Connection between Parenting Styles and Self-harm in Adolescence

The impacts of latent profiles and transitions of stresses on adolescent mental health: A person-centred analysis

Research has demonstrated robust links between adolescent stress and serious psychological problems. The current study aimed to identify latent stress profiles of 1510 adolescents (59.7% females; Mage  = 16.77 years, SD = 0.86) based on five stresses (parental stresses, family environment stresses, academic stresses, teacher stresses, and peer stresses) at three time points (T1/2/3). Moreover, this study would investigate the transition patterns of these profiles over time and examine the associations between the profiles and adverse psychological symptoms (e.g., anxiety, depression, nonsuicidal self-injury [NSSI], and suicidal ideation). Three latent stress profiles were identified, including High-stress profile, Medium-stress profile, and Low-stress profile. The three profiles were significantly different on the levels of T1/2/3 anxiety, depression, NSSI, and suicidal ideation. The profile memberships remained relatively stable across three time points. Notably, the present study found gender differences, with boys were more likely to be in the High-stress profile and to transition from the Medium- to the High-stress profile, compared to girls. Furthermore, left-behind adolescents were more likely to be in the High-stress profile than non-left-behind adolescents. The findings highlight the importance of adopting 'this-approach-fits-this-profile' interventions for adolescents. Parents and teachers are advised to adopt different strategies for girls and boys.

Adolescent Predictors of Deliberate Self-Harm Thoughts and Behavior Among Young Adults: A Longitudinal Cross-National Study

PURPOSE

This study builds upon and extends previous longitudinal research on deliberate self-harm (DSH) among youth by investigating which risk and protective factors during adolescence predict DSH thoughts and behavior in young adulthood.

METHODS

Self-report data came from 1,945 participants recruited as state-representative cohorts from Washington State and Victoria, Australia. Participants completed surveys in seventh grade (average age 13 years), as they transitioned through eighth and ninth grades and online at age 25 years. Retention of the original sample at age 25 years was 88%. A range of risk and protective factors in adolescence for DSH thoughts and behavior in young adulthood were examined using multivariable analyses.

RESULTS

Across the sample, 9.55% (n = 162) and 2.83% (n = 48) of young adult participants reported DSH thoughts and behaviors, respectively. In the combined risk-protective factor multivariable model for young adulthood DSH thoughts, depressive symptoms in adolescence (adjusted odds ratio [AOR] = 1.05; confidence interval [CI] = 1.00-1.09) increased risk, while higher levels of adolescent adaptive coping strategies (AOR = 0.46; CI = 0.28-0.74), higher levels of adolescent community rewards for prosocial behavior (AOR = 0.73; CI = 0.57-0.93), and living in Washington State decreased risk. In the final multivariable model for DSH behavior in young adulthood, less positive family management strategies during adolescence remained the only significant predictor (AOR = 1.90; CI = 1.01-3.60).

DISCUSSION

DSH prevention and intervention programs should not only focus on managing depression and building/enhancing family connections and support but also promote resilience through efforts to promote adaptive coping and connections to adults within one's community who recognize and reward prosocial behavior.

Health-related quality of life in children, adolescents and young adults with self-harm or suicidality: A systematic review

OBJECTIVE

Self-harm and suicidality are associated with substantial social and economic burden, especially among children, adolescents and young adults. The aim of this review was to systematically synthesize the literature on the association between health-related quality of life and self-harm/suicidality in children, adolescents and young adults.

METHODS

Searches were conducted via MEDLINE, PsycINFO, CINAHL, EconLit and EMBASE. Search terms were the combination of the following blocks: (1) self-harm/suicidality, (2) health-related quality of life/well-being/life satisfaction and (3) children/adolescents/young adults. The quality of studies was assessed using the Effective Public Health Practice Project tool.

RESULTS

We identified 23 relevant studies. Findings showed that participants who reported self-harm had lower well-being, life satisfaction or overall health-related quality of life compared to those without self-harm. There was also evidence supporting the association between health-related quality of life and suicidal attempt. However, the results for the association with suicidal ideation remained inconsistent. Additionally, mental health, emotional well-being, physical health, oral health, existential well-being and family quality of life were found to be significant domains associated with self-harm or suicidality. Regarding the quality of included studies, 35% (n = 8), 39% (n = 9) and 26% (n = 6) of studies were scored as 'Strong', 'Moderate' and 'Weak', respectively.

CONCLUSION

Findings from the review showed that health-related quality of life varied according to the severity of suicidality (from ideation to attempt). There was also no evidence to infer the direction of causality between health-related quality of life and self-harm/suicidality. The findings suggest a need for further research, in particular longitudinal studies to fill identified gaps in the literature.

