trauma and Non-Suicidal Self-Injury Among Chinese Adolescents: The Chain-Mediated Role of Alexithymia and Rumination. Psychiatry Investig 2024; 21:726-735. [PMID: 39089698 PMCID: PMC11298262 DOI: 10.30773/pi.2024.0041] [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: 02/20/2024] [Revised: 04/07/2024] [Accepted: 05/09/2024] [Indexed: 08/04/2024] Open
Abstract
OBJECTIVE To explore the associations between childhood trauma, alexithymia, rumination, and non-suicidal self-injury (NSSI) among adolescents and to provide theoretical and empirical evidence for effective prevention, identification, and intervention of NSSI in the future. METHODS Questionnaires, including the Childhood Trauma Questionnaire, the twenty-item Toronto Alexithymia scale, the Ruminative Responses Scale, and the Adolescents Self-Harm Scale, were given to 1,270 Chinese teenagers. The mediating role was simulated utilizing Amos 24.0. RESULTS The Pearson's product-difference correlation analyses indicated the two-by-two significant correlations between childhood trauma, alexithymia, rumination, and NSSI. The structural equation modeling suggests that alexithymia and rumination partially mediate between childhood trauma and NSSI in teenagers, respectively. Additionally, it reveals that alexithymia and rumination chain mediate between childhood trauma and NSSI. CONCLUSION The study confirms the impact of childhood trauma on adolescents' NSSI and also highlights the mediating role of alexithymia and rumination between the two. This study enriches the findings of NSSI and provides a theoretical basis for preventing and intervening in dysfunctional behaviors among adolescents.
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Affiliation(s)
- Qiaoling Wang
- Education Center for Mental Health, Yantai Vocational College of Culture and Tourism, Shandong, China
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Liang Y, Wang Y, Bai R, Liu X. Gender-Specific Trajectories of Non-Suicidal Self-Injury among Adolescents: Predictive Roles of Distal and Proximal Risk Factors. J Youth Adolesc 2024:10.1007/s10964-024-02040-4. [PMID: 38926214 DOI: 10.1007/s10964-024-02040-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 06/19/2024] [Indexed: 06/28/2024]
Abstract
Non-suicidal self-injury (NSSI) is considered a strong risk factor for suicide. Although NSSI is prevalent among adolescents and varies by gender, few studies have examined the gender-specific trajectory of NSSI and its predictors. This study examined the trajectory of NSSI among Chinese adolescent boys and girls separately, and the roles of distal (i.e., childhood maltreatment and its specific subtypes) and proximal risk factors (i.e., emotional dysregulation, peer victimization) on their trajectories. A total of 3290 Chinese adolescents (Mage = 13.08; SD = 0.84; 57.6% boys) participated in assessments at three time points. Latent class growth models identified three trajectories for boys: Low stable (92.5%), moderate increasing (5.0%) and high decreasing (2.5%). Four trajectories were identified for girls: Low stable (87.9%), moderate increasing (7.6%), high decreasing (3.0%) and high stable (1.5%). Multinomial logistic regression analyses revealed that both emotional dysregulation and emotional abuse predicted the trajectories of moderate increasing, high decreasing and high stable for girls, as well as predicted moderate increasing and high decreasing trajectories for boys. Peer victimization served as a significant risk factor predicting the moderate increasing and high decreasing trajectories only for girls, while overall childhood maltreatment was a remarkable predictor for the moderate increasing and high decreasing trajectories of boys. The findings highlighted the importance of gender differences in understanding the progression of NSSI and the key predictors, informing effective strategies for prevention and intervention.
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Affiliation(s)
- Yiting Liang
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Yumeng Wang
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Rong Bai
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Xia Liu
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China.
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Cao P, Peng R, Yuan Q, Zhou R, Ye M, Zhou X. Predictors of non-suicidal self-injury in adolescents with depressive disorder: the role of alexithymia, childhood trauma, and body investment. Front Psychol 2024; 15:1336631. [PMID: 38638510 PMCID: PMC11024233 DOI: 10.3389/fpsyg.2024.1336631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 02/27/2024] [Indexed: 04/20/2024] Open
Abstract
Purpose This study analyzes the relationship of alexithymia, childhood trauma, and body investment to non-suicidal self-injury (NSSI) behaviors in adolescents with depressive disorder and whether they have predictive and diagnostic value for non-suicidal self-injury (NSSI) behaviors in adolescents with depressive disorder. Patients and methods A total of 225 patients with a diagnosis of adolescent depressive disorder were included in the study and were divided into two groups according to the DSM-5 criteria: 98 cases without NSSI and 127 cases with NSSI. Compare the demographic data, 24-item Hamilton Depression Scale (HAMD-24), 20-item Toronto Alexithymia Scale (TAS-20), Childhood Trauma Questionnaire-Short Form (CTQ-SF), and Body Investment Scale (BIS) scores between two groups. Binary logistic regression was used to analyze the independent risk factors contributing to NSSI behaviors in adolescents with depression, and establish four predictive models. Based on the models' predictive probability, the ROC curves were plotted to calculate the value of the predictive diagnostic effect. Results The group without NSSI had lower scores than the group with NSSI on HAMD-24 total score, TAS-20 total score, difficulty identifying feelings, difficulty describing feelings, and externally focused thinking, as well as lower scores on CTQ-SF total score, physical neglect, emotional neglect, physical abuse, and emotional abuse. In contrast, the BIS total score, body image feelings and attitudes, body care, and body protection factor scores were higher for the group without NSSI. The BIS body care factor score and the CTQ-SF emotional abuse factor score were significantly linked with adolescents diagnosed with depressive disorder who exhibited NSSI behaviors. These results provide a good diagnostic model for adolescents with depressive disorder. Conclusion Low levels of body care and childhood emotional abuse may independently contribute to the implementation of NSSI in adolescents with depressive disorder. Body investment and childhood trauma are valuable in diagnosing and predicting NSSI behaviors and should be considered as potentially important factors in clinical treatment.
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Affiliation(s)
- Panpan Cao
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Anhui Psychiatric Center, Hefei, China
| | - Ran Peng
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Anhui Psychiatric Center, Hefei, China
| | - Qiuyu Yuan
- Bengbu Mental Health Center, Anhui Veterans Hospital, Anmin Hospital Affiliated to Bengbu Medical College, Bengbu, China
| | - Ruochen Zhou
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Anhui Psychiatric Center, Hefei, China
| | - Mengting Ye
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Anhui Psychiatric Center, Hefei, China
| | - Xiaoqin Zhou
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Anhui Psychiatric Center, Hefei, China
- Department of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
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Bahali K, Durcan G, Topal M, Önal BS, Bilgiç A, Tanıdır C, Aytemiz T, Yazgan Y. Parental attachment and childhood trauma in adolescents engaged in non-suicidal self-injury. Early Interv Psychiatry 2024; 18:173-180. [PMID: 37438893 DOI: 10.1111/eip.13452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 06/06/2023] [Accepted: 07/02/2023] [Indexed: 07/14/2023]
Abstract
AIM In this study, it was aimed to compare parental attachment and childhood traumas in adolescents with NSSI with healthy peers. METHODS Fifty adolescents aged 14-18 years with lifetime NSSI and 56 healthy peers were included in the study. Inventory of Statements About Self-injury (ISAS), The Parental Bonding Instrument (PBI) and Child Trauma Questionnaire (CTQ-28) scales were used. RESULTS Eighty-two percentage of the NSSI group and 70% of the control group were girls. The mean age was 15.6 ± 1.1 years in the NSSI group and 15.3 ± 0.9 years in the control group. There was no significant difference between the groups in terms of age and gender. The NSSI group had more negative scores than the control group in terms of childhood traumas and attachment characteristics to both mother and father. The analyses showed that mother PBI care/control and sexual abuse score had a relationship with both ISAS Autonomic Functions and ISAS Social Functions scores. CONCLUSIONS These results suggest that secure attachment with the mother may be protective for both the autonomic and social functions of the NSSI. Therefore, interventions for dysfunctional parental attachment may prevent the development of NSSI.
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Affiliation(s)
- Kayhan Bahali
- Department of Psychology, Istanbul Gelisim University, Istanbul, Turkey
| | - Gizem Durcan
- Department of Child and Adolescent Psychiatry, Medical Faculty of Cerrahpasa, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Melike Topal
- Department of Child and Adolescent Psychiatry, University of Health Sciences, Basaksehir Cam ve Sakura Research and Training Hospital, Istanbul, Turkey
| | - Bedia Sultan Önal
- Department of Child and Adolescent Psychiatry, Medical Faculty, Giresun University, Giresun, Turkey
| | - Ayhan Bilgiç
- Faculty of Medicine, Izmir University of Economics, İzmir, Turkey
| | - Canan Tanıdır
- Department of Psychology, Istanbul Gelisim University, Istanbul, Turkey
| | - Tuğçe Aytemiz
- Child and Adolescent Psychology Laboratory, University of Health Sciences, Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
| | - Yankı Yazgan
- Department of Child and Adolescent Psychiatry, Güzel Günler Clinic, Istanbul, Turkey
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
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Klebanov B, Tsur N, Katz C. "Many bad things had been happening to me": Children's perceptions and experiences of polyvictimization in the context of child physical abuse. CHILD ABUSE & NEGLECT 2023; 145:106429. [PMID: 37683405 DOI: 10.1016/j.chiabu.2023.106429] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 08/14/2023] [Accepted: 08/20/2023] [Indexed: 09/10/2023]
Abstract
BACKGROUND The association between child maltreatment and polyvictimization has received growing attention since being identified by Finkelhor and colleagues in 2005. OBJECTIVE The current study was designed to explore the experiences and perceptions of children who reported polyvictimization during forensic interviews. METHODS This mixed-methods study sample comprised 117 children aged 5-14, referred for the first time to forensic interviews following suspected physical abuse by a parent. More than one-third of the children reported polyvictimization. A thematic analysis was carried out to spotlight these children's experiences. RESULTS The analysis identified three main themes: the way children comprehend the polyvictimization, the consequences of the polyvictimization regarding the children's negative self-attribution, and the way the polyvictimization was constructed through the dynamic with the forensic interviewers. CONCLUSIONS The findings pointed to the importance of the forensic interview platform in assessing children's maltreatment burden. The current study also provided a glance into the possible involvement of the mechanics of self-blame among maltreated children. These findings have the potential to enhance our understanding of the excessive psychological toll taken on polyvictimized children.
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Affiliation(s)
- Bella Klebanov
- Bob Shapell Scool of Social Work, Tel Abib university, Israel
| | - Noga Tsur
- Bob Shapell Scool of Social Work, Tel Abib university, Israel
| | - Carmit Katz
- Bob Shapell Scool of Social Work, Tel Abib university, Israel.
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Korem N, Ben-Zion Z, Spiller TR, Duek OA, Harpaz-Rotem I, Pietrzak RH. Correlates of avoidance coping in trauma-exposed U.S. military veterans: Results from the National Health and Resilience in Veterans Study. J Affect Disord 2023; 339:89-97. [PMID: 37437721 DOI: 10.1016/j.jad.2023.07.036] [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: 03/06/2023] [Revised: 06/13/2023] [Accepted: 07/08/2023] [Indexed: 07/14/2023]
Abstract
Avoidant coping strategies, which involve cognitions and behaviors aimed to avoid dealing with stressful experiences, are associated with adverse long-term mental and physical health outcomes. In response to traumatic events, these strategies can be maladaptive as they may interfere with the adaptive integration of traumatic events into consolidated memories. Using data from a nationally representative sample of more than 3000 trauma-exposed U.S. military veterans (mean time since trauma 30.9 years, SD = 19.9), we employed a network analytic approach to examine pairwise associations between key sociodemographic, personality, and psychosocial risk factors in relation to the endorsement of avoidant coping strategies. Results revealed that negative affect symptoms of posttraumatic stress disorder (PTSD) and adverse childhood experiences were positively associated with engagement in avoidance coping, and that greater emotional stability and conscientiousness were negatively associated with this measure. Secondary network analysis of individual negative affect symptoms of PTSD suggested that blaming oneself and/or others for the traumatic event, emotional neglect, and sexual abuse were most strongly linked to avoidance coping. Collectively, these results suggest that strong feelings of blame related to trauma, emotional neglect, and sexual abuse are associated with greater likelihood of engaging in avoidance coping, while emotional stability and conscientiousness are associated with a lower likelihood of engaging in such strategies.
