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Soufi Amlashi R, Majzoobi M, Forstmeier S. The relationship between acculturative stress and psychological outcomes in international students: a systematic review and meta-analysis. Front Psychol 2024; 15:1403807. [PMID: 39021659 PMCID: PMC11253713 DOI: 10.3389/fpsyg.2024.1403807] [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: 03/19/2024] [Accepted: 06/04/2024] [Indexed: 07/20/2024] Open
Abstract
Introduction The current systematic review aimed to examine the relationship between acculturative stress (AS) and psychological outcomes in international students to determine the role AS may play in predicting the mental health of international students. Methods The studies included in the current systematic review and meta-analysis had considered AS and its impact on psychological outcomes among international students studying abroad. After checking the studies found in our primary search through the scientific databases in terms of our eligibility criteria, 29 studies were included, of which 26 were eligible for a meta-analysis (total N = 7,247). Results Meta-analysis indicated a moderate mean correlation of AS with psychological outcomes like depression, life satisfaction, quality of life, vocational outcome expectations, drinking behaviors, resilience, health promotion behavior, psychological adjustment, psychological distress, negative affect, and mental health symptoms (r = 0.39) and depression (r = 0.41), respectively. Discussion The review of studies revealed a robust relationship between AS and increased negative psychological outcomes such as depression, psychological distress, and general stress, as well as decreased positive psychological outcomes such as psychological adjustment, mental health, life satisfaction, and quality of life.
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Affiliation(s)
- Rasa Soufi Amlashi
- Developmental Psychology and Clinical Psychology of the Lifespan, University of Siegen, Siegen, Germany
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Nagy LM, Muehlenkamp JJ. Negative self-perceptions and severity of NSSI: Testing the benefits and barriers model. J Clin Psychol 2024; 80:1365-1376. [PMID: 38401145 DOI: 10.1002/jclp.23667] [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: 06/23/2023] [Revised: 01/18/2024] [Accepted: 02/10/2024] [Indexed: 02/26/2024]
Abstract
Nonsuicidal self-injury (NSSI) is theorized to be caused by negative associations with the self, including low self-esteem, but the mechanisms explaining why low self-esteem is related to more severe NSSI are unclear. The current study aimed to address this limitation by evaluating a mediation model, proposing that low self-esteem would relate to more severe NSSI through increasing self-punishment motivations. Data came from 468 undergraduate students with a history of NSSI who completed an online survey measuring NSSI characteristics and functions, self-esteem, and self-punishment motivations for NSSI. Mediation was tested using a structural equation model using bootstrapped 95% percentile-corrected confidence intervals in which NSSI severity was modeled as a latent variable composed of NSSI frequency, recency, and versatility of methods. The total model was significant and the indirect effect of self-esteem on NSSI severity through self-punishment motives was significant. Self-esteem also retained significant direct effects on NSSI severity, indicating partial mediation. These results provide support for the benefits and barriers model of NSSI, suggesting that negative self-views increase risk for more severe NSSI through self-punishment motivations. Clinical interventions that emphasize self-compassion and focus on modifying self-punishment motivations may help reduce NSSI behavior.
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Affiliation(s)
- Laura M Nagy
- Department of Psychology, High Point University, High Point, North Carolina, USA
| | - Jennifer J Muehlenkamp
- Department of Psychology, University of Wisconsin-Eau Claire, Eau Claire, Wisconsin, USA
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Lei H, Xiong J, Rao Y, Zhu T, Zhang X. Relationships among self-esteem, depression and self-injury in adolescents: a longitudinal study. Front Public Health 2024; 12:1406283. [PMID: 38813433 PMCID: PMC11135207 DOI: 10.3389/fpubh.2024.1406283] [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: 03/24/2024] [Accepted: 04/29/2024] [Indexed: 05/31/2024] Open
Abstract
Objective Non-suicidal self-injury is a widespread mental health concern among adolescents. This study aimed to examine the relationship between self-esteem, depression, and self-injury among adolescents using a longitudinal research design. Methods The Self-Esteem Scale (SES), Child Depression Inventory (CDI), and Adolescent Self-Injury Scale (ASIS) were used to follow up 1,265 junior middle school students on three occasions with six-month intervals. Results At all three time points, there were significant gender differences in self-esteem, depression, and self-injury. Self-esteem was negatively correlated with depression and self-injury at all three time points, while depression and self-injury were significantly positively correlated. Cross-lagged analysis revealed that self-esteem at Time 1 (T1) did not significantly predict self-injury at Time 2 (T2), but self-esteem (T2) significantly predicted self-injury at Time 3 (T3; β = -0.079, p < 0.05). Similarly, self-injury (T1) significantly predicted self-esteem (T2; β = -0.140, p < 0.001), and self-injury (T2) significantly predicted self-esteem (T3; β = -0.071, p < 0.01). Horizontal and longitudinal mediating analysis showed that depression served as a complete mediator in both the pathway from self-esteem to self-injury and from self-injury to self-esteem. Cross-lagged analysis showed that self-esteem (T1) significantly predicts depression (T2; β = -0.070, p < 0.05), which in turn predict self-injury (T3; β = 0.126, p < 0.001). Similarly, self-injury (T1) predicted depression (T2; β = 0.055, p < 0.05), which further predicted self-esteem (T3; β = -0.218, p < 0.001). Conclusion The self-esteem, depression, and self-injury of adolescents are closely related; self-esteem and self-injury predict each other; self-esteem indirectly affects self-injury through depression; and self-injury indirectly affects self-esteem through depression. Based on the relationship of bi-directional prediction of self-esteem and self-injury mediated by depression, this study proposes a theoretical model of depression-mediated self-esteem and self-injury cycle.
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Affiliation(s)
- Hui Lei
- College of Education, Hunan Agricultural University, Changsha, China
| | - Jingru Xiong
- College of Education, Hunan Agricultural University, Changsha, China
| | - Yuling Rao
- College of Education, Hunan Agricultural University, Changsha, China
| | - Ting Zhu
- College of Education, Hunan Agricultural University, Changsha, China
| | - Xiaocui Zhang
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, China
- Medical Psychological Institute of Central South University, Changsha, China
- National Clinical Research Center for Mental Disorders, Changsha, China
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Zhou SC, Zhou Z, Tang Q, Yu P, Zou H, Liu Q, Wang XQ, Jiang J, Zhou Y, Liu L, Yang BX, Luo D. Prediction of non-suicidal self-injury in adolescents at the family level using regression methods and machine learning. J Affect Disord 2024; 352:67-75. [PMID: 38360362 DOI: 10.1016/j.jad.2024.02.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 02/07/2024] [Accepted: 02/12/2024] [Indexed: 02/17/2024]
Abstract
BACKGROUND Adolescent non-suicidal self-injury (NSSI) is a major public health issue. Family factors are significantly associated with NSSI in adolescents, while studies on forecasting NSSI at the family level are still limited. In addition to regression methods, machine learning (ML) techniques have been recommended to improve the accuracy of family-level risk prediction for NSSI. METHODS Using a dataset of 7967 students and their primary caregivers from a cross-sectional study, logistic regression model and random forest model were used to test the forecasting accuracy of NSSI predictions at the family level. Cross-validation was used to assess model prediction performance, including the area under the receiver operator curve (AUC), precision, Brier score, accuracy, sensitivity, specificity, positive predictive value and negative predictive value. RESULTS The top three important family-related predictors within the random forest algorithm included family function (importance:42.66), family conflict (importance:42.18), and parental depression (importance:27.21). The most significant family-related risk predictors and protective predictors identified by the logistic regression model were family history of mental illness (OR:2.25) and help-seeking behaviors of mental distress from parents (OR:0.65), respectively. The AUCs of the two models, logistic regression and random forest, were 0.852 and 0.835, respectively. LIMITATIONS The key limitation is that this cross-sectional survey only enabled the authors to examine predictors that were considered to be proximal rather than distal. CONCLUSIONS These findings highlight the significance of family-related factors in forecasting NSSI in adolescents. Combining both conventional statistical methods and ML methods to improve risk assessment of NSSI at the family level deserves attention.
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Affiliation(s)
- Si Chen Zhou
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China
| | - Zhaohe Zhou
- School of Basic Medical Sciences, Chengdu University, Chengdu, China
| | - Qi Tang
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China
| | - Ping Yu
- Wuhan Mental Health Center, Wuhan, China; Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Huijing Zou
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China
| | - Qian Liu
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China
| | - Xiao Qin Wang
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China
| | - Jianmei Jiang
- The Central Hospital of Enshi Tujia Autonomous Prefecture, Enshi, China
| | - Yang Zhou
- Wuhan Mental Health Center, Wuhan, China; Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Lianzhong Liu
- Wuhan Mental Health Center, Wuhan, China; Wuhan Hospital for Psychotherapy, Wuhan, China
| | - Bing Xiang Yang
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China; Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China.
| | - Dan Luo
- Center for Wise Information Technology of Mental Health Nursing Research, School of Nursing, Wuhan University, Wuhan, China; Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, China.
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Guo X, Wu S, Dong W, Zhang Y, Su Y, Chen C. The Effect of Bullying Victimization on Adolescent Non-Suicidal Self-Injury: The Mediating Roles of Alexithymia and Self-Esteem. Psychol Res Behav Manag 2024; 17:783-797. [PMID: 38444719 PMCID: PMC10911978 DOI: 10.2147/prbm.s450195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 02/19/2024] [Indexed: 03/07/2024] Open
Abstract
Background & Aim Non-suicidal self-injury (NSSI) in adolescents is a serious public health issue influenced by the interaction of multiple factors. The purpose of this study was to investigate the multiple mediating roles of alexithymia and self-esteem in the association between bullying victimization and NSSI in a sample of Chinese adolescents. Methods A survey of 1299 adolescents from two public middle schools in Henan Province, China, was undertaken. Data were collected using the Chinese version of the Delaware bullying victimization scale-student (DBVS-S), the Toronto Alexithymia-20 Scale (TAS-20-C), the Rosenberg self-esteem scale (RSES), and the adolescent self-injury questionnaire. Besides, we performed a structural equation modeling (SEM) with latent variables using AMOS 26.0 to examine the relationship between variables and the mediating effects. Results The SEM analysis found that not only can bullying victimization directly impact NSSI, but that alexithymia and self-esteem have a chain mediating effect in the association between bullying victimization and NSSI. This mediating effect contributed 22.47% to the total effect. Conclusion These findings validate bullying victimization, alexithymia, and low self-esteem are important variables that affect NSSI among Chinese adolescents. Educators need to implement some prevention and intervention strategies to ameliorate the campus atmosphere and adolescents' mental health aimed at avoiding NSSI behavior in adolescence.
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Affiliation(s)
- Xiajun Guo
- Institute of Nursing and Health, School of Nursing and Health, Henan University, Kaifeng, Henan, People’s Republic of China
| | - Sijia Wu
- Institute of Nursing and Health, School of Nursing and Health, Henan University, Kaifeng, Henan, People’s Republic of China
| | - Wanglin Dong
- Institute of Nursing and Health, School of Nursing and Health, Henan University, Kaifeng, Henan, People’s Republic of China
| | - Yiqiu Zhang
- Institute of Nursing and Health, School of Nursing and Health, Henan University, Kaifeng, Henan, People’s Republic of China
| | - Yue Su
- Institute of Nursing and Health, School of Nursing and Health, Henan University, Kaifeng, Henan, People’s Republic of China
| | - Chaoran Chen
- Institute of Nursing and Health, School of Nursing and Health, Henan University, Kaifeng, Henan, People’s Republic of China
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Qin Q, Yang G, Li Y, Wu W, Wang J, Chen Z, Kong X, Zhang W, Zou H. The relationship between major life events and non-suicidal self-injury among college students: the effect of rumination and body image. Front Public Health 2024; 11:1308186. [PMID: 38298255 PMCID: PMC10828039 DOI: 10.3389/fpubh.2023.1308186] [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] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 12/18/2023] [Indexed: 02/02/2024] Open
Abstract
Background Non-suicidal self-injury (NSSI) poses a growing risk to public health worldwide. While numerous studies have identified major life events as key risk factors for NSSI, the mechanisms by which emotional and cognitive problems mediate or moderate this relationship remain unclear. To enhance the understanding of this field, we will draw upon the cascade theory of self-injury and the benefits and barriers model, to examine the relationship between major life events and NSSI, as well as the effect of rumination and body image. Methods A sample of 2,717 college students (Mage = 19.81 years; SD = 1.09) participated in this study and anonymously completed the questionnaires. The moderated mediation model were conducted using Model 4 and Model 15 of the Process macro program in SPSS. Results The results showed that rumination mediated the positive relationship between major life events and NSSI. Furthermore, body image was found to moderate both the relationship between major life events and NSSI, as well as the relationship between rumination and NSSI. Conclusion The current findings suggest that rumination is an important mediator in the relationship between major life events and NSSI among college students. Teachers, parents, and researchers should recognize the important role of body image self-perceptions of college students and actively promote a healthy and accurate body image.
