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Mota MSSD, Ulguim HB, Jansen K, Cardoso TDA, Souza LDDM. Are big five personality traits associated to suicidal behaviour in adolescents? A systematic review and meta-analysis. J Affect Disord 2024; 347:115-123. [PMID: 37956831 DOI: 10.1016/j.jad.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 08/05/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Suicidal behaviour is one of the main causes of death worldwide, especially among teenagers, and its development is potentially associated with the development of personality. The aim of this systematic review and meta-analysis is to describe the association between the Big Five Personality Traits and suicidal behaviour in adolescents. METHODS Seven databases were systematically searched between June 2022 and July 2022 with no language or year restrictions. We searched for a combination of the following search items (suicid* OR suicidal behaviour OR suicidal ideation OR suicide attempts OR self injury OR self-destructive behaviour OR self-harm OR suicidal risk) AND (personality OR personality traits OR temperament OR neuroticism OR extraversion OR agreeableness OR openness to experience OR conscientiousness) AND (adolescents OR youth OR teenagers OR young adults). Meta-analysis procedures were performed using the R software. A random-effect-model was performed for the models through the incorporation of τ2, based on the DerSimonion Lard method. RESULTS Seven studies met all inclusion criteria and were included in this systematic review. Our meta-analysis showed that higher neuroticism are both associated and a risk factor for suicidal behaviour. Higher levels of openness to experience and agreeableness, and lower levels of extraversion and conscientiousness, were linked to suicidal behaviour, especially self-harm. LIMITATIONS Due to the heterogeneity of the studies, we were only able to perform meta-analysis regarding neuroticism. CONCLUSION The present study may help professionals to identify adolescents in higher risk for suicidal behaviour, enabling the development of early interventions to prevent suicidality in this population.
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Affiliation(s)
- Manuela Silva Silveira da Mota
- Program of Graduate Studies in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil; Chronobiology and Sleep Laboratory, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Graduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Helena Bohm Ulguim
- Program of Graduate Studies in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Karen Jansen
- Program of Graduate Studies in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Taiane de Azevedo Cardoso
- Program of Graduate Studies in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil; Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia
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Akbari M, Seydavi M, Firoozabadi MA, Babaeifard M. Distress tolerance and lifetime frequency of non-suicidal self-injury (NSSI): A systematic review and meta-analysis. Clin Psychol Psychother 2024; 31:e2957. [PMID: 38343352 DOI: 10.1002/cpp.2957] [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: 12/01/2023] [Revised: 01/20/2024] [Accepted: 01/22/2024] [Indexed: 02/15/2024]
Abstract
NSSI has recently been recognized as a significant health issue given its documented association with psychopathology and across a broad spectrum of psychiatric disorders. It has been found that individuals experiencing heightened emotions, which is referred to as an emotional cascade, are more likely to engage in self-injury behaviour due to low levels of distress tolerance (DT). The current meta-analysis using PRISMA guidelines sought to quantify the strength of the association between DT and lifetime frequency of NSSI using 22 eligible studies (N = 14,588; F = 60.7%; age = 23.35 ± 7.30), mainly from the United States. The correlation between emotional DT and NSSI was a small negative correlation (r = -.14), and it was non-significant for behavioural DT and NSSI (r = .02). Also, the effect-size was significant for studies that used interview-based measure of NSSI (r = -.24), and it was non-significant when self-report measures of NSSI (r = -.11) utilized. The association between DT and NSSI was significant and negative across the general population (r = -.47), university students (r = -.17), and inpatients (r = -.27); surprisingly, it was significant and positive among adolescents or high school students (r = .17). The observed effect-sizes were independent of publication year, mean age and its standard deviation, study quality, female proportion, DT, NSSI measures reliability, and clinical status. Future studies on NSSI should consider DT as a spectrum from distress intolerance to distress over-tolerance, given that it seems it has different functions when different samples (e.g., adolescents) are studied.
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Affiliation(s)
- Mehdi Akbari
- Department of Clinical Psychology, Faculty of Psychology and Education, Kharazmi University, Tehran, Iran
| | - Mohammad Seydavi
- Department of Clinical Psychology, Faculty of Psychology and Education, Kharazmi University, Tehran, Iran
| | - Mahsa Akbarian Firoozabadi
- Department of Clinical Psychology, Faculty of Psychology and Education, Kharazmi University, Tehran, Iran
| | - Maryam Babaeifard
- Department of Clinical Psychology, Faculty of Psychology and Education, Kharazmi University, Tehran, Iran
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Esposito C, Dragone M, Affuso G, Amodeo AL, Bacchini D. Prevalence of engagement and frequency of non-suicidal self-injury behaviors in adolescence: an investigation of the longitudinal course and the role of temperamental effortful control. Eur Child Adolesc Psychiatry 2023; 32:2399-2414. [PMID: 36123505 PMCID: PMC10682258 DOI: 10.1007/s00787-022-02083-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 09/10/2022] [Indexed: 11/30/2022]
Abstract
Non-suicidal self-injury (NSSI) is among the most frequent maladaptive behaviors reported in adolescence, with prevalence rates around 18-22% in community samples worldwide. The onset of NSSI typically occurs between early and middle adolescence, with a peak during middle adolescence (14-15 years) and a subsequent decline during late adolescence. This study investigated the growth curves of NSSI across four years during adolescence, analyzing simultaneously the probability of engagement in NSSI at least once (i.e., prevalence) and the frequency of engagement once initiated (i.e., severity). Furthermore, the study examined the predicting role of effortful control on NSSI over time (time-varying effects), net of other key risk factors for NSSI, such as anxiety-depression and bullying victimization. A sample of 430 Italian adolescents enrolled in Grade 9 at baseline was involved in the study. Based on the Latent Growth Curve Zero-inflated Poisson methodology, the results indicated a negative quadratic trend of both NSSI prevalence, with an increase between T1 and T3 followed by a decrease in the subsequent wave, and NSSI frequency once initiated, with a peak at T2 followed by a decline over time. The results also showed that adolescents who reported low effortful control abilities had a heightened probability of involvement in NSSI at each time point, whereas no significant association was found with NSSI frequency once initiated. Findings from this study offer important insights into the developmental course of NSSI and point out the need for future in-depth investigations of the mechanisms that might underlie NSSI prevalence and severity throughout adolescence.
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Affiliation(s)
- Concetta Esposito
- Department of Humanities, University of Naples "Federico II", Naples, Italy.
| | - Mirella Dragone
- Department of Humanities, University of Naples "Federico II", Naples, Italy
| | - Gaetana Affuso
- Department of Psychology, University of Campania "L. Vanvitelli", Caserta, Italy
| | - Anna Lisa Amodeo
- Department of Humanities, University of Naples "Federico II", Naples, Italy
| | - Dario Bacchini
- Department of Humanities, University of Naples "Federico II", Naples, Italy
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Zinchuk M, Kustov G, Popova S, Mishin I, Voinova N, Gersamija A, Yakovlev A, Guekht A. Functions of nonsuicidal self-injurious behavior in Russian patients with suicidal ideation. Front Public Health 2023; 11:1270944. [PMID: 38026411 PMCID: PMC10660280 DOI: 10.3389/fpubh.2023.1270944] [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: 08/01/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction Nonsuicidal self-injurious behavior (NSSI) is an important risk factor for future suicide attempts. Previous research has identified a number of motivations for engaging in NSSI. The aim of the present study was to translate the Inventory of Statements About Self-Injury (ISAS) into Russian and then to evaluate its psychometric properties in a sample of patients with non-psychotic mental disorders and suicidal ideation (SI). Other aims were to determine the prevalence of specific NSSI functions in this population and to assess the relationship between different NSSI functions and clinical and psychological parameters. Participants and methods The study was conducted at the largest center for non-psychotic mental disorders in Moscow. All admitted patients with both NSSI and SI completed the Russian version of the ISAS-II, underwent the Self-Injurious Thoughts and Behaviors Interview, and completed the Personality Inventory for DSM-5 and ICD-11 Brief Form Plus-Modified, the Beck Depression Inventory, and the State-Trait Anxiety Inventory. Results A total of 614 patients were included in the study. 543 (88.4%) patients were assigned female at birth with a mean age of 24.86 (7.86) years. Factor analysis supported a two-factor structure (Intrapersonal and Interpersonal) of the Russian version of the ISAS-II, but in contrast to the original study, the "Marking distress" function loaded more strongly on the Interpersonal factor. In people with non-psychotic mental disorders and SI, Interpersonal functions of NSSI are associated with more severe depressive symptoms (r = 0.34), 12 months history of NSSI (r = 0.30), higher number of NSSI methods (r = 0.41), likelihood of future NSSI (r = 0.35) and psychoticism (r = 0.32). Conclusion The Russian version of the ISAS-II is a valid and reliable instrument for assessing NSSI functions in a population at high risk for suicide attempts. Interpersonal functions are associated with a number of unpleasant clinical and psychological features.