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Affiliation(s)
- Nachshon Korem
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Department of Comparative Medicine, Yale University School of Medicine, New Haven, CT, USA; U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA.
| | - Ziv Ben-Zion
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Department of Comparative Medicine, Yale University School of Medicine, New Haven, CT, USA; U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA
| | - Tobias R Spiller
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA; University of Zurich (UZH), Zurich, Switzerland; Department of Consultation-Liaison Psychiatry and Psychosomatic Medicine, University Hospital Zurich (USZ), Zurich, Switzerland; Psychiatric University Hospital Zurich (PUK), Zurich, Switzerland
| | - Or A Duek
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; Department of Epidemiology, Biostatistics and Community Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ilan Harpaz-Rotem
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA; Department of Psychology, Yale University, New Haven, CT, USA
| | - Robert H Pietrzak
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA; U.S. Department of Veterans Affairs National Center for Posttraumatic Stress Disorder, VA Connecticut Healthcare System, West Haven, CT, USA; Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, CT, USA
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Ilieff M, Hamza CA. A Longitudinal Examination of Recent Posttraumatic Stress Symptoms and Nonsuicidal Self-Injury among University Students. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:773-782. [PMID: 37593057 PMCID: PMC10427599 DOI: 10.1007/s40653-023-00544-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/30/2023] [Indexed: 08/19/2023]
Abstract
Nonsuicidal self-injury is a burgeoning mental health concern amongst post-secondary students. In the present study, the link between posttraumatic stress symptoms (PTSS) and nonsuicidal self-injury (NSSI) was examined among post-secondary students over time, while accounting for the role of co-occurring depressive symptoms. Participants were 841 first-year university students with self-reported lifetime histories of trauma who reported on traumatic experiences, PTSS, depressive symptoms, and NSSI at three time points over the course of their first year of university. This study also included exploratory correlational analyses of the relation among PTSS and motivations for NSSI engagement. As expected, PTSS predicted NSSI engagement among students within and across time, though effects were small. The strongest correlations were among PTSS and engaging in NSSI for the purposes of fulfilling self-punishment desires and anti-dissociation (e.g., to reduce feelings of numbness). This study provides further support for theories underscoring NSSI as a means of coping with intra- and interpersonal distress among post-secondary students experiencing stressful life events, such as trauma.
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Affiliation(s)
- Maria Ilieff
- Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, 252 Bloor St W, Toronto, ON M5S 1V6 Canada
| | - Chloe A. Hamza
- Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, 252 Bloor St W, Toronto, ON M5S 1V6 Canada
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Yue Y, Wang Y, Yang R, Zhu F, Yang X, Lu X, Zhu P, Wu Z, Li Z, Zhao X, Du X. Gender difference in the associations of childhood maltreatment and non-suicidal self-injury among adolescents with mood disorders. Front Psychiatry 2023; 14:1162450. [PMID: 37304441 PMCID: PMC10248456 DOI: 10.3389/fpsyt.2023.1162450] [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: 02/09/2023] [Accepted: 05/09/2023] [Indexed: 06/13/2023] Open
Abstract
Background Non-suicidal self-injury (NSSI) is a common feature among adolescents with mood disorders. Although childhood maltreatment has shown to be associated with non-suicidal self-injury (NSSI), previous studies have yielded mixed results in terms of different subtypes of childhood maltreatment and only few studies have investigated the effects of gender. The present cross-sectional study investigated effects of different types of childhood maltreatment on NSSI, as well as the role of gender in these effects. Methods In this cross-sectional study, a total of 142 Chinese adolescent inpatients with mood disorders (37 males and 105 females) were consecutively recruited within a psychiatric hospital. Demographic and clinical characteristics were collected. Participants were administered the Childhood Trauma Questionnaire (CTQ), the Functional Assessment of Self-Mutilation (FASM). Results 76.8% of the sample reported engaging NSSI in the previous 12 months. Female participants were more likely to engage in NSSI than males (p < 0.001). Participants in the NSSI group reported significantly more experiences of emotional abuse (p < 0.001) and emotional neglect (p = 0.005). With regards to gender differences, female participants who have experienced emotional abuse were more likely to engage in NSSI (p = 0.03). Conclusion As a whole, NSSI represents a frequent phenomenon among adolescent clinical populations and females were more likely to engage in NSSI than males. NSSI was significantly related to experiences of childhood maltreatment and specifically related to emotional abuse and emotional neglect over and above other types of childhood maltreatment. Females were more sensitive to emotional abuse than males. Our study highlights the importance of screening for subtypes of childhood maltreatment as well as considering the effects of gender.
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Affiliation(s)
- Yan Yue
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
- Suzhou Medical College of Soochow University, Suzhou, China
| | - Yi Wang
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Ruchang Yang
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
- Suzhou Medical College of Soochow University, Suzhou, China
| | - Feng Zhu
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Xuna Yang
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Xinchuan Lu
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Ping Zhu
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Zhengyan Wu
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Zhe Li
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Xueli Zhao
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Xiangdong Du
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
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12
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He H, Hong L, Jin W, Xu Y, Kang W, Liu J, Song J, Zheng T, Chen H, Zhao K. Heterogeneity of non-suicidal self-injury behavior in adolescents with depression: latent class analysis. BMC Psychiatry 2023; 23:301. [PMID: 37127584 PMCID: PMC10152699 DOI: 10.1186/s12888-023-04808-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 04/20/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) by adolescent patients with depression has become a serious public health problem. This cross-sectional study aims to identify subgroups of adolescents based on NSSI and explore the factors related to these subgroups. METHODS The study recruited 326 in- and out-patient adolescents (263 girls and 63 boys) aged 12 to 18 years (mean = 14.7, SD = 1.6) who had self-injured in the past year. Latent class indicators included 12 NSSI variables, as well as suicidal ideation. Logistic regression examined associations between identified classes and related factors. RESULTS In this study, two distinct subgroups were identified: a "high suicidal ideation NSSI group" (n = 129, 39.6%) and a "low suicidal ideation NSSI group" (n = 197, 60.4%). Depression (OR = 1.10; 95% CI, 1.05-1.16), female (OR = 2.01; 95% CI, 1.09-3.69), left-behind experience (OR = 2.08; 95% CI, 1.17-3.71), single-parent family (OR = 1.84; 95% CI, 1.11-3.04) and peer victimization (OR = 1.04; 95% CI, 1.02-1.05) increases the probability of belonging to the "high suicidal ideation NSSI group". A high level of perceived social support (OR = 0.99; 95% CI, 0.97-0.99) was a protective factor towards NSSI. CONCLUSIONS This study identifies two subgroups of NSSI and the factors associated with each subgroup. The early identification of high-risk groups for major NSSI in adolescents diagnosed with depression is possible due to the identification of correlating factors. Different treatment plans can be developed for different subtypes of NSSI to improve the effectiveness of prevention and intervention, promoting the healthy physical and mental development of adolescents with depression.
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Affiliation(s)
- He He
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Lan Hong
- The Third Hospital of QuZhou, Quzhou, 324003, China
| | - Wei Jin
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Yao Xu
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Wei Kang
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Jie Liu
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Jingyao Song
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325035, China
| | - Tiansheng Zheng
- The Affiliated Kangning Hospital of Wenzhou Medical University, Wenzhou, China
| | - Hong Chen
- Department of Psychiatry, First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | - Ke Zhao
- Lishui Second People's Hospital Affiliated to Wenzhou Medical University, Lishui, China.
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, Wenzhou, China.
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13
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Yang L, Jia FF, Lu XY, Jia CX. Internalizing and externalizing problems mediate the relationship between maltreatment and self-harm among UK adolescents. J Affect Disord 2023; 333:240-248. [PMID: 37084976 DOI: 10.1016/j.jad.2023.04.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Revised: 03/30/2023] [Accepted: 04/14/2023] [Indexed: 04/23/2023]
Abstract
BACKGROUND Maltreatment is a significant predictive factor for self-harm in adolescents. Internalizing and externalizing problems are both common psychopathological issues in adolescents. This study aimed to look into the link between maltreatment and self-harm in a large sample of adolescents in the UK, as well as the mediating effects that internalizing and externalizing problems play in this link. METHODS Data were pulled from the UK Millennium Cohort Study, and a total of 8894 adolescents were included in this analysis. All variables were assessed by Questionnaires. Path analysis was performed to assess the mediating effects of internalizing and externalizing problems in the link between maltreatment and self-harm. RESULTS 23.4 % of samples reported self-harm incidents during the preceding 12 months. Emotional abuse and physical abuse were significantly related to self-harm, and adolescents who had experienced multiple forms of maltreatment were more prone to self-harm. Mediation analysis revealed that internalizing problems were the primary mediator in the link between emotional abuse and self-harm, with the mediation effect size being 0.29. Internalizing and externalizing problems performed similarly in the link between physical abuse and self-harm, with mediation effect sizes of 0.23 and 0.19, respectively. LIMITATIONS The majority of the data was gathered through self-reporting. CONCLUSIONS Emotional abuse and physical abuse were significant predictors of self-harm, and their links with self-harm were partially mediated via internalizing and externalizing problems. Better supervision of maltreatment, and timely intervention for both internalizing and externalizing problems, are critical in preventing self-harm among adolescents.
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Affiliation(s)
- Li Yang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Fei-Fei Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
| | - Xin-Yi Lu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.
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14
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Khazaei S, Salehi A, Molavi Vardanjani H. Prevalence and correlates of child maltreatment among mothers in the Kurdistan province, Western Iran. Int J Psychiatry Med 2023:912174231163740. [PMID: 36932644 DOI: 10.1177/00912174231163740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/19/2023]
Abstract
OBJECTIVE Parental child maltreatment is a serious public health issue worldwide. As mothers take on a significant proportion of parenting duties in two-parent families, knowledge of maternal risk factors for child maltreatment is essential. METHODS In this cross-sectional study, 135 mothers with their last child below 18 years old in Kurdistan province were enrolled. A validated Persian version of the ISPCAN Child Abuse Screening Tool-Parent version, Beck Anxiety Inventory, and Beck Depression Inventory were administered. RESULTS The prevalence of severe and moderate physical punishment was 78.5% and 71.9%, respectively. Psychological punishment was reported by 99.3% of respondents, and 48.9% reported neglect. A relationship was found between child physical and emotional abuse and low maternal education (P < 0.01), domestic violence (P = 0.02), maternal exposure to maltreatment during childhood (P = 0.03), maternal depression (p < 0.01), and maternal anxiety (P < 0.01). A relationship was found between neglect and residence in rural areas (P < 0.01), domestic violence, and low maternal education (P = 0.02). CONCLUSION Maternal child maltreatment in Iran is increased in mothers with psychological disorders and those with certain demographic characteristics. Clinicians should be alert to these potential risk factors.