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Affiliation(s)
- Qian Qin
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Guangni Yang
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
- Department of Psychology, Lingnan University, Hong Kong, China
| | - Yue Li
- College of Teacher Education, South China Normal University, Guangzhou, China
| | - Wanchun Wu
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
| | - Jianping Wang
- College of Teacher Education, South China Normal University, Guangzhou, China
- Journal of South China Normal University, South China Normal University, Guangzhou, China
| | - Ziyao Chen
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
| | - Xiaohua Kong
- 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
| | - Hongyu Zou
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
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Liu J, Yao Y, Deng X, Xu X, He W. How does emotional abuse affect adolescents' non-suicidal self-injury urges? A moderated chain mediation model. CHILD ABUSE & NEGLECT 2024; 147:106535. [PMID: 37980785 DOI: 10.1016/j.chiabu.2023.106535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 10/24/2023] [Accepted: 11/02/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND Studying non-suicidal self-injury (NSSI) among adolescents has high clinical significance. Its urges have been identified as a potential predictor of NSSI behavior and may serve as a crucial intervention target. OBJECTIVE This study uses a moderated chain mediation model to explore the relationship between emotional abuse and adolescent NSSI urges. Additionally, we examine the mediating roles of ego depletion and self-esteem and the moderating effect of resilience. PARTICIPANTS AND SETTING We recruited 1129 Chinese adolescents (age M = 16.68; SD = 0.78; 49.4 % men) from secondary vocational schools in China. METHODS We assessed emotional abuse, ego depletion, self-esteem, and NSSI urges in a longitudinal investigation across two time points (T1: March 2023, T2: June 2023). RESULTS After controlling for age, sex, NSSI urges and self-esteem at T1, our study validates a moderated chain mediation model and finds that the mediating effect via self-esteem is 0.026 (95%CI = [0.011,0.046]), and the chain mediating effect via ego depletion and self-esteem is 0.031 (95%CI = [0.022,0.045]), whereas the direct effect of emotional abuse T1 on NSSI urges T2 is not significant (DE = 0.082, 95%CI = [-0.002, 0.167]) and the mediating effect via ego depletion is also not significant (IE = -0.003, 95%CI = [-0.022, 0.015]). Resilience moderates the impact of emotional abuse on ego depletion (β = 0.09, p < 0.01). CONCLUSIONS These findings suggest that ego depletion and self-esteem are potential mechanisms related to emotional abuse and adolescents' NSSI urges, whereas resilience can play a moderating role in reducing ego depletion.
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Affiliation(s)
- Jie Liu
- School of Psychology, Shanghai Normal University, Shanghai 200234, China
| | - Yan Yao
- Pinghu Vocational Secondary School, China
| | - Xun Deng
- School of Psychology, Shanghai Normal University, Shanghai 200234, China
| | - Xiongwei Xu
- School of Education, Shanghai Normal University, Shanghai 200234, China.
| | - Wen He
- School of Psychology, Shanghai Normal University, Shanghai 200234, China.
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Liu L, Han Y, Lian Y, Wu X, Qiao Z, Wang W. Perceived discrimination and suicidal ideation among impoverished and nonimpoverished college students: Different mechanisms via social support, depressive symptoms, and nonsuicidal self-injury. Suicide Life Threat Behav 2023; 53:910-921. [PMID: 37594174 DOI: 10.1111/sltb.12992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 06/16/2023] [Accepted: 08/04/2023] [Indexed: 08/19/2023]
Abstract
INTRODUCTION Being discriminated against is a potential interpersonal factor leading to suicidal ideation. Compared to nonimpoverished students, impoverished students have disadvantages in different aspects, leading to high risks of negative psychological states. However, few studies have contrasted the mechanism of discrimination in suicidal ideation between impoverished and nonimpoverished college students. The present study aimed to contrast the mediating effects of social support, depressive symptoms, and nonsuicidal self-injury (NSSI) between perceived discrimination and suicidal ideation among impoverished and nonimpoverished college students. METHOD The convenience cluster sampling method was used. A total of 1897 Chinese college students (1084 female; Mage = 19.93, SD = 1.44) participated in the two-wave survey with a six-month interval. RESULTS Perceived discrimination significantly predicted suicidal ideation. Social support, depressive symptoms, and NSSI acted as mediators. However, the structural weights were significantly different between impoverished and nonimpoverished students. Specifically, the role of social support was more significant among impoverished students, while the role of depressive symptoms was more significant among nonimpoverished students. CONCLUSIONS Discrimination is a risk factor leading to suicidal ideation for college students. To intervene in suicidal ideation caused by discrimination, school and social workers should pay extra attention to reduce stress and increase social support for impoverished students.
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Affiliation(s)
- Luming Liu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Yuchen Han
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Yangyu Lian
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Xinchun Wu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
- School of Applied Psychology, Beijing Normal University at Zhuhai, Guangdong, China
| | - Zhihong Qiao
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Wenchao Wang
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University, Beijing, China
- School of Applied Psychology, Beijing Normal University at Zhuhai, Guangdong, China
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Haregu T, Chen Q, Arafat SMY, Cherian A, Armstrong G. Prevalence, correlates and common methods of non-suicidal self-injury in South Asia: a systematic review. BMJ Open 2023; 13:e074776. [PMID: 37993150 PMCID: PMC10668266 DOI: 10.1136/bmjopen-2023-074776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 10/27/2023] [Indexed: 11/24/2023] Open
Abstract
INTRODUCTION The dynamics of self-harm vary substantially around the world, yet it is severely under-researched outside of a small number of high-income 'Western' countries. South Asia is disproportionately impacted by suicide, yet we know less about non-suicidal self-injury (NSSI) in the region. OBJECTIVE To review and summarise evidence on the prevalence, correlates and common methods of NSSI in South Asia. METHODS We searched Medline, Embase and PsycINFO for the period 1 January 2000 to 31 August 2023, for peer-reviewed observational studies. A total of 11 studies from eight South Asian countries that reported prevalence and/or correlates of NSSI were included in this review. We assessed the quality of the studies using the Study Quality Assessment Tools for Observational Cohort and Cross-Sectional Studies. We used meta-regression to describe the sources of heterogeneity. Abstracted data were summarised using thematic synthesis. RESULTS For non-clinical populations, the 12-month prevalence of NSSI ranged from 3.2% to 44.8%, and the lifetime prevalence ranged from 21% to 33%. For clinical populations, the 12-month prevalence of NSSI ranged from 5% to 16.4%, while the lifetime prevalence ranged from 2% to 27%. Male sex, unemployment, financial stress, history of suicidal behaviour and depression were associated with a higher risk of NSSI. Better access to counselling services, higher self-esteem and self-knowledge were associated with a lower risk of NSSI. CONCLUSION The burden of NSSI in South Asia appears to be high in both clinical and non-clinical populations. Further research, especially with general population samples, is needed to build evidence on the epidemiology, context and meaning of NSSI in South Asia to inform the design of context-specific interventions. PROSPERO REGISTRATION NUMBER CRD42022342536.
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Affiliation(s)
- Tilahun Haregu
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Quan Chen
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - S M Yasir Arafat
- Department of Psychiatry, Enam Medical College and Hospital, Savar, Bangladesh
| | - Anish Cherian
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India
| | - Gregory Armstrong
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
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Yu H, Mu Q, Li K. Effects of physical exercise on non-suicidal self-injury in adolescents: the chain mediating role of perceived social support and self-concept. Front Psychiatry 2023; 14:1201863. [PMID: 37876620 PMCID: PMC10591106 DOI: 10.3389/fpsyt.2023.1201863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 09/21/2023] [Indexed: 10/26/2023] Open
Abstract
Objective To study the effect of physical exercise on non-suicidal self-injury in adolescents and to verify the chain mediating role of perceived social support and self-concept. Methods: A survey study was conducted on 1,426 adolescents in Chengdu, Sichuan Province. A chain mediation model was used to verify whether perceived social support and self-concept played a mediating role. Results Physical exercise was significantly negatively associated with non-suicidal self-injury in adolescents (β = -0.53, p < 0.01) and significantly positively associated with perceived social support and self-concept (β = 0.52, 0.54, p < 0.01), and perceived social support and self-concept were significantly negatively associated with non-suicidal self-injury (β = -0.59, p < 0.01; β = -0.64, p < 0.01), and perceived social support was able to significantly and positively associate self-concept (β = 0.76, p < 0.01). Conclusion Perceived social support and self-concept play a chain mediating role in the effect of physical exercise on non-suicidal self-injury in adolescents, and it is recommended that the development of perceived social support and self-concept be emphasized during adolescents' development, which has the potential to reduce the incidence of non-suicidal self-injurious behaviors in adolescents.
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Affiliation(s)
- Haoran Yu
- Institute of Sports Training, Chengdu Sport University, Chengdu, Sichuan, China
| | - Qinglei Mu
- Institute of Physical Education, Chengdu University, Chengdu, Sichuan, China
| | - Ke Li
- Institute of Sports Training, Chengdu Sport University, Chengdu, Sichuan, China
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Duncan‐Plummer T, Hasking P, Tonta K, Boyes M. The relationship between clinical perfectionism and nonsuicidal self-injury: The roles of experiential avoidance, self-esteem, and locus of control. J Clin Psychol 2023; 79:1799-1815. [PMID: 36870072 PMCID: PMC10952541 DOI: 10.1002/jclp.23506] [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: 07/29/2022] [Revised: 02/02/2023] [Accepted: 02/25/2023] [Indexed: 03/06/2023]
Abstract
OBJECTIVES Perfectionism is linked to nonsuicidal self-injury (NSSI). Individuals with elevated perfectionism tend to avoid undesirable emotions and experience lower self-esteem, which are associated with NSSI. However, it is unclear if these mechanisms explain the link between clinical perfectionism and NSSI, and if locus of control is involved. We aimed to explore whether experiential avoidance and self-esteem would mediate the relationship between clinical perfectionism and NSSI, and if locus of control would moderate links between clinical perfectionism and both experiential avoidance and self-esteem. METHOD As part of a larger study, 514 Australian university students (Mage = 21.15 years, SD = 2.40; 73.5% female) completed an online survey of NSSI, clinical perfectionism, experiential avoidance, self-esteem, and locus of control. RESULTS Clinical perfectionism was associated with NSSI history, but not with recent NSSI or past year NSSI frequency. Lower self-esteem, but not experiential avoidance, mediated links between clinical perfectionism and NSSI history, recent NSSI, and NSSI frequency. More external locus of control was associated with NSSI, experiential avoidance, and lower self-esteem, but locus of control did not moderate pathways between clinical perfectionism and experiential avoidance or self-esteem. CONCLUSION University students reporting elevated clinical perfectionism may have a tendency to experience lower self-esteem which is associated with NSSI history, recency, and severity.
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Affiliation(s)
- Thomas Duncan‐Plummer
- School of Population Health, Faculty of Health SciencesCurtin UniversityPerthAustralia
| | - Penelope Hasking
- School of Population Health, Faculty of Health SciencesCurtin UniversityPerthAustralia
- Curtin enAble Institute, Faculty of Health SciencesCurtin UniversityPerthAustralia
| | - Kate Tonta
- School of Population Health, Faculty of Health SciencesCurtin UniversityPerthAustralia
- Curtin enAble Institute, Faculty of Health SciencesCurtin UniversityPerthAustralia
- Centre for Clinical InterventionsPerthAustralia
| | - Mark Boyes
- School of Population Health, Faculty of Health SciencesCurtin UniversityPerthAustralia
- Curtin enAble Institute, Faculty of Health SciencesCurtin UniversityPerthAustralia
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Lin S, Li Y, Sheng J, Wang L, Han Y, Yang X, Yu C, Chen J. Cybervictimization and non-suicidal self-injury among Chinese adolescents: A longitudinal moderated mediation model. J Affect Disord 2023; 329:470-476. [PMID: 36863467 DOI: 10.1016/j.jad.2023.02.124] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2022] [Revised: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 03/04/2023]
Abstract
BACKGROUND Cybervictimization is a risk factor for nonsuicidal self-injury (NSSI). However, there is a lack of evidence on how and under what conditions cybervictimization may influence NSSI. The present study investigated the mediating effect of self-esteem and the moderating effect of peer attachment on the relationship between cybervictimization and NSSI among Chinese adolescents. METHODS Using three-wave longitudinal data for one year, a total of 1368 Chinese adolescents (60 % boys; Mage at Wave 1 = 15.05 years, SD = 0.85) completed the measurement using a self-report method. RESULTS The longitudinal moderated mediation model revealed that cybervictimization is associated with NSSI via restraining the protective effect of self-esteem. Moreover, high peer attachment could buffer the negative effects of cybervictimization, and protect their self-esteem from being hurt, consequently reducing the likelihood of NSSI. LIMITATIONS All variables in this study were self-reported, and the results should be cautiously generalized to other cultures, according to a sample of Chinese adolescents. CONCLUSIONS Results highlight the relation between cybervictimization and NSSI. Recommended intervention and prevention strategies include enhancing the self-esteem of adolescents, breaking the cycle of cybervictimization to NSSI, and providing adolescents with more opportunities to build positive friendships with their peers to buffer the negative effects of cybervictimization.