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Affiliation(s)
- Mikhail Zinchuk
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
| | - Georgii Kustov
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
| | - Sofya Popova
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
| | - Ilya Mishin
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
| | - Nadezhda Voinova
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
| | - Anna Gersamija
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
| | - Alexander Yakovlev
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
- Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, Moscow, Russia
| | - Alla Guekht
- Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia
- Pirogov Russian National Research Medical University, Moscow, Russia
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Başgöze Z, Demers L, Thai M, Falke CA, Mueller BA, Fiecas MB, Roediger DJ, Thomas KM, Klimes-Dougan B, Cullen KR. A Multilevel Examination of Cognitive Control in Adolescents With Nonsuicidal Self-injury. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2023; 3:855-866. [PMID: 37881532 PMCID: PMC10593942 DOI: 10.1016/j.bpsgos.2023.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Revised: 04/13/2023] [Accepted: 04/18/2023] [Indexed: 10/27/2023] Open
Abstract
Background Nonsuicidal self-injury (NSSI), a transdiagnostic behavior, often emerges during adolescence. This study used the Research Domain Criteria approach to examine cognitive control (CC) with a focus on response inhibition and urgency relative to NSSI severity in adolescents. Methods One hundred thirty-eight adolescents, assigned female sex at birth, with a continuum of NSSI severity completed negative and positive urgency measurements (self-report), an emotional Go/NoGo task within negative and positive contexts (behavioral), and structural and functional imaging during resting state and task (brain metrics). Cortical thickness, subcortical volume, resting-state functional connectivity, and task activation focused on an a priori-defined CC network. Eighty-four participants had all these main measures. Correlations and stepwise model selection followed by multiple regression were used to examine the association between NSSI severity and multiunit CC measurements. Results Higher NSSI severity correlated with higher negative urgency and lower accuracy during positive no-inhibition (Go). Brain NSSI severity correlates varied across modalities and valence. For right medial prefrontal cortex and right caudate, higher NSSI severity correlated with greater negative but lower positive inhibition (NoGo) activation. The opposite pattern was observed for the right dorsolateral prefrontal cortex. Higher NSSI severity correlated with lower left dorsal anterior cingulate cortex (ACC) negative inhibition activation and thicker left dorsal ACC, yet it was correlated with higher right rostral ACC positive inhibition activation and thinner right rostral ACC, as well as lower CC network resting-state functional connectivity. Conclusions Findings revealed multifaceted signatures of NSSI severity across CC units of analysis, confirming the relevance of this domain in adolescent NSSI and illustrating how multimodal approaches can shed light on psychopathology.
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Affiliation(s)
- Zeynep Başgöze
- Department of Psychiatry & Behavioral Sciences, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Lauren Demers
- Child Development & Rehabilitation Center, Oregon Health & Science University, Portland, Oregon
| | - Michelle Thai
- Department of Psychology, University of Minnesota, Minneapolis, Minnesota
| | - Chloe A. Falke
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Bryon A. Mueller
- Department of Psychiatry & Behavioral Sciences, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Mark B. Fiecas
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Donovan J. Roediger
- Department of Psychiatry & Behavioral Sciences, University of Minnesota Medical School, Minneapolis, Minnesota
| | - Kathleen M. Thomas
- Institute of Child Development, University of Minnesota, Minneapolis, Minnesota
| | | | - Kathryn R. Cullen
- Department of Psychiatry & Behavioral Sciences, University of Minnesota Medical School, Minneapolis, Minnesota
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Dale K, Case JAC, Dyson MW, Klein DN, Olino TM. Childhood temperament as a predictor of adolescent nonsuicidal self-injury. Dev Psychopathol 2023; 35:1288-1295. [PMID: 34895365 PMCID: PMC9189238 DOI: 10.1017/s095457942100119x] [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] [Indexed: 11/05/2022]
Abstract
Previous cross-sectional work has consistently found associations between neuroticism and impulsivity and nonsuicidal self-injury (NSSI). However, there are few longitudinal studies of personality risk factors for NSSI. In this study, we examined associations between individual differences in temperament at age 3 and NSSI from ages 9 to 15. At age 3, 559 preschool-aged children (54% male; Mage = 42.2 months [SD = 3.10]) completed laboratory assessments of temperament. Parents also completed questionnaires about their child's temperament. Children completed a diagnostic interview assessing NSSI engagement at ages 9, 12, and 15. By the age 15 assessment, 12.4% of adolescents reported engaging in NSSI. In univariate models, we found that higher levels of observed sadness and maternal-reported sadness and anger were associated with increased risk for NSSI. In multivariate models, female sex and maternal-reported anger were significantly associated with greater likelihood of NSSI. Laboratory observed sadness and impulsivity were associated with a higher likelihood of NSSI. This work extends the literature on personality risk factors associated with NSSI by finding longitudinal associations between early childhood negative affect and later NSSI engagement during adolescence.
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Affiliation(s)
- Kristina Dale
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - Julia A C Case
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | | | - Daniel N Klein
- Stony Brook University, Department of Psychology, Stony Brook, USA
| | - Thomas M Olino
- Department of Psychology, Temple University, Philadelphia, PA, USA
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Griffin K, Twynstra J, Gilliland JA, Seabrook JA. Correlates of self-harm in university students: A cross-sectional study. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:959-966. [PMID: 34242122 DOI: 10.1080/07448481.2021.1909049] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Objective: To determine the prevalence of university students who have ever engaged in self-harm and to examine its correlates. Frequency of thinking about self-harm was explored as a secondary outcome. Participants: Students at Western University in London, Ontario, Canada. Methods: This cross-sectional study was completed via an online questionnaire. Logistic regressions assessed the influence of sociodemographic and behavioral factors associated with lifetime self-harm and thoughts about self-harm. Results: The sample consisted of 2626 university students. Almost 25% engaged in self-harm in their lifetime and close to 33% have thought about harming themselves. A non-straight sexual orientation, marijuana use, prescription drugs not prescribed, and mental health problems increased the risk of both outcomes. Females were over two times more likely to engage in self-harm than males. Conclusion: This study provides evidence that is needed for developing effective interventions to reduce the risk of self-harm by targeting university students who are most at-risk.
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Affiliation(s)
- Kylie Griffin
- School of Food and Nutritional Sciences, Brescia University College, London, Ontario, Canada
| | - Jasna Twynstra
- School of Food and Nutritional Sciences, Brescia University College, London, Ontario, Canada
- Department of Medical Biophysics, Western University, London, Ontario, Canada
| | - Jason A Gilliland
- Department of Geography, Western University, London, Ontario, Canada
- Human Environments Analysis Laboratory, Western University, London, Ontario, Canada
- Department of Paediatrics, Western University, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
- School of Health Studies, Western University, London, Ontario, Canada
- Children's Health Research Institute, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
| | - Jamie A Seabrook
- School of Food and Nutritional Sciences, Brescia University College, London, Ontario, Canada
- Human Environments Analysis Laboratory, Western University, London, Ontario, Canada
- Department of Paediatrics, Western University, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Western University, London, Ontario, Canada
- Children's Health Research Institute, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
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Bresin K, Hunt RA. The downside of being openminded: The positive relation between openness to experience and nonsuicidal self-injury. Suicide Life Threat Behav 2023; 53:282-288. [PMID: 36637056 DOI: 10.1111/sltb.12943] [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: 04/25/2022] [Revised: 08/23/2022] [Accepted: 01/03/2023] [Indexed: 01/14/2023]
Abstract
BACKGROUND Sensation seeking and openness are two distinct, but related, individual differences that lead individuals to seek out intense sensations. As a result, these traits may also predispose individuals toward engaging in non-suicidal self-injury (NSSI); however, to date, no models have examined the relation between openness and NSSI after accounting for the influence of sensation. METHOD The goals of this study were to (1) examine the relation between openness and NSSI while accounting for sensation seeking in a sample of racially diverse undergraduates (N = 340) and (2) conduct a meta-analysis of the existing research on the association between NSSI and openness. RESULTS A negative binomial regression model demonstrated a significant positive association between NSSI and openness when accounting for sensation seeking; however, NSSI was not significantly related to sensation seeking. Moreover, multivariate meta-analysis with robust variance revealed a small, but significant, association between NSSI and openness across 15 studies. CONCLUSION Together, these results suggest a positive association between openness and NSSI, highlighting an area for future research in what role openness to experience might play in the development of NSSI.
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Affiliation(s)
- Konrad Bresin
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA.,Department of Counseling and Human Development, University of Louisville, Louisville, Kentucky, USA
| | - Rowan A Hunt
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, Kentucky, USA
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De Salve F, Placenti C, Tagliabue S, Rossi C, Malvini L, Percudani M, Oasi O. Are PID-5 personality traits and self-harm attitudes related? A study on a young adult sample pre-post COVID-19 pandemic. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023; 11:100475. [PMID: 36620760 PMCID: PMC9811916 DOI: 10.1016/j.jadr.2023.100475] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Revised: 12/12/2022] [Accepted: 01/03/2023] [Indexed: 01/06/2023] Open
Abstract
Introduction Different studies confirm a stronger link between maladaptive personality traits and Non-suicidal Self-injury (NSSI). Additionally, the interest in the relationship between the experience of the COVID-19 pandemic and NSSI is growing. The present study aims (a) to investigate differences in personality traits between individuals with NSSI, suicidal ideation, NSSI and suicidal ideation co-occurrence and none; (b) to observe which personality traits predominantly influence the occurrence of self-harm acts; (c) to evaluate the difference in self-harm attitudes pre and post COVID-19 pandemic. Method 270 (108 males and 162 females) participants aged between 18 and 25 were included in the study. Everyone participated in a clinical interview and completed an assessment consisting of the Personality Inventory for DSM-5 (PID-5) and the Health of the Nation Outcome Scales (HoNOS). A multivariate analysis of variance (MANOVA), a multiple hierarchical regression analysis, controlling for age and gender and a T-test for independent samples were conducted. Results The individuals with the highest levels of negative affectivity, detachment, antagonism, and psychoticism are those who simultaneously present suicidal ideation and NSSI. Moreover, age and detachment predicted higher scores in self-harm attitudes. Our results unexpectedly do not confirm an upward trend of NSSI and suicidal ideation during the pandemic period. Limitations The study is cross-sectional, and no causal links can be assumed; the groups involved were not homogeneous for numerosity. Conclusions The results testify that the study of maladaptive traits is fundamental to a greater understanding of NSSIs. Working clinically on those could potentially reduce.
