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Garbutt K, Rennoldson M, Gregson M. Sexual Offending: Adverse Childhood Experiences, Shame, and Self-Compassion Explain the Variance in Self-Harm and Harm Towards Others? SEXUAL ABUSE : A JOURNAL OF RESEARCH AND TREATMENT 2024; 36:662-691. [PMID: 37695944 PMCID: PMC11311929 DOI: 10.1177/10790632231201398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
Research investigating potential pathways from Adverse Childhood Experiences (ACEs) to later self-harming and offending behaviours has inconsistent findings. Past research, however, has not fully explored the interplay between ACEs and modifiable psychological factors, such as shame and self-compassion. The present study explored the relationship between ACE, shame, and self-compassion to identify their role in explaining the variance in later harm in a sample of individuals who have committed sexual offences. Two hundred and fifty adults incarcerated for sexual offences participated. Multiple Regression and Mediation Analyses were applied to establish if ACE, shame and self-compassion explained the variance in harm and explore potential psychological pathways between ACE and harm, with shame and self-compassion as potential modifiable mediators. ACE, shame and self-compassion explained 55% of self-harm and 52% of psychological and physical harm variance. A more complex relationship was indicated for sexual harm, with only 19% of the variance explained by the model. The study increases our understanding of the relationship between variables and potential modifiable pathways between ACEs and later harming behaviours in a sample of individuals with sexual convictions. These modifiable psychological factors could be targeted to increase resilience, post-traumatic growth and reduce the risk of harm in later life.
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Affiliation(s)
- Kerri Garbutt
- Department of Psychology, Nottingham Trent University, Nottingham, UK
| | - Mike Rennoldson
- Department of Psychology, Nottingham Trent University, Nottingham, UK
| | - Mick Gregson
- Department of Psychology, Nottingham Trent University, Nottingham, UK
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Li Y, Li YH, He Y, Chen SS, Chang JJ, Yuan MY, Cao LL, Wang SJ, Wang GF, Su PY. Psychological Resilience Mediates the Association Between Childhood Maltreatment and Self-Harm Phenotype in Chinese Early Adolescents. Child Psychiatry Hum Dev 2024; 55:1073-1082. [PMID: 36445604 DOI: 10.1007/s10578-022-01471-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/15/2022] [Indexed: 12/02/2022]
Abstract
Self-harm (SH) increases significantly in early adolescence with great variability, and childhood maltreatment (CM) contributes to this increase. Understanding the developmental pathway from CM to SH could provide clues for SH prevention. This study used latent class analysis (LCA) to detect the phenotype of SH and explored the role of psychological resilience in the pathway from the CM to SH phenotype among 5724 early adolescents (52.5% male). Three interpretable phenotypes of SH were identified: low SH (57.8%), medium SH (29.0%), and high SH (13.2%). Furthermore, CM was positively associated with the SH phenotype, psychological resilience mediated the association between CM and the SH phenotype (all ps < 0.001), and a larger mediating effect was observed in the medium SH (22.41%). Our findings offer new perspectives that improving psychological resilience can be used as an efficient intervention to reduce the risk of SH among early adolescents who have experienced CM.
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Affiliation(s)
- Yuan Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China
| | - Yong-Han Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China
| | - Yang He
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China
- Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China
| | - Shan-Shan Chen
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China
- Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China
| | - Jun-Jie Chang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China
- Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China
| | - Meng-Yuan Yuan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China
- Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China
| | - Lei-Lei Cao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China
- Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China
| | - Shao-Jie Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China
- Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China
| | - Geng-Fu Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China.
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, Hefei, China.
- NHC Key Laboratory of study on abnormal gametes and reproductive tract, No 81 Meishan Road, 230032, Hefei, Anhui, China.
- Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China.
| | - Pu-Yu Su
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China.
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, Hefei, China.
- NHC Key Laboratory of study on abnormal gametes and reproductive tract, No 81 Meishan Road, 230032, Hefei, Anhui, China.
- Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China.
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Chen SE, Chick CF, O'Hara R. Trauma Exposure Moderates the Link Between Cognitive Flexibility and Suicide Risk in Pre-Adolescent Children. Arch Suicide Res 2024:1-17. [PMID: 39072760 DOI: 10.1080/13811118.2024.2372616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
OBJECTIVES Trauma exposure (TE) and cognitive flexibility (CF) are risk factors for self-injurious thoughts and behaviors (SITBs). However, it is unknown whether these risk factors contribute to mechanisms associated with distinct categories of SITBs. The current study examined the potential moderating role of TE in the relationships between CF and multiple SITBs, including active suicidal ideation (SI), passive SI, non-suicidal self-injury (NSSI), and history of suicide attempt (SA), among pre-adolescent children. METHODS A total of 11,326 children from the Adolescent Brain Cognitive Development study were included in the present study. SITBs and TE were measured by the Kiddy Schedule for Affective Disorder and Schizophrenia (KSADS). CF was measured using the NIH Cognitive Toolbox. RESULTS Cumulative TE moderated the relationship of CF to active SI. Higher CF was associated with lower odds of current SI in children with a single lifetime TE, but not in children without trauma or with two or more TE. As a main effect, two or more TE predicted higher odds of active SI, passive SI, and lifetime SA, but not NSSI. Higher CF was associated with lower odds of passive SI, with effects not moderated by trauma exposure. CONCLUSION The current results clarify previously inconsistent findings about the relationship of CF to SI by identifying cumulative TE as a moderator. CF served as a protective factor against SI, but only in children with a single lifetime trauma. Implications for screening and treatment targets of children at risk for distinct categories of SITBs are discussed.