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Affiliation(s)
- Shuang Lin
- School of Psychology, South China Normal University, 55 West Zhongshan Road, Guangzhou, Guangdong 510631, China; School of Educational Science, Guangdong Polytechnic Normal University, Guangzhou, Guangdong 510665, China
| | - Yongjian Li
- School of Psychology, South China Normal University, 55 West Zhongshan Road, Guangzhou, Guangdong 510631, China
| | - Jing Sheng
- School of Psychology, South China Normal University, 55 West Zhongshan Road, Guangzhou, Guangdong 510631, China
| | - Li Wang
- School of Psychology, South China Normal University, 55 West Zhongshan Road, Guangzhou, Guangdong 510631, China
| | - Yingchun Han
- Teacher Education College of Guangdong University of Education, Guangzhou, Guangdong 510303, China
| | - Xueling Yang
- School of Psychology, South China Normal University, 55 West Zhongshan Road, Guangzhou, Guangdong 510631, China
| | - Chengfu Yu
- Department of Psychology/Research Center of Adolescent Psychology and Behavior, School of Education, Guangzhou University, Guangzhou, Guangdong 510006, China
| | - Jun Chen
- School of Psychology, South China Normal University, 55 West Zhongshan Road, Guangzhou, Guangdong 510631, China.
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Duncan-Plummer T, Hasking P, Tonta K, Boyes M. Cognitive-emotional networks in students with and without a history of non-suicidal self-injury. J Affect Disord 2023; 329:394-403. [PMID: 36828146 DOI: 10.1016/j.jad.2023.02.054] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 02/09/2023] [Accepted: 02/12/2023] [Indexed: 02/24/2023]
Abstract
BACKGROUND Contemporary models of non-suicidal self-injury (NSSI) suggest that emotional vulnerabilities, negative self-schemas, and beliefs about NSSI work together to differentiate students who self-injure from those who do not. However, it is unclear how these mechanisms are differentially related among students with and without a history of NSSI. Considering this, we used a network analysis approach to explore how students with and without a history of NSSI vary in processing their emotional experiences in relation to their self-concepts and beliefs about NSSI. METHOD A sample of 480 university students (Mage = 21.18, SD = 2.43; 73.5 % female) completed self-report measures about their perceived emotional experiences (e.g., emotional reactivity, emotion regulation difficulties), self-concepts (e.g., self-esteem, self-efficacy), and NSSI. RESULTS A network comparison test revealed that students with a history of NSSI perceived themselves to have difficulties regulating particularly intense, unwanted negative emotions. In light of this, students with a history of NSSI expected some benefits of NSSI (e.g., emotion regulation) regardless of potential barriers (e.g., pain). Conversely, for students without a history of NSSI, expecting NSSI to have aversive outcomes was tied to expecting NSSI to have few benefits. LIMITATIONS The cross-sectional design limits inferences to be made about the network structures. CONCLUSIONS Students with and without a history of NSSI appear to differ in their cognitive processing of negative emotions and strategies used to deal with these emotions.
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Affiliation(s)
- Thomas Duncan-Plummer
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Penelope Hasking
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia; Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia.
| | - Kate Tonta
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia; Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia; Centre for Clinical Interventions, Perth, Australia
| | - Mark Boyes
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia; Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
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Özen-Dursun B, Kaptan SK, Giles S, Husain N, Panagioti M. Understanding self-harm and suicidal behaviours in South Asian communities in the UK: systematic review and meta-synthesis. BJPsych Open 2023; 9:e82. [PMID: 37183676 DOI: 10.1192/bjo.2023.63] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/16/2023] Open
Abstract
BACKGROUND Previous findings have indicated that self-harm and suicide are associated with different rates, and different risk and protective factors in South Asian people compared with White people in the UK. Substantial qualitative research has explored experiences of self-harm and suicide in South Asian people. AIMS The study aims to review the existing qualitative evidence on self-harm and suicidal behaviours in South Asian communities in the UK. METHOD Systematic searches were conducted on Medline, EMBASE, PsycINFO, CINAHL, Open Dissertations and the British Library Ethos databases. We selected qualitative studies from both journals and grey literature that included South Asian participants who were resident in the UK and presented perceptions or experiences of self-harm and/or suicidal behaviour. Analysis was undertaken based on the meta-ethnographic approach. RESULTS Fifteen studies were included in the analysis. Experience of self-harm was discussed based on three aspects: behind self-harm, functions of self-harm and recovery from self-harm. 'Behind self-harm' refers to factors associated with self-harm and suicide. 'Functions of self-harm' captures the meaning attributed to self-harm and suicide. 'Recovery from self-harm' encapsulates personal and professional help, and practical suggestions for the improvement of mental health services. CONCLUSIONS Although some similarities with the majority White population were present, there were also crucial differences that need consideration when shaping health policies, improving access to health services and developing culturally sensitive psychosocial interventions for self-harm and suicide specific to South Asian communities in the UK.
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Affiliation(s)
- Büşra Özen-Dursun
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK
| | - Safa Kemal Kaptan
- Global Mental Health and Cultural Psychiatry Research Group, University of Manchester, UK; and Department of Psychology, Boğaziçi University, Türkiye
| | - Sally Giles
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, National Institute for Health and Care Research Greater Manchester Patient Safety Translational Research Centre, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Nusrat Husain
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK; and Mersey Care NHS Foundation Trust, Prescot, UK
| | - Maria Panagioti
- Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, National Institute for Health and Care Research Greater Manchester Patient Safety Translational Research Centre, Faculty of Biology, Medicine and Health, University of Manchester, UK; and Division of Population Health, Health Services Research and Primary Care, School of Health Sciences, National Institute for Health and Care Research School for Primary Care Research, Faculty of Biology, Medicine and Health, University of Manchester, UK
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Kim S, Woo S, Lee JS. Investigation of the Subtypes of Nonsuicidal Self-Injury Based on the Forms of Self-Harm Behavior: Examining Validity and Utility via Latent Class Analysis and Ecological Momentary Assessment. J Korean Med Sci 2023; 38:e132. [PMID: 37128876 PMCID: PMC10151622 DOI: 10.3346/jkms.2023.38.e132] [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: 08/22/2022] [Accepted: 01/19/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND This study aimed to empirically derive and validate subtypes of nonsuicidal self-injury (NSSI) based on the forms of self-harm behavior. METHODS Sixty young adults who exhibited repetitive NSSI completed a clinical interview and baseline measures, followed by a two-week ecological momentary assessment (EMA). A latent class analysis was administered to identify NSSI subtypes based on the forms of self-harm behavior. The subtypes were then compared to baseline clinical and EMA variables, including emotions and urges to self-harm. RESULTS The best-fitting model supported two subtypes: 1) substance abuse and suicide attempt subtype and 2) cutting and scratching subtype. The substance abuse and suicide attempt subtype reported a higher rate of engaging in lifetime suicide plans and suicide attempts and a higher number of lifetime suicide attempts. They also showed significantly higher severity of self-harm behavior, borderline personality traits, anger, posttraumatic symptoms, and difficulties in emotion regulation when compared to the cutting and scratching subtype. However, there was no inter-subtype difference in self-esteem. In the EMA data, anger toward others, feeling of rejection, loneliness, and helplessness were significantly high in the substance abuse and suicide attempt subtype. The variability of anger toward others was also higher in this subtype compared to the cutting and scratching subtype. Finally, in the two-week research period, the substance abuse and suicide attempt group showed a higher rate of reported urges to self-harm with or without suicidal intent. CONCLUSION Findings support the validity of the subtypes based on the forms of self-harm behavior, suggesting the clinical utility of addressing heterogeneity within individuals exhibiting self-harm for assessment and treatment.
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Affiliation(s)
- Sojung Kim
- Department of Psychiatry, Hanyang University Medical Center, Seoul, Korea
- Department of Psychology, Yeungnam University, Gyeongsan, Korea.
| | - Sungbum Woo
- Cultural Contents Technology Research Institute, Gachon University, Seongnam, Korea
- Department of Counseling Psychology, Hanyang Cyber University, Seoul, Korea
| | - Jong-Sun Lee
- Department of Psychology, Kangwon National University, Chuncheon, Korea
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Dong Z, Zhou J, Conti A, Westwood SJ, Fu X, Liu Q, Yuan Y, Huang X, Qiu C, Zhang X, Tang W. Association between alexithymia and non-suicidal self-injury in psychiatric patients: the mediating role of self-esteem and the moderating role of emotional intelligence. J Psychiatr Res 2023; 162:57-64. [PMID: 37088044 DOI: 10.1016/j.jpsychires.2023.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 03/09/2023] [Accepted: 04/05/2023] [Indexed: 04/25/2023]
Abstract
BACKGROUND Raffagnato's theory claims that if people have no words to express their emotions (alexithymia), they express themselves by venting or through non-suicidal self-injury (NSSI). However, these associations have not been confirmed in psychiatric patients. This study explored the relationship between alexithymia and NSSI in psychiatric patients and the potential underlying psychological mechanisms. METHODS This retrospective study involved face-to-face interviews with 449 outpatients consecutively recruited from West China Hospital. Alexithymia, self-esteem, NSSI, and emotional intelligence (EI) were measured. The moderating role of EI and the mediating role of self-esteem between alexithymia and NSSI were also explored. Logistic regressions were used to examine whether sociodemographic, clinical variables and alexithymia were independently associated with NSSI. RESULTS The DSM-5 NSSI disorder and alexithymia prevalences were found to be 32.5% and 45.2%. When the other covariables were controlled for, the alexithymic patients were found to be at increased odds (OR 2.76) of engaging in NSSI behaviors. These results confirmed the strong associations between alexithymia, low self-esteem, and NSSI risk. Lower EI was found to be related to the connections between alexithymia and NSSI. Except for the lower risk in anxiety patients, the risk of NSSI was similar for patients with other mental disorders, CONCLUSION: This study revealed the psychological mechanisms through which alexithymia increases the risk of NSSI. Therefore, to reduce NSSI risk, screening for alexithymia should be emphasized. Self-esteem as a targeted psychological intervention could also assist in mitigating the process from alexithymia to NSSI behaviors, and EI training for psychiatric patients could weaken the relationship between alexithymia and NSSI.
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Affiliation(s)
- Zaiquan Dong
- Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Zhou
- Department of Psychosomatic Medicine, Leshan People's Hospital, Leshan, Sichuan, China
| | - Aldo Conti
- Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Samuel J Westwood
- Department of Psychology, School of Social Science, University of Westminster, London, UK
| | - Xia Fu
- Out-patient Department of West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Qi Liu
- Out-patient Department of West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yanling Yuan
- Department of Pharmacy of West China Hospital, Sichuan University, Chengdu, China
| | - Xia Huang
- Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Changjian Qiu
- Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China
| | - Xiaohui Zhang
- State Key Laboratory of Oral Diseases, National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Wanjie Tang
- Mental Health Centre, West China Hospital, Sichuan University, Chengdu, China; Department of Child & Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
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Chu JT, Koo M. Life Satisfaction and Self-Esteem in Older Adults Engaging in Formal Volunteering: A Cross-Sectional Study in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4934. [PMID: 36981843 PMCID: PMC10048799 DOI: 10.3390/ijerph20064934] [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: 01/27/2023] [Revised: 03/06/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
Previous research has reported an association between life satisfaction, self-esteem, and volunteering. However, it is unclear whether self-esteem is associated with life satisfaction in older adults who are already engaged in volunteering. Therefore, the present study aimed to investigate the association between life satisfaction and self-esteem in older adults who were formally volunteering at a non-governmental organization in Taiwan. A cross-sectional study was conducted on 186 formal volunteers aged ≥ 65 years who were recruited from the Keelung chapter of the Buddhist Compassion Relief Tzu Chi Foundation in Taiwan. A hierarchical stepwise linear regression was used to examine the association between scores on the Satisfaction With Life Scale (SWLS) with the Rosenberg Self-Esteem Scale (RSES) and the Hedonic and Eudaimonic Motives for Activities-Revised (HEMA-R) scale. The results showed that SWLS was significantly associated with RSES score (standardized beta (std. β) = 0.199, p = 0.003), the eudaimonic subscale score of the HEMA-R (std. β = 0.353, p < 0.001), a vegetarian diet (std. β = 0.143, p = 0.027), and volunteering for five days or more a week (std. β = 0.161, p = 0.011). In conclusion, improving self-esteem and promoting eudaimonic motives in older adults who are formally volunteering could be effective strategies for enhancing their levels of life satisfaction.