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Affiliation(s)
- Francesca De Salve
- Department of Psychology, Catholic University of Milan, Largo Agostino Gemelli, 1, 20123 Milano, Italy
| | - Claudio Placenti
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Sofia Tagliabue
- Department of Mental Health and Addiction Services, Niguarda Hospital, Milan, Piazza Ospedale Maggiore, 3, 20162 Milano, Italy
| | - Chiara Rossi
- Department of Psychology, Catholic University of Milan, Largo Agostino Gemelli, 1, 20123 Milano, Italy
| | - Lara Malvini
- Department of Mental Health and Addiction Services, Niguarda Hospital, Milan, Piazza Ospedale Maggiore, 3, 20162 Milano, Italy
| | - Mauro Percudani
- Department of Mental Health and Addiction Services, Niguarda Hospital, Milan, Piazza Ospedale Maggiore, 3, 20162 Milano, Italy
| | - Osmano Oasi
- Department of Psychology, Catholic University of Milan, Largo Agostino Gemelli, 1, 20123 Milano, Italy,Corresponding author
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Oberheim ST, DePue MK, Liu R. Content development and initial psychometric analysis of the problematic hypersexuality scale. JOURNAL OF ADDICTIONS & OFFENDER COUNSELING 2022. [DOI: 10.1002/jaoc.12113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- S. Tyler Oberheim
- Counselor Education University of Florida Gainesville Florida USA
- School of Professional Studies University of Tennessee at Chattanooga Chattanooga Tennessee USA
| | - M. Kristina DePue
- Counselor Education University of Florida Gainesville Florida USA
- Department of Human Development Family Science, and Counseling, University of Nevada Reno Nevada USA
| | - Ren Liu
- Counselor Education University of Florida Gainesville Florida USA
- Department of Quantitative Methods Measurement, and Statistics, University of California Merced, Merced California USA
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Pedrini L, Meloni S, Lanfredi M, Ferrari C, Geviti A, Cattaneo A, Rossi R. Adolescents' mental health and maladaptive behaviors before the Covid-19 pandemic and 1-year after: analysis of trajectories over time and associated factors. Child Adolesc Psychiatry Ment Health 2022; 16:42. [PMID: 35689203 PMCID: PMC9186010 DOI: 10.1186/s13034-022-00474-x] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 05/11/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescents have been deeply exposed to negative consequences of social distancing imposed by Covid-19. There is a lack of longitudinal studies regarding the impact on adolescents of this unfavorable condition, and their results are controversial. The aim of the present prospective study is to assess psychopathological symptoms in adolescent students over time and to evaluate what type of impact the Covid-19 pandemic had on adolescents. Moreover, the association between mental health indexes, potential risk and resilience factors is explored. METHODS Psychopathological symptoms (i.e., anxiety, depression, stress, emotional dysregulation, maladaptive behaviours), and potential risk and resilience factors (i.e., childhood trauma, emotional regulation skills, family function, personality traits) were assessed among a sample of 153 students (72% female; mean age 16.1 ± 0.49), living in a medium-size city in the north of Italy, at two time points: before the outbreak of the Covid-19 pandemic (November 2019-January 2020) and 1 year later (April-May 2021). RESULTS After 1 year, we found an increase in mean scores on anxiety, stress for future uncertainty, and higher frequency of maladaptive behaviours. By contrast, the level of stress related to social domains (i.e., school attendance, romantic relationships, peer pressure) decreased. Dysfunctional emotional regulation skills, childhood trauma, low family functioning, and specific personality traits were associated to higher psychopathological symptoms. Cluster analysis detected three groups of youths based on their change over time in psychopathological symptoms: those who worsened (N = 23; 15%), improved (N = 55; 34%), or remained stable (N = 75; 46%). After controlling for baseline mental health status, those adolescents reporting increase in self-harm (OR = 2.61; p < 0.001), binge-drinking (OR = 3.0; p = 0.007), aggressiveness (OR 1.92; p = 0.004), and binge-eating (OR 2.55; p = 0.003) were more likely to present a worsened mental health condition. CONCLUSION The present results suggest that the Covid-19 pandemic seems to have had a different impact on subgroups of students. Indeed, we found a global worsening of psychological well-being only in a subgroup of adolescents, otherwise other students remained stable or improved. Increased frequency of maladaptive behaviors was found as a predictor of worsened mental health, therefore interventions to strengthen emotional regulation strategies are warranted. Finally, the decrease of stress in social domains could be due to reduction of potential triggering situations, thus indicating only a temporary beneficial effect that requires careful monitoring.
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Affiliation(s)
- Laura Pedrini
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Via Pilastroni, 4, Brescia, Italy.
| | - Serena Meloni
- grid.419422.8Unit of Psychiatry, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Via Pilastroni, 4, Brescia, Italy
| | - Mariangela Lanfredi
- grid.419422.8Unit of Psychiatry, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Via Pilastroni, 4, Brescia, Italy
| | - Clarissa Ferrari
- grid.419422.8Statistics Service, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Via Pilastroni, 4, Brescia, Italy
| | - Andrea Geviti
- grid.419422.8Statistics Service, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Via Pilastroni, 4, Brescia, Italy
| | - Annamaria Cattaneo
- grid.419422.8Biological Psychiatry, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Via Pilastroni, 4, Brescia, Italy ,grid.4708.b0000 0004 1757 2822Department of Pharmacological and Biomolecular Sciences, University of Milan, Milan, Italy
| | - Roberta Rossi
- grid.419422.8Unit of Psychiatry, IRCCS Istituto Centro San Giovanni Di Dio Fatebenefratelli, Via Pilastroni, 4, Brescia, Italy
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Sundar SP, Bhola P. Dimensional Personality Traits and Non-suicidal Self Injury Among Emerging Adults: The Mediating Role of Mentalization. PSYCHOLOGICAL STUDIES 2022. [DOI: 10.1007/s12646-022-00663-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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13
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Bresin K, Mekawi Y. Different Ways to Drown Out the Pain: A Meta-Analysis of the Association Between Nonsuicidal Self-Injury and Alcohol Use. Arch Suicide Res 2022; 26:348-369. [PMID: 32780651 DOI: 10.1080/13811118.2020.1802378] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE There is a significant overlap in the motivations for nonsuicidal self-injury (NSSI) and alcohol use. Moreover, several theories would predict that more frequent alcohol use is likely associated with more NSSI engagement. Still, the size and direction of this association has not been well documented in the literature. METHOD To address this gap, the goal of this article was to conduct a meta-analysis of the relation between alcohol use and NSSI. RESULTS Across 57 samples and 141,669 participants, we found that there was a significant positive association between NSSI and alcohol use, odds ratio = 1.78, 95% confidence interval [1.53, 2.07], k = 64, m = 52. Moderator analyses found that this effect was stronger for younger samples and samples with more severe alcohol use problems. CONCLUSIONS These results help establish a link between NSSI and alcohol use. Implications and future directions for NSSI research and intervention are discussed.HighlightsThere are several reasons to think that NSSI and alcohol use are linked.No reviews or meta-analyses have been conducted.We found a significant and small effect linking greater NSSI with greater alcohol use.
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14
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Forbes CN, Tull MT, Lavender JM, Dixon-Gordon KL, Gratz KL. Development and Initial Validation of the Body-focused Self-damaging Behavior Expectancies Questionnaire. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2022. [DOI: 10.1007/s10862-021-09906-y] [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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15
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Krug I, Arroyo MD, Giles S, Dang AB, Kiropoulos L, De Paoli T, Buck K, Treasure J, Fuller-Tyszkiewicz M. A new integrative model for the co-occurrence of non-suicidal self-injury behaviours and eating disorder symptoms. J Eat Disord 2021; 9:153. [PMID: 34809723 PMCID: PMC8607624 DOI: 10.1186/s40337-021-00508-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 11/07/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The high co-occurrence of non-suicidal self-injury (NSSI) behaviours and eating disorder (ED) symptoms suggests these conditions share common aetiological processes. We assessed a new integrative model of shared factors for NSSI and ED symptoms, where affect dysregulation, impulsivity, self-esteem, and body dissatisfaction mediated the relationship between insecure attachment and maladaptive schemas and NSSI and ED symptoms. A further aim of the study was to assess whether the model behaved similarly across a clinical eating disorder (ED) and a community sample. METHOD 123 females with a lifetime ED diagnosis and 531 female individuals from the community completed an online survey, which included measures assessing the variables of interest. A cross-sectional single time point analysis was used. RESULTS Invariance testing indicated that the model was structurally non-invariant (different across groups). The proposed integrative model was a good fit for the ED group, but for the community sample only a revised model reached an acceptable fit. Both attachment and maladaptive schemas, included early in the model, were implicated in the pathways leading to ED and NSSI symptoms in the ED and community groups. In the community group, impulsivity, a mediator, was a shared predictor for NSSI and bulimic symptoms. No other mediating variables were shared by NSSI and ED symptoms in the two groups. Overall, the proposed model explained slightly more variance for the ED group relative to the community group in drive for thinness (R2 = .57 vs .51) and NSSI (R2 = .29 vs .24) but less variance in bulimic symptoms (R2 = .33 vs .39). CONCLUSION We conclude that the current model provides only limited support for explaining the comorbidity between NSSI and ED symptoms. It is vital to consider both common (e.g., attachment and maladaptive schemas) and specific factors (e.g., impulsivity) to better understand the pathways that lead to the co-occurrence of NSSI and ED symptoms. A new integrative model assessed whether emotion dysregulation, impulsivity, self-esteem, and body dissatisfaction were mediators in the relationship between insecure attachment and maladaptive beliefs about the world and the self and subsequent eating disorder and self-harm symptoms. A further aim was to assess whether the proposed model differed between a clinical eating disorder and a community sample. All participants were female and included 123 patients with a lifetime eating disorder and 531 individuals from the community. Participating individuals completed an online survey at one timepoint, which included measures assessing the variables of interest. The findings of the current study indicated that the proposed model was a good match for the clinical eating disorder sample, but for the community sample only a revised model yielded acceptable statistical fit. Both insecure attachment and maladaptive beliefs about the world and the self, included early in the model, were indirectly related to eating disorder and self-harm symptoms for both the eating disorder and the community groups. Impulsivity, a mediator, was the only shared predictor for self-harm, and bulimic symptoms in the community group. We conclude that the current model provides only limited support for explaining the comorbidity between self-harming behaviours and disordered eating symptoms.