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Affiliation(s)
- Sahel Khazaei
- MPH Department, 48435Shiraz University of Medical Sciences, Shiraz, Iran
| | - Alireza Salehi
- MPH Department, 48435Shiraz University of Medical Sciences, Shiraz, Iran
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15
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Salles BM, Maturana de Souza W, Dos Santos VA, Mograbi DC. Effects of DBT-based interventions on alexithymia: a systematic review. Cogn Behav Ther 2023; 52:110-131. [PMID: 36426727 DOI: 10.1080/16506073.2022.2117734] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
While dialectical behavior therapy (DBT) appears effective for some psychiatric conditions commonly associated with alexithymia, it is unclear whether DBT improves difficulties experienced by alexithymic individuals. This review investigated the current evidence on the effectiveness of DBT-based interventions in improving alexithymia. A qualitative synthesis of studies that investigated the efficacy of DBT on self-reported alexithymia was performed, identifying eligible studies using EBSCO/Essentials, Google Scholar, PubMed, Web of Science, and PsychINFO databases. Eight studies were identified. Overall, the results were inconclusive due to the heterogeneity of the studies but suggest that DBT-based interventions may be associated with self-reported decreases in alexithymia and increases in the ability to identify emotional states. The literature is limited by significant methodological problems, such as the low number of controlled trials, small samples, and high variability between DBT programs, which increases the risk of bias across study outcomes. More research is needed to reach conclusions regarding the effectiveness of DBT in improving alexithymia. Future studies should conduct randomized controlled trial designs (primarily with active treatment control conditions), greater standardization of DBT-based interventions, and a more in-depth examination of the level of participant involvement in long-term DBT-based interventions may help to understand whether DBT improves alexithymia difficulties.
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Affiliation(s)
- Bruno M Salles
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de Janeiro, Brazil
| | - Wayson Maturana de Souza
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de Janeiro, Brazil
| | - Veruska Andrea Dos Santos
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de Janeiro, Brazil
| | - Daniel C Mograbi
- Department of Psychology, Pontifical Catholic University of Rio de Janeiro (PUC-Rio), Rio de Janeiro, Brazil.,Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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16
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Wang Q, Liu X. Child Abuse and Non-Suicidal Self-Injury among Chinese Migrant Adolescents: The Moderating Roles of Beliefs About Adversity and Family Socioeconomic Status. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:3165-3190. [PMID: 35616091 DOI: 10.1177/08862605221104537] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Although research has indicated the association between child abuse and non-suicidal self-injury (NSSI), few studies have examined their relationship in a particular sample of Chinese rural-to-urban migrant adolescents who tend to experience parental abuse and engage in NSSI. More importantly, factors moderating the relationship between child abuse and migrant adolescents' NSSI have been understudied. To address this issue, this study aimed to examine whether beliefs about adversity and family socioeconomic status (SES) moderated the longitudinal relationship between child abuse and NSSI in a sample of Chinese migrant adolescents. 308 Chinese rural-to-urban migrant adolescents (aged 10-14; 138 boys) completed the two-wave survey. Self-reported questionnaires regarding child abuse, NSSI, beliefs about adversity, and family SES were used. Results showed that child abuse was significantly positively related to NSSI a year later. Moreover, the interaction of child abuse, beliefs about adversity, and family SES was significant. Specifically, for migrant adolescents with low SES, positive beliefs about adversity played a protective role in the association between child abuse and NSSI; while for those with high SES, such beliefs showed vulnerability. Findings underscore the importance of considering multiple resilient factors simultaneously by examining beliefs about adversity and SES as the moderating mechanisms in the association between child abuse and NSSI. Findings also emphasize the significance of developing differential interventions targeting NSSI in abused Chinese migrant adolescents. Positive beliefs about adversity are important in buffering the negative effect of child abuse for migrant adolescents with low SES. For those with high SES, special attention should be given to the interactive impact of child abuse, beliefs about adversity, and family SES.
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Affiliation(s)
- Quanquan Wang
- Collaborative Innovation Centre of Assessment for Basic Education Quality, Institute of Developmental Psychology, Beijing Normal University, China
| | - Xia Liu
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, China
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17
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Wu J, Liu S, Luo J, Li X, You J. The effects of childhood abuse, depression, and self-compassion on adolescent nonsuicidal self-injury: A moderated mediation model. CHILD ABUSE & NEGLECT 2023; 136:105993. [PMID: 36584519 DOI: 10.1016/j.chiabu.2022.105993] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Revised: 12/03/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Nonsuicidal self-injury (NSSI) is a widespread public health issue in adolescents. Exploring the risk and protective variables of NSSI is critical for prevention and intervention. Based on the experiential avoidance model (Chapman et al., 2006) and Nock's (2009) integrated model of NSSI, the current study tested a moderated mediation model to examine the impact of two risk factors, childhood abuse and depression, and one protective factor, self-compassion, on NSSI. METHODS Self-report measures were conducted among 758 Chinese adolescents (329 females and 429 males, mean age = 14.16 years, SD = 1.92) in Hong Kong, China regarding childhood abuse, depression, self-compassion, and NSSI. RESULTS Childhood abuse was found to be positively linked to NSSI, and this connection was mediated by depression. Self-compassion weakened the strength between childhood abuse and NSSI, along with that between childhood abuse and depression. CONCLUSIONS These results assist in understanding how NSSI develops and facilitate future studies to investigate how the risk and protective variables for NSSI interact. The clinical application of these findings was also discussed.
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Affiliation(s)
- Jie Wu
- Mental Health Education and Counseling Center, Guangdong University of Technology, Guangzhou 510006, PR China; Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, & School of Psychology, South China Normal University, Guangzhou, 510631, P. R. China
| | - Sihan Liu
- Faculty of Psychology, Beijing Normal University, Beijing 100875, PR China
| | - Jiawen Luo
- Mental Health Education and Counseling Center, Guangdong University of Technology, Guangzhou 510006, PR China
| | - Xiaoan Li
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, & School of Psychology, South China Normal University, Guangzhou, 510631, P. R. China
| | - Jianing You
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, & School of Psychology, South China Normal University, Guangzhou, 510631, P. R. China.
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18
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Bach B, Bo S, Simonsen E. Maladaptive personality traits may link childhood trauma history to current internalizing symptoms. Scand J Psychol 2022; 63:468-475. [PMID: 35606936 PMCID: PMC9790355 DOI: 10.1111/sjop.12830] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Revised: 04/08/2022] [Accepted: 04/22/2022] [Indexed: 12/30/2022]
Abstract
Research supports a strong relationship between childhood maltreatment and internalizing psychopathology (e.g., anxiety and depression), and features of personality are assumed to explain some of this relationship. In this study, we proposed a model in which maladaptive traits mediate the effect of childhood trauma history on internalizing symptoms in adult individuals. A mixed sample (N = 462) composed of 142 psychiatric patients and 320 community-dwelling individuals completed the Childhood Trauma Questionnaire (CTQ), the Personality Inventory for DSM-5 (PID-5), and the Symptom Checklist (SCL-27) for internalizing psychopathology. The effect of childhood traumas explained 34% of the variance in internalizing symptoms while controlling for the influence of age and gender. The traits accounted for 78% of this effect, which was predominantly exerted through the domains of Negative Affectivity, Detachment, and Psychoticism, and specifically through the facets of Depressivity, Suspiciousness, Anxiousness, Perceptual Dysregulation, and Distractibility. This finding provides preliminary support for the proposed model indicating that the aforementioned maladaptive trait domains potentially function as mediating links by which childhood traumas are translated into internalizing symptoms in adulthood. However, these findings must be interpreted with caution due to the cross-sectional and retrospective mono-method design of this study. Clinical implications are discussed in relation to transdiagnostic treatment and the potential value of specifying trait domain specifiers in ICD-11 and DSM-5 models of personality disorders.
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Affiliation(s)
- Bo Bach
- Psychiatric Research UnitCenter for Personality Disorder Research, Region ZealandSlagelseDenmark
| | - Sune Bo
- Department of Child and Adolescent PsychiatryRegion ZealandRoskildeDenmark
| | - Erik Simonsen
- Psychiatric Research UnitCenter for Personality Disorder Research, Region ZealandSlagelseDenmark,Faculty of Health and Medical SciencesUniversity of CopenhagenCopenhagenDenmark
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19
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Nilsson M, Lundh L, Westling S. Childhood maltreatment and self-hatred as distinguishing characteristics of psychiatric patients with self-harm: A comparison with clinical and healthy controls. Clin Psychol Psychother 2022; 29:1778-1789. [PMID: 35467060 PMCID: PMC9790602 DOI: 10.1002/cpp.2744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 04/19/2022] [Accepted: 04/20/2022] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Deliberate self-harm (DSH) is common in clinical populations. Childhood maltreatment (CM) and attitudes both towards oneself and towards DSH may be of importance for the development of DSH. This study aimed to test whether patients with DSH report more CM, more negative attitudes towards oneself and more positive attitudes towards DSH than a clinical and a healthy comparison group, and whether the effects of CM are mediated by negative attitudes towards oneself. METHOD Females with DSH and psychiatric disorders (n = 34), females without DSH but with psychiatric disorders (n = 31) and healthy female individuals (n = 29) were compared regarding DSH, CM, attitudes towards the self and attitudes towards self-harm. RESULTS Females with DSH reported more emotional abuse and more self-hatred as compared to both comparison groups. The effect of emotional abuse was mediated by self-hatred. The DSH-group had significantly more positive attitudes towards DSH than the healthy comparison group. CONCLUSION Self-hatred and CM in the form of emotional abuse may be distinguishing characteristics of female patients with DSH in psychiatric settings. The present results are compatible with the hypothesis that emotional abuse leads to DSH via self-hatred, but the cross-sectional nature of the study precludes any causal conclusions. The clinical utility of the results is discussed.
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Affiliation(s)
- Magnus Nilsson
- Department of Clinical Sciences, PsychiatryLund UniversityLundSweden
| | | | - Sofie Westling
- Clinical Psychiatric Research CenterRegion SkåneLundSweden
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20
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Tsur N, Katz C. "And Then Cinderella Was Lying in My Bed": Dissociation Displays in Forensic Interviews With Children Following Intrafamilial Child Sexual Abuse. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP15336-NP15358. [PMID: 34000885 DOI: 10.1177/08862605211016347] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Child sexual abuse (CSA) has been implicated in dissociative peritraumatic and post-traumatic symptoms and disorders. Although explicitly relevant to the legal process following alleged CSA, very little is known about dissociative manifestations in the context of forensic interviews with children following abuse. The current study was designed to uncoverperi- and post-traumatic dissociation of abused children as revealed in forensic interviews. The study examines the display of dissociation in 42 forensic interviews with children (29 girls, aged 4-14) following intra familial child sexual abuse (IFCSA). Thematic analysis was used to identify key expressions of dissociation in all of the forensic interviews. The analyses identified depersonalization and derealization in the children's description of the abuse. This was manifested both in an inability to feel things that happened during the incidents or imagination and fantasies that were reported as part of the abusive incidents. The children's interviews also revealed the potential manifestations of dissociative amnesia, which was evident in the children's attempts to communicate their retrieval difficulties to the forensic interviewers. Finally, it was identified that the forensic interviews were a platform in which dissociative post-traumatic reactions were activated and often displayed in sensory flashbacks. The current findings uncover the importance of acknowledging trauma and dissociation in the context of forensic interviews with abused children and the urgent need to implement unique responses to trauma within practical guidelines.