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Affiliation(s)
- Jo-Tzu Chu
- Graduate Institute of Long-Term Care, Tzu Chi University of Science and Technology, Hualien City 970302, Taiwan
| | - Malcolm Koo
- Graduate Institute of Long-Term Care, Tzu Chi University of Science and Technology, Hualien City 970302, Taiwan
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
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Yao Z, Pang L, Xie J, Shi S, Ouyang M. The relationship between social anxiety and self-injury of junior high school students: Mediation by intolerance of uncertainty and moderation by self-esteem. Front Public Health 2023; 11:1046729. [PMID: 36969616 PMCID: PMC10034106 DOI: 10.3389/fpubh.2023.1046729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 02/15/2023] [Indexed: 03/11/2023] Open
Abstract
ObjectiveThe problem of adolescents' self-injury has gradually attracted social attention, however, a lack of research exists on the internal mechanism between social anxiety and self-injury. This study explored the relationship between social anxiety and self-injury in Chinese junior high school students.MethodAn adolescent self-injury questionnaire, social anxiety scale, intolerance of uncertainty questionnaire and self-injury questionnaire were used to survey 614 junior high school students.ResultsThe results showed that: (1) social anxiety had a significant positive predictive effect on self-injury; (2) intolerance of uncertainty had a significant mediating effect between social anxiety and self-injury; and (3) self-esteem had a significant moderating effect on the mediating effect of intolerance of uncertainty.ConclusionThe study suggested that social anxiety in junior high school students has an impact on self-injury through mediation of intolerance of uncertainty and modulation of self-esteem.
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Affiliation(s)
- Zhendong Yao
- Normal College, Hunan University of Arts and Science, Changde, China
| | - Lu Pang
- School of Preschool Education, Hunan College for Preschool Education, Changde, China
| | - Jin Xie
- Mental Health Service Center, Huanghuai University, Zhumadian, China
| | - Seqin Shi
- No. 1 Middle School of Loudi, Loudi, China
| | - Min Ouyang
- Students Affairs Department, Xiangnan University, Chenzhou, China
- College of Educational Science and Law, Xiangnan University, Chenzhou, China
- *Correspondence: Min Ouyang
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Vafaei T, Samavi SA, Whisenhunt JL, Najarpourian S. An investigation of self-injury in female adolescents: a qualitative study. QUALITY & QUANTITY 2023; 57:1-24. [PMID: 36816810 PMCID: PMC9923642 DOI: 10.1007/s11135-023-01632-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/03/2023] [Indexed: 02/16/2023]
Abstract
This study aimed to investigate the phenomenon of self-injury among female adolescents. The research was qualitative, and the sampling method was purposive non-random; the sample size was 20 Iranian girl adolescents aged 13-15 years who had experienced non-suicidal self-injury. Data were collected through semi-structured interviews. The data analysis process was performed during three coding steps (open, axial, selective), through which the basic codes and categories were identified. Study results indicate that the main factors in adolescents' self-injury were individual or psychological (thoughts, emotions, and behaviors) and social (peers, family, communication with different gender, communication with others, media/cyberspace, school, and economic). In the former, the role of emotions was remarkable, while in the latter, the family played a key role. Further, results revealed that communication within the family was an important motivating and sustentative factor in adolescents' self-injury. The results can help counselors in working with adolescents who self-injure; results can also be used in the development and implementation of treatment plans.
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Affiliation(s)
- Tayebeh Vafaei
- Department of Counseling, University of Hormozgan, Bandar Abbas, Iran
| | | | - Julia L. Whisenhunt
- Department of Counseling, Higher Education, and Speech-Language Pathology, University of West Georgia, Carrollton, GA USA
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Li M, Wang H, Li J, Deng Y, Yu C. Peer victimization, depression, and non-suicidal self-injury among Chinese adolescents: the moderating role of the 5-HTR2A gene rs6313 polymorphism. Child Adolesc Psychiatry Ment Health 2022; 16:108. [PMID: 36575481 PMCID: PMC9795745 DOI: 10.1186/s13034-022-00532-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 11/19/2022] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND Peer victimization is a crucial risk predictor for adolescent non-suicidal self-injury (NSSI). However, adolescent NSSI reactions to peer victimization exhibit large individual differences. This study explored whether depression mediated the association between peer victimization and adolescent NSSI, and whether this mediating path was moderated by the 5-HTR2A gene rs6313 polymorphism. METHODS A total of 667 adolescents (Meanage = 12.81, SD = 0.48) completed questionnaires regarding peer victimization, depression, and NSSI. Genomic DNA was extracted from saliva and buccal cells from each participant. RESULTS The results showed that the positive relation between peer victimization and adolescent NSSI was mediated by depression. Moreover, the triple interaction between peer victimization, rs6313 polymorphism, and gender on adolescent depression was significant. And the triple interaction between depression, rs6313 polymorphism, and gender on adolescent NSSI was also significant. Specifically, the risk effect of peer victimization on adolescent NSSI through increased depression was stronger for female adolescents with CC genotype than for female adolescents with CT or TT genotype, and male adolescents with CT or TT genotype. However, the indirect effect was nonsignificant for male adolescents with CC genotype. CONCLUSIONS These findings promote the etiological understanding of adolescent NSSI, highlighting the mediating and moderating effect between peer victimization and NSSI, and adding evidence supporting the relationship between the 5-HTR2A gene rs6313 polymorphism, depression and adolescent NSSI.
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Affiliation(s)
- Meijin Li
- grid.411863.90000 0001 0067 3588Department of Psychology and Research Center of Adolescent Psychology and Behavior, School of Education, Guangzhou University, Guangzhou, 510006 China
| | - Huahua Wang
- grid.411863.90000 0001 0067 3588Department of Psychology and Research Center of Adolescent Psychology and Behavior, School of Education, Guangzhou University, Guangzhou, 510006 China
| | - Jingjing Li
- School of Psychology, South China Normal University, Guangzhou, 510631, China.
| | - Yuting Deng
- grid.411863.90000 0001 0067 3588Department of Psychology and Research Center of Adolescent Psychology and Behavior, School of Education, Guangzhou University, Guangzhou, 510006 China
| | - Chengfu Yu
- Department of Psychology and Research Center of Adolescent Psychology and Behavior, School of Education, Guangzhou University, Guangzhou, 510006, China.
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Unique and shared correlates of disordered eating and non-suicidal self-injury among school-based adolescents. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2022. [DOI: 10.1016/j.jadr.2022.100453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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22
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Meheli S, Banerjee D. Revisiting Social Stigma in Non-suicidal Self-injury: A Narrative Review. CONSORTIUM PSYCHIATRICUM 2022; 3:6-18. [PMID: 39044918 PMCID: PMC11262124 DOI: 10.17816/cp196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 09/23/2022] [Indexed: 11/08/2022] Open
Abstract
Non-suicidal self-injury (NSSI) is highly prevalent in our community. Yet, there is a significant discrepancy between the number of individuals engaging in NSSI and those who seek treatment for NSSI. This discrepancy can be due to the high social stigma associated with the behavior. The impact of NSSI stigma is significant and can impair the quality of life in the individuals engaging in NSSI, delay help-seeking, reduce access to mental health care and further fuel misinformation. Even though the symptomatology, risks, and demographics of NSSI have received attention in terms of research, there is limited literature on NSSI stigma and its consequences. With that background set, this review provides a bird's-eye view of the different levels of stigma in NSSI (public, self, and health care), associated discrimination, the various aspects of such stigmatization (NSSI-related language, physical scarring, misinformation, the media), and, finally, the collaborative clinical-outreach interventions for mitigating NSSI-associated social stigma. If NSSI is indeed recognized as a clinical disorder, future research would need to focus on these constructs of stigma and treat them with the same importance as the one given to clinical studies of intervention and symptomatology in NSSI.
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Li Y, He K, Xue C, Li C, Gu C. The Impact of Self-Consistency Congruence on Non-Suicidal Self-Injury in College Students: The Mediating Role of Negative Emotion and the Moderating Role of Gender. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11898. [PMID: 36231200 PMCID: PMC9564789 DOI: 10.3390/ijerph191911898] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 09/07/2022] [Accepted: 09/09/2022] [Indexed: 06/16/2023]
Abstract
Non-suicidal self-injury (NSSI) can be defined as the deliberate destruction of body tissues to generate harm. College students have a higher incidence of NSSI. With the deepening of research on college students' NSSI, the connection between their self-consistency congruence and NSSI has drawn the attention of many scholars. The current study examined the association between self-concordance and NSSI, the mediating function of negative emotions, and the moderating role of gender. We surveyed 1020 college students from three universities in Jiangxi Province using a self-concordant scale, a NSSI questionnaire, and a negative emotion questionnaire. The results showed that self-concordance was negatively correlated with NSSI. There is an obvious negative connection between self-consistency congruence and negative emotions. There was a significant positive correlation between negative emotions and the NSSI scores. Negative emotions could mediate the association between self-consistency congruence and NSSI. Compared to males, females' self-concordant effects on negative emotions are easier to moderate.
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Affiliation(s)
- Yang Li
- Mental Health Education Center and Education Development Research Institute, Nanchang University, Nanchang 330038, China
- School of Psychology, Central China Normal University, Wuhan 430000, China
| | - Keke He
- Mental Health Education Center and Education Development Research Institute, Nanchang University, Nanchang 330038, China
| | - Changfeng Xue
- Mental Health Education Center and Education Development Research Institute, Nanchang University, Nanchang 330038, China
| | - Chun Li
- Department of Preschool Education, Qingdao University, Qingdao 266000, China
| | - Chuanhua Gu
- School of Psychology, Central China Normal University, Wuhan 430000, China
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Childhood maltreatment and nonsuicidal self-injury among younger Chinese prisoners: the mediating role of self-esteem. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03647-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Torales J, Torres-Romero AD, Di Giuseppe MF, Rolón-Méndez ER, Martínez-López PL, Heinichen-Mansfeld KV, Barrios I, O'Higgins M, Almirón-Santacruz J, Melgarejo O, Ruiz Díaz N, Castaldelli-Maia JM, Ventriglio A. Technostress, anxiety, and depression among university students: A report from Paraguay. Int J Soc Psychiatry 2022; 68:1063-1070. [PMID: 35652309 DOI: 10.1177/00207640221099416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Although technologies (including information, e-learning, and communication) have been daily employed by University students in the last years, the COVID-19 pandemic has led to a considerable increase in their use. Technostress is a modern term referring to levels of stress caused by the prolonged exposure to technology. AIM The aim of this study is to assess the technostress and related anxiety and depression among Paraguayan University students, describing their sociodemographic characteristics and relevant associations. METHODS A cross-sectional and descriptive study has been conducted. Participants were recruited through an Internet-based survey. Technostress, anxiety, and depression have been assessed with the Technostress Questionnaire (TechQ), the Generalized Anxiety Disorder-7 (GAD-7) questionnaire, and the Patient Health Questionnaire-2 (PHQ-2), respectively. RESULTS A total of 378 participants were included, 74.1% of whom were women. According to the TechQ scores, 47.4% of the participants reported a low/moderate level of technostress whereas 5.2% showed severe scores. About 58.5% of participants reported a GAD-7 score ⩾10, meeting diagnostic criteria for generalized anxiety. About 60.3% scored ⩾3 at the PHQ-2 reporting significant levels of depression. Technostress has been significantly associated with levels of anxiety (p < .001) as well as depression (p < .001). CONCLUSION Our results suggest further research regarding the implications of technostress on the well-being of University students. Specific measures aimed to improve students' coping with the challenges of technology and technostress should be promoted.