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Affiliation(s)
- Isabel Krug
- Melbourne School of Psychological Sciences, University of Melbourne Psychology Clinic, Redmond Barry, Level 7, North Melbourne, VIC, 3051, Australia.
| | - Mercedes Delgado Arroyo
- Melbourne School of Psychological Sciences, University of Melbourne Psychology Clinic, Redmond Barry, Level 7, North Melbourne, VIC, 3051, Australia.,Department of Psychiatry, University Hospital Vall de' Hebron, Barcelona, Spain
| | - Sarah Giles
- Melbourne School of Psychological Sciences, University of Melbourne Psychology Clinic, Redmond Barry, Level 7, North Melbourne, VIC, 3051, Australia
| | - An Binh Dang
- Melbourne School of Psychological Sciences, University of Melbourne Psychology Clinic, Redmond Barry, Level 7, North Melbourne, VIC, 3051, Australia
| | - Litza Kiropoulos
- Melbourne School of Psychological Sciences, University of Melbourne Psychology Clinic, Redmond Barry, Level 7, North Melbourne, VIC, 3051, Australia
| | - Tara De Paoli
- Melbourne School of Psychological Sciences, University of Melbourne Psychology Clinic, Redmond Barry, Level 7, North Melbourne, VIC, 3051, Australia
| | - Kim Buck
- Melbourne School of Psychological Sciences, University of Melbourne Psychology Clinic, Redmond Barry, Level 7, North Melbourne, VIC, 3051, Australia
| | - Janet Treasure
- Department of Psychological Medicine, Institute of Psychiatry and Neuroscience, Section of Eating Disorders, King's College London, London, UK
| | - Matthew Fuller-Tyszkiewicz
- School of Psychology, Deakin University, Geelong, VIC, Australia.,Centre for Social and Early Emotional Development, Deakin University, Burwood, VIC, Australia
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Sorgi KM, Ammerman BA, Cheung JC, Fahlgren MK, Puhalla AA, McCloskey MS. Relationships between Non-Suicidal Self-Injury and Other Maladaptive Behaviors: Beyond Difficulties in Emotion Regulation. Arch Suicide Res 2021; 25:530-551. [PMID: 31994980 DOI: 10.1080/13811118.2020.1715906] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Non-suicidal self-injury (NSSI) co-occurs with both other maladaptive behaviors (e.g., aggression) and emotion dysregulation. However, the extent to which these maladaptive behaviors are linked to NSSI independent of emotion dysregulation is unclear. The present study examined relationships between NSSI and six other maladaptive behaviors among university undergraduates. When controlling for demographic variables, emotion dysregulation, and other maladaptive behaviors, binge eating, purging, illicit drug use, and physical aggression were each related to lifetime NSSI history and/or severity. No maladaptive behaviors were significantly related to the presence of current diagnostic-level NSSI in these multivariate analyses. Results suggest that some maladaptive behaviors may relate uniquely to NSSI risk independent of emotion dysregulation, highlighting the importance of considering such behaviors in self-injury assessment and treatment.
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17
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Goddard A, Hasking P, Claes L, McEvoy P. Big Five Personality Clusters in Relation to Nonsuicidal Self-Injury. Arch Suicide Res 2021; 25:390-405. [PMID: 31769355 DOI: 10.1080/13811118.2019.1691099] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Nonsuicidal self-injury (NSSI) is a complex behavior that serves many functions and may be motivated by several factors. Although previously limited to the context of personality disorders, consideration of how general personality traits might be related to NSSI warrants examination. Our aims were to investigate whether clusters based upon the Big Five personality traits exist among people who have engaged in NSSI, and explore systematic differences with regard to gender, age, key indicators of NSSI severity, functions of NSSI, emotional avoidance, alexithymia, psychological distress, and emotion regulation strategies. A sample of 236 university students (83% female, M age = 21.59, SD = 5.43) who had engaged in NSSI completed an anonymous online questionnaire. Cluster analysis yielded three subgroups who were characterized by tendencies for resilience, dysregulation, and disagreeableness. Resilient and dyregulated profiles fell within opposite ends of a continuum with regard to severity of NSSI, psychological distress and alexithymia, and adaptive vs less adaptive emotion regulation strategies. Dysregulated characteristics were also associated with affect regulation and self-punishment functions of NSSI. Disagreeable characteristics were associated with high alexithymia and psychological distress. Implications of these findings for theory and tailored treatment approaches to NSSI are discussed.
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18
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Lanfredi M, Macis A, Ferrari C, Meloni S, Pedrini L, Ridolfi ME, Zonca V, Cattane N, Cattaneo A, Rossi R. Maladaptive behaviours in adolescence and their associations with personality traits, emotion dysregulation and other clinical features in a sample of Italian students: a cross-sectional study. Borderline Personal Disord Emot Dysregul 2021; 8:14. [PMID: 33941285 PMCID: PMC8094601 DOI: 10.1186/s40479-021-00154-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 04/08/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Emotion Dysregulation (ED), childhood trauma and personality are linked to the occurrence of maladaptive behaviours in adolescence which, in turn, may be related to increased risk for psychopathology in the life course. We sought to explore the relationship among the occurrence of different clusters of maladaptive behaviours and ED, clinical features (i.e. impulsivity, childhood maltreatment, anxiety, depressive symptoms) and personality traits that have been found to be associated to Borderline Personality Disorder (BPD), in a sample of 179 adolescent students. METHODS Multiple Correspondence Analysis (MCA) was applied to detect clustered types of maladaptive behaviours and groups of students were defined as individuals engaging in these clustered behaviours (non-suicidal self-injury-NSSI, binge eating, binge drinking, cannabis use, and sexual risk behaviours). Logistic models were used to evaluate the association among clinical scales, and student groups. Mediation analysis was used to evaluate whether clinical features affected the association between personality traits and student groups. RESULTS MCA analysis allowed to identify three student groups: NSSI/binge eating (NSSI-BE) behaviours, other maladaptive behaviours and "none". Higher scores in ED, impulsivity, childhood maltreatment, anxiety and depressive symptoms increased the risk of belonging to the cluster of NSSI-BE behaviours compared to the other two groups. ED, depression and anxiety symptoms were found to be mediators of the relationship between specific personality traits, mainly pertaining to the negative affectivity construct, and NSSI/BE. CONCLUSIONS Individuals engaging in NSSI-BE behaviours represent a vulnerable adolescent population. ED, depression and anxiety were mediators of the relationship between a variety of personality traits related to BPD and NSSI and binge eating behaviours. Findings have important clinical implications in terms of prevention and interventions among adolescents engaging in self-damaging behaviours.
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Affiliation(s)
- Mariangela Lanfredi
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, via Pilastroni 4, I-25125, Brescia, Italy.
| | - Ambra Macis
- Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Clarissa Ferrari
- Service of Statistics, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Serena Meloni
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, via Pilastroni 4, I-25125, Brescia, Italy
| | - Laura Pedrini
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, via Pilastroni 4, I-25125, Brescia, Italy
| | | | - Valentina Zonca
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Stress, Psychiatry and Immunology Laboratory, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Nadia Cattane
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Anna Cattaneo
- Biological Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Department of Pharmacological Biomolecular Sciences, University of Milan, Milano, Italy
| | - Roberta Rossi
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, via Pilastroni 4, I-25125, Brescia, Italy
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Kowalewska E, Gola M, Kraus SW, Lew-Starowicz M. Spotlight on Compulsive Sexual Behavior Disorder: A Systematic Review of Research on Women. Neuropsychiatr Dis Treat 2020; 16:2025-2043. [PMID: 32943868 PMCID: PMC7478918 DOI: 10.2147/ndt.s221540] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 08/07/2020] [Indexed: 12/16/2022] Open
Abstract
PURPOSE OF REVIEW World Health Organization recently included compulsive sexual behavior disorder (CSBD) to the upcoming 11th edition of International Classification of Diseases (6C72). Despite the potential benefits of this decision (eg, the acceleration of research in the field will allow the development of effective treatments), previous research focused mainly on men, and as a result, we do not have an accurate clinical picture of compulsive sexual behavior (CSB) among women. Therefore, in this systematic review, we aim to present available knowledge on this topical subject. Literature search was conducted in the guideline of PRISMA methodology. Studies were identified from multiple databases including Academic Search Ultimate, SocINDEX, PsycARTICLES, PsycINFO, PubMed, and MEDLINE. Out of a total of 10,531 articles identified and screened, 58 were included in this review. Included studies covered the following topics: prevalence and etiology of CSB, behavioral and cognitive processes involved, comorbidities, personality traits, psychosocial and interpersonal difficulties, traumatic experiences, and treatments. RECENT FINDINGS Available studies indicate that CSB symptom severity is lower in women than in men. Overall, women reported consuming pornography less often than men and exhibit lower rates of feeling urges to these materials. CSB symptoms (including problematic pornography use) have been found to be positively related to trait psychopathy, impulsivity, sensation seeking, attention-deficit/hyperactivity disorder symptoms, obsessive-compulsive disorder, pathological buying, sexual dysfunctions, general psychopathology, child sexual abuse, while negatively related to dispositional mindfulness. SUMMARY Conclusions that can be drawn from prior studies are considerably limited. There are no accurate estimates of the CSB prevalence or severity among women, and studies have been mostly conducted on non-clinical populations, which has limited application for women diagnosed with CSBD.