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Affiliation(s)
- Noga Tsur
- Tel Aviv University, Tel Aviv, Israel
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21
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Pearce H, Smoliak O, Lewis SP. Individuals’ accounts and explanations of continued engagement in non-suicidal self-injury: a qualitative study. COUNSELLING PSYCHOLOGY QUARTERLY 2022. [DOI: 10.1080/09515070.2022.2108762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
- Heather Pearce
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
| | - Olga Smoliak
- Family Relations and Applied Nutrition, University of Guelph, Guelph, Ontario, Canada
| | - Stephen P. Lewis
- Department of Psychology, University of Guelph, Guelph, Ontario, Canada
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22
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Liu J, Liu X, Wang H, Gao Y. Friend support buffers the relationship between maltreatment and nonsuicidal self-injury in adolescence. Suicide Life Threat Behav 2022; 52:802-811. [PMID: 35352850 DOI: 10.1111/sltb.12864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 01/02/2022] [Accepted: 01/03/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Prior studies have mostly focused on the risk factors for nonsuicidal self-injury (NSSI), but only a few studies have emphasized the related protective factors. The present study examined whether maltreatment and behavioral problems were risk factors for NSSI. Moreover, we also sought to understand whether and how friend support provides a buffer against NSSI. METHOD A total of 436 adolescents completed self-report surveys that addressed maltreatment, behavioral problems, friend support, and NSSI at three different time points. RESULTS There were significant positive correlations between maltreatment and NSSI. In the mediation analyses, we found that maltreatment was indirectly associated with NSSI via behavioral problems. Friend support demonstrated a long-term buffering effect on NSSI. Specifically, friend support had a protective effect on NSSI not only under high maltreatment levels, but also under high behavioral problem levels. CONCLUSION These findings contribute to the understanding of the influences of both maltreatment, behavioral problems (risk factors), and friend support (protective factors) on NSSI. In the context of intervention and education, it is important to consider the value of friend support when discussing NSSI.
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Affiliation(s)
- Jinmeng Liu
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Xia Liu
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Hui Wang
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Yemiao Gao
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
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23
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Andersson H, Aspeqvist E, Dahlström Ö, Svedin CG, Jonsson LS, Landberg Å, Zetterqvist M. Emotional Dysregulation and Trauma Symptoms Mediate the Relationship Between Childhood Abuse and Nonsuicidal Self-Injury in Adolescents. Front Psychiatry 2022; 13:897081. [PMID: 35966492 PMCID: PMC9366744 DOI: 10.3389/fpsyt.2022.897081] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Accepted: 06/22/2022] [Indexed: 11/17/2022] Open
Abstract
Background Nonsuicidal self-injury (NSSI) is common in adolescents. Emotion dysregulation has been identified as a core mechanism in the development and maintenance of NSSI and it is therefore an important target when addressing NSSI. The pathogenic connection between different kinds of childhood abuse, difficulties in emotion regulation and NSSI needs further investigation. The objective of this study was to examine whether difficulties with emotion regulation and trauma symptoms, separately and together, mediate the relationships between sexual, physical and emotional abuse and NSSI. Method Cross-sectional data was collected from 3,169 adolescent high-school students aged 16-19 years (M = 18.12, SD = 0.45). Data from self-reported experiences of childhood abuse, current difficulties with emotion regulation (measured with the Difficulties with Emotion Regulation Scale, DERS-16) and trauma symptoms (measured with the Trauma Symptom Checklist for Children, TSCC), and NSSI were collected. Structural Equation Modeling (SEM) was used to test the proposed relationships between variables. Results The prevalence of life-time NSSI was 27.4%. Prevalence of reported childhood abuse was 9.2, 17.5, and 18.0% for sexual, physical, and emotional abuse, respectively. Childhood abuse, difficulties with emotion regulation and trauma symptoms exhibited significant positive associations with NSSI in adolescents. Emotional dysregulation and trauma symptoms were both found to mediate the relationship between childhood abuse and NSSI. Latent variable models were found to fit data well. Conclusion Results indicate that increased levels of emotional dysregulation and trauma symptoms in relation to childhood abuse contribute to the increased risk of NSSI. Further, results point to some aspects of emotional dysregulation and trauma symptoms being more important in this regard. Clinical implications are discussed.
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Affiliation(s)
- Hedvig Andersson
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Erik Aspeqvist
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Örjan Dahlström
- Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden
| | - Carl Göran Svedin
- Department of Social Sciences, Marie Cederschiöld University, Stockholm, Sweden
| | - Linda S. Jonsson
- Department of Social Sciences, Marie Cederschiöld University, Stockholm, Sweden
| | - Åsa Landberg
- Department of Social Sciences, Marie Cederschiöld University, Stockholm, Sweden
| | - Maria Zetterqvist
- Department of Child and Adolescent Psychiatry, Linköping University Hospital, Linköping, Sweden
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24
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Kruzan KP, Muehlenkamp JJ, Claes L. Identity, self-blame, and body regard in NSSI: A test of moderated-mediation. Compr Psychiatry 2022; 116:152322. [PMID: 35533434 PMCID: PMC9219562 DOI: 10.1016/j.comppsych.2022.152322] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 12/15/2021] [Revised: 04/05/2022] [Accepted: 04/13/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Prior work suggests that an unstable identity is an important developmental factor impacting risk for non-suicidal self-injury (NSSI), partly because it can foster lowered self-esteem and self-blame coping styles. Theoretical models suggest that how one regards the self, including experiences of and reactions to one's body (e.g., body regard), impact how factors such as identity instability and coping styles influence NSSI behavior. This study tested whether body regard moderated the mediational effect of self-blame coping on the relationship between poor self-concept clarity and past-year NSSI. METHODS A sample of 1906 university students had complete data from an anonymous online questionnaires measuring self-concept clarity, self-blame coping, and past-year NSSI behaviors. RESULTS Past-year NSSI was reported by 23.5% of the sample. Moderated mediational regression analyses using the PROCESS macro for SPSS were run. Body regard significantly moderated the effects of self-blame coping and poor self-concept clarity on NSSI such that neither risk factor was associated with NSSI when body regard was high. Poor self-concept clarity also retained a significant, although weakened, direct relationship with NSSI in the full model. CONCLUSIONS Positive body regard is protective and appears to mitigate the strength of the relationships between poor self-concept clarity and self-blame coping on past year NSSI. When body regard is low or average, poor self-concept clarity is associated with increased NSSI, partly through the effect of self-blame coping. Treatments that address body- and self-perceptions related to self-concept may enhance the effectiveness of interventions used to reduce NSSI behavior.
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Affiliation(s)
- Kaylee P Kruzan
- Center for Behavioral Intervention Technologies, 446 E. Ontario St., Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Jennifer J Muehlenkamp
- Department of Psychology, 105 Garfield Ave, University of Wisconsin Eau Claire, Eau Claire, WI 54701, USA.
| | - Laurence Claes
- KU Leuven, Faculty of Psychology and Educational Sciences, Tiensestraat 102, 3000 Leuven, Belgium; University of Antwerp, Faculty of Medicine and Health Sciences, Universiteitsplein 1, 2610 Wilrijk (Antwerp), Belgium
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Borg SL, Schaefer LM, Hazzard VM, Herting N, Peterson CB, Crosby RD, Crow SJ, Engel SG, Wonderlich SA. Relationships Between Childhood Abuse and Eating Pathology Among Individuals with Binge-Eating Disorder: examining the Moderating Roles of Self-Discrepancy and Self-Directed Style. Eat Disord 2022; 30:355-369. [PMID: 33734931 PMCID: PMC8448781 DOI: 10.1080/10640266.2020.1864588] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Childhood maltreatment appears to increase the risk for eating disorders (EDs). The current study examined potential moderating factors (i.e., self-discrepancy and negative self-directed style), which may increase or decrease the impact of maltreatment (i.e., emotional abuse, physical abuse, sexual abuse) on later ED symptoms. One hundred seven men and women with binge-eating disorder (BED) completed semi-structured interviews and questionnaires assessing childhood maltreatment, self-discrepancy, negative self-directed style, and ED pathology. Linear regression was used to examine the moderating role of self-discrepancy and negative self-directed style in the associations between each type of abuse and level of ED severity. Actual:ought self-discrepancy (i.e., the difference between one's self and who one believes they ought to be) moderated the relationships between ED pathology and emotional abuse (β =.26 p =.007), as well as physical abuse (β =.23, p =.02). Results suggest that the relationship between childhood abuse (i.e., emotional abuse, physical abuse) and ED pathology may be stronger for those with higher levels of actual:ought self-discrepancy. Further clarification of the relationships between actual:ought self-discrepancy and distinct forms of childhood abuse is needed, as well as intervention studies examining whether targeting actual:ought self-discrepancy provides an additional benefit for trauma-exposed individuals with BED.
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Affiliation(s)
- Skylar L. Borg
- Sanford Research, Center for Bio-behavioral Research, Fargo, North Dakota, USA
| | - Lauren M. Schaefer
- Sanford Research, Center for Bio-behavioral Research, Fargo, North Dakota, USA
| | - Vivienne M. Hazzard
- Sanford Research, Center for Bio-behavioral Research, Fargo, North Dakota, USA
| | - Nicola Herting
- Sanford Research, Center for Bio-behavioral Research, Fargo, North Dakota, USA
- Red River Children’s Advocacy Center, Fargo, North Dakota, USA
| | - Carol B. Peterson
- University of Minnesota, Department of Psychiatry and Behavioral Sciences, Minneapolis, Minnesota, USA
| | - Ross D. Crosby
- Sanford Research, Center for Bio-behavioral Research, Fargo, North Dakota, USA
- University of North Dakota School of Medicine and Health Sciences, Department of Psychiatry and Behavioral Science, Fargo, North Dakota, USA
| | - Scott J. Crow
- University of Minnesota, Department of Psychiatry and Behavioral Sciences, Minneapolis, Minnesota, USA
- The Emily Program, St. Paul, Minnesota, USA
| | - Scott G. Engel
- Sanford Research, Center for Bio-behavioral Research, Fargo, North Dakota, USA
- University of North Dakota School of Medicine and Health Sciences, Department of Psychiatry and Behavioral Science, Fargo, North Dakota, USA
| | - Stephen A. Wonderlich
- Sanford Research, Center for Bio-behavioral Research, Fargo, North Dakota, USA
- University of North Dakota School of Medicine and Health Sciences, Department of Psychiatry and Behavioral Science, Fargo, North Dakota, USA
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Wang X, Ding W, Xie R, Wu W, Jiang M, Kayani S, Li W. The influence of child maltreatment on teacher-student and peer relationships: The mediating roles of cognitive reappraisal and expressive suppression. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03268-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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El Nagar ZM, Barakat DH, Rabie MAEM, Thabeet DM, Mohamed MY. Relation of Non-Suicidal Self-Harm to Emotion Regulation and Alexithymia in Sexually Abused Children and Adolescents. JOURNAL OF CHILD SEXUAL ABUSE 2022; 31:431-446. [PMID: 35254212 DOI: 10.1080/10538712.2022.2047855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 01/22/2022] [Accepted: 02/06/2022] [Indexed: 06/14/2023]
Abstract
Child sexual abuse is a global issue affecting children. It burdens the entire society physically and mentally. It can cause eating disorders and non-suicidal self-injury in abused people (NSSI). Emotion regulation (ER) is an important etiological link between purging, NSSI, and abusive experiences. We interviewed 80 people, ranged in age from 13 to 20, of whom 62.5% had CSA, versus 30 healthy controls. The Toronto Alexithymia Scale, an eating disorders clinical interview, the Difficulties in Emotion Regulation Scale (DERS) to assess emotion dysregulation, the Self-punishment Scale to assess NSSI, the Mini-Kid for children under the age of 18, and the Structured Clinical Interview for DSM-IV Axis I Disorders (SCID I) for those aged 18 and older were given to victims. CSA was found in 62.5% of the participants. Emotional dysregulation was strongly linked to CSA. Descriptive and identifying difficulties in feelings and externally oriented thinking (p0.001, p0.03, p0.001) were found to be associated with the development of alexithymia. CSA participants had higher NSSI than controls, with 28% having severe self-punishment symptoms (P0.001). Finally, CSA is common in kids and teens. It has negative effects on future generations' mental and physical health. All of these conditions can lead to alexithymia.