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Affiliation(s)
- Julio Torales
- Department of Medical Psychology, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay.,Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - Anthon Daniel Torres-Romero
- Neuroscience Research Students Network, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - Matías Franco Di Giuseppe
- Neuroscience Research Students Network, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - Elías René Rolón-Méndez
- Neuroscience Research Students Network, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - Patricia Lorena Martínez-López
- Neuroscience Research Students Network, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | | | - Iván Barrios
- Department of Statistics (Santa Rosa Campus), School of Medical Sciences, National University of Asunción, Paraguay
| | - Marcelo O'Higgins
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - José Almirón-Santacruz
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - Osvaldo Melgarejo
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - Noelia Ruiz Díaz
- Department of Psychiatry, School of Medical Sciences, National University of Asunción, San Lorenzo, Paraguay
| | - João Mauricio Castaldelli-Maia
- Department of Neuroscience, Fundação do ABC, Santo André, Brazil.,Department of Psychiatry, University of São Paulo, Brazil
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Italy
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Aghamohammadi S, Mazaheri M, Fata L, Mootabi F. Relationship between Non-Suicidal Self-Injury and Attachment: Protocol for Systematic Review and Meta-Analysis (Preprint). JMIR Res Protoc 2022; 12:e40808. [DOI: 10.2196/40808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 01/28/2023] [Accepted: 03/15/2023] [Indexed: 03/17/2023] Open
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Stagaki M, Nolte T, Feigenbaum J, King-Casas B, Lohrenz T, Fonagy P, Montague PR. The mediating role of attachment and mentalising in the relationship between childhood maltreatment, self-harm and suicidality. CHILD ABUSE & NEGLECT 2022; 128:105576. [PMID: 35313127 PMCID: PMC10466023 DOI: 10.1016/j.chiabu.2022.105576] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 01/01/2022] [Accepted: 02/17/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Although the relationship between childhood maltreatment, self-harm and suicidality is well-established, less is known about the mediating mechanisms explaining it. Based on a developmental mentalisation-based theoretical framework, childhood adversity compromises mentalising ability and attachment security, which in turn increase vulnerability to later stressors in adulthood. OBJECTIVE This study aimed to investigate the role of attachment and mentalising as potential mechanisms in the relationship between childhood maltreatment, self-harm and suicidality. PARTICIPANTS AND SETTING We recruited 907 adults from clinical and community settings in Greater London. METHODS The study design was cross-sectional. Participants completed self-report questionnaires on retrospectively rated childhood trauma, and current attachment to the romantic partner, mentalising, self-harm, suicidal ideation and attempt. We used structural equation modelling to examine the data and conceptualized childhood maltreatment as a general factor in a confirmatory bifactor model. RESULTS The results showed that childhood maltreatment was both directly associated with self-harm and suicidality and indirectly via the pathways of attachment and mentalising. CONCLUSIONS These findings indicate that insecure attachment and impaired mentalising partially explain the association between childhood maltreatment, self-harm and suicidality. Clinically, they provide support for the potential of mentalisation-based therapy or other psychosocial interventions that aim to mitigate the risk of self-harm and suicidality among individuals who have experienced childhood maltreatment via increasing understanding of self and other mental states.
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Affiliation(s)
- Maria Stagaki
- Division of Psychiatry, University College London, London, United Kingdom.
| | - Tobias Nolte
- Wellcome Trust Centre for Neuroimaging, University College London, London, United Kingdom; Anna Freud National Centre for Children and Families, London, United Kingdom
| | - Janet Feigenbaum
- Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - Brooks King-Casas
- Fralin Biomedical Research Institute, Department of Psychology, Virginia Tech, Roanoke, VA, United States of America
| | - Terry Lohrenz
- Fralin Biomedical Research Institute, Department of Psychology, Virginia Tech, Roanoke, VA, United States of America
| | - Peter Fonagy
- Anna Freud National Centre for Children and Families, London, United Kingdom; Research Department of Clinical, Educational and Health Psychology, University College London, London, United Kingdom
| | - P Read Montague
- Wellcome Trust Centre for Neuroimaging, University College London, London, United Kingdom; Fralin Biomedical Research Institute, Department of Psychology, Virginia Tech, Roanoke, VA, United States of America; Department of Physics, Virginia Tech, Blacksburg, VA, United States of America; Department of Psychiatry and Behavioral Medicine, Virginia Tech Carilion School of Medicine, Virginia Tech, Roanoke, VA, United States of America
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Nam G, Moon H, Lee JH, Hur JW. Self-referential processing in individuals with nonsuicidal self-injury: An fMRI study. Neuroimage Clin 2022; 35:103058. [PMID: 35671558 PMCID: PMC9168135 DOI: 10.1016/j.nicl.2022.103058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 05/18/2022] [Accepted: 05/21/2022] [Indexed: 12/03/2022]
Abstract
Individuals with NSSI rated negative adjectives as more relevant. Altered self-referential processing in NSSI related to temporoparietal and subcortical areas. Brain activity in inferior parietal lobe related to ‘nonsuicidality’ in people with NSSI.
Nonsuicidal self-injury (NSSI) is associated with considerable deficits in managing negative self-directed internal experiences. The present study explores the neurophysiological correlates of self-referential processing in individuals with NSSI. A total of 26 individuals with NSSI (≥5 episodes of NSSI behavior in the past year, without suicide attempts) and 35 age-, sex-, education-, and intelligence quotient (IQ)-matched controls participated in this study. Participants underwent fMRI scanning as they performed a personal relevance rating task, which required them to evaluate the personal relevance of emotional words. As predicted, we found that individuals engaging in NSSI tended to rate negative adjectives as more relevant and positive adjectives as less relevant. An analysis of functional neuroimaging data showed that the NSSI group had increased activity relative to the control group in the inferior parietal lobe, inferior temporal gyrus, calcarine, insula, and thalamus in response to positive adjectives. The NSSI group also demonstrated greater activation in the calcarine and reduced activation in the inferior frontal gyrus in response to negative self-referential stimuli compared with the control group. In addition, increased right inferior parietal lobe activity during positive self-referential processing was correlated with reduced suicidal ideation in the NSSI group. Our study provides neural evidence for self-referential processing bias in individuals with NSSI and highlights the need for further research to clarify the pathophysiological features that are specific to NSSI.
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Affiliation(s)
- Gieun Nam
- Department of Psychology, Chung-Ang University, Seoul, Republic of Korea
| | - Hyeri Moon
- School of Psychology, Korea University, Seoul, Republic of Korea
| | - Jang-Han Lee
- Department of Psychology, Chung-Ang University, Seoul, Republic of Korea.
| | - Ji-Won Hur
- School of Psychology, Korea University, Seoul, Republic of Korea.
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Meng L, Qu D, Bu H, Huo L, Qi L, Yang J, Zheng T, Du X, He K, Wang Y, Zhou Y. The Psychosocial Correlates of Non-suicidal Self-Injury Within a Sample of Adolescents With Mood Disorder. Front Public Health 2022; 10:768400. [PMID: 35273935 PMCID: PMC8902037 DOI: 10.3389/fpubh.2022.768400] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 01/10/2022] [Indexed: 11/13/2022] Open
Abstract
Background According to the integrated theoretical model, adolescents' behaviors were the outcome of the complex interplay between multiple levels. Non-suicidal self-injury (NSSI) is a serious and high prevalent problem among adolescents with mood disorders. However, a systematic perspective on psychosocial correlates among Chinese clinical adolescents is still rare. Method The impact of several factors at the individual (i.e., sex, age, self-esteem, and psychological distress), family (i.e., family structure, family income, and family support), and social level (i.e., living environment, peer support, and teacher support) on the frequency of NSSI behaviors were investigated in the current study. This research included 621 Chinese adolescents with mood disorders from 20 hospitals. Results Three-steps hierarchical regression analyses indicated that lower levels of psychological distress and higher levels of self-esteem were most associated with less frequency of NSSI behaviors. In addition, family support was negatively associated with the frequency of NSSI behaviors. After controlling the factors at individual and family levels, no significant association was found between the factors at the social level and the frequency of NSSI behaviors. Conclusion These findings provide preliminary support for the notion that adolescent self-esteem and family support may effectively shield them from problematic behavior; nevertheless, adolescents suffering from more emotional pain can be even riskier. Thus, further intervention strategies should consider the non-independence of individual capacities, co-combinatory effects of mood disorder, and family environment in treating those vulnerable Chinese adolescents.
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Affiliation(s)
| | - Diyang Qu
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - He Bu
- Department of Social and Behavioural Sciences, City University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Lijuan Huo
- Affiliated Brain Hospital of Guangzhou Medical University, Guangzhou, China
| | - Ling Qi
- School of Health Science and Nursing, Wuhan Polytechnic University, Wuhan, China
| | - Jiezhi Yang
- Shenzhen Health Development Research Center, Shenzhen, China
| | - Tiansheng Zheng
- Kangning Hospital Affiliated to Wenzhou Medical University, Wenzhou, China
| | - Xiangdong Du
- Suzhou Guangji Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | | | - Yanni Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Lanzhou, China
| | - Yongjie Zhou
- Shenzhen Mental Health Center, Shenzhen Kangning Hospital, Shenzhen, China
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Kim H, Hur JW. What's Different About Those Who Have Ceased Self-Injury? Comparison Between Current and Lifetime Nonsuicidal Self-Injury. Arch Suicide Res 2022; 27:718-733. [PMID: 35446236 DOI: 10.1080/13811118.2022.2064256] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVE The current study aimed to investigate the sociodemographic and psychological variables as well as the function of NSSI related to the cessation of NSSI by analyzing the difference between those currently engaged in nonsuicidal self-injury (NSSI) and those who have stopped NSSI behaviors. METHODS A total of 490 adults with a history of NSSI (359 females) were assigned to one of two groups: NSSI engagement within the last 12 months or "current NSSI" (n = 402) vs. no episode of NSSI in the previous 12 months or "lifetime NSSI" (n = 88). RESULTS There were no significant group differences in sex or socioeconomic status, while individuals with current NSSI were slightly younger than those who had ceased NSSI behavior. Regarding the functions of NSSI, the current NSSI group endorsed more intrapersonal functions. Moreover, the participants who had ceased NSSI behavior reported significantly less perceived stress, dysfunctional attitudes, alexithymia, emotion reactivity, and suicidal ideation. On the other hand, the lifetime NSSI group showed greater psychological resources such as self-esteem, distress tolerance, and resilience. CONCLUSIONS We revealed apparent differences in NSSI functions, clinical symptoms, and psychological resources depending on the maintenance and cessation of NSSI. This study highlights the need for a better understanding of the factors that stop as well as those that continue NSSI behaviors. HIGHLIGHTSThe lifetime NSSI group reported less intrapersonal NSSI functions.The current NSSI group suffered from more clinical symptoms.Individuals who ceased NSSI had more psychological resources.
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Kapatais A, Williams AJ, Townsend E. The Mediating Role of Emotion Regulation on Self-harm among Gender Identity and Sexual Orientation Minority (LGBTQ+) Individuals. Arch Suicide Res 2022; 27:165-178. [PMID: 35446245 DOI: 10.1080/13811118.2022.2064254] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVE The present study was conducted to (1) investigate the role of emotion regulation difficulties among self-harming Lesbian, Gay, Bisexual, Transgender, Queer, or Questioning (LGBTQ+) individuals and (2) to test for a mediating role of emotion regulation difficulties in self-harm among LGBTQ + individuals. METHOD This study investigated the relationship between LGBTQ + status, self-reported levels of emotion regulation difficulties, and self-harm in a community sample (N = 484, aged 16-63), using an online cross-sectional survey. RESULTS LGBTQ + individuals reported more emotion regulation difficulties and were almost seven times more likely to self-harm than non-LGBTQ + participants. Being an LGBTQ + participant was associated with greater self-harm frequency when controlling for age, income, and difficulties in emotion regulation. Emotion regulation difficulties mediated the association between LGBTQ + status and both self-harm status and frequency. CONCLUSIONS The present findings suggest that treating emotion regulation difficulties might reduce both the prevalence and lifetime frequency of self-harm episodes among gender identity and sexual orientation minority individuals. Targeting emotion regulation might be used as an early prevention strategy among LGBTQ + individuals who are at risk for self-harm. Further, enhancing emotion regulation skills among self-harming LGBTQ + individuals might replace maladaptive emotion regulation strategies with healthy alternatives, and can, therefore, foster resilience. HIGHLIGHTSLGBTQ + individuals are at high risk for self-harm.ER-mediated the association between LGBTQ + status and self-harm.Targeting emotion regulation in LGBTQ + people may help reduce self-harm.