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He X, Yu Q, Peng J, Yu J, Wu T, Qin Y, Wang S, Dong T, Liao Y, Hu C, Yang P, Yang B. Correlations between non-suicidal self-injury and problematic internet use among Chinese adolescents: a systematic review and meta-analysis. Front Psychiatry 2024; 15:1408508. [PMID: 39135988 PMCID: PMC11317390 DOI: 10.3389/fpsyt.2024.1408508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 07/10/2024] [Indexed: 08/15/2024] Open
Abstract
Background Non-Suicidal Self-Injury (NSSI) has continued to be a major issue for public health worldwide, especially among teenagers. Studies have found a certain correlation between NSSI and Problematic Internet Use (PIU). However, this relationship is still unclear among Chinese adolescents, a specific population. Hence, a meta-analysis was carried out on observational studies to explore the connection between NSSI and PIU in Chinese teenagers, aiming to provide more clarity on the correlation. Methods To identify the link between NSSI and PIU, we scoured seven digital repositories until November 16, 2023. Employing a random-effects meta-analysis framework, we delved into the association between NSSI and PIU. Additionally, we carried out subgroup evaluations to scrutinize variables including geographical location, age demographics, research methodology, diagnostic instruments, gender, and variables controlled for confounding, like symptoms of depression. For amalgamating data, STATA software (version 16) was deployed. Results In this analysis, we included 15 research papers encompassing a collective sample of 137,166 individuals. Our findings revealed a significant positive association between NSSI and PIU within the adolescent population in China, with an Odds Ratio (OR) of 2.02 and a 95% Confidence Interval (CI) ranging from 1.73 to 2.37. Notably, this correlation was markedly stronger in specific subgroups: adolescents from China's Western regions exhibited an OR of 4.22 (95% CI: 3.44, 5.18); middle school attendees had an OR of 2.09 (95% CI: 1.92, 2.28); those diagnosed with concurrent depression disorders showed an OR of 2.32 (95% CI: 1.98, 2.73); and female adolescents demonstrated an OR of 2.49 (95% CI: 2.26, 2.75), highlighting the nuanced dynamics of this relationship. Conclusion This meta-analysis indicates that PIU among adolescents is associated with an increased risk of NSSI. Our findings underscore the importance of targeting specific populations, including those in the western region of China, middle school students, adolescents with comorbid depression disorders, and female adolescents, who may be at higher risk of PIU and subsequently NSSI. These results emphasize the need for tailored interventions and preventive strategies to address these intertwined issues effectively. Systematic review registration PROSPERO, identifier CRD42024496579.
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Affiliation(s)
- Xubin He
- Chongqing Mental Health Center, Chongqing, China
| | - Qinyao Yu
- Chongqing Medical School, Chongqing, China
| | - Jing Peng
- Chongqing Mental Health Center, Chongqing, China
| | - Jianghong Yu
- Chongqing Mental Health Center, Chongqing, China
| | - Taiying Wu
- Chongqing jiangbei second hospital, Chongqing, China
| | - Yuan Qin
- Chongqing Mental Health Center, Chongqing, China
| | | | - Tiaoxia Dong
- Chongqing Mental Health Center, Chongqing, China
| | - Yulong Liao
- Chongqing Mental Health Center, Chongqing, China
| | - Chunbi Hu
- Chongqing Mental Health Center, Chongqing, China
| | - Ping Yang
- Chongqing Mental Health Center, Chongqing, China
| | - Bo Yang
- Chongqing Mental Health Center, Chongqing, China
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Wei Q, Liu J, Yin W, Pan S, Dai C, Zhou L, Jiang X, Wang C, Wu J. Association between childhood emotional abuse and non-suicidal self-injury among Guangxi adolescents in China: A moderated mediation model. J Affect Disord 2024:S0165-0327(24)01171-6. [PMID: 39029701 DOI: 10.1016/j.jad.2024.07.111] [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: 01/29/2024] [Revised: 06/25/2024] [Accepted: 07/16/2024] [Indexed: 07/21/2024]
Abstract
BACKGROUND Childhood Emotional Abuse (CEA) is a known risk factor for Non Suicidal Self-injury (NSSI), which could have devastating repercussions. This study aimed to establish whether Parent-Child Attachment (PCA) and depressive symptoms mediated the CEA-NSSI relationship, as well as whether school connectedness moderated both the direct and indirect relationships between CEA and NSSI. METHODS Between November and December 2022, 7447 Chinese adolescents in high schools were surveyed through multi-stage cluster random sampling. The participants completed self-reported questionnaires that assessed CEA, PCA, depressive symptoms, school connectedness, and NSSI. Relationships between these variables were examined through moderated mediation analysis using SPSS macro-PROCESS. RESULTS After controlling for sociodemographic variables, we found that CEA correlated positively with NSSI through two different pathways: the mediating role of depressive symptoms and the chain-mediating role of both PCA and depressive symptoms. Moreover, school connectedness could moderate the direct and indirect relationships between CEA and NSSI. LIMITATIONS The study's cross-sectional design does not allow for causal inferences. CONCLUSIONS Overall, PCA, depressive symptoms, and school connectedness could affect the CEA-NSSI relationship.
