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Marcinkevičiūtė M, Vilutytė L, Gailienė D. Experience of pre-suicidal suffering: insights from suicide attempt survivors. Int J Qual Stud Health Well-being 2024; 19:2370894. [PMID: 38913782 PMCID: PMC11198122 DOI: 10.1080/17482631.2024.2370894] [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: 02/06/2024] [Accepted: 06/18/2024] [Indexed: 06/26/2024] Open
Abstract
PURPOSE Psychache significantly contributes to the suicidal process. However, the transition from pre-suicidal suffering to a suicide crisis remains one of the least explored stages in suicidology. METHODS We retrospectively explored experience of pre-suicidal suffering through semi-structured, in-depth interviews with 12 individuals recruited from the Vilnius City Mental Health Center, Lithuania. Interpretative phenomenological analysis was employed to identify recurring patterns. RESULTS Nine primary group experiential themes emerged: Certain adverse life events occurring during the suicidal process were not immediately perceived as connected; Complex traumatic events laid the groundwork for a profound sense of lack; A compensatory mechanism balanced the experience of profound lack; Exhaustion ensued from efforts to sustain the compensatory mechanism; The main trigger directly challenged the compensatory mechanism; The affective state followed the experience of the main triggering event; Dissociation served to isolate psychache; Thoughts of suicide experienced as automatic; Suicide was perceived as a means to end suffering. CONCLUSION The findings suggest that the suicidal process unfolds over an extended period of suffering, culminating in a crisis to alleviate unbearable psychological pain. In clinical practice, identifying the main triggering event discussed in this study can be pivotal in understanding the essence of suffering characterized by profound lacking and developed compensatory mechanisms.
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Affiliation(s)
- Miglė Marcinkevičiūtė
- Centre for Suicidology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
| | | | - Danutė Gailienė
- Centre for Suicidology, Institute of Psychology, Vilnius University, Vilnius, Lithuania
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Güngördü E, Ayaydin H. Peer Bullying and Psychiatric Diagnoses in Adolescents with Nonsuicidal Self-Injury. Psychiatry 2024:1-16. [PMID: 39102646 DOI: 10.1080/00332747.2024.2379752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/07/2024]
Abstract
OBJECTIVES The aim of this study was to determine the comorbid psychiatric diagnoses, peer bullying rates and NSSI characteristics in adolescents who engage in self-injuring behavior. MATERIALS AND METHODS This case-controlled cross-sectional study was conducted between 1 March 2020 and 1 May 2021 in the Child and Adolescent Psychiatry and Paediatrics outpatient clinic of a hospital in the Southeastern Anatolia region of Turkey. The data of 50 adolescents with NSSI and 60 adolescents without NSSI attending school were compared. The data in the study were obtained using sociodemographic form prepared by the researchers, the Affective Disorders and Schizophrenia Interview Schedule for School-Age Children-Present and Lifetime Version-Dsm-5, Peer Bullying Scale Adolescent Form and Self-Injurious Behaviour Assessment Inventory. RESULTS Fifty adolescents (70% female) with a mean age of 15.4 years (S.D. = 1.4) with NSSI were included as case group and 60 adolescents (66.7% female) with a mean age of 15.5 years (S.D. = 1.3) without NSSI were included as control group. Banging/hitting self was the most common NSSI method, while affect regulation was the most common function. In the case group, verbal, isolation and damage to belongings among the victim subtypes in the last year were found to be significantly higher than in the control group. It was found that there was a positive correlation between the variety of self-injury methods and bullying exposure scores in adolescents with NSSI. Depression disorders, anxiety disorders, oppositional defiant disorder, attention deficit hyperactivity disorder, conduct disorder, and post-traumatic stress disorder diagnoses were found to be more prevalent in the group with NSSI. CONCLUSIONS Based on the finding, it was found that psychiatric diagnoses are more common in adolescents with NSSI, peer bullying subtypes are seen at a higher rate, and as bullying scores increase, the variety of NSSI methods also increases. It is thought that providing psychiatric evaluation and treatment for adolescents with NSSI, establishing cooperation with school and family for peer bullying, developing preventive mental health policies and effective intervention programmes may be beneficial.
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Lee CHJ, Hernández Ortiz JM, Glenn CR, Kleiman EM, Liu RT. An evaluation of emotion recognition, emotion reactivity, and emotion dysregulation as prospective predictors of 12-month trajectories of non-suicidal self-injury in an adolescent psychiatric inpatient sample. J Affect Disord 2024; 358:302-308. [PMID: 38423368 DOI: 10.1016/j.jad.2024.02.086] [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: 06/13/2023] [Revised: 02/01/2024] [Accepted: 02/26/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Little is known about trajectories of NSSI. We aimed to identify NSSI trajectories in adolescent psychiatric inpatients and emotional processes that differentiate between trajectories. METHODS Participants were 180 adolescents (71.7 % female; mean age of 14.89 years, SD = 1.35) from a psychiatric inpatient facility. NSSI was assessed at their index hospitalization, as well as 6, and 12 months after discharge. Emotion recognition, emotion reactivity, and emotion dysregulation were assessed at baseline. Latent class mixture modeling was used to identify different NSSI trajectories and ANOVAs were used to evaluate predictors of the trajectories. RESULTS Analyses yielded three NSSI trajectories. These included a stable low-frequency class (90.53 % of sample), a stable moderate-frequency class, and a class characterized by high-frequency NSSI at baseline but that largely resolves by 6-month follow-up. After adjustments for multiple comparisons were made, only emotion regulation at baseline differentiated between the trajectories, with greater overall emotion dysregulation and greater emotional non-acceptance (a facet of emotion dysregulation) characterizing the initially high-frequency class and the stable moderate-frequency class more than the stable low-frequency class (ps < .05). Difficulties engaging in goal-directed behavior when distressed characterized the stable moderate-frequency NSSI class more than the stable low-frequency class (p < .05). Limitations The study sample consists predominantly of female and White adolescents and thus may not generalize to other demographic groups. CONCLUSIONS The current findings suggest that interventions involving emotion regulation with adolescents who engage in NSSI would particularly benefit from a focus on increasing acceptance of emotional experiences.
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Affiliation(s)
- Ching-Hua Julie Lee
- Harvard T.H. Chan School of Public Health, United States of America; Tsaotun Psychiatric Center, Ministry of Health and Welfare, Taiwan
| | | | - Catherine R Glenn
- Department of Psychology, Old Dominion University, United States of America; Virginia Consortium Program in Clinical Psychology, United States of America
| | - Evan M Kleiman
- Department of Psychology, Rutgers University, United States of America
| | - Richard T Liu
- Department of Psychiatry, Massachusetts General Hospital, United States of America; Department of Psychiatry, Harvard Medical School, United States of America; Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, United States of America.
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Sack L, Seddon JA, Sosa-Hernandez L, Thomassin K. Typologies of Non-Suicidal Self-Injury Functions and Clinical Correlates Among Inpatient Youth. Child Psychiatry Hum Dev 2024; 55:999-1009. [PMID: 36350479 DOI: 10.1007/s10578-022-01465-x] [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] [Accepted: 10/24/2022] [Indexed: 11/11/2022]
Abstract
This study identified typologies of specific non-suicidal self-injury (NSSI) functions among youth admitted for psychiatric hospitalization and investigated clinically relevant correlates. Inpatient youth (n = 68) aged 10-17 years reported on their reasons to engage in NSSI, frequency and severity of NSSI, and symptoms of borderline personality disorder (BPD). A latent class analysis using youth's specific NSSI functions as indicators found two NSSI function typologies, which were differentially associated with clinical correlates. The Multiple Functions class (n = 28) endorsed to "feel something," "punish self," "escape feelings," "relieve anxiety," "stop feeling self-hatred," "stop feeling angry," "show much they are hurting," and "create a hurt that can be soothed." Conversely, the Single/Avoidant Function class (n = 40) endorsed one primary function-i.e., to "escape feelings." Youth in the Multiple Functions class reported significantly more frequent self-injury and greater BPD symptomology. The present study illustrates the importance of examining constellations of specific NSSI functions in inpatient care settings, given their unique associations with NSSI frequency and features of BPD. These findings could inform targeted psychological screening and, in turn, guide the implementation of interventions for elevated NSSI frequency and BPD symptomology among inpatient youth, based on NSSI functions endorsed.
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Affiliation(s)
- Leah Sack
- Department of Psychology, University of Guelph, 50 Stone Rd. E, Guelph, ON, N1G 1V4, Canada.
| | - Jessica A Seddon
- Department of Psychology, University of Guelph, 50 Stone Rd. E, Guelph, ON, N1G 1V4, Canada
| | | | - Kristel Thomassin
- Department of Psychology, University of Guelph, 50 Stone Rd. E, Guelph, ON, N1G 1V4, Canada
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Shen Y, Guo J, Wang C, Huang Z, Yi Y, You J. Self-disgust mediates the effect of problematic mobile social media use on non-suicidal self-injury in adolescents: A latent growth curve analysis. J Adolesc 2024. [PMID: 39075629 DOI: 10.1002/jad.12376] [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: 02/19/2024] [Revised: 05/27/2024] [Accepted: 06/25/2024] [Indexed: 07/31/2024]
Abstract
OBJECTIVE Previous research linked problematic mobile social media use to non-suicidal self-injury (NSSI). However, little research explored the underlying mechanism. Drawing on the social displacement hypothesis, which suggests that excessive social media use may disrupt offline social interactions, leading to negative emotional experiences, the study employs a longitudinal design to explore the relationship between problematic mobile social media use and NSSI, with a specific emphasis on the mediating role of self-disgust. METHODS A total of 1,684 Chinese adolescents (52.3% females; Mage = 14.59 years, SDage = 1.27) completed self-report questionnaires regarding problematic mobile social media use, self-disgust, and NSSI. The assessment was conducted in three waves, 6 months apart. RESULTS Using latent growth curve and structural equation modeling, our study observed a consistent linear decline in NSSI levels over time. Higher initial NSSI levels correlated with a slower reduction. Problematic mobile social media use positively influenced the initial level of NSSI. Additionally, self-disgust played a mediating role in the relationship between problematic mobile social media use and NSSI. CONCLUSIONS The study underscores the importance of understanding the emotional experiences behind social media use, beyond mere usage duration. By revealing the mediating role of self-disgust, it provides new insights into the complex interplay between problematic mobile social media use and adolescent NSSI.
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Affiliation(s)
- Yunhong Shen
- Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain, Center for Studies of Psychological Application, Ministry of Education, & School of Psychology, Cognition and Education Sciences (South China Normal University), South China Normal University, Guangzhou, China
| | - Jiaqi Guo
- Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain, Center for Studies of Psychological Application, Ministry of Education, & School of Psychology, Cognition and Education Sciences (South China Normal University), South China Normal University, Guangzhou, China
| | - Chuhan Wang
- Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain, Center for Studies of Psychological Application, Ministry of Education, & School of Psychology, Cognition and Education Sciences (South China Normal University), South China Normal University, Guangzhou, China
| | - Zixi Huang
- Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain, Center for Studies of Psychological Application, Ministry of Education, & School of Psychology, Cognition and Education Sciences (South China Normal University), South China Normal University, Guangzhou, China
| | - Yuzhe Yi
- Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain, Center for Studies of Psychological Application, Ministry of Education, & School of Psychology, Cognition and Education Sciences (South China Normal University), South China Normal University, Guangzhou, China
| | - Jianing You
- Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain, Center for Studies of Psychological Application, Ministry of Education, & School of Psychology, Cognition and Education Sciences (South China Normal University), South China Normal University, Guangzhou, China
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Zheng Q, Zhou HY, Li K, Liu Y, Nan W, Gong J. The effectiveness of mindfulness-based intervention for psychological distress and emotion regulation in college students with non-suicidal self-injury. Appl Psychol Health Well Being 2024. [PMID: 39032127 DOI: 10.1111/aphw.12580] [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: 01/27/2024] [Accepted: 07/11/2024] [Indexed: 07/22/2024]
Abstract
This study explored the effectiveness of a short-term mindfulness-based intervention (MBI) on psychological distress, mindfulness levels, emotion regulation, and impulsivity among college students with non-suicidal self-injury (NSSI). Participants completed four questionnaires, including the Five Facet Mindfulness Questionnaire, the Depression Anxiety Stress Scale, the Emotion Regulation Questionnaire, and the Brief Barratt Impulsivity Scale, and two behavioral tasks, including an emotion regulation task and a stop signal task (SST), at three time points. Compared with the healthy group, the NSSI group had a significantly greater level of psychological distress and a lower level of mindfulness. Compared with the NSSI control group and the healthy group, the NSSI MBI group had significantly increased mindfulness levels and decreased psychological distress after the intervention. In the NSSI MBI group, regardless of which emotion regulation strategy was adopted when viewing negative pictures, the intensity of negative emotions during the emotion regulation task was significantly reduced. Moreover, in the NSSI MBI group, the effectiveness of the MBI on the mindfulness level, stress level, and emotion regulation process was maintained at the follow-up. The present study provided empirical support that short-term MBI has the potential to help individuals with NSSI by enhancing their emotion regulation.