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Affiliation(s)
- Ewelina Kowalewska
- Department of Psychiatry, Centre of Postgraduate Medical Education, Warsaw, Poland
| | - Mateusz Gola
- Swartz Center for Computational Neuroscience, Institute for Neural Computations, University of California, San Diego, CA, USA
- Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Shane W Kraus
- Department of Psychology, University of Nevada, Las Vegas, NV, USA
| | - Michal Lew-Starowicz
- Department of Psychiatry, Centre of Postgraduate Medical Education, Warsaw, Poland
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20
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Gromatsky MA, He S, Perlman G, Klein DN, Kotov R, Waszczuk MA. Prospective Prediction of First Onset of Nonsuicidal Self-Injury in Adolescent Girls. J Am Acad Child Adolesc Psychiatry 2020; 59:1049-1057. [PMID: 31445872 DOI: 10.1016/j.jaac.2019.08.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2018] [Revised: 07/18/2019] [Accepted: 08/15/2019] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Adolescent nonsuicidal self-injury (NSSI) is a significant risk factor for suicidal behavior and an important clinical marker of psychopathology. NSSI is especially common in adolescent girls. A number of psychosocial correlates of adolescent NSSI have been identified, including problems characterized by disinhibition and negative affectivity. However, it is unknown whether these characteristics prospectively predict first-onset NSSI, limiting our understanding of its etiology and prevention. The current study addresses this gap in the literature. METHOD Participants in the Adolescent Development of Emotion and Personality Traits (ADEPT) project at Stony Brook University who had not experienced NSSI at baseline (462 girls, mean age = 14.39 years, SD = 0.62 years) completed baseline measures of hypothesized risk factors related to problems with disinhibition and negative affectivity, including adolescent psychopathology, personality and clinical traits, and parental psychopathology. First onset of NSSI was monitored at 9-month intervals by in-person and telephone interviews over the next 36 months. RESULTS There were 42 first onsets of NSSI (9.1%) in the 3 years since baseline. First-onset NSSI was independently predicted by adolescents' low conscientiousness, high avoidance, and parental substance abuse at baseline. The composite risk index predicting first-onset NSSI demonstrated good accuracy for identifying girls who will start self-injuring (area under the curve = 0.78, sensitivity = 0.85, specificity = 0.57). CONCLUSION These results highlight the role of disinhibition and avoidance in the development of NSSI. The risk index predicting NSSI onset may help to guide the design and application of novel interventions to prevent this condition in adolescent girls.
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21
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Personality traits and dysfunctional construal of online health promotion messages. Eat Weight Disord 2019; 24:1137-1144. [PMID: 29058272 DOI: 10.1007/s40519-017-0451-4] [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: 05/08/2017] [Accepted: 10/04/2017] [Indexed: 10/18/2022] Open
Abstract
PURPOSE With the Internet becoming increasingly popular as a source of information, blogs offering healthy lifestyle techniques and knowledge have become popular and accessible. Despite their focus on health, these blogs portray content that may be negatively construed by viewers, especially those with or at risk for eating disorders. The present study investigated changes in affect and self-esteem after viewing a prototypic health blog. Personality traits, specifically neuroticism and conscientiousness, were also investigated. METHODS A prototypic health blog was constructed after extensive review of existing blogs. A parallel format was then followed to create a home décor website for a control condition. Female undergraduate students were randomly assigned to one of two blog sites, and participants completed an earlier personality assessment and post-viewing study questionnaires. RESULTS Contrary to the hypothesis that readers of the health blog will report more negative outcomes, no main effect of blog condition was found. However, individuals high in trait neuroticism experienced greater differences in negative affect, but not self-esteem, when viewing the health blog versus the control blog. CONCLUSIONS This study found that viewing health blogs did not have immediate effects on affect and self-esteem, but more neurotic individuals were more inclined to experience negative affect when viewing health promotion messages. Personality traits assessed prior to the experiment were more predictive of negative affect and self-esteem during the experiment than blog viewing conditions. No level of evidence, experimental study.
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22
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Personality Correlates of Self-Injury in Adolescent Girls: Disentangling the Effects of Lifetime Psychopathology. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2019; 46:1677-1685. [PMID: 29488108 DOI: 10.1007/s10802-018-0403-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Adolescent non-suicidal self-injury (aNSSI) is associated with abnormal scores on personality traits, such as high neuroticism. However, no studies to date have examined personality facets of self-injury in a cohort younger than college-age. Plus, adolescent psychopathologies, especially Depressive Disorders, are associated with a similar personality profile and are highly comorbid with aNSSI. Consequently, it remains unclear whether personality provides insights about aNSSI in youth beyond that due to underlying psychopathology. 550 community-dwelling 13- to 15-year-old never-depressed adolescent girls were interviewed for lifetime aNSSI and lifetime psychopathology. Personality traits, broad domains and specific facets, were assessed by self-report. Never-depressed adolescent girls who endorse aNSSI often met lifetime criteria for psychiatric disorders (NSSI: 20/43; 46.5% vs. non-aNSSI: 131/507; 26.1%). aNSSI and lifetime psychopathology were each independently associated with several traits (e.g., high neuroticism and conscientiousness), whereas some traits only discriminated aNSSI (e.g., high melancholia, a facet of neuroticism related to sadness and negative self-evaluation) or lifetime psychopathology independent of each other (e.g., low positive emotionality; low agreeableness). Furthermore, a multivariate model identified high melancholia, high openness to experience, and low conscientiousness as incrementally independent correlates of lifetime aNSSI over and above psychiatric illness. Proneness to melancholia, interest in new things, and poor self-control incrementally track aNSSI in never-depressed adolescent girls. Importantly, this emerges early in course (13-15 years of age) and is independent of lifetime psychiatric diagnosis. Implications for updating etiological models and clinical utility of personality assessment are discussed.
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Kolbeck K, Moritz S, Bierbrodt J, Andreou C. Borderline Personality Disorder: Associations Between Dimensional Personality Profiles and Self-Destructive Behaviors. J Pers Disord 2019; 33:249-261. [PMID: 29505390 DOI: 10.1521/pedi_2018_32_346] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Ongoing research is shifting towards a dimensional understanding of borderline personality disorder (BPD). Aim of this study was to identify personality profiles in BPD that are predictive of self-destructive behaviors. Personality traits were assessed (n = 130) according to the five-factor model of personality (i.e., Neuroticism, Extraversion, Openness to Experience, Agreeableness, Conscientiousness) and an additional factor called Risk Preference. Self-destructive behavior parameters such as non-suicidal self-injury (NSSI) and other borderline typical dyscontrolled behaviors (e.g., drug abuse) were assessed by self-report measures. Canonical correlation analyses demonstrated that Neuroticism, Extraversion, and Conscientiousness are predictors of NSSI. Further, Neuroticism, Agreeableness, and Risk Preference were associated with dyscontrolled behaviors. Our results add further support on personality-relevant self-destructive behaviors in BPD. A combined diagnostic assessment could offer clinically meaningful insights about the causes of self-destruction in BPD to expand current therapeutic repertoires.
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Affiliation(s)
- Katharina Kolbeck
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg, Hamburg, Germany
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg, Hamburg, Germany
| | - Julia Bierbrodt
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg, Hamburg, Germany
| | - Christina Andreou
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg, Hamburg, Germany.,Center for Psychotic Disorders, University Psychiatric Clinics, University of Basel, Switzerland
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Shanahan N, Brennan C, House A. Self-harm and social media: thematic analysis of images posted on three social media sites. BMJ Open 2019; 9:e027006. [PMID: 30782950 PMCID: PMC6367987 DOI: 10.1136/bmjopen-2018-027006] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 12/12/2018] [Accepted: 12/13/2018] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To explore the nature of images tagged as self-harm on popular social media sites and what this might tell us about how these sites are used. DESIGN A visual content and thematic analysis of a sample of 602 images captured from Twitter, Instagram and Tumblr. RESULTS Over half the images tagged as self-harm had no explicit representation of self-harm. Where there was explicit representation, self-injury was the most common; none of these portrayed images of graphic or shocking self-injury. None of the images we captured specifically encouraged self-harm or suicide and there was no image that could be construed as sensationalising self-harm.Four themes were found across the images: communicating distress, addiction and recovery, gender and the female body, identity and belonging. CONCLUSIONS Findings suggest that clinicians should not be overly anxious about what is being posted on social media. Although we found a very few posts suggesting self-injury was attractive, there were no posts that could be viewed as actively encouraging others to self-harm. Rather, the sites were being used to express difficult emotions in a variety of creative ways, offering inspiration to others through the form of texts or shared messages about recovery.
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Affiliation(s)
- Nicola Shanahan
- Division of Psychological and Social Medicine, University of Leeds, Leeds, UK
| | - Cathy Brennan
- Division of Psychological and Social Medicine, University of Leeds, Leeds, UK
| | - Allan House
- Division of Psychological and Social Medicine, University of Leeds, Leeds, UK
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25
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Victor SE, Muehlenkamp JJ, Hayes NA, Lengel GJ, Styer DM, Washburn JJ. Characterizing gender differences in nonsuicidal self-injury: Evidence from a large clinical sample of adolescents and adults. Compr Psychiatry 2018; 82:53-60. [PMID: 29407359 PMCID: PMC5845831 DOI: 10.1016/j.comppsych.2018.01.009] [Citation(s) in RCA: 54] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2017] [Revised: 12/12/2017] [Accepted: 01/15/2018] [Indexed: 10/18/2022] Open
Abstract
While nonsuicidal self-injury (NSSI) is common in both men and women, research exploring the intersection of NSSI and gender has been limited by the use of small samples of males drawn primarily from non-clinical populations. To address these limitations, we analyzed data from a large sample of patients enrolled in an NSSI partial hospitalization program (PHP) to compare males and females across several variables, including NSSI characteristics, correlates, and pre-post treatment outcomes. Results indicated similar NSSI characteristics and treatment outcomes for males and females, with few exceptions. Males notably reported lower severity levels for most NSSI correlates (e.g., psychopathology, suicidality), highlighting the need to screen males for NSSI even when reporting comparatively less impairment. Finally, our results also suggest that PHP treatment for NSSI can be beneficial for both males and females. These findings have implications for the assessment, diagnosis, conceptualization, and treatment of NSSI in males and females.