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Affiliation(s)
- Qiaoyue Wei
- Department of Preventive Medicine, School of Public Health, Wuhan University, Wuhan 430071, China; Department of Psychology, School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - Jianbo Liu
- Department of Child Psychiatry of Shenzhen Kangning Hospital, Shenzhen Mental Health Center, School of mental health, Shenzhen University, Shenzhen 518003, China
| | - Wenwen Yin
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - Shuibo Pan
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - Chenyangzi Dai
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - Linhua Zhou
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - Xiaoyu Jiang
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - Chunyan Wang
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning 530021, China
| | - Junduan Wu
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning 530021, China; Department of Guangxi Medical College, 8 Kunlun Road, Nanning 530023, China.
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Calvete E, Prieto-Fildalgo A, Faura-García J, Orue I. The role of testosterone and cortisol levels in nonsuicidal selfinjury in adolescents. J Adolesc 2024. [PMID: 39021249 DOI: 10.1002/jad.12380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Revised: 05/27/2024] [Accepted: 07/09/2024] [Indexed: 07/20/2024]
Abstract
INTRODUCTION Nonsuicidal selfinjury (NSSI) is an important problem in adolescence, which is thought to serve several reinforcement functions (positive vs. negative, automatic vs. social). While the psychological mechanisms involved in NSSI are relatively well known, there is an important gap in the knowledge regarding the underlying biological mechanisms. This study examined the role of testosterone (T) and cortisol (C) in the frequency and reinforcement functions of NSSI. METHODS A total of 423 adolescents (age range = 13-17; 54.4% girls) from Basque Country (Spain) provided saliva samples to determine T and C levels and completed measures of NSSI 6 months later in 2017-2018. RESULTS The results showed that T but not C was significantly associated with higher NSSI frequency and the four types of NSSI functions. In addition, C moderated the predictive association between T and NSSI for automatic negative reinforcement, such that this association was significant only when C was high. Participant sex did not moderate any association between hormones and NSSI. CONCLUSIONS These preliminary results suggest that testosterone levels can affect NSSI behaviors in adolescence, thus helping to explain the increase in NSSI during this stage. Moreover, in situations in which NSSI serves to alleviate negative internal states, high levels of cortisol can be involved.
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Affiliation(s)
- Esther Calvete
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
| | - Angel Prieto-Fildalgo
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
| | - Juan Faura-García
- Faculty of Education, International University of La Rioja, Logrono, Spain
- Faculty of Health Sciences, University of Isabel I, Burgos, Spain
| | - Izaskun Orue
- Department of Psychology, Faculty of Health Sciences, University of Deusto, Bilbao, Spain
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García-Fernández A, Martínez-Cao C, Sánchez-Fernández-Quejo A, Bobes-Bascarán T, Andreo-Jover J, Ayad-Ahmed W, Cebriá AI, Díaz-Marsá M, Garrido-Torres N, Gómez S, González-Pinto A, Grande I, Iglesias N, March KB, Palao DJ, Pérez-Díez I, Roberto N, Ruiz-Veguilla M, de la Torre-Luque A, Zorrilla I, Pérez V, Sáiz PA, García-Portilla MP. Validation of the Spanish Childhood Trauma Questionnaire-Short Form in adolescents with suicide attempts. Front Psychol 2024; 15:1378486. [PMID: 39045440 PMCID: PMC11264239 DOI: 10.3389/fpsyg.2024.1378486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 05/28/2024] [Indexed: 07/25/2024] Open
Abstract
Background Child maltreatment is associated with a higher probability of mental disorders and suicidal behavior in adolescence. Therefore, accurate psychometric instruments are essential to assess this. Objective To validate the Spanish version of the Childhood Trauma Questionnaire-Short Form (CTQ-SF) in adolescents with suicide attempts. Methods Multisite cohort study of 208 adolescents with suicide attempts using data from the following scales: Mini International Neuropsychiatric Interview (MINI), Columbia Suicide Severity Rating Scale (C-SSRS), Patient Health Questionnaire (PHQ-9), and CTQ-SF. Statistical analysis: CTQ-SF scores analyzed by descriptive statistics. Internal consistency: McDonald's omega and Cronbach's alpha. Concurrent validity with PHQ-9 and C-SSRS scores: Spearman correlation coefficient. Structural validity: Confirmatory factor analysis. Results Floor and ceiling effects: Physical abuse and neglect as well as sexual abuse demonstrated high floor effects (50.0, 35.1, and 61.1% of adolescents, respectively). No ceiling effects were found. The CTQ-SF had excellent internal consistency (McDonald's omega = 0.94), as did the majority of its subscales (Cronbach's alpha 0.925-0.831) except for physical neglect (0.624). Its concurrent validity was modest, and the emotional neglect subscale had the lowest Spearman correlation coefficients (0.067-0.244). Confirmatory factor analysis: Compared with alternative factor structures, the original CTQ-SF model (correlated 5-factor) exhibited a better fit [S-B χ 2 = 676.653, p < 0; RMSEA (90% CI = 0.076-0.097) = 0.087; SRMR = 0.078; CFI = 0.980; TLI = 0.978]. Conclusion The Spanish CTQ-SF is a reliable, valid instrument for assessing traumatic experiences in adolescents at high risk of suicide. It appears appropriate for use in routine clinical practice to monitor maltreatment in this group.