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Affiliation(s)
- Qiongjuan Zheng
- Department of Psychology and Center for Brain and Cognitive Sciences, School of Education, Guangzhou Higher Education Mega Center, Guangzhou University, Guangzhou, China
| | - Han-Yu Zhou
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
- Shanghai Changning Mental Health Centre, Shanghai, China
| | - Keshuang Li
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Yaohong Liu
- Department of Psychology and Center for Brain and Cognitive Sciences, School of Education, Guangzhou Higher Education Mega Center, Guangzhou University, Guangzhou, China
| | - Weizhi Nan
- Department of Psychology and Center for Brain and Cognitive Sciences, School of Education, Guangzhou Higher Education Mega Center, Guangzhou University, Guangzhou, China
| | - Jingbo Gong
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
- Shanghai Changning Mental Health Centre, Shanghai, China
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Calvete E, Prieto-Fildalgo A, Faura-García J, Orue I. The role of testosterone and cortisol levels in nonsuicidal selfinjury in adolescents. J Adolesc 2024. [PMID: 39021249 DOI: 10.1002/jad.12380] [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: 02/28/2024] [Revised: 05/27/2024] [Accepted: 07/09/2024] [Indexed: 07/20/2024]
Abstract
INTRODUCTION Nonsuicidal selfinjury (NSSI) is an important problem in adolescence, which is thought to serve several reinforcement functions (positive vs. negative, automatic vs. social). While the psychological mechanisms involved in NSSI are relatively well known, there is an important gap in the knowledge regarding the underlying biological mechanisms. This study examined the role of testosterone (T) and cortisol (C) in the frequency and reinforcement functions of NSSI. METHODS A total of 423 adolescents (age range = 13-17; 54.4% girls) from Basque Country (Spain) provided saliva samples to determine T and C levels and completed measures of NSSI 6 months later in 2017-2018. RESULTS The results showed that T but not C was significantly associated with higher NSSI frequency and the four types of NSSI functions. In addition, C moderated the predictive association between T and NSSI for automatic negative reinforcement, such that this association was significant only when C was high. Participant sex did not moderate any association between hormones and NSSI. CONCLUSIONS These preliminary results suggest that testosterone levels can affect NSSI behaviors in adolescence, thus helping to explain the increase in NSSI during this stage. Moreover, in situations in which NSSI serves to alleviate negative internal states, high levels of cortisol can be involved.
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Affiliation(s)
- Esther Calvete
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
| | - Angel Prieto-Fildalgo
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
| | - Juan Faura-García
- Faculty of Education, International University of La Rioja, Logrono, Spain
- Faculty of Health Sciences, University of Isabel I, Burgos, Spain
| | - Izaskun Orue
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
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Wang Z, Chen Y, Tao Z, Yang M, Li D, Jiang L, Zhang W. Quantifying the Importance of Non-Suicidal Self-Injury Characteristics in Predicting Different Clinical Outcomes: Using Random Forest Model. J Youth Adolesc 2024; 53:1615-1629. [PMID: 38300442 DOI: 10.1007/s10964-023-01926-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 12/03/2023] [Indexed: 02/02/2024]
Abstract
Existing research on non-suicidal self-injury (NSSI) among adolescents has primarily concentrated on general risk factors, leaving a significant gap in understanding the specific NSSI characteristics that predict diverse psychopathological outcomes. This study aims to address this gap by using Random Forests to discern the significant predictors of different clinical outcomes. The study tracked 348 adolescents (64.7% girls; mean age = 13.31, SD = 0.91) over 6 months. Initially, 46 characteristics of NSSI were evaluated for their potential to predict the repetition of NSSI, as well as depression, anxiety, and suicidal risks at a follow-up (T2). The findings revealed distinct predictors for each psychopathology. Specifically, psychological pain was identified as a significant predictor for depression, anxiety, and suicidal risks, while the perceived effectiveness of NSSI was crucial in forecasting its repetition. These findings imply that it is feasible to identify high-risk individuals by assessing key NSSI characteristics, and also highlight the importance of considering diverse NSSI characteristics when working with self-injurers.
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Affiliation(s)
- Zhenhai Wang
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
| | - Yanrong Chen
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
| | - Zhiyuan Tao
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
| | - Maomei Yang
- Tangxia No.2 Junior High School, Dongguan, Guangdong, China
| | - Dongjie Li
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
| | - Liyun Jiang
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
| | - Wei Zhang
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China.
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Ahmad SI, Hinshaw SP. A Qualitative Analysis of Perspectives on Self-directed Violence in a Prospective Longitudinal Study of Young Women With and Without Childhood ADHD. J Atten Disord 2024; 28:1255-1266. [PMID: 38294171 PMCID: PMC11168017 DOI: 10.1177/10870547231221729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
OBJECTIVE Non-suicidal self-directed violence (NSSDV) is a significant and growing youth public health crisis. Girls with ADHD are at increased risk of engaging in NSSDV, yet qualitative studies with this population-to better understand manifestations, motivations, and developmental course-are lacking. METHOD We conducted semi-structured, qualitative interviews with a sub-sample of 57 young women (32 with childhood ADHD, 25 neurotypical comparisons; mean age of 27 years, part of a larger prospective longitudinal study) regarding histories and manifestations of NSSDV. RESULTS Inductive and deductive analysis revealed several key themes, including self-perceived reasons for engaging in NSSDV (affect regulation, attention seeking, self-punishment, asserting control), impulsivity, secretiveness, and in some cases motivations for desistance. CONCLUSION Findings underscore the importance of early education and screening, especially among high-risk clinical populations. Increased resources and supports for professionals, parents, and peers are indicated, along with countering the persistent stigma associated with ADHD and NSSDV.
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Affiliation(s)
| | - Stephen P. Hinshaw
- University of California, San Francisco, USA
- University of California, Berkeley, USA
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Nordkamp A, Roed K, Videbech P, Midtgaard J. 'Throw me a life buoy, please': A systematic review and thematic synthesis of qualitative evidence regarding nurses' experiences of caring for inpatients with borderline personality disorder and/or non-suicidal self-injury. J Psychiatr Ment Health Nurs 2024. [PMID: 38940193 DOI: 10.1111/jpm.13077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 06/11/2024] [Accepted: 06/14/2024] [Indexed: 06/29/2024]
Abstract
AbstractIntroductionNon‐suicidal self‐injury (NSSI) is prevalent in individuals diagnosed with borderline personality disorder (BPD), particularly in inpatient settings. This poses challenges, leading to frustration and powerlessness among healthcare professionals. This, in turn, puts mental health nurses at risk of compassion fatigue (CF), impacting treatment quality.AimWe conducted a systematic review and meta‐synthesis to investigate the experiences of mental health nurses caring for people with BPD and/or NSSI in inpatient settings.MethodLiterature search was performed in MEDLINE, CINAHL, PsychINFO and Web of Science. The Critical Appraisal Skills Programme (CASP) was used to critically appraise each study. For synthesis of findings from original studies, Thomas and Harden's thematic synthesis was used.ResultsIn total 1492 studies were screened of which seven met the inclusion criteria. We identified four main analytical themes: ‘Notions on nursing’, ‘Reality calls’, ‘Fall of ideals’ and ‘Throw me a lifebuoy, please’, with each two subthemes included.DiscussionDespite nurses' strong motivations for positive change and assistance, unexpected demands lead to emotional exhaustion, affecting their care provision.Implications for PracticeThe study underscores the necessity of addressing nurses' emotional strain through education and skill‐oriented training, enhancing their resilience and reducing CF risk, ultimately securing adequate care, and improving patient outcomes.
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Affiliation(s)
- Annika Nordkamp
- Centre for Applied Research in Mental Health Care (CARMEN), Mental Health Centre Glostrup, Glostrup, Denmark
- Child and Adolescent Mental Health Center, Copenhagen University Hospital - Mental Health Services CPH, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kickan Roed
- Centre for Applied Research in Mental Health Care (CARMEN), Mental Health Centre Glostrup, Glostrup, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Poul Videbech
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Center for Neuropsychiatric Depression Research (CNDR), Mental Health Centre Glostrup, Glostrup, Denmark
| | - Julie Midtgaard
- Centre for Applied Research in Mental Health Care (CARMEN), Mental Health Centre Glostrup, Glostrup, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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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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Zhang Y, Gong L, Feng Q, Hu K, Liu C, Jiang T, Zhang Q. Association between negative life events through mental health and non-suicidal self-injury with young adults: evidence for sex moderate correlation. BMC Psychiatry 2024; 24:466. [PMID: 38914977 PMCID: PMC11197180 DOI: 10.1186/s12888-024-05880-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 05/31/2024] [Indexed: 06/26/2024] Open
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) has exhibited an increasing trend in recent years and is now globally recognized as a major public health problem among adolescents and young adults. Negative life events (NLEs) are positively associated with NSSI. We sought to explore (1) whether sex plays a role in the risk of NLEs leading to NSSI and (2) the role played by mental health (MH). METHODS We adopted a multi-stage cluster sampling method to select college students across four grades from May to June 2022. Generalized linear models were used to evaluate the relationships between NLEs, sex, MH and NSSI, presented as incidence-rate ratios (RRs) with 95% confidence intervals (CIs). We examined the complex relationship between these variables using the PROCESS method for moderation analysis. RESULTS Following the exclusion of data that did not meet the study requirements, data from 3,578 students (mean age: 20.53 [± 1.65] years) were included. Poisson regression results indicate that high-level NLEs (RR = 0.110, 95%CI: 0.047-0.173) are associated with increased NSSI. Furthermore, interaction effects were observed among sex, NLEs and NSSI. MH and sex moderated the relationship between NLEs and NSSI. CONCLUSION Identifying risk factors for NSSI is also important when exploring the interaction between NLEs and MH given the potential for NSSI to significantly increase the risk of later psychopathological symptoms and substance abuse problems. In addition, the significance of sex differences in risk factors for NSSI should be determined. This study evaluated how the impact of NLEs on NSSI can be reduced among adolescents from multiple perspectives.
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Affiliation(s)
- Yi Zhang
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Li Gong
- Wuxi Huishan District People's Hospital, Wuxi, Jiangsu, 214187, China
| | - Qing Feng
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China
| | - Keyan Hu
- The First Affiliated Hospital, College of Clinical Medicine of Henan, University of Science and Technology, Luoyang, Henan, 471003, China
| | - Chao Liu
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China
| | - Tian Jiang
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China.
| | - Qiu Zhang
- Department of Endocrinology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230022, China.
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Boyne H, Hamza CA. Pain tolerance as a 'barrier' to nonsuicidal self-injury: A longitudinal study. Psychiatry Res 2024; 336:115925. [PMID: 38678744 DOI: 10.1016/j.psychres.2024.115925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 03/26/2024] [Accepted: 04/22/2024] [Indexed: 05/01/2024]
Abstract
Theoretical perspectives underscore that low pain tolerance may be a relevant 'barrier' to non-suicidal self-injury (NSSI). However, there is limited longitudinal work on the link between pain tolerance and NSSI, which is needed to assess if pain tolerance precedes NSSI engagement, and/or if NSSI precedes altered pain tolerance. Further, assessing both NSSI frequency and versatility (or number of NSSI methods), in addition to engagement, can provide a more nuanced understanding of the influence of pain on NSSI severity. In the present study, 1125 undergraduate students at a large university (72 % female, Mage = 17.96) reported on their NSSI frequency, NSSI versatility, and perceived pain tolerance. Four individual regressions were run to examine the potential bidirectional nature of the association between NSSI frequency and pain tolerance, and NSSI versatility and pain tolerance. Pain tolerance predicted both NSSI frequency and versatility over time. Neither NSSI frequency nor versatility predicted pain tolerance. Results suggest that high pain tolerance may be a risk factor for severe NSSI engagement.
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Affiliation(s)
- Holly Boyne
- 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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Yu J, Kim MS, Kim M. Non-suicidal self-injury motivation scale in a community sample of adolescents: a methodological study. BMC Psychol 2024; 12:292. [PMID: 38790066 PMCID: PMC11127424 DOI: 10.1186/s40359-024-01795-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 05/17/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND The prevalence of non-suicidal self-injury among South Korean adolescents has increased significantly, requiring academic attention. This methodological study aims to develop a non-suicidal self-injury motivation scale for adolescents and evaluate its validity and reliability. METHODS In the first phase of scale development, the factors constituting self-injury motivation were identified through a literature review and analysis of online counseling data from self-injuring adolescents. In the second phase, 45 initial preliminary items were derived based on the identified factors, and 38 preliminary items were selected through content validation by experts. In the scale validation phase, the survey was conducted using 38 items. Data were collected from adolescents with a history of self-injury, using exploratory factor analysis (EFA) involving 715 participants and confirmatory factor analysis (CFA) involving 537 participants. The EFA involved 27.0% male and 73.0% female participants, with a mean age of 16.83 years, and the CFA involved 20.7% male and 79.3% female participants, with a mean age of 16.15 years. The data collected were tested for validity and reliability using SPSS 28.0 and M-plus. RESULTS The EFA yielded four factors and 24 items. The factors were named interpersonal influence, emotion regulation, sensation seeking, and anti-suicide, and the scale had an explanatory power of 55.8%. In the CFA, the fit of the 23-item model after deleting one item with low standardized factor loadings was x2 = 1081.52 (p < .001), CFI = 0.829, RMSEA = 0.084, and SRMR = 0.075, confirming the acceptability of the self-injury motivation scale for adolescents. The scale evaluation results for convergent validity and discriminant validity met the criteria. The reliability test results showed that the overall reliability (Cronbach's α) was 0.88, and the reliability (Cronbach's α) of each factor was 0.89 for interpersonal influence, 0.83 for emotion regulation, 0.63 for sensation seeking, and 0.80 for anti-suicide, satisfying internal consistency. CONCLUSION In this study, the self-injury motivation scale for adolescents in the community comprised four factors and 23 items. The scale can be used to examine self-injury motivation among adolescents in the community and to develop self-injury prevention intervention programs.