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Affiliation(s)
- Sarah E Victor
- University of Pittsburgh School of Medicine, 201 North Craig Street Suite 408, Pittsburgh, PA 15213, USA.
| | - Jennifer J Muehlenkamp
- University of Wisconsin - Eau Claire, Hibbard Hall 277, 105 Garfield Avenue, Eau Claire, WI 54701, USA
| | - Nicole A Hayes
- Northwestern University Feinberg School of Medicine, Abbott Hall Suite 1204, 710 N Lake Shore Drive, Chicago, IL 60611, USA
| | - Gregory J Lengel
- Drake University, 323 Olin Hall, 2708 Forest Ave, Des Moines, IA 50311, USA
| | - Denise M Styer
- AMITA Health Alexian Brothers Behavioral Health Hospital, 1650 Moon Lake Boulevard, Hoffman Estates, IL 60169, USA
| | - Jason J Washburn
- Northwestern University Feinberg School of Medicine, Abbott Hall Suite 1204, 710 N Lake Shore Drive, Chicago, IL 60611, USA; AMITA Health Alexian Brothers Behavioral Health Hospital, 1650 Moon Lake Boulevard, Hoffman Estates, IL 60169, USA
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Fox KR, Ribeiro JD, Kleiman EM, Hooley JM, Nock MK, Franklin JC. Affect toward the self and self-injury stimuli as potential risk factors for nonsuicidal self-injury. Psychiatry Res 2018; 260:279-285. [PMID: 29223043 DOI: 10.1016/j.psychres.2017.11.083] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 11/27/2017] [Accepted: 11/27/2017] [Indexed: 11/19/2022]
Abstract
Few risk factors for nonsuicidal self-injury (NSSI) have been identified. This study investigated diminished aversion toward self-injury (i.e., NSSI, suicide/death stimuli) and self-criticism as unique NSSI risk factors. After terminating a treatment study, 154 adults with a recent and frequent NSSI history completed self-report and computer-based measures of psychopathology, implicit and explicit self-criticism, and implicit aversion to NSSI and suicide/death. Participants were then contacted 4 weeks later to test factors predicting NSSI frequency over this follow-up period. Diminished aversion toward NSSI stimuli and self-criticism significantly predicted NSSI 4 weeks later. These effects were unique from other theoretically important predictors, such as past week NSSI frequency and total number of NSSI methods used. Findings provide support that erosion of barriers to NSSI (e.g., aversion to self-injurious stimuli, decreased self-worth) may facilitate continued engagement in these dangerous behaviors. Results shed light on potential treatment targets for NSSI.
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Affiliation(s)
- Kathryn R Fox
- Department of Psychology, Harvard University, Cambridge, MA, USA.
| | - Jessica D Ribeiro
- Department of Psychology, Florida State University, Tallahassee, FL, USA; Military Suicide Research Consortium, USA
| | - Evan M Kleiman
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Jill M Hooley
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Matthew K Nock
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Joseph C Franklin
- Department of Psychology, Florida State University, Tallahassee, FL, USA
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Jardin C, Sharp C, Garey L, Vanwoerden S, Crist N, Elhai JD, Zvolensky MJ. Compelled to Risk: Does Sexual Compulsivity Explain the Connection Between Borderline Personality Disorder Features and Number of Sexual Partners? J Pers Disord 2017; 31:738-752. [PMID: 28072043 DOI: 10.1521/pedi_2017_31_277] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Having more sexual partners increases the likelihood of new HIV infections among women. Women with more borderline personality disorder (BPD) features have been known to have greater numbers of sexual partners. However, the mechanisms linking BPD features with more sexual partners remain to be clarified. Sexual compulsivity (lack of control, increased distress over sexual behavior) may be one such explanatory factor, as it overlaps with BPD features (e.g., impulsivity, negative affectivity). The present study examined whether sexual compulsivity explained the relation of BPD features with number of sexual partners among a diverse sample of college females (N = 1,326). Results demonstrated a significant indirect effect of BPD features via sexual compulsivity on number of sexual partners. These findings support the relation between BPD features and sexual compulsivity and suggest sexual compulsivity as a target in the promotion of the sexual health of women with BPD who demonstrate risky sexual practices.
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Affiliation(s)
- Charles Jardin
- Department of Psychology, University of Houston, Houston, Texas
| | - Carla Sharp
- Department of Psychology, University of Houston, Houston, Texas.,Adolescent Treatment Program, The Menninger Clinic, Houston, Texas
| | - Lorra Garey
- Department of Psychology, University of Houston, Houston, Texas
| | | | - Nic Crist
- Department of Psychology, University of Houston, Houston, Texas
| | - Jon D Elhai
- Department of Psychology and Department of Psychiatry, University of Toledo, Toledo, Ohio
| | - Michael J Zvolensky
- Department of Psychology, University of Houston, Houston, Texas.,Department of Behavioral Sciences, University of Texas MD Anderson Cancer Center, Houston, Texas
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Turner BJ, Jin HM, Anestis MD, Dixon-Gordon KL, Gratz KL. Personality pathology and intentional self-harm: cross-cutting insights from categorical and dimensional models. Curr Opin Psychol 2017; 21:55-59. [PMID: 29017093 DOI: 10.1016/j.copsyc.2017.09.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Revised: 09/08/2017] [Accepted: 09/14/2017] [Indexed: 02/07/2023]
Abstract
This paper reviews current literature on the links between personality pathology and intentional self-harm, including nonsuicidal self-injury (NSSI) and suicidal behaviors. Specifically, this review highlights recent advances stemming from longitudinal, epidemiological, and health registry studies, as well as emerging research on pathological personality traits and intentional self-harm, and integrates current knowledge across dimensional and categorical frameworks to provide recommendations for clinical practice and future research. This review provides strong evidence that personality disorders marked by intense and unstable negative affect, detachment/low extraversion, aggression/hostility, and specific facets of impulsivity may be considered risk factors for suicidal behaviors. Further, there is some evidence of a stronger relation between maladaptive personality traits and suicidal versus non-suicidal intentional self-harm.
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Affiliation(s)
- Brianna J Turner
- Department of Psychology, University of Victoria, PO Box 1700 STN CSC, Victoria, BC, Canada V8W 2Y2
| | - Hyejin M Jin
- Department of Psychology, University of Southern Mississippi, 118 College Drive, Box #5025, Hattiesburg, MS 39406, USA
| | - Michael D Anestis
- Department of Psychology, University of Southern Mississippi, 118 College Drive, Box #5025, Hattiesburg, MS 39406, USA
| | - Katherine L Dixon-Gordon
- Department of Psychological and Brain Sciences, University of Massachusetts, 135 Hicks Way, Amherst, MA 01003, USA
| | - Kim L Gratz
- Department of Psychology, University of Toledo, 2801 West Bancroft Street, Toledo, OH 43606, USA.
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Benjet C, González-Herrera I, Castro-Silva E, Méndez E, Borges G, Casanova L, Medina-Mora ME. Non-suicidal self-injury in Mexican young adults: Prevalence, associations with suicidal behavior and psychiatric disorders, and DSM-5 proposed diagnostic criteria. J Affect Disord 2017; 215:1-8. [PMID: 28288307 DOI: 10.1016/j.jad.2017.03.025] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 02/23/2017] [Accepted: 03/08/2017] [Indexed: 01/26/2023]
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) may lead to scarring, infection, accidental death and psychological distress. Little is known about NSSI in the general population of young adults in developing countries like Mexico. The current study examined the prevalence of any NSSI and each type of NSSI, the prevalence of meeting DSM-5 proposed criteria, and finally the association of NSSI with socio-demographic variables, suicidal behavior and psychiatric disorders. METHODS This study was conducted in a community sample of 1071 young adults between 19 and 26 years of age residents of Mexico City. RESULTS The lifetime prevalence of NSSI was 18.56% with females having 87% greater odds. The 12-month prevalence was 3.19%. Only 0.22% of the total sample and 6.96% of those that self-injured in the past 12 months met full criteria proposed by DSM-5, in part due to the lack of reported impairment; 39.99% of those that self-injured reported impairment. Suicidal behavior commonly co-occurred with NSSI. All lifetime anxiety, mood, disruptive behavior and substance use disorders were associated with greater risk for lifetime NSSI whereas only 12-month depression and substance use disorder was associated with greater risk of 12-month NSSI. LIMITATIONS The cross-sectional nature of the study precludes conclusions of causality and directionality and the study excluded institutionalized and homeless young adults. CONCLUSIONS NSSI is a concerning problem in young adults from Mexico City due to the important associations with all types of psychiatric disorders and suicidal behavior. Because many who self-injure do not perceive impairment, they are unlikely to seek treatment.
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Affiliation(s)
- Corina Benjet
- National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico.
| | | | | | - Enrique Méndez
- National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico
| | - Guilherme Borges
- National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico
| | - Leticia Casanova
- National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico
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Abstract
Abstract. Background: Alcohol use and nonsuicidal self-injury (NSSI) appear to share a conceptual overlap in functions (e.g., tension reduction). Alcohol use has been identified as a risk factor for NSSI, and higher rates of alcohol use have been documented among those with NSSI history. Aims: This study examined whether NSSI-related alcohol expectancies affect relations between NSSI and alcohol use. Method: Participants were 367 college students (73% female) asked to complete an online survey about their drinking behavior and lifetime NSSI. Results: NSSI and alcohol use were highly prevalent in this sample: 56% endorsed lifetime NSSI and 74% endorsed current alcohol use. Of note, 43% (n = 147) endorsed both behaviors. Positive NSSI-related alcohol expectancies showed a significant association with lifetime NSSI. In addition, positive NSSI-related alcohol expectancies were associated with more frequent drinking behavior for individuals with a history of NSSI, particularly those who had engaged in two or more methods of lifetime NSSI. Conclusion: Alcohol use and NSSI represent high-risk behaviors commonly employed to regulate unwanted affective states. Interventions targeting substance use and/or NSSI may consider assessing positive NSSI and substance use expectancies, as the presence of these beliefs suggests a higher risk profile.