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Affiliation(s)
- Ainoa García-Fernández
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
| | - Clara Martínez-Cao
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
| | | | - Teresa Bobes-Bascarán
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
- Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
- Department of Psychology, Universidad de Oviedo, Oviedo, Spain
| | - Jorge Andreo-Jover
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | | | - Ana Isabel Cebriá
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Mental Health Service, Hospital Universitari Parc Taulí, Unitat Mixta de Neurociència Traslacional (I3PT-INc-UAB), Sabadell, Barcelona, Spain
- Department of Clinical and Health Psychology, Faculty of Psychology, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Marina Díaz-Marsá
- Department of Legal Medicine, Psychiatry, and Pathology, Universidad Complutense de Madrid (UCM), Madrid, Spain
- Hospital Clínico San Carlos, Madrid, Spain
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | - Nathalia Garrido-Torres
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Institute of Biomedicine of Seville (IBiS), Sevilla, Spain
- Hospital Virgen del Rocío, Sevilla, Spain
- Department of Psychiatry, University of Seville, Sevilla, Spain
| | - Sandra Gómez
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències, Universitat de Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Ana González-Pinto
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department Psychiatry, UPV/EHU, Vitoria, Spain
- BIOARABA, Vitoria, Spain
- Hospital Universitario de Alava, Vitoria, Spain
| | - Iria Grande
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències, Universitat de Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Noelia Iglesias
- Department of Psychiatry, Clinical Psychology and Mental Health, La Paz University Hospital, Madrid, Spain
| | - Katya B. March
- Hospital La Paz Institute for Health Research (IdiPAZ), Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Diego J. Palao
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Mental Health Service, Hospital Universitari Parc Taulí, Unitat Mixta de Neurociència Traslacional (I3PT-INc-UAB), Sabadell, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Faculty of Medicine, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain
| | - Iván Pérez-Díez
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry, Universidad Autónoma de Madrid (UAM), Madrid, Spain
| | - Natalia Roberto
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències, Universitat de Barcelona (UB), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Hospìtal Clinic de Barcelona, Barcelona, Spain
- Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Miguel Ruiz-Veguilla
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Institute of Biomedicine of Seville (IBiS), Sevilla, Spain
- Hospital Virgen del Rocío, Sevilla, Spain
- Department of Psychiatry, University of Seville, Sevilla, Spain
| | - Alejandro de la Torre-Luque
- Department of Legal Medicine, Psychiatry, and Pathology, Universidad Complutense de Madrid (UCM), Madrid, Spain
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | - Iñaki Zorrilla
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department Psychiatry, UPV/EHU, Vitoria, Spain
- BIOARABA, Vitoria, Spain
- Hospital Universitario de Alava, Vitoria, Spain
| | - Víctor Pérez
- Institute of Neuropsychiatry and Addictions, Hospital del Mar, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Autonomous University of Barcelona, Barcelona, Spain
- Hospital del Mar Medical Research Institute, Barcelona, Spain
| | | | - Pilar A. Sáiz
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
- Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | - María Paz García-Portilla
- Department of Psychiatry, Universidad de Oviedo, Oviedo, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Spain
- Instituto Universitario de Neurociencias del Principado de Asturias (INEUROPA), Oviedo, Spain
- Servicio de Salud del Principado de Asturias (SESPA), Oviedo, Spain
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
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Liu Y, Fang Y, Chen Y, Qin F, Li X, Feng R, Luo X, Wen J, Chen Y, Teng Z, Zeng Y. Relationship between childhood trauma and non-suicidal self-injury in high school students: the mediating role of the stress perception and the moderating role of teacher-student relationship. BMC Psychol 2024; 12:379. [PMID: 38978110 PMCID: PMC11232308 DOI: 10.1186/s40359-024-01883-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2024] [Accepted: 07/02/2024] [Indexed: 07/10/2024] Open
Abstract
This study delves into the correlation between childhood trauma and non-suicidal self-injury (NSSI) behaviors among high school students. Additionally, it examines the mediating role of stress perception and the moderating role of the teacher-student relationship in this association. A questionnaire survey was administered to 1,329 high school students in Yunnan Province to assess childhood trauma, NSSI behaviors, and stress perception. Firstly, the survey revealed a 12% prevalence of NSSI, with girls exhibiting a higher occurrence compared to boys (OR = 0.413, 95% CI: 0.280-0.609). Secondly, childhood trauma emerged as a significant predictor of NSSI behavior, irrespective of gender or whether the individual was an only child (r = 0.17, P < 0.01). Thirdly, stress perception functioned as a mediator in the relationship between childhood trauma and NSSI among high school students (t = 4.65, P < 0.01). The mediation effect occupies 26.56% of the total effect. Furthermore, the teacher-student relationship moderated the mediating effect of stress perception on the link between childhood trauma and NSSI (β = 0.0736, P < 0.01). Notably, individuals with strong teacher-student relationships exhibited a significant elevation in stress perception upon exposure to childhood trauma. The findings of this study support a moderated mediation model in the association between childhood trauma and NSSI, suggesting profound implications for the development of targeted interventions and prevention strategies among high school students.