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Affiliation(s)
- Jungok Yu
- College of Nursing, Dong-A University, Busan, South Korea
| | - Myo-Sung Kim
- Department of Nursing, Dong-Eui University, Busan, South Korea.
| | - Miyoung Kim
- Department of Nursing, Kaya University, Gimhae, South Korea
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Lissak S, Ophir Y, Tikochinski R, Brunstein Klomek A, Sisso I, Fruchter E, Reichart R. Bored to death: Artificial Intelligence research reveals the role of boredom in suicide behavior. Front Psychiatry 2024; 15:1328122. [PMID: 38784160 PMCID: PMC11112344 DOI: 10.3389/fpsyt.2024.1328122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 04/18/2024] [Indexed: 05/25/2024] Open
Abstract
Background Recent advancements in Artificial Intelligence (AI) contributed significantly to suicide assessment, however, our theoretical understanding of this complex behavior is still limited. Objective This study aimed to harness AI methodologies to uncover hidden risk factors that trigger or aggravate suicide behaviors. Methods The primary dataset included 228,052 Facebook postings by 1,006 users who completed the gold-standard Columbia Suicide Severity Rating Scale. This dataset was analyzed using a bottom-up research pipeline without a-priory hypotheses and its findings were validated using a top-down analysis of a new dataset. This secondary dataset included responses by 1,062 participants to the same suicide scale as well as to well-validated scales measuring depression and boredom. Results An almost fully automated, AI-guided research pipeline resulted in four Facebook topics that predicted the risk of suicide, of which the strongest predictor was boredom. A comprehensive literature review using APA PsycInfo revealed that boredom is rarely perceived as a unique risk factor of suicide. A complementing top-down path analysis of the secondary dataset uncovered an indirect relationship between boredom and suicide, which was mediated by depression. An equivalent mediated relationship was observed in the primary Facebook dataset as well. However, here, a direct relationship between boredom and suicide risk was also observed. Conclusion Integrating AI methods allowed the discovery of an under-researched risk factor of suicide. The study signals boredom as a maladaptive 'ingredient' that might trigger suicide behaviors, regardless of depression. Further studies are recommended to direct clinicians' attention to this burdening, and sometimes existential experience.
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Affiliation(s)
- Shir Lissak
- The Faculty of Data and Decision Sciences, Technion - Israel Institute of Technology, Haifa, Israel
| | - Yaakov Ophir
- The Faculty of Data and Decision Sciences, Technion - Israel Institute of Technology, Haifa, Israel
- The Centre for Human-Inspired Artificial Intelligence (CHIA), University of Cambridge, Cambridge, United Kingdom
| | - Refael Tikochinski
- The Faculty of Data and Decision Sciences, Technion - Israel Institute of Technology, Haifa, Israel
| | | | - Itay Sisso
- Cognitive Science Department, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Eyal Fruchter
- Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel
| | - Roi Reichart
- The Faculty of Data and Decision Sciences, Technion - Israel Institute of Technology, Haifa, Israel
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Blees A, Jakobowitz S, Hofer J, Konrad N, Krebs J, Opitz-Welke A. Self-harm among inmates of the Berlin prison system. Front Psychiatry 2024; 15:1362188. [PMID: 38757137 PMCID: PMC11096798 DOI: 10.3389/fpsyt.2024.1362188] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 04/22/2024] [Indexed: 05/18/2024] Open
Abstract
Introduction Self-harming behavior in prisoners is a prevalent phenomenon, with international studies estimating a 4% prevalence rate. However, studies on self-injurious behavior in the German prison system are currently lacking. Therefore, our study aims to conduct an initial assessment. Methods The Criminological Service for the Berlin Prison System distributed questionnaires on incidents of self-harm to all Berlin prisons, except for juvenile detention centers. The questionnaires were supplemented with medical data, such as psychiatric diagnoses and medication. Results 62 questionnaires were returned, which could be attributed to 52 inmates. Compared to the average population in the Berlin prison system, the study sample exhibited variations in age, gender distribution and nationality. 94% of the inmates received a psychiatric diagnosis. Two-thirds of the male inmates had substance use disorders, while 83% of the female inmates had emotionally unstable personality resp. borderline disorders. Prior to self-harm, 87% of the inmates were administered psychiatric medication. Discussion Our study found similarities between the study population and international studies in the distribution of certain characteristics. We assume that many of the postulated risk factors can also apply to Berlin prisoners. However, the study is limited by the small number of cases and the absence of a control group.
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Affiliation(s)
- Alexander Blees
- Institute of Forensic Psychiatry, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Prison Hospital Berlin, Berlin, Germany
| | - Sharon Jakobowitz
- Criminological Service for the Berlin Prison System and Social Services of the Judiciary, Berlin, Germany
| | - Jakob Hofer
- Institute of Forensic Psychiatry, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Prison Hospital Berlin, Berlin, Germany
| | - Norbert Konrad
- Institute of Forensic Psychiatry, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Prison Hospital Berlin, Berlin, Germany
| | - Julia Krebs
- Institute of Forensic Psychiatry, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Prison Hospital Berlin, Berlin, Germany
| | - Annette Opitz-Welke
- Institute of Forensic Psychiatry, Charité-Universitätsmedizin Berlin, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Prison Hospital Berlin, Berlin, Germany
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17
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de Neve-Enthoven NGM, Ringoot AP, Jongerling J, Boersma N, Berges LM, Meijnckens D, Hoogendijk WJG, Grootendorst-van Mil NH. Adolescent Nonsuicidal Self-Injury and Suicidality: A Latent Class Analysis and Associations with Clinical Characteristics in an At-Risk Cohort. J Youth Adolesc 2024; 53:1197-1213. [PMID: 38112847 PMCID: PMC10980641 DOI: 10.1007/s10964-023-01922-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 11/27/2023] [Indexed: 12/21/2023]
Abstract
Nonsuicidal self-injury (NSSI) is frequently encountered in adolescents, but its predictive value for suicidality or other clinical characteristics is challenging due to its heterogeneous nature. This study used latent class analysis to identify subgroups of NSSI and compared these on sociodemographic characteristics, adverse outcomes and protective factors. The study included 966 high-risk adolescents, Mage 14.9 y, SD 0.9 y, 51.8% female. Four classes emerged: (1) "Low NSSI-Low suicidality", (2) "Moderate NSSI-Low suicidality", (3) "Moderate NSSI-High suicidality", and (4) "High NSSI-High suicidality". Girls predominated in the high suicidality classes. Generally, Class 4 had the poorest outcomes: more internalizing and externalizing problems, less social support from friends and families and worst self-esteem. These findings emphasize the need for interventions tailored to specific phenotypes of adolescents engaging in NSSI.
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Affiliation(s)
- N G M de Neve-Enthoven
- Department of Psychiatry, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - A P Ringoot
- Department of Psychology and Educational Sciences, Open University of the Netherlands, Heerlen, the Netherlands
- Department of Psychology, Educational and Child Studies, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - J Jongerling
- Tilburg School of Social and Behavioral Sciences, Department of Methodology, Tilburg University, Tilburg, the Netherlands
| | - N Boersma
- Clinical Psychologist at Yulius, Dordrecht, the Netherlands
| | - L M Berges
- Department of Psychiatry, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - D Meijnckens
- MIND Platform, Utrecht, the Netherlands
- Stichting Zelfbeschadiging (Self-harm Foundation), Utrecht, the Netherlands
| | - W J G Hoogendijk
- Department of Psychiatry, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - N H Grootendorst-van Mil
- Department of Psychiatry, Erasmus MC University Medical Center, Rotterdam, the Netherlands.
- Epidemiological and Social Psychiatric Research Institute (ESPRi), Erasmus MC University Medical Center, Rotterdam, the Netherlands.
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18
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Curtis C. Interrupting the Self-Harm Continuum. CRISIS 2024; 45:210-216. [PMID: 38229543 DOI: 10.1027/0227-5910/a000937] [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: 01/18/2024]
Abstract
Background: Nonsuicidal self-injury (NSSI) has increased rapidly and is frequently linked to suicidal behavior; it has been argued that these behaviors are key points on a self-harm continuum. Aims: The current research explored self-harm and help-seeking behaviors, with the aim of identifying possibilities for prevention of further harm, including suicide. Methods: An online survey of 304 New Zealanders was undertaken, with the majority being aged under 25 and female. Results: Nearly half of the sample had engaged in self-harm and most of those had experienced suicidal thoughts; close to a quarter had made a suicide attempt. NSSI was used as a way of dealing with emotional distress. Very few sought help of any kind, especially professional support; of those who did seek professional support, most found it helpful but did not necessarily stop self-harming as a result. Limitations: Men are under-represented in the sample - though this is in accordance with the population of people who engage in NSSI. Conclusion: Many participants engaged in NSSI and also had suicidal thoughts using NSSI as an emotion regulation strategy; some participants appeared to use NSSI rather than attempting suicide. Given a link between NSSI and suicidal thoughts and behaviors, reluctance to seek help and on-going injurious behavior among some who do seek help, there is a need for increased identification and proactive support specifically focusing on improving emotion regulation and targeted at injurious behavior.
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Affiliation(s)
- Cate Curtis
- School of Psychology, University of Waikato, New Zealand
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19
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Zhou SC, Zhou Z, Tang Q, Yu P, Zou H, Liu Q, Wang XQ, Jiang J, Zhou Y, Liu L, Yang BX, Luo D. Prediction of non-suicidal self-injury in adolescents at the family level using regression methods and machine learning. J Affect Disord 2024; 352:67-75. [PMID: 38360362 DOI: 10.1016/j.jad.2024.02.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 02/07/2024] [Accepted: 02/12/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Adolescent non-suicidal self-injury (NSSI) is a major public health issue. Family factors are significantly associated with NSSI in adolescents, while studies on forecasting NSSI at the family level are still limited. In addition to regression methods, machine learning (ML) techniques have been recommended to improve the accuracy of family-level risk prediction for NSSI. METHODS Using a dataset of 7967 students and their primary caregivers from a cross-sectional study, logistic regression model and random forest model were used to test the forecasting accuracy of NSSI predictions at the family level. Cross-validation was used to assess model prediction performance, including the area under the receiver operator curve (AUC), precision, Brier score, accuracy, sensitivity, specificity, positive predictive value and negative predictive value. RESULTS The top three important family-related predictors within the random forest algorithm included family function (importance:42.66), family conflict (importance:42.18), and parental depression (importance:27.21). The most significant family-related risk predictors and protective predictors identified by the logistic regression model were family history of mental illness (OR:2.25) and help-seeking behaviors of mental distress from parents (OR:0.65), respectively. The AUCs of the two models, logistic regression and random forest, were 0.852 and 0.835, respectively. LIMITATIONS The key limitation is that this cross-sectional survey only enabled the authors to examine predictors that were considered to be proximal rather than distal. CONCLUSIONS These findings highlight the significance of family-related factors in forecasting NSSI in adolescents. Combining both conventional statistical methods and ML methods to improve risk assessment of NSSI at the family level deserves attention.
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Affiliation(s)
- Si Chen Zhou
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China
| | - Zhaohe Zhou
- School of Basic Medical Sciences, Chengdu University, Chengdu, China
| | - Qi Tang
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China
| | - Ping Yu
- Wuhan Mental Health Center, Wuhan, China; Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Huijing Zou
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China
| | - Qian Liu
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China
| | - Xiao Qin Wang
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China
| | - Jianmei Jiang
- The Central Hospital of Enshi Tujia Autonomous Prefecture, Enshi, China
| | - Yang Zhou
- Wuhan Mental Health Center, Wuhan, China; Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Lianzhong Liu
- Wuhan Mental Health Center, Wuhan, China; Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Bing Xiang Yang
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China; Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China.
| | - Dan Luo
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China; Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China.
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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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Brager-Larsen A, Zeiner P, Mehlum L. DSM-5 Non-Suicidal Self-Injury Disorder in a Clinical Sample of Adolescents with Recurrent Self-Harm Behavior. Arch Suicide Res 2024; 28:523-536. [PMID: 37506259 DOI: 10.1080/13811118.2023.2192767] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/30/2023]
Abstract
INTRODUCTION Non-suicidal self-injury disorder (NSSID) is a new diagnosis proposed in DSM-5 with a need of further study, especially in adolescent clinical populations where non-suicidal self-injury (NSSI) is particularly prevalent. We aimed to study characteristics of NSSID and estimate an optimal cutoff frequency level of NSSI behavior. METHODS Data were collected from 103 outpatient adolescents (ages 12-18) with recurrent self-harm behavior. RESULTS Adolescents with NSSID reported significantly more frequent NSSI behavior and suicide attempts than adolescents without NSSID. Frequency of NSSI, global functioning, depressive symptoms, number of self-harm methods and anxiety symptoms best discriminated between adolescents with and without NSSID. An optimal cutoff level for a diagnosis of NSSID was found to be ≥15 days with NSSI during the last year, which led to a reduction in the rate of adolescents diagnosed with NSSID from 54% to 46%. CONCLUSION This study shows that NSSID is a highly impairing disorder characterized by high risk of multiple NSSI and suicide attempts, decreased functioning and other associated psychiatric disorders. Clinical awareness of these risks are important to ensure early detection and treatment. Future prospective longitudinal studies are needed to further validate the characteristics of the NSSID diagnosis and its clinical utility.