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Dunlop BJ, Coleman SE, Hartley S, Carter LA, Taylor PJ. Self-injury in young bisexual people: A microlongitudinal investigation (SIBL) of thwarted belongingness and self-esteem on non-suicidal self-injury. Suicide Life Threat Behav 2022; 52:317-328. [PMID: 34890052 DOI: 10.1111/sltb.12823] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/25/2021] [Accepted: 11/19/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Bisexual people are at an elevated risk for non-suicidal self-injury (NSSI). Psychological factors including self-esteem and thwarted belongingness may help explain this risk. The aim of the current study was to investigate associations between self-esteem, thwarted belongingness and NSSI urges and behavior in young bisexual people. METHODS Participants aged 16-25 from 25 countries took part in this microlongitudinal online survey study (N = 207). Mixed-effects linear and logistic regression were used for analysis, given the nested structure of data. Analysis examined the relationship between self-esteem and thwarted belongingness on NSSI urges and behavior at the same point in time, and lagged by one week. RESULTS At the same timepoint, self-esteem and thwarted belongingness both had significant between- and within-person associations with NSSI urges and behavior. For lagged models, self-esteem had significant between-person effects on urges, and thwarted belongingness had significant within-person effects. For NSSI behavior, both variables were only associated with between-person effects. CONCLUSION Findings support previous research suggesting the importance of self-esteem in explaining NSSI among sexual minorities. Preventative and intervention strategies to improve self-esteem may help reduce NSSI risk. Future studies should focus upon the experiences of bisexual people with intersecting identities and ensure that studies are statistically powered from inception to detect effects.
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Affiliation(s)
- Brendan J Dunlop
- Division of Psychology and Mental Health, School of Health Sciences, The University of Manchester, Manchester, UK
| | - Sophie E Coleman
- Division of Psychology and Mental Health, School of Health Sciences, The University of Manchester, Manchester, UK
| | - Samantha Hartley
- Division of Psychology and Mental Health, School of Health Sciences, The University of Manchester, Manchester, UK.,Pennine Care NHS Foundation Trust, Ashton-Under-Lyne, UK
| | - Lesley-Anne Carter
- Division of Population Health, Health Services Research & Primary Care, The University of Manchester, Manchester, UK
| | - Peter J Taylor
- Division of Psychology and Mental Health, School of Health Sciences, The University of Manchester, Manchester, UK
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Park YH, Jeong YW, Kang YH, Kim SW, Park SY, Kim KJ, Lee JY, Choi DB. Mediating the effects of depression in the relationship between university students' attitude toward suicide, frustrated interpersonal needs, and non-suicidal self-injury during the COVID-19 pandemic. Arch Psychiatr Nurs 2022; 37:25-32. [PMID: 35337435 DOI: 10.1016/j.apnu.2021.11.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 11/09/2021] [Accepted: 11/17/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE The study aimed to examine the relationship on attitudes toward suicide, frustrated interpersonal needs, and non-suicidal self-injury (NSSI) of the university students. METHODS The participants included 175 university students. Data were analyzed using the SPSS PROCESS macro (Model 4). RESULTS Depression showed a fully mediating effect on the relationship between one's attitude toward suicide and NSSI behaviors. Furthermore, depression showed a full mediating impact on the relationship between frustrated interpersonal needs and NSSI behaviors. CONCLUSIONS These findings indicate that suicidal attitudes and frustrated interpersonal needs should be considered significant factors for developing NSSI preventions and intervention among university students.
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Affiliation(s)
- Young-Hee Park
- Department of Nursing, Dongguk University College of Nursing, 123 Dongdae-ro, Gyeongju-si, Gyeongsangbuk-do 38066, Republic of Korea
| | - Yeo-Won Jeong
- Department of Nursing, Dongguk University College of Nursing, 123 Dongdae-ro, Gyeongju-si, Gyeongsangbuk-do 38066, Republic of Korea.
| | - Yeon-Hwa Kang
- Department of Nursing, Dongguk University College of Nursing, 123 Dongdae-ro, Gyeongju-si, Gyeongsangbuk-do 38066, Republic of Korea
| | - Si-Won Kim
- Department of Nursing, Dongguk University College of Nursing, 123 Dongdae-ro, Gyeongju-si, Gyeongsangbuk-do 38066, Republic of Korea
| | - Su-Yeon Park
- Department of Nursing, Dongguk University College of Nursing, 123 Dongdae-ro, Gyeongju-si, Gyeongsangbuk-do 38066, Republic of Korea
| | - Kyeong-Ji Kim
- Department of Nursing, Dongguk University College of Nursing, 123 Dongdae-ro, Gyeongju-si, Gyeongsangbuk-do 38066, Republic of Korea
| | - Ji-Yoon Lee
- Department of Nursing, Dongguk University College of Nursing, 123 Dongdae-ro, Gyeongju-si, Gyeongsangbuk-do 38066, Republic of Korea
| | - Da-Bin Choi
- Department of Nursing, Dongguk University College of Nursing, 123 Dongdae-ro, Gyeongju-si, Gyeongsangbuk-do 38066, Republic of Korea
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Lee SE, Yim M, Hur JW. Beneath the surface: Clinical and psychosocial correlates of posting nonsuicidal self-injury content online among female young adults. COMPUTERS IN HUMAN BEHAVIOR 2022. [DOI: 10.1016/j.chb.2022.107262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Cipriano A, Aprea C, Bellone L, Cotrufo P, Cella S. Non-Suicidal Self-Injury: A School-Based Peer Education Program for Adolescents During COVID-19 Pandemic. Front Psychiatry 2022; 12:737544. [PMID: 35095587 PMCID: PMC8793799 DOI: 10.3389/fpsyt.2021.737544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 12/13/2021] [Indexed: 12/21/2022] Open
Abstract
Introduction: Non-suicidal self-injury (NSSI) constitutes a major health concern among youth. However, less is known about the useful ways to prevent NSSI. As such, the NSSI- Peer Education Program (NSSI-PEP) aims to intervene on the vulnerability factors that predispose to NSSI by applying a peer education approach. The NSSI-PEP is grounded on the psychoanalytic tradition's tenets, implementing modules targeting four crucial risk factors for NSSI: pubertal transformation, body image, self-esteem, and emotion regulation. Methods: Selected 8th grade students were trained to serve as peer educators and held a peer-education intervention for 6th and 7th grade students. Pre- and post-intervention assessments were conducted in order to evaluate the program's effectiveness. Results: Results revealed preliminary support for the program's feasibility, as students reported greater emotion regulation abilities (p = 0.038) and significant changes in self-esteem (p<0.001), personal alienation (p = 0.005), body image (p < 0.001), and maturity fear (p < 0.001). Also, NSSI-PEP was positively evaluated by participants. Discussion: Our pilot study provides preliminary empirical support for the NSSI-PEP, representing a promising way to address areas of vulnerability for NSSI onset. Findings may also help current policies to promote targeted preventive activities and produce sizable benefits to society.
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Affiliation(s)
| | | | | | | | - Stefania Cella
- Observatory on Eating Disorders, Department of Psychology, University of Campania “Luigi Vanvitelli”, Caserta, Italy
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Wong SL, Chung MC. The subjective experience of non-suicidal self-injury among female Chinese university students. Nord J Psychiatry 2022; 76:18-28. [PMID: 34061715 DOI: 10.1080/08039488.2021.1929461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The purpose of this study was to explore the subjective experience of non-suicidal self-injury (NSSI) among female Chinese university students in Hong Kong. DESIGN Interpretative phenomenological analysis was used. METHODS Seven female students participated in the study, two engaged in biting and scratching, and three in cutting. RESULTS The majority of them indicated negative attitudes towards NSSI and saw no particular meaning attached to it. However, they all persisted with their behaviours, which suggested that they were unable to stop. Students found themselves in a paradoxical situation whereby although they saw no real benefit of NSSI, they still engaged in it to cope with distress. Feelings characterised by this distress were about entrapment and issues with academia, intimacy, loneliness, insecurity, negative self-worth, regulating distressing emotions, increasing positive physical sensations, healing oneself, and feeling alive. CONCLUSIONS The experience of hurting themselves persistently for these female students symbolised their struggle with academic or relationship difficulties, self-acceptance, emotional regulation and survival without self-injury.
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Affiliation(s)
- Siu Ling Wong
- Student Affairs Office, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Man Cheung Chung
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
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Nilsson M, Lundh L, Westling S. Childhood maltreatment and self-hatred as distinguishing characteristics of psychiatric patients with self-harm: A comparison with clinical and healthy controls. Clin Psychol Psychother 2022; 29:1778-1789. [PMID: 35467060 PMCID: PMC9790602 DOI: 10.1002/cpp.2744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 04/19/2022] [Accepted: 04/20/2022] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Deliberate self-harm (DSH) is common in clinical populations. Childhood maltreatment (CM) and attitudes both towards oneself and towards DSH may be of importance for the development of DSH. This study aimed to test whether patients with DSH report more CM, more negative attitudes towards oneself and more positive attitudes towards DSH than a clinical and a healthy comparison group, and whether the effects of CM are mediated by negative attitudes towards oneself. METHOD Females with DSH and psychiatric disorders (n = 34), females without DSH but with psychiatric disorders (n = 31) and healthy female individuals (n = 29) were compared regarding DSH, CM, attitudes towards the self and attitudes towards self-harm. RESULTS Females with DSH reported more emotional abuse and more self-hatred as compared to both comparison groups. The effect of emotional abuse was mediated by self-hatred. The DSH-group had significantly more positive attitudes towards DSH than the healthy comparison group. CONCLUSION Self-hatred and CM in the form of emotional abuse may be distinguishing characteristics of female patients with DSH in psychiatric settings. The present results are compatible with the hypothesis that emotional abuse leads to DSH via self-hatred, but the cross-sectional nature of the study precludes any causal conclusions. The clinical utility of the results is discussed.
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Affiliation(s)
- Magnus Nilsson
- Department of Clinical Sciences, PsychiatryLund UniversityLundSweden
| | | | - Sofie Westling
- Clinical Psychiatric Research CenterRegion SkåneLundSweden
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Toukhy N, Ophir S, Stukalin Y, Halabi S, Hamdan S. The relationship between non-suicidal self-injury, identity conflict, and risky behavior among Druze adolescents. Front Psychiatry 2022; 13:938825. [PMID: 36440397 PMCID: PMC9681829 DOI: 10.3389/fpsyt.2022.938825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 10/25/2022] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES This study aimed to explore the prevalence of non-suicidal self-injury (NSSI) among Druze adolescents in Israel, an ethnic minority, and examine the influence of identity conflict, depression, and performance of risky behaviors on such adolescents' engagement in NSSI. This investigation is important because little is known about NSSI among adolescents from ethnic minorities. METHODS Overall, 290 Druze adolescents aged 16-18 (mean = 16.26, standard deviation = 0.9) years (63.9% female) participated in this study. They were recruited through snowball sampling from three Druze schools that agreed to participate in the study. All participants completed self-report measures for NSSI, depression, anxiety, engagement in risky behaviors, emotion regulation, sleep problems, and identity integration. RESULTS Almost 20% of the total sample engaged in NSSI. Those who engaged in NSSI reported more significant depression, anxiety, sleep problems, and engagement in risky behaviors when compared with those who did not engage in NSSI. Moreover, those who engaged in NSSI reported experiencing a higher level of identity conflict. Further analysis revealed an indirect effect of identity conflict on NSSI through engagement in risky behaviors. CONCLUSIONS This study's findings clarify the prevalence of NSSI among Druze adolescents, as well as contributing factors, and also highlights the importance of developing interventions that specifically target this unique ethnic group.