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Temperament and character traits in female adolescents with nonsuicidal self-injury disorder with and without comorbid borderline personality disorder. Child Adolesc Psychiatry Ment Health 2017; 11:4. [PMID: 28101133 PMCID: PMC5237331 DOI: 10.1186/s13034-016-0142-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 12/21/2016] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Temperament and character traits of adolescents with nonsuicidal self-injury disorder (NSSI) might differentiate those- with and without comorbid borderline personality disorder (BPD). METHODS Participants were 57 female adolescents with NSSI disorder without BPD (NSSI - BPD), 14 adolescents with NSSI disorder and BPD (NSSI + BPD), 32 clinical controls (CC), and 64 nonclinical controls (NC). Temperament and character traits were assessed with the Junior Temperament and Character Inventory, and impulsivity with the Barratt Impulsiveness Scale and a Go/NoGo task. RESULTS Adolescents with NSSI disorder scored significantly higher on novelty seeking and harm avoidance and lower on persistence, self-directedness, and cooperativeness than CC. The NSSI + BPD group scored even higher than the NSSI - BPD group on novelty seeking and harm avoidance and lower on persistence and cooperativeness (d ≥ 0.72). Adolescents with NSSI reported higher levels of impulsivity than the CC and NC group. However, this difference was not found in a Go/NoGo task. CONCLUSIONS The results provide further evidence for a distinct diagnostic entity of NSSI disorder.
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You J, Lin MP, Xu S, Hu WH. Big Five personality traits in the occurrence and repetition of nonsuicidal self-injury among adolescents: The mediating effects of depressive symptoms. PERSONALITY AND INDIVIDUAL DIFFERENCES 2016. [DOI: 10.1016/j.paid.2016.05.057] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Mikheeva OV, Tragesser SL. Personality features, disordered eating, and alcohol use among college students: A latent profile analysis. PERSONALITY AND INDIVIDUAL DIFFERENCES 2016. [DOI: 10.1016/j.paid.2016.02.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Fox KR, Franklin JC, Ribeiro JD, Kleiman EM, Bentley KH, Nock MK. Meta-analysis of risk factors for nonsuicidal self-injury. Clin Psychol Rev 2015; 42:156-67. [PMID: 26416295 PMCID: PMC4772426 DOI: 10.1016/j.cpr.2015.09.002] [Citation(s) in RCA: 260] [Impact Index Per Article: 28.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Revised: 08/25/2015] [Accepted: 09/10/2015] [Indexed: 11/19/2022]
Abstract
Nonsuicidal self-injury (NSSI) is a prevalent and dangerous phenomenon associated with many negative outcomes, including future suicidal behaviors. Research on these behaviors has primarily focused on correlates; however, an emerging body of research has focused on NSSI risk factors. To provide a summary of current knowledge about NSSI risk factors, we conducted a meta-analysis of published, prospective studies longitudinally predicting NSSI. This included 20 published reports across 5078 unique participants. Results from a random-effects model demonstrated significant, albeit weak, overall prediction of NSSI (OR=1.59; 95% CI: 1.50 to 1.69). Among specific NSSI risk factors, prior history of NSSI, cluster b, and hopelessness yielded the strongest effects (ORs>3.0); all remaining risk factor categories produced ORs near or below 2.0. NSSI measurement, sample type, sample age, and prediction case measurement type (i.e., binary versus continuous) moderated these effects. Additionally, results highlighted several limitations of the existing literature, including idiosyncratic NSSI measurement and few studies among samples with NSSI histories. These findings indicate that few strong NSSI risk factors have been identified, and suggest a need for examination of novel risk factors, standardized NSSI measurement, and study samples with a history of NSSI.
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Affiliation(s)
- Kathryn R Fox
- Department of Psychology, Harvard University, United States.
| | | | - Jessica D Ribeiro
- Department of Psychology, Harvard University, United States; Military Suicide Research Consortium, United States
| | - Evan M Kleiman
- Department of Psychology, Harvard University, United States
| | - Kate H Bentley
- Center for Anxiety and Related Disorders, Boston University, United States
| | - Matthew K Nock
- Department of Psychology, Harvard University, United States
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Kiekens G, Bruffaerts R, Nock M, Van de Ven M, Witteman C, Mortier P, Demyttenaere K, Claes L. Non-Suicidal Self-Injury Among Dutch and Belgian Adolescents: Personality, Stress and Coping. Eur Psychiatry 2015; 30:743-9. [DOI: 10.1016/j.eurpsy.2015.06.007] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2015] [Revised: 05/28/2015] [Accepted: 06/22/2015] [Indexed: 10/23/2022] Open
Abstract
AbstractBackgroundThis study examines: (1) the prevalence of Non-Suicidal Self-Injury (NSSI) among Dutch and Belgian adolescents, (2) the associations between Big Five personality traits and NSSI engagement/versatility (i.e., number of NSSI methods), and (3) whether these associations are mediated by perceived stress and coping.MethodsA total of 946 Flemish (46%) and Dutch (54%) non-institutionalized adolescents (Mean age = 15.52; SD = 1.34, 44% females) were surveyed. Measures included the NSSI subscale of the Self-Harm-Inventory, the Dutch Quick Big Five Personality questionnaire, the Perceived Stress Scale and the Utrecht Coping List for Adolescents. Examination of zero-order correlations was used to reveal associations, and hierarchical regression analysis was used to reveal potential mediators which were further examined within parallel mediation models by using a bootstrapping-corrected procedure.ResultsLifetime prevalence of NSSI was 24.31%. Neuroticism; perceived stress; and distractive, avoidant, depressive, and emotional coping were positively associated with NSSI engagement, whereas Agreeableness, Conscientiousness; and active, social, and optimistic coping were negatively associated with NSSI engagement. Observed relationships between personality traits and NSSI engagement were consistently explained by perceived stress and depressive coping. A higher versatility of NSSI was not associated with any Big Five personality trait, but was associated with higher scores on perceived stress and depressive coping and with lower scores on active and optimistic coping.ConclusionOur study suggests that a specific personality constellation is associated with NSSI engagement via high stress levels and a typical depressive reaction pattern to handle stressful life events.
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Kress VE, Newgent RA, Whitlock J, Mease L. Spirituality/Religiosity, Life Satisfaction, and Life Meaning as Protective Factors for Nonsuicidal Self-Injury in College Students. JOURNAL OF COLLEGE COUNSELING 2015. [DOI: 10.1002/jocc.12012] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Victoria E. Kress
- Department of Counseling, Special Education, and School Psychology; Youngstown State University
| | - Rebecca A. Newgent
- Department of Counselor Education; Western Illinois University-Quad Cities
| | - Janis Whitlock
- Bronfenbrenner Center for Translational Research; Cornell University
| | - Laura Mease
- Department of Counseling, Special Education, and School Psychology; Youngstown State University
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Bresin K, Schoenleber M. Gender differences in the prevalence of nonsuicidal self-injury: A meta-analysis. Clin Psychol Rev 2015; 38:55-64. [DOI: 10.1016/j.cpr.2015.02.009] [Citation(s) in RCA: 288] [Impact Index Per Article: 32.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2014] [Revised: 02/21/2015] [Accepted: 02/27/2015] [Indexed: 11/16/2022]
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The association between nonsuicidal self-injury and the emotional disorders: A meta-analytic review. Clin Psychol Rev 2015; 37:72-88. [DOI: 10.1016/j.cpr.2015.02.006] [Citation(s) in RCA: 119] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 02/16/2015] [Accepted: 02/17/2015] [Indexed: 12/27/2022]
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Kharsati N, Bhola P. Patterns of non-suicidal self-injurious behaviours among college students in India. Int J Soc Psychiatry 2015; 61:39-49. [PMID: 24869850 DOI: 10.1177/0020764014535755] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Non-suicidal self-injurious behaviour (NSSI) is a growing concern among youth and rarely reaches the attention of mental health and medical services. AIMS The study explored the occurrence, methods, characteristics and reported reasons for NSSI among a sample of college students in India. METHODS A total of 470 participants from undergraduate and postgraduate colleges completed the Functional Assessment of Self Mutilation (FASM) questionnaire. RESULTS Results indicated that 31.2% of the participants reported NSSI in the past year, with the mean age of onset being 15.9 years. Moderate/severe forms of NSSI were reported by 19.8% of the sample. The most common method was self-hitting (15.2%) followed by cutting or carving skin (13.2%). A majority of self-injurers endorsed multiple methods of NSSI, and there were no significant gender differences in NSSI rates. The NSSI was performed both to regulate internal emotional states (automatic reinforcement) and to influence others in the environment (social reinforcement).The most commonly endorsed reasons for NSSI were 'to feel relaxed' and 'to get control of the situation', while the least frequently endorsed reasons were 'to make others angry' and 'to avoid college, work, or other activities'. CONCLUSION The findings underscore the need to increase the awareness and understanding of NSSIs and to plan targeted interventions among college youth.
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Affiliation(s)
| | - Poornima Bhola
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bangalore, India
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Swannell SV, Martin GE, Page A, Hasking P, St John NJ. Prevalence of nonsuicidal self-injury in nonclinical samples: systematic review, meta-analysis and meta-regression. Suicide Life Threat Behav 2014; 44:273-303. [PMID: 24422986 DOI: 10.1111/sltb.12070] [Citation(s) in RCA: 849] [Impact Index Per Article: 84.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Accepted: 08/28/2013] [Indexed: 12/13/2022]
Abstract
Published prevalence estimates of nonsuicidal self-injury (NSSI) among nonclinical samples are highly heterogeneous, raising concerns about their reliability and hindering attempts to explore the alleged increase in NSSI over time. Accordingly, the objectives of this study were to investigate the influence of methodological factors on heterogeneity in NSSI prevalence estimates, explore changes over time, and estimate overall international NSSI prevalence. Results showed that methodological factors contributed over half (51.6%) of the heterogeneity in prevalence estimates, and, after adjusting for these factors, NSSI prevalence did not increase over time. Overall, pooled NSSI prevalence was 17.2% among adolescents, 13.4% among young adults, and 5.5% among adults. Clearly, development of standardized methodology in NSSI research is crucial if accurate estimates are desired.