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Oh Y, Shin C, Lee J, Oh K, Seo H, Chung S, Lee JJ. Comparing Ruminative and Distracting Responses and Emotion Regulation Difficulties in Early Community Adolescents With and Without Self-Harm. Soa Chongsonyon Chongsin Uihak 2024; 35:127-135. [PMID: 38601104 PMCID: PMC11001500 DOI: 10.5765/jkacap.230068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 12/11/2023] [Accepted: 12/26/2023] [Indexed: 04/12/2024] Open
Abstract
Objectives This study aimed to compare the demographic characteristics, responses to negative emotions, and difficulties in emotion regulation between self-harming adolescents and control individuals aged 12-14 years from the community. Methods Data were collected from adolescents in Chungcheong Province, South Korea, between September 2021 and November 2022. Demographic characteristics and responses to the Depressed Mood Questionnaire and Difficulties in Emotion Regulation Scale-16 (DERS-16) were compared between the self-harm and control groups. Results The self-harm group exhibited a higher prevalence of child abuse (odds ratio [OR]=4.787, 95% confidence interval [CI]=1.591-14.409, p=0.005) and school bullying victimization (OR=4.495, 95% CI=2.353-8.588, p<0.001) than those in the control group. The selfharm group displayed higher levels of rumination (t=7.88, p<0.001) and reduced distraction responses (reverse score t=2.25, p=0.025) than those of the control group. Additionally, the self-harm group scored higher on all subscales and the total DERS-16 score (t=7.61, p<0.001). Conclusion Interventions for self-harming adolescents should address child abuse and bullying victimization. Prevention programs for self-harming adolescents should focus on reducing rumination responses, increasing distractive responses, and addressing difficulties in emotion regulation using dialectical behavior therapy-skill training.
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Affiliation(s)
- Yeontaek Oh
- Department of Psychiatry, Gongju National Hospital, Gongju, Korea
| | - Cheolgyu Shin
- Department of Child and Adolescent Psychiatry, Gongju National Hospital, Gongju, Korea
| | - Jonggook Lee
- Department of Psychiatry, Gongju National Hospital, Gongju, Korea
| | - Keun Oh
- Department of Psychiatry, Gongju National Hospital, Gongju, Korea
| | - Heeyoung Seo
- Department of Psychiatry, Gongju National Hospital, Gongju, Korea
| | - Seungwon Chung
- Department of Psychiatry, Chungbuk National University Hospital, Cheongju, Korea
| | - Je Jung Lee
- Department of Psychiatry, Gongju National Hospital, Gongju, Korea
- Department of Child and Adolescent Psychiatry, Gongju National Hospital, Gongju, Korea
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Natividad A, Huxley E, Townsend ML, Grenyer BFS, Pickard JA. What aspects of mindfulness and emotion regulation underpin self-harm in individuals with borderline personality disorder? J Ment Health 2024; 33:141-149. [PMID: 36916308 DOI: 10.1080/09638237.2023.2182425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 11/16/2022] [Indexed: 03/16/2023]
Abstract
BACKGROUND Self-harm presents significant risk for individuals with borderline personality disorder (BPD). Both self-harm and BPD are associated with deficits in mindfulness and emotion dysregulation. Previous research suggests that thought suppression and emotional inexpressivity may underpin self-harm in people with BPD, suggesting potential links to self-harm functions common for those with BPD. More research is needed to strengthen our understanding of this relationship. AIMS This study examines how BPD symptoms, mindfulness, emotion dysregulation and self-harm functions are related. METHODS Australian community outpatients diagnosed with BPD (N = 110) completed measures of mindfulness, emotion dysregulation and self-harm functions. Serial mediation analyses were conducted to examine relationships between variables. RESULTS BPD symptoms, chronic emptiness, mindfulness skills, describing and non-reacting, emotion dysregulation areas of emotion regulation strategies and poor emotional clarity were associated with recent self-harm. Various combinations of describing, strategies and clarity mediated the path between emptiness and self-harm functions more likely to be endorsed by individuals with a diagnosis of BPD. Describing was associated with all but anti-suicide function, while strategies was associated with all but anti-dissociation. CONCLUSION The study highlights how individuals with BPD experiencing chronic emptiness may benefit from treatment targeting describing skills and adaptive emotion regulation strategies.
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Affiliation(s)
- Ana Natividad
- School of Psychology, University of Wollongong, Wollongong, Australia
| | - Elizabeth Huxley
- School of Psychology, University of Wollongong, Wollongong, Australia
| | | | - Brin F S Grenyer
- School of Psychology, University of Wollongong, Wollongong, Australia
| | - Judy A Pickard
- School of Psychology, University of Wollongong, Wollongong, Australia
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Lin L, Liu Y, Qiu S, Yang Y, Yang Y, Tian M, Wang S, Zhang J, Bai X, Xu Z. Orbital frontal cortex functional connectivity during gain anticipation linking the rumination and non-suicidal self-injury in late adolescence. J Affect Disord 2024; 350:673-680. [PMID: 38228278 DOI: 10.1016/j.jad.2024.01.117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Revised: 12/22/2023] [Accepted: 01/09/2024] [Indexed: 01/18/2024]
Abstract
OBJECTIVE Non-suicidal self-injury (NSSI) is prevalent and especially among the adolescence population. It has been argued that abnormal brain activations in reward processing could be regarded as objective biomarkers in NSSI, but the evidence is mixed. This study aims to explore the reward processing mechanism of NSSI from the perspective of functional brain circuitry and investigate the role of a cognitive factor (rumination). METHOD Seventy-one 17-21 years old participants performed a monetary incentive delay (MID) task during functional magnetic resonance imaging scanning. Psychophysiological interaction (PPI) analysis was used to test the inner-group differences of brain functional connectivity. In addition, a mediation model was established with the mediation effect of rumination on the relationship between functional brain circuitry and NSSI. RESULTS PPI analysis suggested that functional connectivity of the orbital frontal cortex (OFC) (with precuneus, SMA) was significantly enhanced in NSSI in the gain > loss contrast, but not in the loss > gain contrast. Mediation analysis revealed that rumination mediated the relationship between NSSI and the OFC- precuneus functional connectivity in the gain > loss contrast. CONCLUSION Our research revealed that the abnormal OFC functional connectivity in gain (not loss) anticipation can be served as the sensitive biomarkers of NSSI. And there was a chain path for NSSI, that was from functional brain circuitry to negative cognition and then to problem behavior.
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Affiliation(s)
- Lin Lin
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin 300387, China; Center of Cooperative Innovation for Assessment and Promotion of National Mental Health under Ministry of Education, Tianjin 300387, China; Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
| | - Yu Liu
- Intelligent Laboratory of Child and Adolescent Mental Health and Crisis Intervention of Zhejiang Province, Zhejiang Normal University, Jinhua 321004, Zhejiang, China; Department of Psychology, Zhejiang Normal University, Jinhua 321004, Zhejiang, China
| | - Shaojie Qiu
- Faculty of Psychology, Beijing Normal University, Beijing 100875, China
| | - Yanan Yang
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin 300387, China; Center of Cooperative Innovation for Assessment and Promotion of National Mental Health under Ministry of Education, Tianjin 300387, China; Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
| | - Yang Yang
- Collaborative Innovation Center of Assessment Toward Basic Education Quality, Beijing Normal University, Beijing 100875, China
| | - Mingyangjia Tian
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin 300387, China; Center of Cooperative Innovation for Assessment and Promotion of National Mental Health under Ministry of Education, Tianjin 300387, China; Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
| | - Song Wang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu 610041, Sichuan, China; Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China
| | - Jie Zhang
- Central University of Finance and Economics, Beijing 100081, China; Buffalo State Department of Sociology, State University of New York, Buffalo 10001, USA
| | - Xuejun Bai
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin 300387, China; Center of Cooperative Innovation for Assessment and Promotion of National Mental Health under Ministry of Education, Tianjin 300387, China; Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
| | - Zhansheng Xu
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin 300387, China; Center of Cooperative Innovation for Assessment and Promotion of National Mental Health under Ministry of Education, Tianjin 300387, China; Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China.
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Ke J, Wu J, Zhao W, Wang Y, Zhang Z, Tong Q, Guo Z, Wen Y, Li N, Yu F, Xie S, Zhu C, Wang K, Zhang L. Childhood maltreatment and engaging in NSSI for automatic-negative reinforcement: The mediating role of alexithymia and moderating role of help-seeking attitudes. J Affect Disord 2024; 350:295-303. [PMID: 38211755 DOI: 10.1016/j.jad.2024.01.068] [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: 08/31/2023] [Revised: 12/21/2023] [Accepted: 01/04/2024] [Indexed: 01/13/2024]
Abstract
BACKGROUND There is evidence indicating that childhood maltreatment is linked to the occurrence of non-suicidal self-injury (NSSI). Nevertheless, the association between childhood maltreatment and the automatic-negative reinforcement aspect of NSSI remains understudied. Chapman's (2006) experiential avoidance model posits that the main factor in sustaining NSSI is negative reinforcement, specifically through the avoidance or escape from distressful emotional experiences. The current study examines a conceptual framework based on this theory and the available literature that explores the potential mediation role of alexithymia in the relation between childhood maltreatment and the automatic-negative reinforcement of NSSI. Additionally, this study investigates how this process may be influenced by individuals' attitudes toward seeking professional help. METHODS 3657 adolescents (1616 females) completed questionnaires regarding childhood maltreatment, alexithymia, help-seeking attitudes, the NSSI, and its functions. RESULTS The findings of the study exposed a positive link between childhood maltreatment and the automatic-negative reinforcement of NSSI, with the mediating role of alexithymia. Interestingly, it was unexpected to discover that individuals with high help-seeking attitudes experienced an intensification of the relationship between childhood maltreatment and both alexithymia and the automatic-negative reinforcement of NSSI. LIMITATION The study's cross-sectional design hindered the inference of causality. CONCLUSION The present study demonstrated that it is crucial to consider the impact of both alexithymia and help-seeking attitudes in adolescents who have experienced maltreatment. These findings hold implications for preventive interventions that target the reduction of NSSI behaviors driven by automatic-negative reinforcement.
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Affiliation(s)
- Jing Ke
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Jiayi Wu
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Weixiang Zhao
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Yuebing Wang
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Ze Zhang
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Qing Tong
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Zixuan Guo
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Yan Wen
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Nan Li
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China; Department of Neurology, The First Affiliated Hospital of Anhui Medical University, The School of Mental Health and Psychological Sciences, Hefei, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China; Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Anhui Medical University, Hefei, China; Anhui Province Key Laboratory of Affective Computing & Advanced Intelligent Machine, Hefei, China
| | - Fengqiong Yu
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Sisi Xie
- Anhui Mental Health Center, Hefei, China
| | - Chunyan Zhu
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
| | - Kai Wang
- Department of Neurology, The First Affiliated Hospital of Anhui Medical University, The School of Mental Health and Psychological Sciences, Hefei, China; Anhui Province Key Laboratory of Cognition and Neuropsychiatric Disorders, Hefei, China; Collaborative Innovation Center for Neuropsychiatric Disorders and Mental Health, Anhui Medical University, Hefei, China.
| | - Lei Zhang
- The School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China; Research Center for Translational Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China; Key Laboratory of Philosophy and Social Science of Anhui Province on Adolescent Mental Health and Crisis Intelligence Intervention, Hefei, China.
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Leino T, Finserås TR, Skogen JC, Pallesen S, Kristensen JH, Mentzoni RA, Sivertsen B. Examining the relationship between non-suicidal self-harm and suicidality within the past 12-months and gaming problems in Norwegian full-time students. BMC Psychiatry 2024; 24:234. [PMID: 38549054 PMCID: PMC10976819 DOI: 10.1186/s12888-024-05694-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Accepted: 03/18/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Although gaming problems are associated with poor mental health, few population-based studies have examined its association with self-harm and suicidality. This study investigates the association between gaming problems, non-suicidal self-harm and suicidality within the past year, stratified by sex among Norwegian full-time students. METHODS Data derived from the Norwegian Students' Health and Wellbeing Study 2022 (N = 59,544). The respondents were categorized into non-gamers, recreational gamers, engaged gamers, problematic gamers, and addicted gamers based on the Game Addiction Scale for Adolescents. Log-link binomial regression models, stratified by sex, adjusted for age, were used to estimate the risk ratio of non-suicidal self-harm (ideation and behavior) and suicidal behaviors (ideation and attempt) across different levels of gaming problems. RESULTS Among females, the risk of non-suicidal self-harm and suicidal ideation increased from non-gamer to problem gamer, with no differences between problem and addicted gamers. Among males, the risk of non-suicidal self-harm increased from non-gamers to engaged gamers, but no differences were observed between engaged, problematic, and addicted gamers. No sex × gaming category interaction was observed for suicide attempts. Engaged and addicted gamers had higher risks of suicide attempt than non-gamers and recreational gamers. CONCLUSIONS Gaming problems are associated with increased risk of non-suicidal self-harm and suicidal ideation among females. Among males, no differences were observed between engaged, problem and addicted gamers. The results highlight sex when studying health related outcomes and their association to level of gaming problems. Longitudinal studies are warranted to uncover the temporal mechanisms between IGD, non-suicidal self-harm and suicidality.
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Affiliation(s)
- Tony Leino
- Department of Psychosocial Science, University of Bergen, Bergen, 5015, Norway.
- Norwegian Competence Center for Gambling and Gaming Research, University of Bergen, Bergen, 5015, Norway.