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Affiliation(s)
- Yilin Liu
- The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Yuan Fang
- The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Yuanling Chen
- School of Public Health and Health Management, Qujing Medical College, Qujing, Yunnan, China
| | - Fuyi Qin
- The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Xinrui Li
- The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Ruibin Feng
- The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Xinyu Luo
- The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Jia Wen
- The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Yatang Chen
- Central Laboratory, Chongqing University Central Hospital, Chongqing, China
| | - Zhaowei Teng
- The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China.
| | - Yong Zeng
- The Second Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China.
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9
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Liang Y, Wang Y, Bai R, Liu X. Gender-Specific Trajectories of Non-Suicidal Self-Injury among Adolescents: Predictive Roles of Distal and Proximal Risk Factors. J Youth Adolesc 2024:10.1007/s10964-024-02040-4. [PMID: 38926214 DOI: 10.1007/s10964-024-02040-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 06/19/2024] [Indexed: 06/28/2024]
Abstract
Non-suicidal self-injury (NSSI) is considered a strong risk factor for suicide. Although NSSI is prevalent among adolescents and varies by gender, few studies have examined the gender-specific trajectory of NSSI and its predictors. This study examined the trajectory of NSSI among Chinese adolescent boys and girls separately, and the roles of distal (i.e., childhood maltreatment and its specific subtypes) and proximal risk factors (i.e., emotional dysregulation, peer victimization) on their trajectories. A total of 3290 Chinese adolescents (Mage = 13.08; SD = 0.84; 57.6% boys) participated in assessments at three time points. Latent class growth models identified three trajectories for boys: Low stable (92.5%), moderate increasing (5.0%) and high decreasing (2.5%). Four trajectories were identified for girls: Low stable (87.9%), moderate increasing (7.6%), high decreasing (3.0%) and high stable (1.5%). Multinomial logistic regression analyses revealed that both emotional dysregulation and emotional abuse predicted the trajectories of moderate increasing, high decreasing and high stable for girls, as well as predicted moderate increasing and high decreasing trajectories for boys. Peer victimization served as a significant risk factor predicting the moderate increasing and high decreasing trajectories only for girls, while overall childhood maltreatment was a remarkable predictor for the moderate increasing and high decreasing trajectories of boys. The findings highlighted the importance of gender differences in understanding the progression of NSSI and the key predictors, informing effective strategies for prevention and intervention.
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Affiliation(s)
- Yiting Liang
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Yumeng Wang
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Rong Bai
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Xia Liu
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China.
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10
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Zhang R, Hou F, Lin Y, Geng Y, Kong F. Associations between emotional maltreatment, depression and self-harm among Chinese adolescents: A three-wave longitudinal mediation model. CHILD ABUSE & NEGLECT 2024; 152:106761. [PMID: 38531286 DOI: 10.1016/j.chiabu.2024.106761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 03/16/2024] [Accepted: 03/19/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Self-harm seriously endangers adolescents' physical and mental health. However, the longitudinal mechanism of self-harm is not yet clear. OBJECTIVE This study explored the inconsistent relationships between two types of emotional maltreatment and self-harm across three waves, regarding depression as a potential mediator and gender as a moderator of these associations. PARTICIPANTS AND SETTING A sample of 588 Chinese adolescents (Mage at T1 = 12.79 years) in a middle school completed the assessment of demographic information, emotional maltreatment, depression and self-harm within one year. METHODS Path analysis models were created to estimate the relationship of emotional maltreatment with self-harm and the mediating effect of depression. A multi-group analysis was applied to investigate the moderating effect of gender. RESULTS There existed positive associations between emotional abuse at T1 and self-harm at T2 and T3 (β = 0.12, SE = 0.05, p = 0.006; β = 0.09, SE = 0.05, p = 0.054), and the mediating effect of emotional abuse at T1 on self-harm at T3 via depression at T2 was significant (Indirect effect = 0.05, SE = 0.02, 95 % CI [0.02, 0.08]). Multi-group analysis of gender revealed no significant differences in the cross-lagged pathways, but there were stronger links for girls than boys among self-harm at T1, T2, and T3 (p < 0.001). CONCLUSIONS Emotional abuse but not emotional neglect could significantly predict self-harm. Furthermore, depression played a mediating role in the longitudinal relationship between emotional abuse and self-harm. Girls who had high levels of self-harm at a previous time point were more inclined than boys to harm themselves at a subsequent time point. These findings provide a different perspective to develop effective prevention and intervention measures.
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Affiliation(s)
- Ruiping Zhang
- School of Education, Zhengzhou University, Zhengzhou 450001, China
| | - Fan Hou
- School of Education, Zhengzhou University, Zhengzhou 450001, China
| | - Ye Lin
- School of Education, Zhengzhou University, Zhengzhou 450001, China
| | - Yaoguo Geng
- School of Education, Zhengzhou University, Zhengzhou 450001, China.
| | - Feng Kong
- School of Psychology, Shaanxi Normal University, Xi'an 710062, China.