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Berardelli I, Sarubbi S, Rogante E, Erbuto D, Giuliani C, Lamis DA, Innamorati M, Pompili M. Association between Childhood Maltreatment and Suicidal Ideation: A Path Analysis Study. J Clin Med 2022; 11:jcm11082179. [PMID: 35456272 PMCID: PMC9027208 DOI: 10.3390/jcm11082179] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 03/23/2022] [Accepted: 04/05/2022] [Indexed: 02/04/2023] Open
Abstract
Epidemiological studies have suggested that childhood maltreatment increases suicidal ideation, and dissociative symptoms and hopelessness are involved in this relation. To better address this issue, we used a path analysis model to examine the role of different types of childhood maltreatment on suicidal ideation, investigating whether hopelessness and dissociative symptoms mediated this relation. A sample of 215 adult psychiatric inpatients was enrolled between January 2019 and January 2020, at the psychiatric unit of Sant’Andrea Medical Center in Rome, Italy. The Childhood Trauma Questionnaire (CTQ), Beck Hopelessness Scale (BHS), Dissociative Experiences Scale (DES-II), and Columbia-Suicide Severity Rating Scale (C-SSRS) were used to test the hypotheses. Results revealed that the presence of sexual abuse directly affected suicidal ideation (β = 0.18, SE = 0.8, p < 0.05), while emotional abuse and neglect indirectly increased suicidal ideation via dissociation (β = 0.05, SE = 0.02, 95% C.I. 0.01/0.09) and hopelessness (β = 0.10, SE = 0.03, 95% C.I. = 0.04/0.16). Professionals working with children should be aware of the long-term consequences of childhood maltreatment, particularly suicide risk. Furthermore, professionals working with adults should inquire about past childhood maltreatment.
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Affiliation(s)
- Isabella Berardelli
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Centre, Sant’Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy; (I.B.); (D.E.)
| | - Salvatore Sarubbi
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell’Università 30, 00185 Rome, Italy;
| | - Elena Rogante
- Department of Psychology, Sapienza University of Rome, Via dei Marsi 78, 00185 Rome, Italy;
| | - Denise Erbuto
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Centre, Sant’Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy; (I.B.); (D.E.)
| | - Carlotta Giuliani
- Psychiatry Residency Training Program, Psychiatry Unit, Sant’Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, 00185 Rome, Italy;
| | - Dorian A. Lamis
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA 30303, USA;
| | - Marco Innamorati
- Department of Human Sciences, European University of Rome, Via degli Aldobrandeschi 190, 00163 Rome, Italy;
| | - Maurizio Pompili
- Department of Neurosciences, Mental Health and Sensory Organs, Suicide Prevention Centre, Sant’Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University of Rome, Via di Grottarossa 1035, 00189 Rome, Italy; (I.B.); (D.E.)
- Correspondence: ; Tel.: +39-063-377-5675; Fax: +39-063-377-5342
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Li S, Zhao F, Yu G. Childhood Emotional Abuse and Depression Among Adolescents: Roles of Deviant Peer Affiliation and Gender. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP830-NP850. [PMID: 32401127 DOI: 10.1177/0886260520918586] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Adolescent depression is a significant concern around the world. There is a pressing need to explore risk factors for this disorder to develop better interventions. Based on an integration of attachment theory, Bronfenbrenner's ecological systems theory, and relational theory, the current study aimed to examine (a) whether childhood emotional abuse (CEA) would be significantly and positively related to adolescents' depression, (b) whether deviant peer affiliation would mediate the relation between CEA and depression, and (c) whether gender would moderate the direct and indirect relations between CEA and adolescent's depression via deviant peer affiliation. Participants were 961 Chinese adolescents (Mage = 15.21 years, SD = 1.57). They completed questionnaires regarding demographics, CEA, other types of childhood maltreatment (i.e., physical abuse, sexual abuse, physical neglect, and emotional neglect), deviant peer affiliation, and depression. Results showed that CEA was positively related to adolescent depression even after controlling for other types of childhood maltreatment, and this relation was mediated by deviant peer affiliation. Furthermore, moderated mediation analyses indicated that gender moderated the relation between CEA and deviant peer affiliation, with the relation being stronger for girls than for boys. However, gender did not moderate the relation between deviant peer affiliation and depression, as well as the direct relation between CEA and depression. Results highlight that interventions aimed at reducing CEA may protect adolescents, especially girls from the risks of deviant peer affiliation and depression.
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Affiliation(s)
- Sen Li
- Renmin University of China, Beijing, China
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Gan KQ, Tang CSK. Sibling Violence and Psychological Adjustment: The Role of Maladaptive Coping and Maternal Authoritativeness. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:NP526-NP550. [PMID: 32383633 DOI: 10.1177/0886260520917510] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This study examined the phenomenon of sibling violence in Singapore. The underlying mechanisms through which maternal authoritativeness and maladaptive coping influenced psychological adjustment following sibling violence were also investigated. Questionnaires were administered to 287 female and 128 male Singaporean college students between the ages of 18 to 27. Results showed that lifetime and past-year prevalence estimates of sibling violence in college students in Singapore were 89.9% and 62.0%, respectively. Lifetime psychological sibling violence involvement and past-year sibling violence involvement (both physical and psychological) were significantly related to maladaptive coping and overall psychological adjustment; lifetime sibling violence involvement was significantly related to maternal authoritativeness, anxiety, and depression only. Maladaptive coping was found to be a significant mediator between past-year physical and psychological sibling violence involvement and two measures of psychological adjustment, anxiety and depression. Maternal authoritativeness functioned as a moderator only for the relationship between past-year psychological sibling violence exposure and psychological adjustment. At low but not high levels of maternal authoritativeness, past-year psychological violence involvement was significantly related to higher levels of anxiety and depression, and lower levels of self-esteem. These findings show that sibling violence is a pervasive problem in Asian countries as well, such as in Singapore. There is a need to educate both the public and the relevant authorities so that steps can be taken to protect those who have experienced or are at risk of experiencing such violence. Through elucidating the role of maternal authoritativeness and maladaptive coping, the present study also suggests new avenues for interventions to reduce the adverse effects of sibling violence. Limitations and future directions are also discussed.
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Affiliation(s)
- Kai Qi Gan
- National University of Singapore, Singapore
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Qian H, Shu C, Feng L, Xiang J, Guo Y, Wang G. Childhood Maltreatment, Stressful Life Events, Cognitive Emotion Regulation Strategies, and Non-suicidal Self-Injury in Adolescents and Young Adults With First-Episode Depressive Disorder: Direct and Indirect Pathways. Front Psychiatry 2022; 13:838693. [PMID: 35492724 PMCID: PMC9039129 DOI: 10.3389/fpsyt.2022.838693] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 02/24/2022] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Childhood maltreatment (CM), stressful life events (SLE), and cognitive emotion regulation strategies (CERS) have been considered crucial in the development of non-suicidal self-injury (NSSI) and major depressive disorder (MDD), but the pathways of this association are not clear. We aim to identify direct effects of CM and SLE on NSSI and depression severity and its indirect effects via CERS in adolescents and young adults with a diagnosis of MDD. METHODS A total of 114 patients (aged 14-24 years) with first episode MDD were included and further divided into the NSSI group (n = 56) and non-NSSI group (n = 58) according to the DSM-5 criteria. Diagnostic interviews and self-report measures were conducted to assess CM, SLE, CERS, and diagnose NSSI. Severity of depressive symptoms was measured using the Hamilton Rating Scale (HAMD). The structural equation model was used to assess the pathways. RESULTS MDD patients with NSSI had more frequent family history of mental illness, more experience of CM and SLE, more serious depression, less use of adaptive CERS, and more use of maladaptive CERS. In the final structural equation model (χ2 = 4.82, df = 6, p = 0.57, CFI = 1.0, TLI = 1.10, and RMSEA = 0), the experience of CM and SLE showed a significant indirect effect on NSSI through adaptive CERS. CM and SLE only had direct effects on depression severity. CONCLUSIONS NSSI are prevalent in adolescents and young adults with MDD and highly intertwined with CM, SLE, and CERS. Adaptive CERS, not maladaptive CERS may be a possible mechanism relating CM and SLE to NSSI in MDD patients.
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Affiliation(s)
- Hong Qian
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Chang Shu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Li Feng
- Wuhan Mental Health Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Junyi Xiang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
| | - Ying Guo
- Wuhan Mental Health Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Gaohua Wang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China
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Tsur N, Katz C, Talmon A. The shielding effect of not responding: Peritraumatic responses to child abuse and their links to posttraumatic symptomatology. CHILD ABUSE & NEGLECT 2021; 121:105224. [PMID: 34392074 DOI: 10.1016/j.chiabu.2021.105224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 06/13/2021] [Accepted: 07/22/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Extensive literature focuses on peritraumatic responses to trauma and their link to subsequent posttraumatic symptomatology. However, although posttraumatic symptomatology following child abuse (CA) has been documented, research on peritraumatic responses to CA is sparse. OBJECTIVE The current study utilizes a new typology of peritraumatic responses to CA and tests whether automatic and behavioral peritraumatic responses to CA differ in their long-term implications for posttraumatic symptomatology, i.e., posttraumatic stress (PTS symptoms), deficiency in self-organization (DSO symptoms; complex posttraumatic symptoms), and dissociation. PARTICIPANTS, SETTINGS AND METHODS One-hundred and eighty adult CA survivors reported on CA, peritraumatic responses, PTS symptoms, DSO symptoms, and dissociation. RESULTS The tendency to freeze and dissociate, and utilize extensive behavioral methods to survive the abuse were implicated in higher posttraumatic symptomatology (F(2,178) > 4.26, p < 0.01). The absence of automatic and behavioral responses were found to be implicated in the lowest levels of posttraumatic symptomatology (p < 0.01) and to buffer the effect of CA severity on PTS and DSO posttraumatic symptoms (0.047 > effect>0.029, p < 0.001). CONCLUSIONS The findings uncovered a novel response pattern, reflected in a tendency to eradicate responses to CA, which was the most protective in regard to its link to later posttraumatic symptomatology. Contrarily, the most scarring peritraumatic responses to CA that arose from the findings were the tendency to freeze and dissociate and utilize various excessive behavioral methods to endure the abuse. These findings imply that CA generates several possible responses, some of which, although allowing for survival in childhood, have adverse effects in adulthood.
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Affiliation(s)
- Noga Tsur
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel.
| | - Carmit Katz
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | - Anat Talmon
- Department of Psychology, Stanford University, CA, United States of America
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Personality functioning as a mediator of adult mental health following child maltreatment. J Affect Disord 2021; 291:126-134. [PMID: 34034217 DOI: 10.1016/j.jad.2021.05.006] [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: 03/16/2021] [Revised: 05/02/2021] [Accepted: 05/05/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND The broad range of adverse health outcomes following child maltreatment (child maltreatment) underscores the need to investigate shared trajectories that contribute to associated physical and mental health problems. Previous research focused on different mechanisms, such as emotion regulation or attachment. In the present study, we propose personality functioning, comprising self- and interpersonal regulation and perception, to mediate between child maltreatment and mental and physical health. METHODS In a German representative sample (N = 2,508), we assessed remembered child maltreatment, levels of personality functioning, and different health outcomes in adulthood, namely somatic symptoms, general mental distress, and body dysmorphic concern. We conducted path analyses to investigate mediation effects in the total sample as well as in female and male subsamples. RESULTS Child maltreatment significantly predicted the assessed health outcomes and showed significant associations with lower levels of personality functioning. Personality functioning partially mediated all health outcomes assessed by significant indirect effects and lowered direct effects of child maltreatment on health outcomes. An exploratory analysis of different facets of personality functioning revealed a pronounced impact of identity perception and self-reflective capacities in mediating between child maltreatment and physical and mental health. Comparable results were found in female and male participants. LIMITATIONS Major limitations of the study are the reliance on cross-sectional data and the use of a screening measure to assess experienced child maltreatment. CONCLUSION Personality functioning may represent a transdiagnostic link to different somatic and psychological symptoms in the aftermath of child maltreatment.