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, 5015, Norway.
| | - Turi Reiten Finserås
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, 5015, Norway
| | - Jens Christoffer Skogen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, 5015, Norway
- Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, 0473, Norway
- Alcohol and Drug Research Western Norway, Stavanger University Hospital, Stavanger, 4068, Norway
| | - Ståle Pallesen
- Department of Psychosocial Science, University of Bergen, Bergen, 5015, Norway
- Norwegian Competence Center for Gambling and Gaming Research, University of Bergen, Bergen, 5015, Norway
| | - Joakim Hellumbråten Kristensen
- Department of Psychosocial Science, University of Bergen, Bergen, 5015, Norway
- Norwegian Competence Center for Gambling and Gaming Research, University of Bergen, Bergen, 5015, Norway
| | - Rune Aune Mentzoni
- Department of Psychosocial Science, University of Bergen, Bergen, 5015, Norway
- Norwegian Competence Center for Gambling and Gaming Research, University of Bergen, Bergen, 5015, Norway
| | - Børge Sivertsen
- Department of Health Promotion, Norwegian Institute of Public Health, Bergen, 5015, Norway
- Department of Research and Innovation, Helse Fonna HF, Haugesund, 5525, Norway
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Guan M, Liu J, Li X, Cai M, Bi J, Zhou P, Wang Z, Wu S, Guo L, Wang H. The impact of depressive and anxious symptoms on non-suicidal self-injury behavior in adolescents: a network analysis. BMC Psychiatry 2024; 24:229. [PMID: 38532354 DOI: 10.1186/s12888-024-05599-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 02/08/2024] [Indexed: 03/28/2024] Open
Abstract
PURPOSE Conceptualizing adolescent NSSI and emotional symptoms as a system of causal elements could provide valuable insights into the development of non-suicidal self-injury (NSSI) in adolescent. This study aimed to explore the intricate relationship between NSSI, depressive symptoms, and anxious symptoms in adolescents, identifying key symptoms to establish a theoretical foundation for targeted and effective interventions addressing NSSI behaviors in this population. METHODS A total of 412 adolescents with NSSI behaviors were selected from outpatients. Generalized anxious disorder scale (GAD-7) and patient health questionnaire (PHQ-9) were employed to measure anxious symptoms and depressive symptoms, respectively. The adolescent non-suicidal self-injury assessment questionnaire (ANSSIAQ) was used to evaluate NSSI of adolescent. Using network analysis, the NSSI、depressive symptoms and anxious symptoms network were constructed to identify the most central symptoms and the bridge symptoms within the networks. RESULTS The findings revealed that the NSSI functional nodes "coping with sadness and disappointment" and "relieving stress or anxious" exhibited the strongest correlation, with a regularized partial correlation coefficient was 0.401. The symptoms "having a desire to harm oneself and unable to stop" and the node "depressive symptoms" had the highest strength centrality in the network, and their strength centrality indices were 1.267 and 1.263, respectively. The bridge nodes were "having a desire to harm oneself and unable to stop" and "expressing one's despair and hopelessness", with expected impact indices of 0.389 and 0.396, respectively. CONCLUSION In adolescents, the network revealed a closer connection between NSSI and depressive symptoms. "The desire to not stop hurting oneself" is not only broadly connected to other nodes but also could activate other nodes to maintain NSSI behavior. In light of these findings, precise targets for pharmacological treatment, psychotherapy, physical therapy, etc., are identified for adolescents with NSSI. Targeting this specific aspect in interventions may contribute to preventing and reducing NSSI behavior in adolescents.
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Affiliation(s)
- Muzhen Guan
- Department of Mental Health, Xi'an Medical College, 710021, Xi'an, China
- Department of psychiatry, the first affiliated hospital, Air Force Medical University, 710032, Xi'an, China
| | - Junchang Liu
- Department of psychiatry, the first affiliated hospital, Air Force Medical University, 710032, Xi'an, China
| | - Xinhong Li
- Department of General Practice, Tangdu Hospital, Air Force Medical University, Xi'an, China
| | - Min Cai
- Department of psychiatry, the first affiliated hospital, Air Force Medical University, 710032, Xi'an, China
| | - Jing Bi
- Department of science, Xi'an Guanmiao primary school, 710086, Xi'an, China
| | - Ping Zhou
- Department of psychiatry, the first affiliated hospital, Air Force Medical University, 710032, Xi'an, China
| | - Zhongheng Wang
- Department of psychiatry, the first affiliated hospital, Air Force Medical University, 710032, Xi'an, China
| | - Songwen Wu
- Department of Mental Health, Xi'an Medical College, 710021, Xi'an, China.
| | - Li Guo
- Department of psychiatry, the first affiliated hospital, Air Force Medical University, 710032, Xi'an, China.
| | - Huaning Wang
- Department of psychiatry, the first affiliated hospital, Air Force Medical University, 710032, Xi'an, China.
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Zhu J, Zhang W, Chen Y, Teicher MH. Joint Trajectories of Depression and Rumination: Experiential Predictors and Risk of Nonsuicidal Self-Injury. J Am Acad Child Adolesc Psychiatry 2024:S0890-8567(24)00114-X. [PMID: 38460746 DOI: 10.1016/j.jaac.2024.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 01/22/2024] [Accepted: 02/29/2024] [Indexed: 03/11/2024]
Abstract
OBJECTIVE Nonsuicidal self-injury (NSSI) is common in adolescence. Rumination is a key risk factor and often co-occurs with depressive symptoms. This is the first study to examine the joint longitudinal trajectories of rumination and depressive symptoms as predictors of NSSI, and the adverse experiences associated with these trajectories. METHOD A community sample of 1,835 adolescents (55.9% male participants, 12.3 ± 0.5 years of age) completed questionnaires to assess adverse childhood experiences, rumination, depressive symptoms, and NSSI. Assessments were made 4 times over 18 months. RESULTS A parallel process growth mixture model showed that youth with high trajectories of rumination but low trajectories of depression had moderately increased odds of NSSI (2.43-fold, 95% CI 1.53-3.91) compared with adolescents with low trajectories of both rumination and depression. Odds ratios (ORs) in adolescents with low trajectories of rumination but increasing or high trajectories of depression were similarly elevated, suggesting that high trajectories of rumination or depression were risk factors in isolation. However, odds were 10.06-fold greater (95% CI 5.68-18.02) when high trajectories of rumination occurred in tandem with high trajectories of depression. Multinomial logistic regression showed that male sex (OR 10.54, 95% CI 5.66-19.63), peer victimization (OR 2.25, 95% CI 1.72-2.96), and parental alienation (OR 1.94, 95% CI 1.46-2.57) were key determinants of membership in the highest risk group. CONCLUSION Risk for NSSI is markedly increased in adolescents with high longitudinal trajectories of depression and rumination. Reducing exposure to peer victimization, cyber victimization, emotional abuse, parental alienation, and interparental conflict may reduce risk.
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Affiliation(s)
| | - Wei Zhang
- School of Psychology, South China Normal University, Guangzhou, China
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Gu H, Chen W, Cheng Y. Longitudinal relationship between harsh parenting and adolescent non-suicidal self-injury: The roles of basic psychological needs frustration and self-concept clarity. CHILD ABUSE & NEGLECT 2024; 149:106697. [PMID: 38412590 DOI: 10.1016/j.chiabu.2024.106697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 02/05/2024] [Accepted: 02/08/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND Harsh parenting has been shown to be associated with adolescents' non-suicidal self-injury (NSSI) behavior. However, less is known about the mechanism underlying the association. OBJECTIVE The aim of this study was to use a one-year longitudinal design to investigate the mediating role of basic psychological needs frustration and the moderating role of self-concept clarity in the association between harsh parenting and NSSI. METHODS Three waves of data (called T1, T2 and T3) were collected 6 months apart, between April 2021 and 2022, in a sample of 786 Chinese adolescents (52.0 % girls; Mage at Wave 1 = 13.27 years). Structural equation model was used to test a longitudinal moderated mediation model, with gender, age and baseline NSSI as covariates. RESULTS The results showed process of mediation in which T1 harsh parenting was longitudinally and positively associated with T3 NSSI through T2 basic psychological needs frustration. Furthermore, moderated mediation analyses revealed that T2 self-concept clarity buffered the adverse impact of T2 needs frustration on T3 NSSI, thereby mitigating the mediation process. CONCLUSIONS The findings support the self-determination theory, and suggest that fostering adolescents' self-concept clarity and satisfying their psychological needs may be useful in programs designed to lower the risk of NSSI.
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Affiliation(s)
- Honglei Gu
- Department of Psychology, Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China.
| | - Wanqin Chen
- Institute of Special Education, Faculty of Education, Beijing Normal University, Beijing, China; School of Education Science, Hunan Normal University, Changsha, China
| | - Yufang Cheng
- Department of Psychology, Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China
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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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Buckmaster R, McNulty M, Guerin S. An exploration of family dynamics in adults who self-harm. Ir J Psychol Med 2024; 41:37-45. [PMID: 34602119 DOI: 10.1017/ipm.2021.59] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES The aim of the present study was to explore how adults who self-harm experience family relationships. METHODS A phenomenological design was employed to examine the dynamic relationship between self-harm and family systems. Semi-structured interviews were conducted with six female adults who attend a community mental health service and engage in self-harm. Transcripts were analysed using Interpretative Phenomenological Analysis (IPA). RESULTS Four superordinate themes emerged from the data and two subordinate themes emerged within each superordinate theme: family interactive patterns (subordinate themes: enmeshed patterns and culture of 'getting on with it'), searching for meaning (subordinate themes: expressing emotional turmoil and engrained worthlessness), relating to others (subordinate themes: guilt and feeling misunderstood) and journey towards life without self-harm (subordinate themes: acceptance and family support). CONCLUSIONS Findings emphasise the role of family systems in understanding self-harm in adults. The study highlights the need for family-based interventions for family members who support adults that self-harm.
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Affiliation(s)
- Ruth Buckmaster
- School of Psychology, University College Dublin, Dublin 4, Ireland
- Health Service Executive Midlands, Laois/Offaly, Ireland
| | - Muireann McNulty
- School of Psychology, University College Dublin, Dublin 4, Ireland
| | - Suzanne Guerin
- School of Psychology, University College Dublin, Dublin 4, Ireland
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Ahmadi F, Goodarzi MA, Taghavi MR, Imani M. Modeling the structural relationships between trauma exposure with substance use tendency, depression symptoms, and suicidal thoughts in individuals with earthquake trauma experience: the mediatory role of peritraumatic dissociation and experiential avoidance. BMC Psychiatry 2024; 24:171. [PMID: 38429677 PMCID: PMC10905816 DOI: 10.1186/s12888-024-05595-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2023] [Accepted: 02/06/2024] [Indexed: 03/03/2024] Open
Abstract
BACKGROUND Despite the fact that studies indicate that earthquake trauma is associated with numerous psychological consequences, the mediating mechanisms leading to these outcomes have not been well-studied. Therefore, this study investigates the relationship between trauma exposure with substance use tendency, depression, and suicidal thoughts, with the mediating role of peritraumatic dissociation and experiential avoidance. METHODS The descriptive-correlational approach was employed in this study. The participants were people who had experienced the Kermanshah earthquake in 2017. A total of 324 people were selected by convenient sampling method. The Traumatic Exposure Severity Scale, the Peritraumatic Dissociative Experiences Questionnaire, the Acceptance and Action Questionnaire, the Iranian Addiction Potential Scale, Beck's Depression Inventory [BDI-II], and Beck's Suicidal Thoughts Scale were used to collect data. The gathered data was analyzed using structural equation modeling in SPSS Ver. 24 and LISREL Ver. 24. RESULTS The study findings indicated that the intensity of the trauma exposure is directly and significantly associated with depression symptoms, peritraumatic dissociation, and experiential avoidance. The severity of exposure to trauma had a significant indirect effect on the tendency to use substances through experiential avoidance. This is while the severity of the trauma experience did not directly correlate with substance use and suicidal thoughts. In addition, peritraumatic dissociation did not act as a mediator in the relationship between the severity of trauma exposure with substance use, depression, and suicidal thoughts. CONCLUSIONS The severity of exposure to the earthquake was associated with symptoms of depression and these findings indicate the importance of experiential avoidance in predicting the tendency to use drugs. Hence, it is essential to design and implement psychological interventions that target experiential avoidance to prevent drug use tendencies and to establish policies that lower depression symptoms following natural disasters.