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11
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Le DQ, Le LKD, Le PH, Yap MBH, Mihalopoulos C. Cost effectiveness of interventions to prevent the occurrence and the associated economic impacts of child maltreatment: A systematic review. CHILD ABUSE & NEGLECT 2024:106863. [PMID: 38816302 DOI: 10.1016/j.chiabu.2024.106863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 05/01/2024] [Accepted: 05/17/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Child maltreatment is a pressing public health concern that poses long-lasting health and economic impacts on children and society. While several preventive interventions have demonstrated their effectiveness in reducing the occurrence of child maltreatment and its associated economic impacts, the cost-effectiveness of such interventions remains unclear. OBJECTIVE This study aims to provide a comprehensive overview and a narrative synthesis of the available economic evidence on child maltreatment preventive interventions in both high-income and low-middle-income countries. METHOD Systematic searches were conducted in MEDLINE, PsycINFO, Embase, CINAHL, Web of Science, and Econlit to identify full economic evaluations and return-on-investment studies on child maltreatment preventive interventions. The methodological quality of eligible studies was assessed using Drummond's 10-point checklist. This review adhered to the PRISMA guidelines, and summarized findings in a narrative synthesis. RESULTS Twenty-six studies met the inclusion criteria. Of these, eight evaluated home visiting, four evaluated early childhood education (ECE), four assessed multi-component (MC), and three examined group-based parent education (GPE) interventions. The remaining studies assessed interventions to prevent abusive head trauma (AHT; n = 2), child sexual abuse (n = 2), physical abuse at school (n = 1), as well as individualized intensive parenting (IIP; n = 2), and counseling (n = 1) interventions. Two studies were conducted in low-middle-income countries, while the others were all in high-income countries. CONCLUSIONS The included studies generally exhibited high methodological quality. Only AHT, ECE, IIP, and MC interventions demonstrated promising cost-effectiveness credentials in preventing child maltreatment. More economic evaluations are needed for interventions with mixed findings (e.g. GPE) and in low-middle-income countries.
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Affiliation(s)
- Dai Quy Le
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Long Khanh-Dao Le
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Phuong Hong Le
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Marie Bee Hui Yap
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia; Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Victoria, Australia
| | - Cathrine Mihalopoulos
- Monash University Health Economics Group, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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12
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Hao Y, Peng P, Wang Q, Zhou Y, Chen S, Wu Q, Liu T, Zhang X. Association between childhood maltreatment and suicidal ideation among Chinese patients with chronic schizophrenia: the mediating role of insomnia. BJPsych Open 2024; 10:e98. [PMID: 38699889 PMCID: PMC11094451 DOI: 10.1192/bjo.2024.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 02/16/2024] [Accepted: 02/26/2024] [Indexed: 05/05/2024] Open
Abstract
BACKGROUND Childhood maltreatment is a well-established transdiagnostic risk factor for suicidal ideation; however, previous studies on their association in schizophrenia have produced highly varied results. Moreover, the mechanism linking childhood maltreatment and suicide ideation remains unclear in schizophrenia. AIMS This cross-sectional study aimed to investigate the association between childhood maltreatment and suicide ideation in people with schizophrenia and tested whether insomnia mediated this relationship. METHOD Positive and Negative Syndrome Scale (PANSS), Insomnia Severity Index (ISI), Childhood Trauma Questionnaire - Short Form and Beck Suicidal Ideation Inventory were employed. Logistic regression and mediation analysis were performed. RESULTS (a) The prevalence of suicide ideation, insomnia, sexual abuse, emotional neglect, emotional abuse, physical abuse and physical neglect was 10% (n = 61), 18% (n = 111), 11% (n = 68), 25% (n = 153), 6.3% (n = 39), 17% (n = 106) and 39% (n = 239), respectively. In all, 52% (n = 320) reported childhood maltreatment; (b) patients with suicide ideation demonstrated higher insomnia and childhood maltreatment. PANSS depression factor, ISI, lifetime suicidal attempts and emotional abuse were independently associated with suicide ideation; (c) insomnia partially mediated the effects of emotional abuse and emotional neglect on suicide ideation, and insomnia completely mediated the effects of physical neglect and physical abuse on suicide ideation. CONCLUSION Our study calls for formal assessments for childhood maltreatment and insomnia in schizophrenia, which might help identify suicide ideation early. In addition, interventions targeting insomnia might help reduce suicide ideation among people with schizophrenia who experience childhood maltreatment.