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Mefford LC, Phillips KD, Chung ML. Childhood Loss Experiences, Religiousness/Spirituality, and Hope as Predictors of Adult Life Satisfaction. Issues Ment Health Nurs 2021; 42:649-659. [PMID: 33052730 DOI: 10.1080/01612840.2020.1828514] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Purpose The purpose of this study was to explore how adaptive patterns of religiousness/spirituality and hope predict adult life satisfaction in adults, even if they had childhood loss experiences.Design and Methods Using a cross-sectional survey design with132 adult participants (mean age 33.8 ± 15.2, 82% female, 78% Caucasian) we estimated two hierarchical regression models to examine how dimensions of religiousness/spirituality (Brief Multidimensional Measure of Religiousness/Spirituality) and hope (Herth Hope Index) predicted adult life satisfaction (Satisfaction with Life Scale) after controlling for effects of adverse childhood experiences (Adverse Childhood Experiences Study Questionnaire) or chronic sorrow from childhood loss (Kendall Chronic Sorrow Instrument).Results When effects of adverse childhood experiences (ACE) were controlled, higher levels of hope (β = .416, p < .001) and forgiveness (β = .273, p = .023) and lower levels of religious/spiritual values/beliefs (β = -.298, p = .014) predicted higher levels of adult life satisfaction. ACE remained a significant predictor of adult life satisfaction in the final model. When controlling for effects of chronic sorrow, higher life satisfaction was predicted only by forgiveness (β = .379, p = .003), values/beliefs (β = -.354, p = .007), and hope (β = .357, p < .001), with chronic sorrow not a significant predictor of adult life satisfaction in the final model.Conclusion: Greater life satisfaction for adult survivors of childhood loss experiences could be promoted by interventions to enhance hope and foster forgiveness. These adult survivors may also need support as they engage with religious/spiritual struggle to reconcile their values and beliefs with childhood loss.
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Affiliation(s)
- Linda C Mefford
- Lansing School of Nursing and Clinical Sciences, Bellarmine University, Louisville, Kentucky, USA.,College of Nursing, The University of Tennessee, Knoxville, Tennessee, USA
| | - Kenneth D Phillips
- College of Nursing, The University of Tennessee, Knoxville, Tennessee, USA.,College of Nursing, East Tennessee State University, Johnson City, Tennessee, USA
| | - Misook L Chung
- College of Nursing, University of Kentucky, Lexington, Kentucky, USA.,College of Nursing, Yonsei University, Seoul, Korea
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Goddard A, Hasking P, Claes L, McEvoy P. Big Five Personality Clusters in Relation to Nonsuicidal Self-Injury. Arch Suicide Res 2021; 25:390-405. [PMID: 31769355 DOI: 10.1080/13811118.2019.1691099] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Nonsuicidal self-injury (NSSI) is a complex behavior that serves many functions and may be motivated by several factors. Although previously limited to the context of personality disorders, consideration of how general personality traits might be related to NSSI warrants examination. Our aims were to investigate whether clusters based upon the Big Five personality traits exist among people who have engaged in NSSI, and explore systematic differences with regard to gender, age, key indicators of NSSI severity, functions of NSSI, emotional avoidance, alexithymia, psychological distress, and emotion regulation strategies. A sample of 236 university students (83% female, M age = 21.59, SD = 5.43) who had engaged in NSSI completed an anonymous online questionnaire. Cluster analysis yielded three subgroups who were characterized by tendencies for resilience, dysregulation, and disagreeableness. Resilient and dyregulated profiles fell within opposite ends of a continuum with regard to severity of NSSI, psychological distress and alexithymia, and adaptive vs less adaptive emotion regulation strategies. Dysregulated characteristics were also associated with affect regulation and self-punishment functions of NSSI. Disagreeable characteristics were associated with high alexithymia and psychological distress. Implications of these findings for theory and tailored treatment approaches to NSSI are discussed.
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Nicol A, Mak AS, Murray K, Kavanagh PS. Early maladaptive schemas in young people who self-injure. J Clin Psychol 2021; 77:1745-1762. [PMID: 34105782 DOI: 10.1002/jclp.23172] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2020] [Revised: 04/12/2021] [Accepted: 04/27/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND There is emerging evidence that early maladaptive schemas (EMS) may be a cognitive vulnerability factor in nonsuicidal self-injury (NSSI). The current study sought to examine the relationship between EMS and NSSI history, and whether this is moderated by gender, in a community youth sample. METHOD Participants were 403 Australian secondary and university students aged between 16 and 25 years, who completed a survey of NSSI history, EMS, and general emotional distress. RESULTS Logistic regression analysis indicated that being female, depression, and EMS scores were useful for differentiating between youth reporting NSSI history and those who did not. High levels of Defectiveness/Shame and Abandonment/Instability schema scores, and low levels of Emotional Inhibition schema scores, were associated with NSSI history. Gender did not moderate the relationships between these EMS scores and NSSI history. CONCLUSIONS Present results suggest that aspects of the schema domain of Disconnection and Rejection are important for identifying NSSI history beyond young people's emotional distress. This provides researchers and clinicians with an opportunity to better target key EMS, especially beliefs about self-defectiveness and feelings of shame, that may be driving the regulatory function of self-injury among youth.
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Affiliation(s)
- Annemarie Nicol
- Centre for Applied Psychology, University of Canberra, Kirinari Street, Bruce, ACT, Australia
| | - Anita S Mak
- Centre for Applied Psychology, University of Canberra, Kirinari Street, Bruce, ACT, Australia
| | - Kristen Murray
- Research School of Psychology, Australian National University, Canberra, ACT, Australia
| | - Phillip S Kavanagh
- Centre for Applied Psychology, University of Canberra, Kirinari Street, Bruce, ACT, Australia
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Tang WC, Lin MP, You J, Wu JYW, Chen KC. Prevalence and psychosocial risk factors of nonsuicidal self-injury among adolescents during the COVID-19 outbreak. CURRENT PSYCHOLOGY 2021; 42:1-10. [PMID: 34092987 PMCID: PMC8167308 DOI: 10.1007/s12144-021-01931-0] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/27/2021] [Indexed: 11/30/2022]
Abstract
The research investigated the prevalence of nonsuicidal self-injury (NSSI) during the COVID-19 outbreak and identified the psychosocial risk factors among junior high school students in Taiwan. Cross-sectional design was applied and 1,060 participants (Mage = 14.66, SD = 0.86 years) were recruited into the study. The prevalence of NSSI was found to be 40.9% (95% confidence interval, 37.9%-43.9%) during the COVID-19 outbreak. The results suggested that the self-injurers group were mostly female, and scored significantly higher in neuroticism, depression, impulsivity, alexithymia, virtual social support, dissatisfaction with academic performance, and lower in subjective wellbeing, self-esteem, actual social support, and family function than the non-injurers group. In addition, high neuroticism, low self-esteem, high virtual social support, high impulsivity, and high alexithymia were independently predictive in the logistic regression analysis. The principal results of this study suggested that NSSI was extremely prevalent among adolescents during the COVID-19 outbreak, and in particularly, personality and virtual environment risk factors and enhancing self-esteem should be the focus of NSSI preventive strategies when targeting this age population. Our results provide a reference towards designing NSSI prevention programs geared toward the high school population during the COVID-19 pandemic.
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Affiliation(s)
- Wen-Ching Tang
- Department of Educational Psychology and Counseling, National Taiwan Normal University, No.162, Sec. 1, Heping E. Rd., Da-an District, Taipei City, 106 Taiwan
| | - Min-Pei Lin
- Department of Educational Psychology and Counseling, National Taiwan Normal University, No.162, Sec. 1, Heping E. Rd., Da-an District, Taipei City, 106 Taiwan
| | - Jianing You
- Center for Studies of Psychological Application & School of Psychology, South China Normal University, No. 155 Zhongshan W. Rd, Tianhe District, Guangzhou, China
| | - Jo Yung-Wei Wu
- Good-Day Psychology Clinic, 5F., No. 167, Xialin Rd., South District, Tainan City, 702 Taiwan
| | - Kuan-Chu Chen
- Department of Educational Psychology and Counseling, National Taiwan Normal University, No.162, Sec. 1, Heping E. Rd., Da-an District, Taipei City, 106 Taiwan
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Sahasrabudhe SA, Silamongkol T, Park YW, Colette A, Eberly LE, Klimes-Dougan B, Coles LD, Cloyd JC, Öz G, Mueller BA, Kartha RV, Cullen KR. Identifying Biological Signatures of N-Acetylcysteine for Non-Suicidal Self-Injury in Adolescents and Young Adults. JOURNAL OF PSYCHIATRY AND BRAIN SCIENCE 2021; 6:e210007. [PMID: 34036177 PMCID: PMC8143039 DOI: 10.20900/jpbs.20210007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The prevalence of non-suicidal self-injury (NSSI) is high in adolescents and young adults. However, there is a paucity of evidence-based treatments to address this clinical problem. An open-label, pilot study in the target population showed that treatment with oral N-acetylcysteine (NAC), a widely available dietary supplement, was associated with reduction in NSSI frequency. In preparation for a biologically informed design of an efficacy trial, a critical preliminary step is to clarify NAC's biological signatures, or measures of the mechanisms underlying its clinical effects. Toward that end, we propose a 2-stage project to investigate NAC's biological signatures (changes in glutathione (GSH) and/or glutamate (Glu)) in women with NSSI. The first stage; a double-blind randomized placebo-controlled study will focus on identifying the optimal dose to achieve meaningful change in GSH and Glu during short-term (4 weeks) NAC treatment in 36 women aged 16-24 years with NSSI. Go/No-go criteria to determine if the study will progress to the second stage include pre-specified changes in brain and blood measures of GSH. Changes in the brain GSH are measured through magnetic resonance spectroscopy (MRS). The dose for the stage 2 will be selected based on the biological changes and the tolerability observed in the stage 1. The stage 2 will seek to replicate the biological signature findings in an 8-week trial in a new patient cohort, and examine the relationships among biological signatures, NAC pharmacokinetics and clinical response. This 2-stage project is unique as it unifies clinical psychiatric measurements, quantitative MRS and pharmacological approaches in the first placebo-controlled clinical trial of NAC in young women with NSSI. TRIAL REGISTRATION The stage 1 trial protocol has been registered on https://clinicaltrials.gov/ with ClinicalTrials.gov ID "NCT04005053" (Registered on 02 July 2019. Available from: https://clinicaltrials.gov/ct2/show/NCT04005053).