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Affiliation(s)
- Farshad Ahmadi
- Department of Clinical Psychology, Faculty of Educational Sciences and Psychology, University of Shiraz, Shiraz, Iran.
| | - Mohammad Ali Goodarzi
- Department of Clinical Psychology, Faculty of Educational Sciences and Psychology, University of Shiraz, Shiraz, Iran
| | - Mohammad Reza Taghavi
- Department of Clinical Psychology, Faculty of Educational Sciences and Psychology, University of Shiraz, Shiraz, Iran
| | - Mahdi Imani
- Department of Clinical Psychology, Faculty of Educational Sciences and Psychology, University of Shiraz, Shiraz, Iran
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Seong E, Lee KH, Lee JS, Kim S, Seo DG, Yoo JH, Han DH, Hwang H, Choi CH, Kim JW. Depression and posttraumatic stress disorder in adolescents with nonsuicidal self-injury: comparisons of the psychological correlates and suicidal presentations across diagnostic subgroups. BMC Psychiatry 2024; 24:138. [PMID: 38373899 PMCID: PMC10877746 DOI: 10.1186/s12888-024-05533-5] [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: 03/31/2023] [Accepted: 01/18/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Nonsuicidal self-injury (NSSI) combined with suicide ideation increases the risk of suicidal behaviors. Depression and posttraumatic stress disorder (PTSD) are comorbidities of NSSI compounding this relationship. The present study compared diagnostic subgroups of NSSI based on current depression and PTSD on psychological correlates (i.e., vulnerabilities and impairment) and suicidal presentations (i.e., suicidal cognitions and behaviors) in a psychiatric sample of adolescents. METHODS Eighty-seven adolescents meeting DSM-5 criteria for NSSI and 104 age-range-matched nonclinical controls (NC) participated. Participants completed self-report measures on psychological vulnerabilities and impairment (e.g., emotion regulation difficulties, negative cognitions). Adolescents with NSSI also completed clinical interviews on psychiatric diagnoses and a recent self-injurious behavior (SIB). Scores on the psychological correlates of NSSI were compared between adolescents with NSSI and NC, and across three diagnostic subgroups of NSSI (A: NSSI+/depression-/PTSD-, n = 14; B: NSSI+/depression+/PTSD-, n = 57; C: NSSI+/depression+/PTSD+, n = 14). Differences between NSSI diagnostic subgroups were tested on the motives for SIB and accompanying suicidal presentations (e.g., desire, intent, motive, lethality). RESULTS Common comorbidities of NSSI included depression, panic disorder, generalized anxiety disorder, and PTSD. The NSSI subgroup classification was significantly associated with panic disorder, which was controlled for in the subsequent group comparisons. Overall, adolescents who engage in NSSI with vs. without depression reported more psychological vulnerabilities and impairment and a greater degree of suicidal thoughts/desire in SIB (i.e., groups B, C >A), which remained significant after controlling for panic disorder. An increased odds of the suicidal motive for SIB was found in adolescents with all three conditions (i.e., group C: NSSI+/depression+/PTSD+) compared to those with NSSI but neither depression nor PTSD (i.e., group A: NSSI+/depression-/PTSD-); however, this was not significant after controlling for panic disorder. CONCLUSIONS Psychological underpinnings of adolescent NSSI in clinical contexts may be largely associated with concurrent depression. Suicidal motives in adolescents who engage in NSSI in the presence of depression and PTSD may be confounded by the co-occurrence of panic disorder. This study warrants the importance of attending to the comorbid depression with NSSI in adolescents as it is related to an increase in suicidal desire accompanying SIB.
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Affiliation(s)
- Eunice Seong
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Kyung Hwa Lee
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Jong-Sun Lee
- Department of Psychology, Kangwon National University, 1 Gangwondaehak-gil, Chuncheon, Gangwon-do, 24341, Republic of Korea
| | - Sojung Kim
- Department of Psychology, Yeungnam University, 280 Daehak-ro, Gyeongsan, Gyeongbuk, 38541, Republic of Korea
| | - Dong Gi Seo
- Department of Psychology, Hallym University, 1 Hallymdaehak-gil, Chuncheon, Gangwon-do, 24252, Republic of Korea
| | - Jae Hyun Yoo
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Doug Hyun Han
- Department of Psychiatry, Chung-Ang University College of Medicine, 84 Heukseok-ro, Dongjak-gu, Seoul, 06973, Republic of Korea
| | - Hyunchan Hwang
- Department of Psychiatry, Chung-Ang University College of Medicine, 84 Heukseok-ro, Dongjak-gu, Seoul, 06973, Republic of Korea
| | - Chi-Hyun Choi
- Seoul Alpha Neuropsychiatric Clinic, 511 Nonhyeon-ro, Gangnam-gu, Seoul, 06131, Republic of Korea
| | - Jae-Won Kim
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
- Department of Psychiatry, Institute of Human Behavioral Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
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Cheng F, Shi L, Xie H, Wang B, Hu C, Zhang W, Hu Z, Yu H, Wang Y. A study of the interactive mediating effect of ADHD and NSSI caused by co-disease mechanisms in males and females. PeerJ 2024; 12:e16895. [PMID: 38348102 PMCID: PMC10860553 DOI: 10.7717/peerj.16895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 01/16/2024] [Indexed: 02/15/2024] Open
Abstract
Background Non-suicidal self-injury (NSSI), of which the predisposing factors are complex and diverse, profoundly affects the physical and mental health of young people. Therefore, this work established an NSSI intermediary network model considering the interaction of multiple factors. A mediating effect between attention-deficit/hyperactivity disorder (ADHD) and NSSI, considering the influence of comorbidities, such as depression, anxiety, and impulsive personality, was proposed based on sex differences. Methods A total of 2,689 middle school students in Ningbo City, Zhejiang Province, China, were randomly sampled and participated in this study. Data regarding their demographic characteristics, attention deficit, hyperactivity/impulsivity, NSSI, anxiety, depression, internet addiction, and other comorbid symptoms were collected and analyzed. After initially screening the data, variables were assessed for significance using a single-factor inter-group difference analytic method, and a binary logistic regression analysis was performed. The intermediary effect of factors influencing NSSI in males and females was also analyzed. Results The overall NSSI rate was 15.16%. The results showed that the impact of individual impulsivity characteristics (impulsiveness, the ADHD with hyperactivity/impulsivity subtype) on NSSI behavior was not significant (regression results, P > 0.05). The degree of association between ADHD with attention deficit and ADHD with comprehension deficit subtypes, and other comorbid symptoms (depression, anxiety, and internet addiction disorder) and NSSI, with odds ratios (ORs) of 7.6/6.42/436.68/3.82/1.86, and 95% bootstrap confidence intervals (CIs) of 4.64, 12.87/3.46, 12.67/137.42, 2659.13/2.32, 6.37/1.31, 2.82, respectively. The results also showed significant effects of ADHD subtypes on comorbid symptoms and the path effects of NSSI (P < 0.01). Among them, the mediating effect was the strongest when anxiety was the mediating variable, and the mediating effect of girls was higher than that of boys. Conclusion The results of this work demonstrated the influence of ADHD symptoms on NSSI behavior. Among patients with ADHD, patients with subtypes with obvious attention deficit characteristics were more likely to exhibit NSSI behavior, whereas the hyperactive impulse subtype had no direct impact on NSSI. We conclude that adolescent impulsivity may not be directly related to NSSI behavior and that impulsive characteristics jointly affect NSSI behavior through a series of NSSI comorbid symptoms. Notably, the probability of symptom onset and the degree of comorbidity was significantly higher in girls than in boys of the same age, and girls were more prone to NSSI behavior. These findings provide effective theoretical support for the prevention and treatment of adolescent NSSI behavior.
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Affiliation(s)
- Fang Cheng
- The Second Affiliated Hospital of Soochow University, Suzhou, China
- Department of Psychiatry, Affiliated Kangning Hospital of Ningbo University, Ningbo, China
- Department of Psychiatry, Ningbo Kangning Hospital, Ningbo, China
| | | | - Huabing Xie
- People’s Hospital of Wuhan University, Wuhan, China
| | - Beini Wang
- Department of Psychiatry, Affiliated Kangning Hospital of Ningbo University, Ningbo, China
- Department of Psychiatry, Ningbo Kangning Hospital, Ningbo, China
| | - Changzhou Hu
- Department of Psychiatry, Affiliated Kangning Hospital of Ningbo University, Ningbo, China
- Department of Psychiatry, Ningbo Kangning Hospital, Ningbo, China
| | - Wenwu Zhang
- Department of Psychiatry, Affiliated Kangning Hospital of Ningbo University, Ningbo, China
- Department of Psychiatry, Ningbo Kangning Hospital, Ningbo, China
| | - Zhenyu Hu
- Department of Psychiatry, Affiliated Kangning Hospital of Ningbo University, Ningbo, China
- Department of Psychiatry, Ningbo Kangning Hospital, Ningbo, China
| | - Haihang Yu
- Department of Psychiatry, Affiliated Kangning Hospital of Ningbo University, Ningbo, China
- Department of Psychiatry, Ningbo Kangning Hospital, Ningbo, China
| | - Yiming Wang
- The Second Affiliated Hospital of Soochow University, Suzhou, China
- Department of Psychiatry, Affiliated Hospital to Guizhou Medical University, Guizhou, China
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Li J, Gu H, Xia T. Childhood maltreatment and NSSI in prisoners: mediation through self-identity and moderation by sensation-seeking. Front Psychiatry 2024; 15:1303033. [PMID: 38370562 PMCID: PMC10869573 DOI: 10.3389/fpsyt.2024.1303033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Accepted: 01/10/2024] [Indexed: 02/20/2024] Open
Abstract
Introduction The prevalence of non-suicidal self-injury (NSSI) among prisoners is widely recognized. However, most research conducted in prisons setting has focused on lifetime engagement in NSSI, with limited knowledge about its correlates and risk factors during imprisonment. Methods Drawing on the integrated theoretical model of NSSI, this study aimed to examine the combined effects of childhood maltreatment (an environmental factor) and two intrapersonal factors, namely self-identity and sensation-seeking, on NSSI. 1042 Chinese male offenders participated in the current study, and regression analyses is used to examine the relationship among variables. Results The results revealed that self-identity mediated the association between childhood maltreatment and prisoners' NSSI. Sensation-seeking moderated the relationship between self-identity and NSSI, and this connection was only significant for offenders with high sensation-seeking. Discussion We discuss the results of the current research and possible practical implications.
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Affiliation(s)
- Juan Li
- School of Educational Science, Hunan Normal University, Changsha, China
| | - Honglei Gu
- School of Educational Science, Hunan Normal University, Changsha, China
- Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China
| | - Tiansheng Xia
- School of Art and Design, Guangdong University of Technology, Guangzhou, China
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Millon EM, Alqueza KL, Kamath RA, Marsh R, Pagliaccio D, Blumberg HP, Stewart JG, Auerbach RP. Non-suicidal Self-injurious Thoughts and Behaviors Among Adolescent Inpatients. Child Psychiatry Hum Dev 2024; 55:48-59. [PMID: 35727385 PMCID: PMC9782727 DOI: 10.1007/s10578-022-01380-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/19/2022] [Indexed: 01/07/2023]
Abstract
Non-suicidal self-injury (NSSI) is a serious public health concern that typically onsets during early adolescence. Adolescents (N = 980, ages 12-19 years) admitted for acute, residential psychiatric treatment completed baseline clinical interviews assessing mental disorders and questionnaires measuring demographics, early life adversity, and symptom severity. Prevalence rates of NSSI for lifetime (thoughts: 78%; behaviors: 72%), past year (thoughts: 74%; behaviors: 65%), and past month (thoughts: 68%; behaviors: 51%) were high. Although effect sizes were modest, the presence of a lifetime depressive disorder, sexual abuse, and comorbidity (i.e., three or more current disorders) were significant correlates of experiencing NSSI thoughts and behaviors. Furthermore, lifetime depressive disorder, current anxiety disorder, and comorbidity were associated with a greater odds of persistent NSSI thoughts and/or behaviors. Longitudinal studies are needed to determine whether targeting these factors reduces the persistence of NSSI thoughts and behaviors.
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Affiliation(s)
- Emma M Millon
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA
| | - Kira L Alqueza
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA
| | - Rahil A Kamath
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA
| | - Rachel Marsh
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA
| | - David Pagliaccio
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA
| | - Hilary P Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Jeremy G Stewart
- Department of Psychology and Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA.
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA.
- Division of Clinical Developmental Neuroscience, Sackler Institute, New York, NY, USA.
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Yuan GF, Liu C, Li X, Fung HW, Wong MYC, Lam SKK, An Y, Feng X. Hurting myself to cope: Using network analysis to understand the association between perceived stigma and non-suicidal self-injury functions among men who have sex with men in China. Arch Psychiatr Nurs 2024; 48:43-50. [PMID: 38453281 DOI: 10.1016/j.apnu.2024.01.005] [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: 02/14/2023] [Revised: 05/04/2023] [Accepted: 01/05/2024] [Indexed: 03/09/2024]
Abstract
Prior studies have demonstrated that perceived stigma is robustly associated with risky and life-threatening behaviors, including non-suicidal self-injury (NSSI), among men who have sex with men (MSM). However, studies regarding the relationship between perceived stigma and NSSI are limited. The present study aimed to investigate the network structure of perceived stigma and NSSI functions, along with bridge nodes, to elucidate how they co-exist. A sample of 2610 Chinese MSM (mean age = 23.99, age range: 18-68 years) was recruited from an online survey platform. All participants completed a web-based survey with measures of perceived stigma and NSSI functions. Results indicated that 'negative attitudes towards homosexuality' and 'disappointment in gay son' were identified as the most central nodes in the perceived stigma network, whereas 'seeking attention' and 'influencing others to change' ranked highest on centrality in the NSSI network. Two bridge connections were exhibited within the combined perceived stigma and NSSI network model: 'unwelcoming in public' and 'avoiding unpleasant tasks' from perceived stigma and NSSI communities, respectively. This is among the first studies investigating the co-occurrence between perceived stigma and NSSI from the network approach. Our findings provide an empirically-based perspective on the importance of family- and community-based interventions, with potential clinical implications for reducing NSSI among sexual and gender minority groups.