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Affiliation(s)
- Nermin Toukhy
- Department of Psychology, Bar Ilan University, Ramat Gan, Israel.,School of Behavioral Sciences, Academic College of Tel-Aviv Yaffo (MTA), Tel Aviv-Yafo, Israel.,Department of Psychological Medicine, Schneider Children's Medical Center, Petah Tikva, Israel
| | - Shir Ophir
- School of Behavioral Sciences, Academic College of Tel-Aviv Yaffo (MTA), Tel Aviv-Yafo, Israel
| | - Yelena Stukalin
- School of Behavioral Sciences, Academic College of Tel-Aviv Yaffo (MTA), Tel Aviv-Yafo, Israel
| | - Samer Halabi
- School of Behavioral Sciences, Academic College of Tel-Aviv Yaffo (MTA), Tel Aviv-Yafo, Israel
| | - Sami Hamdan
- School of Behavioral Sciences, Academic College of Tel-Aviv Yaffo (MTA), Tel Aviv-Yafo, Israel
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Schanz CG, Equit M, Schäfer SK, Michael T. Convergent and Discriminant Validity of the Test of Passive Aggression in a Psychotherapy Outpatient Sample. Front Psychol 2021; 12:723413. [PMID: 34925131 PMCID: PMC8671135 DOI: 10.3389/fpsyg.2021.723413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Accepted: 10/28/2021] [Indexed: 01/09/2023] Open
Abstract
Background: While most clinical aggression questionnaires focus on the assessment of active aggression, the recently developed Test of Passive Aggression (TPA) assesses both self-directed (TPA-SD) and other-directed passive aggression (TPA-OD). Reliability and factorial validity of the TPA have been demonstrated in a clinical sample, while previous evaluations of convergent and discriminant validity were limited to student samples. The current study aimed at addressing this gap by demonstrating convergent and discriminant validity of the TPA in an outpatient sample. Methods: Eighty-two patients admitted to an outpatient psychotherapy unit at Saarland University, Germany, participated in the preregistered study with an assessment of self-reported passive aggression, impulsivity, anger expression, self-compassion, self-esteem, and auto-aggressive mindset. Analyses used regression models with robust maximum likelihood estimations. Results: Self-directed passive aggression showed a significant association with self-compassion, auto-aggressive mindset, self-esteem, and internal anger expression supporting the convergent validity of TPA-SD. Results on discriminant validity of TPA-SD were heterogenous at the first sight, revealing small associations of self-directed passive aggression with anger control but medium associations with impulsivity. However, exploratory analysis showed that the medium association with impulsivity was driven by the non-behavioral impulsivity dimension “inattention” and that both behavioral impulsivity dimensions (“motor-impulsivity” and “unplanned behavior”) demonstrated only weak associations with TPA-SD. Validity of TPA-OD was not supported by the current study. Conclusion: Our findings provide evidence for the validity of the TPA-SD to outpatient samples. Future studies will need to analyze construct validity based on a nomological network using larger and more diverse samples.
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Affiliation(s)
- Christian Günter Schanz
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbruecken, Germany
| | - Monika Equit
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbruecken, Germany
| | - Sarah K Schäfer
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbruecken, Germany
| | - Tanja Michael
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbruecken, Germany
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Hu Z, Yu H, Zou J, Zhang Y, Lu Z, Hu M. Relationship among self-injury, experiential avoidance, cognitive fusion, anxiety, and depression in Chinese adolescent patients with nonsuicidal self-injury. Brain Behav 2021; 11:e2419. [PMID: 34816613 PMCID: PMC8671785 DOI: 10.1002/brb3.2419] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 09/17/2021] [Accepted: 10/12/2021] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To explore relationship among self-injury behavior, experiential avoidance, cognitive fusion, anxiety, and depression in Chinese adolescent patients with nonsuicidal self-injury (NSSI). METHODS Cognitive fusion questionnaire (CFQ), Acceptance and Action Questionnaire-2nd edition (AAQ-II), adolescent nonsuicidal self-injury behavior questionnaire (ANSAQ), Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HAMD) were used as research tools to investigate 120 subjects with NSSI and 130 healthy controls. RESULTS The scores of CFQ and AAQ-II in the NSSI group were significantly higher than those in the healthy control group (p < .001). The results of regression analysis showed that the experiential avoidance score of patients with NSSI could predict the score of self-injury questionnaire (β = 0.585, p < .001); when predicting anxiety, only CFQ (β = 0.361, p < .001) entered the equation, with an explanatory variation of 12.3%; when predicting depression, CFQ (β = 0.287, p < .01) entered the equation, with an explanatory variation of 7.4%. CONCLUSION A high level of cognitive fusion and experiential avoidance may be important factors for the maintenance of self-injury behavior in patients with NSSI.
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Affiliation(s)
- Zhizhong Hu
- Department of Psychosomatic MedicineThe First Affiliated Hospital of Nanchang UniversityNanchangJiangxi ProvinceChina
- School of Public AdministrationNanchang UniversityNanchangJiangxi ProvinceChina
| | - Huijuan Yu
- Department of Psychosomatic MedicineThe First Affiliated Hospital of Nanchang UniversityNanchangJiangxi ProvinceChina
| | - Jingzhi Zou
- Department of Psychosomatic MedicineThe First Affiliated Hospital of Nanchang UniversityNanchangJiangxi ProvinceChina
| | - Yanyan Zhang
- Department of Psychosomatic MedicineThe First Affiliated Hospital of Nanchang UniversityNanchangJiangxi ProvinceChina
- School of Public AdministrationNanchang UniversityNanchangJiangxi ProvinceChina
| | - Zihang Lu
- Department of Psychosomatic MedicineThe First Affiliated Hospital of Nanchang UniversityNanchangJiangxi ProvinceChina
- School of Public AdministrationNanchang UniversityNanchangJiangxi ProvinceChina
| | - Maorong Hu
- Department of Psychosomatic MedicineThe First Affiliated Hospital of Nanchang UniversityNanchangJiangxi ProvinceChina
- School of Public AdministrationNanchang UniversityNanchangJiangxi ProvinceChina
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McIntyre J, Elahi A, Latham C, Mullholland H, Haines-Delmont A, Saini P, Taylor PJ. Does neighbourhood identification buffer against the effects of socioeconomic disadvantage on self-harm? J Affect Disord 2021; 294:857-863. [PMID: 34375213 DOI: 10.1016/j.jad.2021.07.103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/15/2021] [Accepted: 07/26/2021] [Indexed: 11/17/2022]
Abstract
BACKGROUND Socioeconomic disadvantage and lack of group belonging (i.e., social identity) have been linked to poor mental health. However, no research has investigated the relationship between neighbourhood identity and self-harm, nor whether identifying with one's neighbourhood can mitigate the effects of economic stress on self-harm. METHODS Pre-registered secondary data analysis of a large (N = 3412) community health survey conducted in disadvantaged areas of North West England. RESULTS Despite the sample having a relatively high and therefore restricted level of disadvantage, individual and geographic indicators of disadvantage, as well as neighbourhood identification, were unique and strong predictors of self-harm thoughts and behaviours across several analyses. Specifically, experiencing disadvantage and disidentification predicted significantly higher odds of self-harm and self-harm thoughts. No consistent interactive effects emerged. LIMITATIONS The cross-sectional design limits firm conclusions regarding causal effects of neighbourhood identity and disadvantage on self-harm. However, causal direction is supported by past research and theory. The data is self-report, which is subject to response bias. The sample was also recruited from a region of the UK with low numbers of residents from ethnic minority backgrounds. CONCLUSIONS The results are consistent with past research indicating an association between social identity and better mental health, but for the first time extend these effects to self-harm. The findings demonstrate the importance of considering social and economic factors when attempting to prevent suicide and understand and treat self-harm thoughts.
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Affiliation(s)
- Jason McIntyre
- School of Psychology, Liverpool John Moores University, UK
| | - Anam Elahi
- Department of Primary Care and Mental Health. Institute of Population Health, University of Liverpool. UK
| | | | - Helen Mullholland
- Department of Primary Care and Mental Health. Institute of Population Health, University of Liverpool. UK
| | | | - Pooja Saini
- School of Psychology, Liverpool John Moores University, UK
| | - Peter J Taylor
- Division of Psychology and Mental Health, School of Health Sciences, The University of Manchester, Manchester Academic Health Sciences Centre, United Kingdom.
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Self-Critical and Self-Punishment Cognitions Differentiate Those With and Without a History of Nonsuicidal Self-Injury: An Ecological Momentary Assessment Study. Behav Ther 2021; 52:686-697. [PMID: 33990242 DOI: 10.1016/j.beth.2020.08.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/13/2020] [Accepted: 08/30/2020] [Indexed: 12/20/2022]
Abstract
The aim of this study was to examine trait, state, and temporal instability measures of self-critical and self-punishment cognitions to evaluate their respective roles in nonsuicidal self-injury (NSSI). Participants were university students with a history of NSSI (n = 64) and those with no history of NSSI (n = 59). At baseline, participants completed measures assessing history of NSSI behavior, as well as trait measures of self-criticism and self-punishment. After completion of baseline procedures, participants subsequently participated in a 10-day ecological momentary assessment protocol in which self-critical and self-punishment cognitions were assessed in real time three times daily. Employing bivariate and multivariate frameworks, our results demonstrate that both trait and state levels of self-critical and self-punishment cognitions robustly differentiate between young adults with and without a lifetime history of NSSI. The present results also confirm that the temporal instability of these cognitive states also meaningfully differentiate between groups, such that those who exhibit greater fluctuations in these cognitive states are more likely to have a history of NSSI. The current findings suggest that trait, state, and temporal instability of negative self-focused cognitions may be vulnerability factors for engagement in NSSI.
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Hamza CA, Goldstein AL, Heath NL, Ewing L. Stressful Experiences in University Predict Non-suicidal Self-Injury Through Emotional Reactivity. Front Psychol 2021; 12:610670. [PMID: 33927664 PMCID: PMC8076506 DOI: 10.3389/fpsyg.2021.610670] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 03/18/2021] [Indexed: 12/22/2022] Open
Abstract
Theoretical perspectives on non-suicidal self-injury (NSSI; direct and deliberate self-injury without lethal intent such as self-cutting or hitting) have long underscored the affective regulating properties of NSSI. Less attention has been given to the processes through which individuals choose to engage in NSSI, specifically, to regulate their distress. In the present study, we tested one theoretical model in which recent stressful experiences facilitates NSSI through emotional reactivity. Further, we tested whether the indirect link between stressful experiences and NSSI was moderated by several NSSI specific risk factors (e.g., having friends who engage in NSSI). Given the widespread prevalence of NSSI among community-based samples of adolescents and emerging adults, we surveyed 1,125 emerging adults in first-year university at a large academic institution (72% female, Mage = 17.96, 25% with a recent history of NSSI at Time 1). Participants completed an online survey three times (assessments were 4 months apart), reporting on their recent stressful experiences in university, emotional reactivity, NSSI, as well as three NSSI specific risk factors (i.e., close friend engagement in NSSI, high self-disgust, and low fear of pain). As expected, path analysis revealed that there was a significant indirect effect of recent stressful experiences on NSSI engagement, through emotional reactivity. However, this effect was maintained across moderator analyses. These novel findings underscore the salient role of proximally occurring stressors in the prediction of NSSI among emerging adults in university, and can inform developing theoretical perspectives on NSSI.
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Affiliation(s)
- Chloe A Hamza
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, Toronto, ON, Canada
| | - Abby L Goldstein
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, Toronto, ON, Canada
| | - Nancy L Heath
- Department of Educational and Counselling Psychology, McGill University, Montreal, QC, Canada
| | - Lexi Ewing
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, Toronto, ON, Canada
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Taylor PJ, Usher S, Jomar K, Forrester R. Investigating self-concept in self-harm: A repertory grid study. Psychol Psychother 2021; 94 Suppl 2:171-187. [PMID: 32012440 DOI: 10.1111/papt.12269] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 12/19/2019] [Indexed: 01/03/2023]
Abstract
OBJECTIVES The way that individuals perceive themselves and others may be relevant in understanding difficulties with self-harm. Repertory grids provide a relatively underutilized means of investigating self-concept in people who self-harm. This study aimed to examine the association between self-concept, captured through a repertory grid method, and self-harm. METHOD Ninety-eight participants with a history of self-harm took part in the study. A repertory grid was used to derive distances between four elements ('current self', 'ideal self', 'self-harming self', and 'others who self-harm'). Associations between these distances and measures of self-harm behaviour, well-being and perceived recovery, were estimated. RESULTS Repertory grid distances were significantly associated with self-harm. When adjusting for covariates, self-harm in the past year was positively associated with a greater distance (or less perceived similarity) between current and ideal self, and a smaller distance (greater perceived similarity) between current self and others who self-harm. Repertory grid distances were also associated with well-being and perceived recovery. CONCLUSIONS The results are consistent with the idea that self-perception is associated with self-harm and related difficulties. The results also highlight the potential utility of repertory grids as a tool for exploring self-concept. The cross-sectional nature of the study precludes inferences about directionality or the temporal characteristics of associations. PRACTITIONER POINTS More recent experiences of self-harm may be reflected in the way individuals perceive or construe themselves. The way in which individuals who self-harm perceive or construe themselves may also be related to their current well-being and perceived recovery. Repertory grids may be a useful tool in clinical practice for investigating self-concept in those who self-harm. Repertory grids may provide a more idiographic, clinical outcome assessment in those who self-harm.