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Affiliation(s)
- Yuzhu Hao
- Department of Psychiatry, National Clinical Research Centre for Mental Disorders, and National Centre for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Pu Peng
- Department of Psychiatry, National Clinical Research Centre for Mental Disorders, and National Centre for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Qianjin Wang
- Department of Psychiatry, National Clinical Research Centre for Mental Disorders, and National Centre for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yanan Zhou
- Department of Psychiatry, Hunan Brain Hospital (Hunan Second People's Hospital), Changsha, China
| | - Shubao Chen
- Department of Psychiatry, National Clinical Research Centre for Mental Disorders, and National Centre for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Qiuxia Wu
- Department of Psychiatry, National Clinical Research Centre for Mental Disorders, and National Centre for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Tieqiao Liu
- Department of Psychiatry, National Clinical Research Centre for Mental Disorders, and National Centre for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xiangyang Zhang
- CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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13
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Cao P, Peng R, Yuan Q, Zhou R, Ye M, Zhou X. Predictors of non-suicidal self-injury in adolescents with depressive disorder: the role of alexithymia, childhood trauma, and body investment. Front Psychol 2024; 15:1336631. [PMID: 38638510 PMCID: PMC11024233 DOI: 10.3389/fpsyg.2024.1336631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Accepted: 02/27/2024] [Indexed: 04/20/2024] Open
Abstract
Purpose This study analyzes the relationship of alexithymia, childhood trauma, and body investment to non-suicidal self-injury (NSSI) behaviors in adolescents with depressive disorder and whether they have predictive and diagnostic value for non-suicidal self-injury (NSSI) behaviors in adolescents with depressive disorder. Patients and methods A total of 225 patients with a diagnosis of adolescent depressive disorder were included in the study and were divided into two groups according to the DSM-5 criteria: 98 cases without NSSI and 127 cases with NSSI. Compare the demographic data, 24-item Hamilton Depression Scale (HAMD-24), 20-item Toronto Alexithymia Scale (TAS-20), Childhood Trauma Questionnaire-Short Form (CTQ-SF), and Body Investment Scale (BIS) scores between two groups. Binary logistic regression was used to analyze the independent risk factors contributing to NSSI behaviors in adolescents with depression, and establish four predictive models. Based on the models' predictive probability, the ROC curves were plotted to calculate the value of the predictive diagnostic effect. Results The group without NSSI had lower scores than the group with NSSI on HAMD-24 total score, TAS-20 total score, difficulty identifying feelings, difficulty describing feelings, and externally focused thinking, as well as lower scores on CTQ-SF total score, physical neglect, emotional neglect, physical abuse, and emotional abuse. In contrast, the BIS total score, body image feelings and attitudes, body care, and body protection factor scores were higher for the group without NSSI. The BIS body care factor score and the CTQ-SF emotional abuse factor score were significantly linked with adolescents diagnosed with depressive disorder who exhibited NSSI behaviors. These results provide a good diagnostic model for adolescents with depressive disorder. Conclusion Low levels of body care and childhood emotional abuse may independently contribute to the implementation of NSSI in adolescents with depressive disorder. Body investment and childhood trauma are valuable in diagnosing and predicting NSSI behaviors and should be considered as potentially important factors in clinical treatment.
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Affiliation(s)
- Panpan Cao
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Anhui Psychiatric Center, Hefei, China
| | - Ran Peng
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Anhui Psychiatric Center, Hefei, China
| | - Qiuyu Yuan
- Bengbu Mental Health Center, Anhui Veterans Hospital, Anmin Hospital Affiliated to Bengbu Medical College, Bengbu, China
| | - Ruochen Zhou
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Anhui Psychiatric Center, Hefei, China
| | - Mengting Ye
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Anhui Psychiatric Center, Hefei, China
| | - Xiaoqin Zhou
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, China
- Department of Psychiatry, Chaohu Hospital of Anhui Medical University, Hefei, China
- Anhui Psychiatric Center, Hefei, China
- Department of Psychology and Sleep Medicine, The Second Affiliated Hospital of Anhui Medical University, Hefei, China
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14
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Gilbert LK, Matthews S, Dube SR, Annor FB. Approaches for measuring cumulative childhood adversity: A study of youth from 5 sub-Saharan African countries. CHILD ABUSE & NEGLECT 2024; 150:106542. [PMID: 37996356 PMCID: PMC10961201 DOI: 10.1016/j.chiabu.2023.106542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 11/25/2023]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) include forms of abuse, neglect, and household stressors that are potentially early life traumatic experiences. A summed integer count of ACEs is often used to examine cumulative childhood adversity (CCA) but has limitations. OBJECTIVES The current study tests two additional methods for measuring CCA using large samples of youth in low- and middle-income countries. PARTICIPANTS AND SETTING Pooled data were analyzed from a multi-country, nationally representative sample of youth aged 18-24 years (N = 11,498) who completed the Violence Against Children and Youth Surveys (VACS) in Lesotho, Cote d'Ivoire, Kenya, Namibia, and Mozambique. METHODS ACE exposures included: physical, sexual, and emotional violence; witnessing interparental violence; witnessing community violence; orphanhood. CCA was operationalized using an ACE score, ACE impact (standardized regression coefficients from outcome severity), and ACE exposure context (household; intimate partner; peer; community). Associations between CCA with mental distress (MD) were examined by sex using p ≤ 0.05 as the significance level. RESULTS Exposure to ≥3 ACEs was associated with MD (p < 0.05) for both sexes. Among females, all contexts contributed to MD except peer ACEs (p < 0.05). Among males, household and community ACEs contributed to MD. High-impact ACEs were associated with MD both sexes. ACE context was the best-fitting model for these data. CONCLUSIONS The challenges operationalizing CCA warrant continued research to ensure adversity type, severity, and context lead to validly assessing ACEs impact on child wellbeing.