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Affiliation(s)
- Guangzhe Frank Yuan
- School of Education Science, Leshan Normal University, Leshan, China; Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA.
| | - Caimeng Liu
- School of Education Science, Leshan Normal University, Leshan, China.
| | - Xiaoming Li
- Department of Health Promotion Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC, USA
| | - Hong Wang Fung
- Department of Social Work, Faculty of Social Sciences, The Hong Kong Baptist University, Kowloon Tong, Hong Kong
| | - Ming Yu Claudia Wong
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong
| | - Stanley Kam Ki Lam
- The Nethersole School of Nursing, The Chinese University of Hong Kong, Hong Kong
| | - Yuanyuan An
- School of Psychology, Nanjing Normal University, Nanjing, Jiangsu, China.
| | - Xueyou Feng
- Center for Mental Health Education and Counseling, Guangzhou College of Commerce, Guangzhou, China
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Tanaka R, Ando S, Kiyono T, Minami R, Endo K, Miyashita M, Yamasaki S, Kanata S, Fujikawa S, Hiraiwa-Hasegawa M, Nishida A, Kasai K. The longitudinal relationship between dissociative symptoms and self-harm in adolescents: a population-based cohort study. Eur Child Adolesc Psychiatry 2024; 33:561-568. [PMID: 36882639 PMCID: PMC10869437 DOI: 10.1007/s00787-023-02183-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 02/27/2023] [Indexed: 03/09/2023]
Abstract
Previous studies have reported that dissociative symptoms (DIS) are associated with self-harm (SH) in adolescents. However, most of these studies were cross-sectional, which limits the understanding of their theoretical relationship. We aimed to investigate the longitudinal relationship between DIS and SH in the general adolescent population. We used data from the Tokyo Teen Cohort study (N = 3007). DIS and SH were assessed at times 1 and 2 (T1 and T2) (12 years of age and 14 years of age, respectively). DIS were assessed using the parent-report Child Behavior Checklist (CBCL), and severe dissociative symptoms (SDIS) were defined as a score above the top 10th percentile. The experience of SH within 1 year was assessed by a self-report questionnaire. The longitudinal relationship between DIS and SH was examined using regression analyses. Using logistic regression analyses, we further investigated the risk for SH at T2 due to persistent SDIS and vice versa. DIS at T1 tended to predict SH at T2 (odds ratio (OR) 1.11, 95% CI 0.99 to 1.25, p = 0.08), while SH at T1 did not predict DIS at T2 (B = - 0.03, 95% CI - 0.26 to 0.20, p = 0.81). Compared with adolescents without SDIS, those with persistent SDIS had an increased risk of SH at T2 (OR 2.61, 95% CI 1.28 to 5.33, p = 0.01). DIS tended to predict future SH, but SH did not predict future DIS. DIS may be a target to prevent SH in adolescents. Intensive attention should be given to adolescents with SDIS due to their increased risk of SH.
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Affiliation(s)
- Riki Tanaka
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, Japan.
| | - Shuntaro Ando
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, Japan
| | - Tomoki Kiyono
- Department of Psychiatry, Teikyo University Mizonokuchi Hospital, Kanagawa, Japan
| | - Rin Minami
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, Japan
| | - Kaori Endo
- Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Mitsuhiro Miyashita
- Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Syudo Yamasaki
- Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Sho Kanata
- Department of Psychiatry, Teikyo University School of Medicine, Tokyo, Japan
| | - Shinya Fujikawa
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, Japan
| | - Mariko Hiraiwa-Hasegawa
- School of Advanced Science, SOKENDAI (Graduate University for Advanced Studies), Kanagawa, Japan
| | - Atsushi Nishida
- Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, Japan
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Kudinova AY, Brick LA, Armey M, Nugent NR. Micro-sequences of anger and shame and non-suicidal self-injury in youth: an ecological momentary assessment study. J Child Psychol Psychiatry 2024; 65:137-147. [PMID: 37525367 PMCID: PMC10828100 DOI: 10.1111/jcpp.13869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/07/2023] [Indexed: 08/02/2023]
Abstract
OBJECTIVE Non-suicidal self-injury (NSSI) is a significant mental health concern with the highest prevalence among adolescents. NSSI has been conceptualized as one of the maladaptive strategies to cope with challenging affect or a form of self-punishment. Although characterizing moment-to-moment associations between shame and NSSI in individuals' real-world environment and partitioning between- and within-person effects is critical for mobile and timely interventions, most studies examined habitual experiences of negative affective states and focused on adults. METHOD In this study, we focused on in vivo anger at self and others and shame and NSSI among 158 adolescents 3 weeks following their psychiatric hospitalizations using ecological momentary assessment (EMA) technology. RESULTS We found that greater between-person levels of anger at self and others were linked to a higher number of subsequent NSSI occurrences within a day. These findings remained primarily unchanged when we statistically adjusted for participants' age, sex assigned at birth, the number of current psychiatric diagnoses, EMA response rates, and youth lifetime history of SI. Within-person increases in NSSI were linked to increased anger at self over and beyond between-person average levels of NSSI. CONCLUSIONS These findings highlight the potential regulatory role of NSSI to decrease negative affective states and point to the clinical utility of assessing and early mobile interventions targeting challenging affect in youth.
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Affiliation(s)
- Anastacia Y Kudinova
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- Division of Child Psychiatry, Bradley Hospital, Providence, RI, USA
| | - Leslie A Brick
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Michael Armey
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Nicole R Nugent
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
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Vaartstra LD, Taone T, Mezulis A. Cognitive reactivity as a risk factor for non-suicidal self-injury in young adults. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024:1-7. [PMID: 38190282 DOI: 10.1080/07448481.2023.2269450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 10/06/2023] [Indexed: 01/10/2024]
Abstract
OBJECTIVES Non-suicidal self-injury (NSSI) risk in young adults is impacted by both affective and cognitive responses to stress. While previous research shows affective reactivity (AR) increases risk for NSSI, less research has examined the role of cognitive reactivity (CR). The current study examined how individual differences in CR to stress relate to NSSI. PARTICIPANTS The sample included 192 college students (M = 19.84 years, SD = 2.51, 82% women). METHODS Participants completed a baseline questionnaire followed by a laboratory visit involving measures before and after stress induction. RESULTS Analyses indicated that individuals who engage in NSSI reported more affective and cognitive reactivity to stress. Additionally, higher levels of affective and cognitive reactivity uniquely predicted NSSI. A combined model yielded mixed results. Higher levels of AR led to lower levels of CR, while higher levels of CR predicted more NSSI. CONCLUSION In sum, results demonstrated significant but unique effects of affective and cognitive reactivity to stress on NSSI.
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Affiliation(s)
- Luke D Vaartstra
- Department of Clinical Psychology, Seattle Pacific University, Seattle, Washington, USA
| | - Trevor Taone
- Department of Clinical Psychology, Seattle Pacific University, Seattle, Washington, USA
| | - Amy Mezulis
- Department of Clinical Psychology, Seattle Pacific University, Seattle, Washington, USA
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Shan D, Wang Y, Tousey-Pfarrer M, Guo C, Wan M, Wang P, Dai Z, Ge F, Zhang J. Association between patterns of biological rhythm and self-harm: evidence from the baoxing youth mental health (BYMH) cohort. Child Adolesc Psychiatry Ment Health 2024; 18:3. [PMID: 38172979 PMCID: PMC10765742 DOI: 10.1186/s13034-023-00685-w] [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: 09/28/2023] [Accepted: 11/29/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Self-harm, a severe mental health concern among children and adolescents, has varying global prevalence rates. Previous studies have suggested potential associations between specific behavioral aspects of biological rhythm and self-harm risk in these populations. OBJECTIVE Our study aimed to elucidate the relationship between biological rhythm patterns and the propensity of self-harm among Chinese children and adolescents using the Baoxing Youth Mental Health (BYMH) cohort. METHODS We included 1883 Chinese children and adolescents from the BYMH cohort. The self-report questions used to assess biological rhythm and self-harm. We applied Principal Component Analysis (PCA) to distinguish patterns of biological rhythms. Logistic regression models were conducted to estimate the associations between biological rhythm, as well as biological rhythm patterns and risk of self-harm. RESULTS Of the participants, 35.0% reported experiencing lifetime self-harm. PCA revealed six significantly predominant biological rhythm patterns. Elevated risks of self-harm were linked with unhealthy eating practices, daytime tiredness, and unhealthy bedtime snacking. Conversely, patterns emphasizing physical exercise, family meals for breakfast, and nutritious diet exhibited decreased self-harm propensities. These trends persisted across varied self-harm attributes, including type, recency, and frequency of self-harm. CONCLUSIONS This study underscores the critical impact of biological rhythms on self-harm risks among Chinese youth. Targeted lifestyle interventions, focusing on improved sleep and dietary habits, could serve as potent preventive measures. Our findings lay the groundwork for future longitudinal studies to further probe these associations, fostering the creation of tailored interventions to curb self-harm and enhance mental well-being in younger populations.
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Affiliation(s)
- Dan Shan
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
- Department of Biobehavioral Sciences, Columbia University, New York, NY, USA
| | - Yue Wang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Marissa Tousey-Pfarrer
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Cancan Guo
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Mengtong Wan
- School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Peijie Wang
- School of Education, Tianjin University, Tianjin, China
| | - Zhihao Dai
- School of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Fenfen Ge
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.
- Center of Public Health Sciences, Faculty of Medicine, University of Iceland, Reykjavík, Iceland.
- The National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark.
| | - Jun Zhang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China.
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Zhou X, Guo J, Wu H, Chen D, Wang C, You J. The Relationship between Ambivalence over Emotional Expression and Nonsuicidal Self-Injury Among Chinese Adolescents: A Longitudinal Moderated Mediation Model. Arch Suicide Res 2024; 28:90-106. [PMID: 36282550 DOI: 10.1080/13811118.2022.2134068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
BACKGROUND Nonsuicidal self-injury (NSSI) has become a significant mental health concern for adolescents. Previous empirical studies have shown that ambivalence over emotional expression is positively associated with negative emotions and behaviors. However, little is known about the relationship between ambivalence over emotional expression and NSSI among adolescents. Therefore, this study used a longitudinal design to examine the relationship between ambivalence over emotional expression and NSSI among Chinese adolescents, and also to explore the mediating and moderating mechanisms underlying this relationship. METHOD A total of 1,672 students (45.8% males; Mage = 16.12 years, SD = 1.56) in a middle school in Guangzhou were tracked. The investigation was conducted twice, with an interval of 6 months. RESULTS Ambivalence over emotional expression was positively correlated with NSSI. After controlling for gender and baseline NSSI, anxiety symptoms fully mediated the association between ambivalence over emotional expression and NSSI. In addition, the relationship between ambivalence over emotional expression and NSSI was moderated by NSSI refusal self-efficacy. CONCLUSIONS These findings imply that to decrease ambivalence over emotional expression, to reduce anxiety symptoms, and to promote NSSI refusal self-efficacy may be useful for interventions and preventions of NSSI.HIGHLIGHTSTested the relationship between ambivalence over emotional expression and NSSI in adolescents.Examined a moderated-mediation model over six months.Found the mediated effect of anxiety symptoms and moderated effect of NSSI refusal self-efficacy in the relationship between ambivalence over emotional expression and NSSI.
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Xie X, Li Y, Liu J, Zhang L, Sun T, Zhang C, Liu Z, Liu J, Wen L, Gong X, Cai Z. The relationship between childhood maltreatment and non-suicidal self-injury in adolescents with depressive disorders. Psychiatry Res 2024; 331:115638. [PMID: 38035534 DOI: 10.1016/j.psychres.2023.115638] [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: 08/15/2023] [Revised: 11/21/2023] [Accepted: 11/25/2023] [Indexed: 12/02/2023]
Abstract
This study aims to explore the core symptoms of Non-Suicidal Self-Injury (NSSI) in adolescents with depressive disorders and the relationship between childhood maltreatment (CM) and NSSI symptoms by using network analysis. A total of 689 adolescents with depressive disorders participated in the survey. The Chinese version of the Adolescent Non-Suicidal Self-Injury Assessment Questionnaire (ANSAQ) and the Short Form of the Childhood Trauma Questionnaire (CTQ-SF) were employed to measure NSSI and the symptoms of CM, respectively. Using network analysis, the NSSI network and the CM-NSSI network were constructed to identify the most central symptoms and the bridge symptoms within the networks. Within the NSSI network, "Intentional scratches", " Intentionally hitting hard objects with your head ", " Intentionally hitting oneself with fists or harder objects ", and " Intentional pinching " were identified as the primary symptoms of NSSI. "emotional abuse", "sexual abuse", and " Intentionally cut yourself " emerged as three key bridge symptoms linking CM with NSSI. This research is the first to investigate the symptom network of CM-NSSI in a sample of adolescents with depressive disorders, providing a foundation for subsequent NSSI prevention and the development of targeted intervention strategies.
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Affiliation(s)
- Xiangying Xie
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Yinglin Li
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Jingfang Liu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Lili Zhang
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Ting Sun
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Chunlong Zhang
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Zhongchun Liu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Jie Liu
- Virginia Commonwealth University Health System, Richmond, United States
| | - Li Wen
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan 430060, China.
| | - Xuan Gong
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China.
| | - Zhongxiang Cai
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan 430060, China.