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Affiliation(s)
- Peter J Taylor
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Sciences Centre, University of Manchester, UK
| | - Sunny Usher
- Division of Psychology and Mental Health, School of Health Sciences, Manchester Academic Health Sciences Centre, University of Manchester, UK
| | - Khowla Jomar
- STEP 3-4 CAMHS, South Tyrone Hospital, Dungannon, UK
| | - Rebecca Forrester
- Springpark Mental Health Resource Centre, NHS Greater Glasgow and Clyde, UK
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Lindkvist RM, Westling S, Liljedahl SI, Landgren K. A Brief Breathing Space: Experiences of Brief Admission by Self-Referral for Self-Harming and Suicidal Individuals with a History of Extensive Psychiatric Inpatient Care. Issues Ment Health Nurs 2021; 42:172-182. [PMID: 32762578 DOI: 10.1080/01612840.2020.1789787] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Individuals with severe self-harm and experiences of lengthy psychiatric admissions often have complex mental health conditions and are at risk of suicide. In this qualitative study, self-harming individuals with >180 days of psychiatric admission over 12 months shared their experiences of Brief Admission (BA), a standardized crisis-management intervention encouraging self-admission and autonomy. Phenomenological hermeneutic analysis formulated BA as a worthy respite, replacing an old system of having to prove need 'in blood' or wait and get worse. Successes and struggles in early help-seeking, interpreted in the light of human rights and person-centered care, suggested that individual development of autonomy depended on perceived focus on recovery and compassion. Future research may consider ethical and health-economic aspects of BA in a broader perspective.
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Affiliation(s)
- Rose-Marie Lindkvist
- Department of Clinical Sciences, Lund, Psychiatry, Lund University, Clinical Psychiatric Research Center, Region Skåne, Lund, Sweden
| | - Sofie Westling
- Department of Clinical Sciences, Lund, Psychiatry, Lund University, Clinical Psychiatric Research Center, Region Skåne, Lund, Sweden
| | - Sophie I Liljedahl
- Region Västra Götaland, Psykiatri Affektiva, Department of Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden.,Institute of Neuroscience and Physiology, University of Gothenburg, Sahlgrenska Academy, Gothenburg, Sweden
| | - Kajsa Landgren
- Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden.,Division of Psychiatry, Region Skåne, Lund, Sweden
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Evald TA, Møhl B. Before the damage is done: Early childhood hyperactivity difficulties in adolescents with deliberate self-harm - findings from the DALSC cohort. Scand J Child Adolesc Psychiatr Psychol 2021; 8:176-188. [PMID: 33598440 PMCID: PMC7879016 DOI: 10.21307/sjcapp-2020-018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Deliberate self-harm (DSH) is a growing issue among Danish adolescents, and a dramatic increase in the incidence of DSH has been observed since the turn of the millennium. The importance of early childhood factors on later development has been established, but research on the trajectories of DSH is still scarce, and longitudinal studies are much needed. METHOD Participants were 3,291 children and their mothers from The Danish Longitudinal Survey of Children (DALSC), a Danish population-based birth cohort from 1995. Logistic regression and mediation analyses were used to examine significant early childhood determinants of self-harming behavior in adolescence. RESULTS The study found that 17.9% of the children had a history with DSH at the age of 18 years. A significant relationship was found between the likelihood of DSH at the age of 18 years and hyperactivity difficulties assessed through the Strengths and Difficulties Questionnaire (SDQ) at 3 and 7 years of age. Using a mediation model, it is documented that difficulties in peer relationships at the age of 11 years is a partial mediator explaining 19% of the variation. LIMITATIONS i) a vague definition of self-harm in the questionnaires; ii) lack of sample representation as children of lower socio-economic groups have lower participation rates, and only Danish-ethnicity children have been sampled; iii) possibility of omitted variable bias. CONCLUSION The adolescents engaging in DSH are experiencing a more complex range of psychosocial problems than those who do not have experience with DSH. The main finding of the study is that hyperactivity as a risk factor for the development of DSH in adolescence can be identified as early as 3-7 years of age. This relationship between the very early occurring hyperactivity and later DSH, to the best of our knowledge, has not previously been described.
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Affiliation(s)
- Therese A. Evald
- The Finance Committee, City Council of Copenhagen, Copenhagen, Denmark
| | - Bo Møhl
- Faculty of Humanities, Aalborg University, Aalborg, Denmark
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Greitemeyer T, Sagioglou C. Predictors of nonsuicidal self-injury: The independent contribution of benign masochism and antisocial personality. PERSONALITY AND INDIVIDUAL DIFFERENCES 2021. [DOI: 10.1016/j.paid.2020.110380] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Cipriano A, Cella S, Cotrufo P. Non-Suicidal Self-Injury Among Italian Adolescents: The Role of Parental Rejection, Self-Concept, Anger Expression, and Body Investment. CLINICAL NEUROPSYCHIATRY 2020; 17:330-338. [PMID: 34909011 PMCID: PMC8629071 DOI: 10.36131/cnfioritieditore20200602] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Objective Parental rejection, poor self-concept, anger expression, and negative body investment have often been associated with non-suicidal self-injury (NSSI). However, research has investigated each factor separately. To address this shortcoming, the main aim of the study was to integrate these factors and test a hierarchical regression to examine the impact of each factor above and beyond the others. Method A cross-sectional sample of 481 Italian high school students aged 13-19 (Mage=15.48; SD=1.46) were screened by self-report measures that assess parental rejection, self-concept, anger expression, body emotional investment, and NSSI. A semi-structured interview was administered in order to assess the characteristics of self-injurious behaviors. Results After the interview, twenty-three (4.8%) students reported having engaged in NSSI (Mage =12.63; SD=1.58). Neither gender nor age differences were found. The hierarchical regression revealed the NSSI was associated with the inward expression of anger (ORs=1.1–1.7) and the negative body investment (ORs=.037–.281). Conclusions These findings point out that the expression of anger inwardly and the emotional investment in the body may be salient factors to consider in understanding the occurrence of NSSI among adolescents. The clinical relevance of these findings was discussed.
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Affiliation(s)
- Annarosa Cipriano
- Observatory on eating disorders, Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, 81100 Caserta, CE, Italy
| | - Stefania Cella
- Observatory on eating disorders, Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, 81100 Caserta, CE, Italy
| | - Paolo Cotrufo
- Observatory on eating disorders, Department of Psychology, University of Campania "Luigi Vanvitelli", Viale Ellittico 31, 81100 Caserta, CE, Italy
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Gierski F, De Wever E, Benzerouk F, Lannoy S, Kaladjian A, Naassila M, Quaglino V. Disentangling the Relationship Between Self-Esteem and Problematic Alcohol Use Among College Students: Evidence From a Cluster Analytic Approach. Alcohol Alcohol 2020; 55:196-203. [PMID: 31845969 DOI: 10.1093/alcalc/agz097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Revised: 09/20/2019] [Accepted: 10/28/2019] [Indexed: 11/13/2022] Open
Abstract
AIMS Investigation of the relationship between self-esteem and alcohol use among college students has yielded discrepant results. We hypothesized that these discrepancies could originate from a potential heterogeneity of self-esteem patterns among young adult with an alcohol use disorder (AUD). METHODS A community sample of 343 college students was recruited and categorized with or without AUD using the Alcohol Use Disorders Identification Test cut-offs. College students were compared on the dimensions of the Coopersmith Self-Esteem Inventory (CSEI) as well as mood, impulsiveness, alcohol- and other substance-related measures, including drinking motives. RESULTS A cluster analysis conducted among college students with AUD highlighted two subgroups characterized by contrasting patterns on the CSEI: one group with a high level of self-esteem and low levels of anxiety and depression symptoms and one group with a low level of self-esteem and high levels of impulsiveness, mood symptoms and drinking to cope motives. CONCLUSION Findings caution against assuming that AUD is associated with low self-esteem, as reported in previous studies. These results rather emphasize a heterogeneity of self-esteem in college students, showing that high self-esteem was also related to AUD. Implications of these results are major for prevention purposes and clinical practice.
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Affiliation(s)
- Fabien Gierski
- Laboratoire Cognition Santé, Société (C2S - EA 6291), Université de Reims Champagne Ardenne, 57 rue Pierre Taittinger, 51096 Reims Cedex, France.,Pôle Universitaire de Psychiatrie, Etablissement Public de Santé Mentale de la Marne, 8 rue Roger Aubry, 51100 Reims, France.,INSERM U1247 GRAP, Research Group on Alcohol and Drugs, Université de Picardie Jules Verne, Chemin du Thil, 80025 Amiens Cedex 1, France
| | - Elodie De Wever
- Laboratoire CRP-CPO (EA7273), Université de Picardie Jules Verne, Chemin du Thil, 80025 Amiens Cedex 1, France
| | - Farid Benzerouk
- Laboratoire Cognition Santé, Société (C2S - EA 6291), Université de Reims Champagne Ardenne, 57 rue Pierre Taittinger, 51096 Reims Cedex, France.,Pôle Universitaire de Psychiatrie, Etablissement Public de Santé Mentale de la Marne, 8 rue Roger Aubry, 51100 Reims, France
| | - Séverine Lannoy
- Laboratoire Cognition Santé, Société (C2S - EA 6291), Université de Reims Champagne Ardenne, 57 rue Pierre Taittinger, 51096 Reims Cedex, France.,Laboratoire de Psychopathologie Expérimentale, Université catholique de Louvain, Place du Cardinal Mercier, B-1348 Louvain-la-Neuve, Belgium
| | - Arthur Kaladjian
- Laboratoire Cognition Santé, Société (C2S - EA 6291), Université de Reims Champagne Ardenne, 57 rue Pierre Taittinger, 51096 Reims Cedex, France.,Pôle Universitaire de Psychiatrie, Etablissement Public de Santé Mentale de la Marne, 8 rue Roger Aubry, 51100 Reims, France
| | - Mickaël Naassila
- INSERM U1247 GRAP, Research Group on Alcohol and Drugs, Université de Picardie Jules Verne, Chemin du Thil, 80025 Amiens Cedex 1, France
| | - Véronique Quaglino
- Laboratoire CRP-CPO (EA7273), Université de Picardie Jules Verne, Chemin du Thil, 80025 Amiens Cedex 1, France
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Wang S, Xu H, Zhang S, Wan Y, Tao F. Mediating effects of self-esteem in the relationship between childhood maltreatment and non-suicidal self-injury among adolescents: The roles of sex and only-child status. Soc Sci Med 2020; 249:112847. [PMID: 32086153 DOI: 10.1016/j.socscimed.2020.112847] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 11/12/2019] [Accepted: 02/08/2020] [Indexed: 12/17/2022]
Abstract
RATIONALE Although childhood maltreatment is known to be associated with non-suicidal self-injury (NSSI), few studies have investigated the mediating effect of self-esteem on this relationship. Additionally, it is unknown whether the impacts vary by sex or only-child status. OBJECTIVE We investigated the mediating effects of self-esteem on the relationship between childhood maltreatment and NSSI in adolescents and identified the significance of sex and only child status. METHOD An adolescent health survey was conducted in 15 schools in China between 2013 and 2014. In total, 9704 students aged 11-19 years completed standard questionnaires to report the details of childhood maltreatment, NSSI, and self-esteem. RESULTS Childhood maltreatment was negatively correlated with self-esteem and positively correlated with the frequency of NSSI. Lower self-esteem was also correlated with higher NSSI frequency. Self-esteem mediated the relationship between childhood maltreatment and NSSI, and the estimated ratio of the total effect of childhood maltreatment that could be explained by mediation through self-esteem was 16.3%. The ratio was higher in boys (28.6%) than in girls (9.9%), and it was higher in only children (31.5%) than in children with siblings (11.0%). CONCLUSIONS Childhood maltreatment is positively correlated with the frequency of NSSI and may be mediated by self-esteem. Interventions aimed at reducing NSSI associated with childhood maltreatment may be enhanced by efforts to strengthen self-esteem, especially in boys and only children.
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Affiliation(s)
- Shanshan Wang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China
| | - Huiqiong Xu
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China
| | - Shichen Zhang
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China
| | - Yuhui Wan
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China.
| | - Fangbiao Tao
- Department of Maternal, Child & Adolescent Health, School of Public Health, Anhui Medical University, Anhui, China; Anhui Provincial Key Laboratory of Population Health & Aristogenics, Anhui, China
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