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Affiliation(s)
- Siddhee A. Sahasrabudhe
- Center for Orphan Drug Research, Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, MN 55455, USA
| | - Thanharat Silamongkol
- Department of Psychiatry and Behavioral Sciences, Medical School, University of Minnesota, Minneapolis, MN 55454, USA
| | - Young Woo Park
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Alanna Colette
- Department of Psychiatry and Behavioral Sciences, Medical School, University of Minnesota, Minneapolis, MN 55454, USA
| | - Lynn E. Eberly
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN 55455, USA
- School of Public Health, Division of Biostatistics, University of Minnesota, Minneapolis, MN 55455, USA
| | - Bonnie Klimes-Dougan
- Department of Psychology, College of Liberal Arts, University of Minnesota, Minneapolis, MN 55455, USA
| | - Lisa D. Coles
- Center for Orphan Drug Research, Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, MN 55455, USA
| | - James C. Cloyd
- Center for Orphan Drug Research, Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, MN 55455, USA
| | - Gülin Öz
- Center for Magnetic Resonance Research, Department of Radiology, University of Minnesota, Minneapolis, MN 55455, USA
| | - Bryon A. Mueller
- Department of Psychiatry and Behavioral Sciences, Medical School, University of Minnesota, Minneapolis, MN 55454, USA
| | - Reena V. Kartha
- Center for Orphan Drug Research, Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, MN 55455, USA
| | - Kathryn R. Cullen
- Department of Psychiatry and Behavioral Sciences, Medical School, University of Minnesota, Minneapolis, MN 55454, USA
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Emotion regulation, mindfulness, and self-compassion among patients with borderline personality disorder, compared to healthy control subjects. PLoS One 2021; 16:e0248409. [PMID: 33730065 PMCID: PMC7968662 DOI: 10.1371/journal.pone.0248409] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 02/26/2021] [Indexed: 12/27/2022] Open
Abstract
Objectives Emotion regulation difficulties are a major characteristic of personality disorders. Our study investigated emotion regulation difficulties that are characteristic of borderline personality disorder (BPD), compared to a healthy control group. Methods Patients with BPD (N = 59) and healthy participants (N = 70) filled out four self-report questionnaires (Cognitive Emotion Regulation Questionnaire, Difficulties in Emotion Regulation Scale, Five Facet Mindfulness Questionnaire, Self-Compassion Scale) that measured the presence or lack of different emotion-regulation strategies. Differences between the BPD and the healthy control group were investigated by Multivariate Analysis of Variance (MANOVA) and univariate post-hoc F-test statistics. Results People suffering from BPD had statistically significantly (p<0.05) higher levels of emotional dysregulation and used more maladaptive emotion-regulation strategies, as well as lower levels of mindfulness and self-compassion compared to the HC group. Conclusion In comparison to a healthy control group, BPD patients show deficits in the following areas: mindfulness, self-compassion and adaptive emotion-regulation strategies. Based on these results, we suggest that teaching emotion-regulation, mindfulness, and self-compassion skills to patients can be crucial in the treatment of borderline personality disorder.
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Shafti M, Taylor PJ, Forrester A, Pratt D. The Co-occurrence of Self-Harm and Aggression: A Cognitive-Emotional Model of Dual-Harm. Front Psychol 2021; 12:586135. [PMID: 33716854 PMCID: PMC7946988 DOI: 10.3389/fpsyg.2021.586135] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Accepted: 01/29/2021] [Indexed: 11/29/2022] Open
Abstract
There is growing evidence that some individuals engage in both self-harm and aggression during the course of their lifetime. The co-occurrence of self-harm and aggression is termed dual-harm. Individuals who engage in dual-harm may represent a high-risk group with unique characteristics and pattern of harmful behaviours. Nevertheless, there is an absence of clinical guidelines for the treatment and prevention of dual-harm and a lack of agreed theoretical framework that accounts for why people may engage in this behaviour. The present work aimed to address this gap in the literature by providing a narrative review of previous research of self-harm, aggression and dual-harm, and through doing so, presenting an evidence-based theory of dual-harm – the cognitive-emotional model of dual-harm. This model draws from previous studies and theories, including the General Aggression Model, diathesis-stress models and emotional dysregulation theories. The cognitive-emotional model highlights the potential distal, proximal and feedback processes of dual-harm, the role of personality style and the possible emotional regulation and interpersonal functions of this behaviour. In line with our theory, various clinical and research implications for dual-harm are suggested, including hypotheses to be tested by future studies.
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Affiliation(s)
- Matina Shafti
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Peter James Taylor
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
| | - Andrew Forrester
- Division of Psychological Medicine and Clinical Neuroscienecs, School of Medicine, Cardiff University, Cardiff, United Kingdom
| | - Daniel Pratt
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom
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Gao Y, Xiong Y, Liu X, Wang H. The Effects of Childhood Maltreatment on Non-Suicidal Self-Injury in Male Adolescents: The Moderating Roles of the Monoamine Oxidase A (MAOA) Gene and the Catechol-O-Methyltransferase (COMT) Gene. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18052598. [PMID: 33807669 PMCID: PMC7967505 DOI: 10.3390/ijerph18052598] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/22/2021] [Accepted: 03/02/2021] [Indexed: 01/12/2023]
Abstract
(1) Background: Numerous studies suggest strong associations between childhood maltreatment and nonsuicidal self-injury (NSSI); this is also true for the roles of dopaminergic genes in the etiology of some psychopathologies related to NSSI. Investigating the interactions of environments and genes is important in order to better understand the etiology of NSSI. (2) Methods: Within a sample of 269 Chinese male adolescents (Mage = 14.72, SD = 0.92), childhood maltreatment and NSSI were evaluated, and saliva samples were collected for MAOA T941G and COMT Val158Met polymorphism analyses. (3) Results: The results revealed no primary effects attributable to MAOA T941G and COMT Val158Met polymorphism on NSSI. However, there was a significant three-way interaction between MAOA, COMT, and child abuse (β = −0.34, p < 0.01) in adolescent NSSI. Except for carriers of the T allele of MAOA and the Met allele of COMT, all studied male adolescents displayed higher NSSI scores when exposed to a higher level of child abuse. A similar three-way interaction was not observed in the case of child neglect. (4) Conclusions: The results indicate that the MAOA gene and COMT gene play moderating roles in the association between child abuse and NSSI of male adolescents and suggest the polygenic underpinnings of NSSI.
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Hazzard VM, Crosby RD, Crow SJ, Engel SG, Schaefer LM, Brewerton TD, Castellini G, Trottier K, Peterson CB, Wonderlich SA. Treatment outcomes of psychotherapy for binge-eating disorder in a randomized controlled trial: Examining the roles of childhood abuse and post-traumatic stress disorder. EUROPEAN EATING DISORDERS REVIEW 2021; 29:611-621. [PMID: 33660906 DOI: 10.1002/erv.2823] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/22/2020] [Accepted: 01/17/2021] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To examine childhood abuse and post-traumatic stress disorder (PTSD) as predictors and moderators of binge-eating disorder (BED) treatment outcomes in a randomized controlled trial comparing Integrative Cognitive-Affective Therapy with cognitive-behavioural therapy administered using guided self-help. METHOD In 112 adults with BED, childhood abuse was defined as any moderate/severe abuse as assessed by the Childhood Trauma Questionnaire, lifetime PTSD was assessed via the Structured Clinical Interview for DSM-IV, and outcomes were assessed via the Eating Disorder Examination (EDE). Covariate-adjusted regression models predicting binge-eating frequency and EDE global scores at end of treatment and 6-month follow-up were conducted. RESULTS Lifetime PTSD predicted greater binge-eating frequency at end of treatment (B = 1.32, p = 0.009) and childhood abuse predicted greater binge-eating frequency at follow-up (B = 1.00, p = 0.001). Lifetime PTSD moderated the association between childhood abuse and binge-eating frequency at follow-up (B = 2.98, p = 0.009), such that childhood abuse predicted greater binge-eating frequency among participants with a history of PTSD (B = 3.30, p = 0.001) but not among those without a PTSD history (B = 0.31, p = 0.42). No associations with EDE global scores or interactions with treatment group were observed. CONCLUSIONS Results suggest that a traumatic event history may hinder treatment success and that PTSD may be more influential than the trauma exposure itself.
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Affiliation(s)
| | - Ross D Crosby
- Sanford Center for Biobehavioral Research, Fargo, North Dakota, USA.,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
| | - Scott J Crow
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, Minnesota, USA.,The Emily Program, St. Paul, Minnesota, USA
| | - Scott G Engel
- Sanford Center for Biobehavioral Research, Fargo, North Dakota, USA
| | | | - Timothy D Brewerton
- Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Giovanni Castellini
- Department of Health Sciences, Psychiatry Unit, University of Florence, Florence, Italy
| | - Kathryn Trottier
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Carol B Peterson
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, Minnesota, USA
| | - Stephen A Wonderlich
- Sanford Center for Biobehavioral Research, Fargo, North Dakota, USA.,Department of Psychiatry and Behavioral Science, University of North Dakota School of Medicine and Health Sciences, Fargo, North Dakota, USA
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Liu H, Wang W, Yang J, Guo F, Yin Z. The effects of alexithymia, experiential avoidance, and childhood sexual abuse on non-suicidal self-injury and suicidal ideation among Chinese college students with a history of childhood sexual abuse. J Affect Disord 2021; 282:272-279. [PMID: 33418378 DOI: 10.1016/j.jad.2020.12.181] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2020] [Revised: 10/29/2020] [Accepted: 12/23/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Although previous studies have shown that childhood sexual abuse (CSA) experiences might be related to suicide-related thoughts and behaviours in later life, the effects of alexithymia and experiential avoidance (EA) on this relationship have remained unclear. The present study aimed to expand prior findings among Chinese college students with a history of CSA in order to further test the effects of alexithymia on the relationship between CSA and non-suicidal self-injury (NSSI) and suicidal ideation (SI), and its indirect effects on NSSI and SI through EA. METHODS The Childhood Sexual Abuse Questionnaire, the Toronto Alexithymia Scale-20, the Acceptance and Action Questionnaire-II, the Non-Suicidal Self-Injury Questionnaire, and the Symptom Checklist were completed by 6,834 college students (3,829 female). RESULTS Overall, 1404 (20.76%) Chinese college students reported experiences of CSA; students with CSA experiences reported higher rates of SI and NSSI than those without CSA (12.82% vs. 4.50%, 35.11% vs. 20.82%). CSA, alexithymia, and EA were positively related to NSSI and SI. The effect of alexithymia on the relationship between CSA and NSSI and SI were significant. The effects of EA on the relationship between alexithymia and NSSI and SI were significant, too. LIMITATIONS The major limitations of this study are its cross-sectional design and the use of self-report scales, especially retrospective self-reports (e.g., the Childhood Sexual Abuse Questionnaire). CONCLUSIONS This study cast light on the effects of alexithymia, EA, and CSA on NSSI and SI in Chinese college students with a history of CSA. These findings can contribute to the prevention and treatment of suicide-related thoughts and behaviours.
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Affiliation(s)
- Huiying Liu
- School of Marxism, Zhengzhou University, 100 Science Avenue, Zhengzhou, 450001, China
| | - Wan Wang
- School of Marxism, Zhengzhou University, 100 Science Avenue, Zhengzhou, 450001, China.
| | - Jingyi Yang
- School of Education, Zhengzhou University, 100 Science Avenue, Zhengzhou, 450001, China
| | - Fei Guo
- School of Marxism, Zhengzhou University, 100 Science Avenue, Zhengzhou, 450001, China
| | - Zhaochun Yin
- School of International Education, Zhengzhou University, 100 Science Avenue, Zhengzhou, 450001, China
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Tanzer M, Salaminios G, Morosan L, Campbell C, Debbané M. Self-Blame Mediates the Link between Childhood Neglect Experiences and Internalizing Symptoms in Low-Risk Adolescents. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2021; 14:73-83. [PMID: 33692873 PMCID: PMC7900265 DOI: 10.1007/s40653-020-00307-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Childhood neglect is the most common type of maltreatment, ranging from minor isolated incidents to consistent failures in emotional/physical caregiving. It has been associated with developmental impairments and considered a risk factor for the emergence of psychopathology, particularly internalizing disorders. This study aimed to explore individual differences in response to the continuum of severity of neglect in community adolescents, as well as the role of specific cognitive emotion regulation strategies (CERSs) as mediators between childhood neglect and current internalizing symptoms. Low-risk adolescents (12-19 years old; M age 15.88 years; N = 123; 64 Females) completed questionnaires assessing these experiences. We employed a regression model and a simple mediation analyses. Findings indicate a positive association between childhood neglect, internalizing behaviors, and the adoption of self-blame as CERS. Moreover, the use of self-blame in response to everyday stress partially mediated the relationship between neglect and internalizing behaviors (effect size: .28). Findings support the hypothesis that even in a low risk sample, neglect is associated with internalizing symptoms, and highlight the importance of assessing individual differences in the experience of neglect. Moreover, the mediation effect of the CERSs of self-blame might serve as a potential target for psychotherapeutic interventions aimed at reducing internalizing symptoms.