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Tatnell R, Terhaag S, Melvin G. Covid-19 Lockdown and Non-Suicidal Self-Injury: A Mixed Methods Analysis of NSSI During Australia's National Lockdown. Arch Suicide Res 2024; 28:279-294. [PMID: 36594357 DOI: 10.1080/13811118.2022.2155279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE The Covid-19 global pandemic has meant large parts of the world's population have been isolated from others for often months at a time due to lockdown measures to stop the spread. The effects of isolation can be damaging and increase risk of self-injury (NSSI) and suicide. We examined the effects of the first Australian national lockdown on NSSI urges and behavior. METHOD We asked 345 people with current or past lived experience of NSSI both quantitative and qualitative questions about how their urges and behavior changed during lockdown and assessed how changes were related to demographic variables including work and living conditions. RESULTS Women, socially disadvantaged and unemployed people were at greater risk of increased NSSI urges and behavior. Social connection was important, with both quantitative and qualitative responses indicating that for some, decreased social anxiety and social pressures was related to a reduction in NSSI, whereas for others the lack of social connection and engagement was associated with worsening urges and behaviors. CONCLUSION Lockdown had mixed impacts on people with lived experience of NSSI, with most reporting no change or a decrease to urges and behavior, however, for socially disadvantaged people in particular, lockdown lead to worsening urges and behavior and even relapse. Future research might examine these effects longitudinally and with greater focus on intersectionality.HighlightsIdentified NSSI risk/protective factors, and an understanding of lived experienceLockdowns have mixed impacts, some people decreased, some increased NSSISocial connection plays an important role in NSSI engagement and reduction.
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Gu H, Yu W, Cheng Y. Pattern of non-suicidal self-injury in Chinese male prisoners: A latent class analysis. J Clin Psychol 2024; 80:86-96. [PMID: 37705343 DOI: 10.1002/jclp.23595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 07/25/2023] [Accepted: 09/06/2023] [Indexed: 09/15/2023]
Abstract
OBJECTIVES Nonsuicidal self-injury (NSSI) occurs more frequently in the prisoner population than in the general population. Monitoring and management of this behavior is challenging because NSSI may present in diverse ways. People often use more than one method of NSSI, and there are many possible combinations of these behaviors. We used latent class analysis (LCA) to identify subgroups of male inmates based on methods and frequency of NSSI. METHODS A total of 1042 male prisoners in China (Mage = 38.45, SD = 10.67) completed measures of hopelessness, sensation seeking, identity integration, and suicidal ideation, and NSSI was assessed in a structured interview. RESULTS Results of the LCA supported a three-class model: high-NSSI (1.8%), moderate-NSSI (8.0%), and no-or-negligible NSSI (90.2%). Multinomial logistic regression analyses showed that prisoners in the high-NSSI and moderate-NSSI classes were significantly more likely than those in the no-or-negligible NSSI class to show high hopelessness, high sensation seeking, and low identity. Furthermore, suicidal ideation was significantly higher in the high-NSSI and moderate-NSSI classes than in the no-or-negligible NSSI class. CONCLUSIONS Classifying groups of prisoners based on features of NSSI is potentially useful for understanding risk factors and for developing tailored prevention and treatment strategies.
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Affiliation(s)
- Honglei Gu
- Department of Psychology, Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China
| | - Weiming Yu
- Department of Psychology, Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China
| | - Yufang Cheng
- Department of Psychology, Cognition and Human Behavior Key Laboratory of Hunan Province, Hunan Normal University, Changsha, China
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Wright LC, Lopez Chemas N, Cooper C. Lived experience codesign of self-harm interventions: a scoping review. BMJ Open 2023; 13:e079090. [PMID: 38151276 PMCID: PMC10753750 DOI: 10.1136/bmjopen-2023-079090] [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: 08/21/2023] [Accepted: 12/04/2023] [Indexed: 12/29/2023] Open
Abstract
OBJECTIVES This study aims to map existing literature describing how people with lived experience of self-harm have engaged in codesigning self-harm interventions, understand barriers and facilitators to this engagement, and how the meaningfulness of codesign has been evaluated. DESIGN Scoping review by Joanna Briggs Institute methodology. A protocol was published online (http://dx.doi.org/10.17605/OSF.IO/P52UD). DATA SOURCES PubMed, Embase, PsycINFO, Web of Science, Cochrane Library, PROSPERO, ClinicalTrials.gov and relevant websites were searched on 24 December 2022 (repeated 4 November 2023). ELIGIBILITY CRITERIA We included studies where individuals with lived experience of self-harm (first-hand or caregiver) have codesigned self-harm interventions. DATA EXTRACTION AND SYNTHESIS Results were screened at title and abstract level, then full-text level by two researchers independently. Prespecified data were extracted, charted and sorted into themes. RESULTS We included 22 codesigned interventions across mobile health, educational settings, prisons and emergency departments. Involvement varied from designing content to multistage involvement in planning, delivery and dissemination. Included papers described the contribution of 159 female, 39 male and 21 transgender or gender diverse codesigners. Few studies included contributors from a minoritised ethnic or LGBTQIA+ group. Six studies evaluated how meaningfully people with lived experience were engaged in codesign: by documenting the impact of contributions on intervention design or through postdesign reflections. Barriers included difficulties recruiting inclusively, making time for meaningful engagement in stretched services and safeguarding concerns for codesigners. Explicit processes for ensuring safety and well-being, flexible schedules, and adequate funding facilitated codesign. CONCLUSIONS To realise the potential of codesign to improve self-harm interventions, people with lived experience must be representative of those who use services. This requires processes that reassure potential contributors and referrers that codesigners will be safeguarded, remunerated, and their contributions used and valued.
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Affiliation(s)
- Lucy C Wright
- Barts and the London School of Medicine, Queen Mary University of London, London, UK
| | - Natalia Lopez Chemas
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
| | - Claudia Cooper
- Centre for Psychiatry and Mental Health, Wolfson Institute of Population Health, Queen Mary University of London, London, UK
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Paladini G, Sciurpa E, Onorati R, Elhadidy HSMA, Giacomini G, Mamo C, Borraccino A. Gender and Age Influence on Emergency Department Visits for Non-Suicidal Self-Injuries in School Aged Children in Italy: An 11 Years Retrospective Cross-Sectional Study. Int J Public Health 2023; 68:1606370. [PMID: 38164389 PMCID: PMC10757917 DOI: 10.3389/ijph.2023.1606370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 11/30/2023] [Indexed: 01/03/2024] Open
Abstract
Objectives: Non-suicidal self-injury (NSSI) poses a threat in developmental ages, yet there is a scarcity of studies on NSSI trends, especially those in emergency departments (ED). Methods: The aim of this cross-sectional study is to describe trends in ED visits for NSSI among young people aged between 5 and 19 years in Italy from 2011 to 2021 in Piedmont. From the ministerial ED discharge information system, all occurring NSSIs were identified by medical report and/or ICD9CM code and reported as a population rate and a visit rate on all ED requests. Results: The general rate of ED visits remained stable, with around 210,000 (55% males) visits each year, along the whole period from 2011 to 2019, then halved during 2020 and 2021. The NSSI population and visits rates increased from 2013, peaking in 2019 at a rate of around 25 and 23 NSSI visits (girls) and 76 and 69 NSSI (boys) per 100,000 ED visits. In 2020 and 2021, the rate of NSSI visits increased, particularly in girls and among older adolescents. Conclusion: The gradual increase of NSSI over the last decade is a rising public health issue, which deserves wider attention to ensure early detection and prevention.
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Affiliation(s)
- Giovanni Paladini
- Department of Public Health Sciences and Pediatrics, University of Turin, Turin, Italy
| | - Elena Sciurpa
- Department of Public Health Sciences and Pediatrics, University of Turin, Turin, Italy
| | - Roberta Onorati
- Regional Public Health Observatory, Epidemiology Unit, Local Health Board TO3, Grugliasco, Italy
| | | | - Gianmarco Giacomini
- Department of Public Health Sciences and Pediatrics, University of Turin, Turin, Italy
| | - Carlo Mamo
- Regional Public Health Observatory, Epidemiology Unit, Local Health Board TO3, Grugliasco, Italy
| | - Alberto Borraccino
- Department of Public Health Sciences and Pediatrics, University of Turin, Turin, Italy
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Drubina B, Kökönyei G, Várnai D, Reinhardt M. Online and school bullying roles: are bully-victims more vulnerable in nonsuicidal self-injury and in psychological symptoms than bullies and victims? BMC Psychiatry 2023; 23:945. [PMID: 38098002 PMCID: PMC10722836 DOI: 10.1186/s12888-023-05341-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 11/02/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND Bullying leads to adverse mental health outcomes and it has also been linked to nonsuicidal self-injury (NSSI) in community adolescents. It is not clear whether different roles of bullying (bully, victim, bully-victim) are associated with NSSI, furthermore the same associations in cyberbullying are even less investigated. METHODS The aim of the current study was to test whether students involved in school or online bullying differed from their not involved peers and from each other in psychological symptoms (externalizing and internalizing problems) and in NSSI severity (number of episodes, number of methods). Furthermore, mediation models were tested to explore the possible role of externalizing and internalizing problems in the association of school and online bullying roles with NSSI. In our study, 1011 high school students (66.07% girls; n = 668), aged between 14 and 20 years (Mage = 16.81; SD = 1.41) participated. RESULTS Lifetime prevalence of at least one episode of NSSI was 41.05% (n = 415). Students involved in bullying used more methods of NSSI than not involved adolescents. In general, victim status was associated mostly with internalizing symptoms, while bully role was more strongly associated with externalizing problems. Bully-victims status was associated with both types of psychological problems, but this group did not show a significantly elevated NSSI severity compared to other bullying roles. Externalizing and internalizing problems mediated the relationship between bullying roles and NSSI with different paths at different roles, especially in case of current NSSI that happened in the previous month. CONCLUSIONS Results highlight that students involved in bullying are more vulnerable to NSSI and to psychological symptoms compared to their peers who are not involved in bullying. It is suggested that bullying roles, especially bully-victim status, need to be identified in school and online settings and thus special attention should be addressed to them to reduce psychological symptoms and NSSI, for example by enhancing adaptive coping skills.
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Affiliation(s)
- Boglárka Drubina
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary.
| | - Gyöngyi Kökönyei
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- NAP3.0-SE Neuropsychopharmacology Research Group, Hungarian Brain Research Program, Semmelweis University, Budapest, Hungary
- Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary
| | - Dóra Várnai
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- Heim Pál National Institute of Pediatrics, Budapest, Hungary
| | - Melinda Reinhardt
- Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
- 14th District Medical Center, Child and Adolescent Psychiatry, Budapest, Hungary
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Dai Y, Jiang T, Gaer W, Poon KT. Workplace Objectification Leads to Self-Harm: The Mediating Effect of Depressive Moods. PERSONALITY AND SOCIAL PSYCHOLOGY BULLETIN 2023:1461672231213898. [PMID: 38047443 DOI: 10.1177/01461672231213898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
In the current research, we aimed to extend the literature on workplace objectification and contribute to employees' well-being by exploring whether and how workplace objectification increases self-harm as well as the coping strategy that may weaken the effect. Employing archive data analytic, correlational, longitudinal, and experimental designs, we found that workplace objectification was associated with, or led to, self-harm, irrespective of whether such actions provided an escape from work. This effect could not be simply ascribed to the negative nature of workplace objectification. We further found that depressive moods mediated this effect. The detrimental effect of workplace objectification on self-harm was lessened when employees perceived higher alternatives in life. Theoretical and managerial implications were discussed.
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Affiliation(s)
- Yuwan Dai
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Tonglin Jiang
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Wangchu Gaer
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Kai-Tak Poon
- Department of Psychology and Centre for Psychosocial Health, The Educational University of Hong Kong, Hong Kong, China
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50
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Patel KK, Sheridan MA, Bonar AS, Giletta M, Hastings PD, Nock MK, Rudolph KD, Slavich GM, Prinstein MJ, Miller AB. A preliminary investigation into cortical structural alterations in adolescents with nonsuicidal self-injury. Psychiatry Res Neuroimaging 2023; 336:111725. [PMID: 38456014 PMCID: PMC10917139 DOI: 10.1016/j.pscychresns.2023.111725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
The structural neural correlates underlying youth nonsuicidal self-injury (NSSI) warrant further exploration. Few studies have explored the association between NSSI and brain structure in adolescence, and no studies have investigated differences in the relation between age and brain structure in youth with NSSI. This preliminary investigation examined associations between NSSI history, age, and cortical structure using magnetic resonance imaging in adolescent girls (N=100, Mage=13.4 years) at increased risk for psychopathology. We conducted whole-brain analyses to investigate the associations between age and cortical structure, NSSI history and cortical structure, and NSSI history as a moderator of the association between age and cortical structure. Results suggested that age was associated with less cortical thickness and surface area in the left and right prefrontal, temporal, and parietal cortex. NSSI history was associated with less left insula and left inferior parietal cortex cortical surface area. Among adolescents with NSSI history, older age predicted greater left inferior parietal cortex surface area and was not associated with left precentral cortex surface area. Among adolescents without NSSI history, older age predicted smaller surface areas as expected with the typical trajectory of neurodevelopment. Overall, our results suggest differences in cortical surface area development in adolescents with NSSI history.
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Affiliation(s)
- Kinjal K Patel
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Margaret A Sheridan
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Adrienne S Bonar
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Matteo Giletta
- Department of Developmental, Personality, and Social Psychology, Ghent University, Ghent, Belgium
- Department of Developmental Psychology, Tilburg University, Tilburg, Netherlands
| | - Paul D Hastings
- Department of Psychology, University of California, Davis, Davis, CA, USA
| | - Matthew K Nock
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Karen D Rudolph
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - George M Slavich
- Cousins Center for Psychoneuroimmunology and Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, CA, USA
| | - Mitchell J Prinstein
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Adam Bryant Miller
- Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- RTI International, Research Triangle Park, NC, USA
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