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Affiliation(s)
- Sarah V Swannell
- School of Medicine, The University of Queensland, Brisbane, Qld, Australia
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Young R, Sproeber N, Groschwitz RC, Preiss M, Plener PL. Why alternative teenagers self-harm: exploring the link between non-suicidal self-injury, attempted suicide and adolescent identity. BMC Psychiatry 2014; 14:137. [PMID: 24885081 PMCID: PMC4067739 DOI: 10.1186/1471-244x-14-137] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2013] [Accepted: 05/05/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The term 'self-harm' encompasses both attempted suicide and non-suicidal self-injury (NSSI). Specific adolescent subpopulations such as ethnic or sexual minorities, and more controversially, those who identify as 'Alternative' (Goth, Emo) have been proposed as being more likely to self-harm, while other groups such as 'Jocks' are linked with protective coping behaviours (for example exercise). NSSI has autonomic (it reduces negative emotions) and social (it communicates distress or facilitates group 'bonding') functions. This study explores the links between such aspects of self-harm, primarily NSSI, and youth subculture. METHODS An anonymous survey was carried out of 452 15 year old German school students. Measures included: identification with different youth cultures, i.e. Alternative (Goth, Emo, Punk), Nerd (academic) or Jock (athletic); social background, e.g. socioeconomic status; and experience of victimisation. Self-harm (suicide and NSSI) was assessed using Self-harm Behavior Questionnaire and the Functional Assessment of Self-Mutilation (FASM). RESULTS An "Alternative" identity was directly (r ≈ 0.3) and a "Jock" identity inversely (r ≈ -0.1) correlated with self-harm. "Alternative" teenagers self-injured more frequently (NSSI 45.5% vs. 18.8%), repeatedly self-injured, and were 4-8 times more likely to attempt suicide (even after adjusting for social background) than their non-Alternative peers. They were also more likely to self-injure for autonomic, communicative and social reasons than other adolescents. CONCLUSIONS About half of 'Alternative' adolescents' self-injure, primarily to regulate emotions and communicate distress. However, a minority self-injure to reinforce their group identity, i.e. 'To feel more a part of a group'.
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Affiliation(s)
- Robert Young
- MRC Social and Public Health Sciences Unit, University of Glasgow, Glasgow G12 8RZ, Scotland.
| | - Nina Sproeber
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Steinhoevelstr. 5, D- 89075 Ulm, Germany
| | - Rebecca C Groschwitz
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Steinhoevelstr. 5, D- 89075 Ulm, Germany
| | - Marthe Preiss
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Steinhoevelstr. 5, D- 89075 Ulm, Germany
| | - Paul L Plener
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Steinhoevelstr. 5, D- 89075 Ulm, Germany
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Abstract
Nonsuicidal self-injury (NSSI) has a high prevalence among the general undergraduate population, but as yet, no study has investigated the rate of NSSI among medical students despite the high levels of depression and suicidal ideation found in this population. Our study aimed to estimate the prevalence of NSSI and suicide attempts in German medical students and explore the associations between these behaviors and the five major personality traits. Seven hundred fourteen medical students (67% women; age range, 18-35 years; mean age, 23.1 years) participated in an online survey. We report a lifetime prevalence of 14.3% for NSSI and 1.5% for suicide attempt. The students with NSSI showed higher levels of neuroticism and openness to experience but lower levels of conscientiousness and extraversion on the NEO Five-Factor Inventory. Our results are in line with previous research from other countries regarding the prevalence of NSSI among students and its association with personality.
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Bracken-Minor KL, McDevitt-Murphy ME. Differences in features of non-suicidal self-injury according to borderline personality disorder screening status. Arch Suicide Res 2014; 18:88-103. [PMID: 24354453 DOI: 10.1080/13811118.2013.809040] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Given that non-suicidal self-injury (NSSI) disorder is being considered for the upcoming Diagnostic and Statistical Manual of Mental Disorders (DSM-5), it is important to consider how NSSI occurs with and without borderline personality disorder (BPD). Participants were 480 undergraduates who completed online questionnaires and were assigned to 4 groups based on NSSI and BPD status. Analyses revealed BPD-positive self-injurers had higher self-punishment, anti-suicide, and anti-dissociation functions of NSSI and higher rates of cutting and burning than BPD-negative self-injurers. Furthermore, difficulty in emotion regulation, not distress tolerance, was most critical in distinguishing between groups. Differences between BPD-positive and BPD-negative self-injurers provide preliminary support for NSSI as a distinct disorder. However, more research in this area is needed.
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Non-suicidal self-injury (functions) in eating disorders: Associations with reactive and regulative temperament. PERSONALITY AND INDIVIDUAL DIFFERENCES 2014. [DOI: 10.1016/j.paid.2013.09.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Bresin K. Five indices of emotion regulation in participants with a history of nonsuicidal self-injury: a daily diary study. Behav Ther 2014; 45:56-66. [PMID: 24411115 DOI: 10.1016/j.beth.2013.09.005] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2013] [Revised: 09/16/2013] [Accepted: 09/19/2013] [Indexed: 11/18/2022]
Abstract
Theory has proposed that nonsuicidal self-injury (NSSI) is a response to intense frequent negative affect (NA) that is difficult to control. Therefore, individual differences that are related to emotion dysregulation should be higher in individuals who engage in NSSI compared to healthy controls. Though current research supports this prediction, this research could be strengthened by corroborating evidence from daily diary studies. The current study used a daily diary protocol to thoroughly examine the emotional correlates of NSSI. Individuals with and without a history of NSSI rated their affect daily for 14 days. This information was used to score multiple indices of emotionality (e.g., mean level, within-person variation, reactivity). The results showed that compared to controls, individuals who engaged in NSSI had higher mean levels, within-person variation, and lower emotional differentiation of NA, but groups did not differ on inertia of NA or reactivity of NA. Moreover, individuals with a history of NSSI reported lower levels of positive affect and lower inertia of positive affect. These results are discussed in terms of affect regulation models of NSSI and treatment implications.
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Dir AL, Karyadi K, Cyders MA. The uniqueness of negative urgency as a common risk factor for self-harm behaviors, alcohol consumption, and eating problems. Addict Behav 2013; 38:2158-62. [PMID: 23454879 DOI: 10.1016/j.addbeh.2013.01.025] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2012] [Accepted: 01/31/2013] [Indexed: 11/16/2022]
Abstract
Research suggests that self-control, affective lability, and negative urgency are associated with deliberate self-harm, problematic alcohol consumption, and eating problems. Few studies have fully examined how negative urgency might uniquely explain the effects of self-control and affective lability on these outcomes, as compared to other impulsivity-related traits. This was the goal of the current study. Of an initial group of 734 undergraduate students, 29% indicated a history of deliberate self-harm. These 215 individuals were randomly matched with a group of non-self-harmers (total N=430; mean age=22.36, SD=6.59; 76.2% female). Self-harmers showed higher rates of alcohol use (F(2, 186)=5.48, p<.001) and eating problems (F(2, 186)=7.74, p<.001). In a structural equation model, negative urgency was significantly associated with self-harming frequency (β=3.81, p<.001), variety of self-harm methods (β=5.79, p<.001), the number of years of self-harming (β=2.75, p<.001), problematic alcohol use (β=1.80, p<.05), and eating problems (β=3.99, p<.001). Negative urgency was positively associated with affective lability (β=7.71, p<.001) and negatively associated with self-control (β=-13.59, p<.001). Negative urgency is the only impulsivity-related trait that is a common risk factor associated with increased self-harm, problematic alcohol use, and eating problems.
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Affiliation(s)
- Allyson L Dir
- Department of Psychology, Indiana University-Purdue University, Indianapolis, IN 46202, USA.
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Moller CI, Tait RJ, Byrne DG. Deliberate Self-Harm, Substance Use, and Negative Affect in Nonclinical Samples: A Systematic Review. Subst Abus 2013; 34:188-207. [DOI: 10.1080/08897077.2012.693462] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Bresin K, Gordon KH. Endogenous opioids and nonsuicidal self-injury: A mechanism of affect regulation. Neurosci Biobehav Rev 2013; 37:374-83. [DOI: 10.1016/j.neubiorev.2013.01.020] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2012] [Revised: 12/20/2012] [Accepted: 01/11/2013] [Indexed: 01/02/2023]
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Non-suicidal Self-Injury (NSSI): A Case for Using Emotionally Focused Family Therapy. CONTEMPORARY FAMILY THERAPY 2013. [DOI: 10.1007/s10591-013-9236-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Mullins-Sweatt SN, Lengel GJ, Grant DM. Non-suicidal self-injury: the contribution of general personality functioning. Personal Ment Health 2013; 7:56-68. [PMID: 24343925 DOI: 10.1002/pmh.1211] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2011] [Revised: 04/02/2012] [Accepted: 06/12/2012] [Indexed: 11/10/2022]
Abstract
Non-suicidal self-injury (NSSI) is a public health problem of increasing significance. The purpose of the present study was to determine if individuals with and without a history of NSSI would differ significantly on the domains and facets of the Five Factor Model (FFM) as well as the facets from the UPPS-P Impulsive Behaviour Scale. Self-report measures of personality, borderline personality disorder and NSSI were administered to an undergraduate sample (n = 211). Individuals who had engaged in NSSI had significantly elevated levels of FFM facets of neuroticism (i.e. anxiousness, angry hostility, depressiveness, self-consciousness, impulsiveness and vulnerability) and openness (i.e. aesthetics, feelings and values) and significantly lower levels of conscientiousness (i.e. order, achievement, self-discipline and deliberation). Additionally, those with an NSSI history scored higher on UPPS-P negative urgency, lack of premeditation and lack of perseverance. The knowledge gained from this study provides further support for personality's role in NSSI. This information may aid in the identification of risk factors for NSSI and assist in efforts examining interventions for NSSI that are targeted toward personality-relevant strategies.
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