Trends and Prevalence of Hospital Admissions Related to Deliberate Self-Poisoning and Used Substances in Romanian Adolescents between 2016 and 2022

Rates of self-poisoning are increasing substantially all around the world, with self-poisoning being the most common form of self-harm leading to hospitalization in children and adolescents. This study aims to investigate the trends in the number of deliberate self-poisoning admissions in Romanian adolescents during the period of 2016-2022, as well as the most frequently used substances and the impact of the COVID-19 pandemic on hospital admissions due to self-poisoning and substance use in relation to these episodes. The sample included 178 patients admitted to the Clinic of Pediatric Psychiatry in Cluj-Napoca from 2016 to 2022 due to an episode of self-poisoning. Data were collected on patients' sociodemographic characteristics, psychosocial characteristics, and medical histories. We report a slight overall increase in the self-poisoning admission rate during the studied period. There was a decrease during the initial period of the pandemic, with significantly increasing rates in the second year of the pandemic. The mean prevalence rate of hospital admissions due to self-poisoning episodes during the study period was 3.14% (95% CI 2.72, 3.63). Adolescent girls were identified as the most vulnerable group, with the female-to-male ratio increasing dramatically. In terms of substance use, benzodiazepines; over-the-counter analgesics, including paracetamol; and antidepressants were the most frequently used substances. We emphasize the importance of careful consideration in prescribing psychotropic drugs, as well as the need for regulation of over-the-counter drug dispensation.

Sleep duration, depressive symptoms, and digital self-harm among adolescents

BACKGROUND

This study examines the relationship between sleep duration, depression, and engagement in a novel cyber behavior, digital self-harm, among adolescents.

METHOD

Logistic regression analyses were conducted using cross-sectional data from the 2019 Florida Youth Substance Abuse Survey (N = 9,819; 48% male; avg. grade level = 9th grade [SD = 1.9]) to analyze the association between sleep duration and digital self-harm. A Karlson-Holm-Breen (KHB) analysis was used to assess whether depressive symptoms attenuate this association.

RESULTS

Bivariate results indicated that longer sleep duration was associated with lower incidence of digital self-harm. Multivariate results showed that sleep duration was inversely associated with engaging in digital self-harm, net of all covariates. Depressive symptoms attenuated the influence of sleep duration on digital self-harm by 50.72%.

CONCLUSIONS

Both insufficient sleep and depressive symptoms were associated with engagement in digital self-harm among adolescents. Prospective research is needed, however, to confirm this pathway. Practitioners and clinicians should consider discussing digital self-harm with adolescents and parents, especially if adolescents are experiencing poor sleep and depressive symptoms.

The Role of Psychological Factors in Non-suicidal Self-injury of Female Adolescents

Background: Non-suicidal self-injury (NSSI) is defined as inflicting damage to one’s own body. It begins in adolescence and tends to become chronic. Objectives: Considering the high prevalence and chronicity of NSSI among girls, the present study aimed to investigate the factors affecting the prevalence of NSSI in female adolescents from their perspective. Methods: The participants consisted of 604 female high-school students in Saveh, aged 14 - 17 years (14.29 ± 1.11), who were selected via random cluster sampling from November 2018 to January 2019. They answered six questionnaires, including the Inventory of Statements About Self-injury (ISAS), Ways of Coping questionnaire (WCQ), Child Abuse Self-report scale (CASRS), Family Emotional Involvement and Criticism scale (FEICS), Emotion Reactivity scale (ERS), and Aggression questionnaire (AQ). Data were analyzed using logistic regression analysis. Results: The predictor variables of child abuse, emotion reactivity, perceived parental criticism, family emotional involvement, and problem- and emotion-focused coping styles could successfully distinguish NSSI individuals from those without NSSI (P < 0.05). There were no significant differences between minor and moderate groups. Conclusions: Family emotional support is a protective factor, while criticism, child abuse, and emotion-focused coping style are risk factors for NSSI.

Impact of Parents' Knowledge about the Development of Self-Esteem in Adolescents and Their Parenting Practice on the Self-Esteem and Suicidal Behavior of Urban High School Students in Nepal

Background: Suicide is the third leading cause of death in adolescents worldwide, self-esteem is a strong protective factor, and parents may be able to provide interventions. This cross-sectional study aimed to determine how parents can help enhance their adolescent’s self-esteem and prevent suicidal behavior among adolescents in Nepal. Methods: Self-administered questionnaires were distributed to adolescents aged 13–19 years and their parents at eight high schools in three provinces in Nepal (n = 575 pairs). The data were analyzed using descriptive and inferential statistics (bivariate and multivariate regression analyses). Results: The mean self-esteem score of adolescents according to the Rosenberg Self-Esteem Scale was 16.59, and the prevalence of suicidal behavior was 11.3%. Parent’s knowledge about the development of self-esteem in adolescents was significantly positively related to parenting practice (communication, support, positive reinforcement, etc.) (B = 1.0, 95% confidence interval, CI 0.89–1.11) and authoritative parenting style (B = 0.2, 95% CI 0.15–0.25). Parental authoritativeness was positively associated with the self-esteem of their adolescents (B = 0.1, 95% CI 0.01–0.18), while adolescents with authoritarian parents were prone to suicidal risk behavior (adjusted odds ratio, AOR = 1.1, 95% CI 1.0–1.19). Conclusion: Counseling to parents based on our findings would be helpful to enhance the self-esteem and prevent suicidal risk behavior in their adolescent children.