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Affiliation(s)
- Michal Tanzer
- Psychoanalysis Unit, Research Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB UK
| | - George Salaminios
- Psychoanalysis Unit, Research Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB UK
| | - Larisa Morosan
- Developmental Clinical Psychology Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
| | - Chloe Campbell
- Psychoanalysis Unit, Research Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB UK
| | - Martin Debbané
- Psychoanalysis Unit, Research Department of Clinical, Educational and Health Psychology, University College London, 1-19 Torrington Place, London, WC1E 7HB UK
- Developmental Clinical Psychology Unit, Faculty of Psychology and Educational Sciences, University of Geneva, Geneva, Switzerland
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Hatkevich C, Sumlin E, Sharp C. Examining Associations Between Child Abuse and Neglect Experiences With Emotion Regulation Difficulties Indicative of Adolescent Suicidal Ideation Risk. Front Psychiatry 2021; 12:630697. [PMID: 33889096 PMCID: PMC8057346 DOI: 10.3389/fpsyt.2021.630697] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 02/15/2021] [Indexed: 12/11/2022] Open
Abstract
Objective: Preliminary work indicates one specific aspect of emotion dysregulation (i.e., limited access to emotion regulation strategies) uniquely associates with adolescent suicide ideation. An optimal score cut point on a measure of this emotion dysregulation impairment has been identified to indicate risk for past-year suicidal ideation. Examining types of child abuse and neglect associated with being above cut-off on this measure may point to interactive environmental effects associated with subsequent risk for suicidal ideation. The primary aim of this study was to investigate the relations between multiple types of child abuse and neglect with being above cutoff on a measure of limited access to emotion regulation strategies in a psychiatrically severe adolescent sample. Method: The full sample included 203 psychiatric adolescents (Mean age = 15.31 years; 66.5% female; 74.4% White), assigned to two groups: (1) those at or above cutoff on the access to emotion regulation strategies subscale (n = 139); and (2) those below cutoff (n = 64). Results: Significant differences were only evidenced between the emotion regulation cutoff groups on emotional abuse, after covarying for other types of abuse and neglect; significant group differences were not evidenced on any other type of abuse or neglect (sexual or physical abuse, emotional or physical neglect). Conclusion: Relative to other types of abuse and neglect, emotional abuse may be differentially related to experiencing limited access to emotion regulation strategies, at the level indicative of suicide ideation risk. Clinical implications are discussed.
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Affiliation(s)
- Claire Hatkevich
- Department of Child and Adolescent Psychiatry and Behavioral Sciences, Children's Hospital of Philadelphia, Philadelphia, PA, United States
| | - Eric Sumlin
- Department of Psychology, University of Houston, Houston, TX, United States
| | - Carla Sharp
- Department of Psychology, University of Houston, Houston, TX, United States
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Kautz MM, Burke TA, Siegel DM, Case J, Alloy LB. The role of reward sensitivity and childhood maltreatment in predicting nonsuicidal self-injury. Suicide Life Threat Behav 2020; 50:1250-1263. [PMID: 33135809 DOI: 10.1111/sltb.12718] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 06/07/2020] [Accepted: 06/24/2020] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Findings from prior research on reward sensitivity in nonsuicidal self-injury (NSSI) have been mixed. Childhood maltreatment is an independent risk factor for NSSI and for hyposensitivity to rewards. This study aimed to disentangle the role of reward sensitivity as a predictor of NSSI for those with an elevated severity of childhood maltreatment. METHOD In a diverse undergraduate sample (N = 586), trait reward sensitivity (i.e., behavioral approach system subscales) and the severity of maltreatment were assessed as predictors of a lifetime history of NSSI. In a subset of this sample (n = 51), predictors of NSSI urge intensity were measured using ecological momentary assessment. RESULTS Individuals with elevated maltreatment who reported less positive responsiveness to rewards were more likely to have a lifetime history of NSSI. Those with elevated maltreatment who reported a lower likelihood to approach rewards experienced more intense NSSI urges across the ten-day observation period. However, those with elevated maltreatment who reported a greater likelihood to approach rewards experienced less intense NSSI urges. CONCLUSIONS The role of reward sensitivity as a cognitive risk factor for NSSI varies depending on childhood maltreatment history. Findings indicate that, for those with elevated maltreatment, hypersensitivity to approaching rewards may decrease risk for NSSI urges.
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Affiliation(s)
- Marin M Kautz
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - Taylor A Burke
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - David M Siegel
- Graduate School of Applied and Professional Psychology, Rutgers The State University of New Jersey, New Brunswick, NJ, USA
| | - Julia Case
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - Lauren B Alloy
- Department of Psychology, Temple University, Philadelphia, PA, USA
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Tian X, Yang G, Jiang L, Yang R, Ran H, Xie F, Xu X, Lu J, Xiao Y. Resilience is inversely associated with self-harm behaviors among Chinese adolescents with childhood maltreatment. PeerJ 2020; 8:e9800. [PMID: 33194348 PMCID: PMC7485485 DOI: 10.7717/peerj.9800] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 08/03/2020] [Indexed: 12/31/2022] Open
Abstract
Background Abundant studies have identified the association between childhood maltreatment and self-harm (SH), but little has been discussed with regard to the role of resilience in SH behaviors of adolescents who had experienced childhood maltreatment. In this study, we investigated if resilience, as well as its five dimensions, could present negative associations with presence, repetition, and severity of SH among maltreated and neglected adolescents in China. Methods A cross-sectional survey including 2,084 maltreated teenagers aged from 10 to 17 years was conducted in southwest China Yunnan province. The Childhood Trauma Questionnaire (CTQ), The Resilience Scale for Chinese Adolescents (RSCA), and the Modified version of Adolescents Self-Harm Scale (MASHS) were adopted to measure childhood maltreatment experiences, psychological resilience, and SH behaviors of the respondents, respectively. Binary univariate and multivariate logistic regression models were employed to discuss the associations between resilience and occurrence, repetition, severity of SH. Results Among the participants who met the criteria of CTQ, the prevalence rates of SH were 63.83%, 73.94%, 71.50%, 55.53%, and 58.21% for physical abuse (PA), emotional abuse (EA), sexual abuse (SA), physical neglect (PN), and emotional neglect (EN). Final regression model demonstrated that resilience was in general inversely associated with SH, repeated SH, and severe SH for all types of childhood maltreatment, with adjusted odds ratios (aORs) ranging from 0.29 (95% CI: 0.19-0.44) to 0.46 (95% CI: 0.26-0.81). Of the five dimensions of resilience, emotion regulation served as the strongest associated factor of SH among abused youths, regardless of maltreatment types. Besides, compared with those who had lower level of goal concentration and interpersonal assistance, subjects with higher resilience level reported significantly decreased risks of SH occurrence, SH repetition, and more severe SH, in adolescents who had experienced EA and PN. Conclusions Resilience showed inverse association with childhood maltreatment related SH in Chinese adolescents. These findings preliminarily indicated that interventions targeting on building up resilience, especially enhancing emotion regulation ability, improving goal concentration, and consolidating interpersonal assistance, could be effective in reducing SH risk, repetition, and severity in maltreated Chinese teenagers.
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Affiliation(s)
- Xin Tian
- School of Public Health, Kunming Medical University, Kunming, China.,The First Affiliated Hospital, Kunming Medical University, Kunming, China
| | | | - Linling Jiang
- The First Affiliated Hospital, Kunming Medical University, Kunming, China
| | - Runxu Yang
- The First Affiliated Hospital, Kunming Medical University, Kunming, China
| | - Hailiang Ran
- School of Public Health, Kunming Medical University, Kunming, China
| | - Fujia Xie
- The First Affiliated Hospital, Kunming Medical University, Kunming, China
| | - Xiufeng Xu
- The First Affiliated Hospital, Kunming Medical University, Kunming, China
| | - Jin Lu
- The First Affiliated Hospital, Kunming Medical University, Kunming, China
| | - Yuanyuan Xiao
- School of Public Health, Kunming Medical University, Kunming, China
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Muller DL, Buser TJ, Farag MS, Buser JK. Experiences of Unintentionally Severe Harm During Nonsuicidal Self‐Injury Among College Students. JOURNAL OF COLLEGE COUNSELING 2020. [DOI: 10.1002/jocc.12168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Daniella L. Muller
- Department of Graduate Education, Leadership, and Counseling Rider University
| | - Trevor J. Buser
- Graduate School of Counseling and Psychology Naropa University
| | - Mena S. Farag
- Department of Graduate Education, Leadership, and Counseling Rider University
| | - Juleen K. Buser
- Department of Graduate Education, Leadership, and Counseling Rider University
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Chen L, Ngoubene-Atioky AJ, Zanardelli G, Yuanping D, Yu L. Childhood Abuse and Suicidal Behaviors Among Chinese Migrant Workers: The Mediating Role of Alexithymia and Social Support. Arch Suicide Res 2020; 24:633-647. [PMID: 31502515 DOI: 10.1080/13811118.2019.1658142] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
This study aims to investigate the lifetime prevalence of suicidal behaviors in a sample of Chinese migrant workers. It also examined the mediating role of alexithymia and social support in the link between childhood abuse and suicidal behaviors. A total of 1,563 migrant workers were surveyed by using cluster sampling. Results showed that the estimated lifetime prevalence of suicide ideation, plan, and attempt among Chinese migrant workers was 12.8%, 8.1%, and 4.6%, respectively. Structural equation modeling analyses revealed a significant positive association between childhood abuse and suicidal behaviors; this association was partially mediated by social support. A significant path from childhood abuse through alexithymia and social support to suicidal behaviors was also established. Findings of this study emphasize the importance of social support and alexithymia in understanding the possible mechanisms underlying the relationship between childhood abuse and suicidal behaviors and suggest possible avenues for suicide interventions.
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50
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Alexithymia and self-harm: A review of nonsuicidal self-injury, suicidal ideation, and suicide attempts. Psychiatry Res 2020; 288:112920. [PMID: 32279008 DOI: 10.1016/j.psychres.2020.112920] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2019] [Revised: 03/12/2020] [Accepted: 03/13/2020] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Suicide attempts are a significant global public health concern. Research into non-traditional factors, such as the presence of alexithymia, may shed light on the prediction of suicidal behaviours, which can aid intervention and prevention strategies. To ascertain whether alexithymia is a unique risk factor for suicide attempts, this article reviews the evidence on alexithymia related to suicidal ideation, attempts, and non-suicidal self-injury (NSSI). METHODS A literature search was conducted for original articles examining the general and psychiatric populations. RESULTS There is consistent evidence linking alexithymia with suicidal ideation and NSSI, but inconsistent evidence linking it to suicide attempts. CONCLUSION The relationship between alexithymia and suicidality seems to differ based on whether the research focuses on suicidal ideation, suicide attempts, or NSSI. The relationship between alexithymia and suicidality can be understood within the context of multiple code theory and childhood trauma. Future research should explore the whether alexithymia can reliably distinguish between those with a single attempt and those with multiple suicide attempts as well as alexithymia levels pre- and post-intervention with suicide-related behavior as outcomes in treatment studies.
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