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Affiliation(s)
- Leah K Gilbert
- Eunice Kennedy Shriver Pediatric Trauma and Critical Illness Branch, National Institute for Child Health and Human Development, National Institutes of Health, Bethesda, MD, United States.
| | - Sarah Matthews
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
| | - Shanta R Dube
- Levine College of Health Sciences, Department of Public Health, Wingate University, Wingate, NC, United States
| | - Francis B Annor
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, United States
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15
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Wang H, Xu S, Wang S, Wang Y, Chen R. Association between sports-related concussions and the risk of self-injury thoughts and behaviors: Who, and under what circumstances? J Affect Disord 2024; 350:801-812. [PMID: 38272361 DOI: 10.1016/j.jad.2024.01.182] [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: 09/11/2023] [Revised: 01/16/2024] [Accepted: 01/18/2024] [Indexed: 01/27/2024]
Abstract
BACKGROUND Understanding the association between sport-related concussions and the risk of suicidal and non-suicidal self-injury thoughts and behaviors (SITBs), including non-suicidal self-injury (NSSI), suicidal ideation (SI), suicidal plan (SP), and suicidal attempt (SA), is crucial for suicide prevention. We aimed to identify the circumstances in which individuals with or without a concussion are vulnerable to SITBs. METHODS The cross-sectional study included 85,469 students from 63 Chinese university with a mean age of 19.6 years. Firstly, propensity score matching, and inverse probability of treatment weighting (IPTW) were used to match the concussion and non-concussion group based on a range of biological, social, and psychological factors. Subsequently, multivariable logistic regression and a decision tree algorithm were employed to evaluate the interaction and cumulative impact of these risk factors and concussion on the probability of SITBs. RESULTS In the unmatched sample, concussion exposures were associated with all SITBs, with NSSI (OR, 1.41), SI (OR, 1.10), SP (OR, 1.23), and SA (OR, 1.28). However, the matched and weighted sample only had a significant association with NSSI and SI. The decision tree model revealed that, in the unmatched sample, among individuals without depressive symptoms or childhood emotional abuse, the risk of concussion on SITBs increased from 45.5 % to 65.2 % (χ2, 9.370; adjusted P = .002) after experiencing sexual abuse and verbal bullying. In the matched sample, the risk increased from 46.2 % to 64.6 % (χ2, 6.848; adjusted P = .009). CONCLUSION Our study revealed that individuals who suffered concussions exhibited a significantly higher risk of SITBs.
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Affiliation(s)
- Huagen Wang
- Vanke School of Public Health, Tsinghua University, Beijing, China; Institute for Healthy China, Tsinghua University, Beijing, China
| | - Shicun Xu
- Northeast Asian Research Center, Jilin University, Changchun 130012, China; Department of Population, Resources and Environment, Northeast Asian Studies College, Jilin University, Changchun 130012, China.
| | - Shihui Wang
- Vanke School of Public Health, Tsinghua University, Beijing, China; Institute for Healthy China, Tsinghua University, Beijing, China
| | - Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, China
| | - Runsen Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China; Institute for Healthy China, Tsinghua University, Beijing, China.
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16
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Rost K, Gossmann E, Fegert JM, Ziegenhain U, Köhler-Dauner F. Long-term consequences of childhood emotional abuse in mothers on parental load and child mental health. Acta Psychol (Amst) 2024; 244:104169. [PMID: 38341882 DOI: 10.1016/j.actpsy.2024.104169] [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: 08/02/2023] [Revised: 01/29/2024] [Accepted: 01/29/2024] [Indexed: 02/13/2024] Open
Abstract
BACKGROUND Childhood emotional maltreatment can be associated with long-term consequences on mental health. In addition, transgenerational transmission of adverse childhood experiences to the next generation can occur and thus have an impact on the mental health of one's own children. OBJECTIVE The purpose of this study was to examine the role of stress on the association between childhood emotional maltreatment and parental load what is referred to in this study as limitations in parental functioning that affect the resources available to parents to cope with the demands of raising, caring for, and providing for their child. Furthermore the effect of parental load on the mental health of one's own children will be examined. PARTICIPANTS AND SETTING N = 237 mother-child dyads (age mother M = 33.76, SD = 4.07 years; age child M = 11.91 months, SD = 0.89 months) from a longitudinal cohort study were examined at two different measuring points. METHODS Emotional abuse, perceived stress, parental load and child mental health were assessed using self and external report questionnaires. RESULTS The calculation of a mediation showed that the association of emotional abuse and parental load was completely mediated by perceived stress (indirect effect ab = 0.44, 95 %-CI[0.17, 0.78]). In addition, effects of parental load on the child's mental health (β = 0.13, 95%CI [0.07;0.20]), mainly hyperactivity (β = 0.06, 95%CI [0.03;0.11]) and prosocial behavior (β = -0.04, 95%CI [-0.07; -0.01]), were evident. CONCLUSIONS The results of this study provide evidence that the mental health of children can be influenced in the long term by increased parental load.
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Affiliation(s)
- Katharina Rost
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany.
| | - Emily Gossmann
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany
| | - Jörg M Fegert
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany
| | - Ute Ziegenhain
- Department of Child and Adolescent Psychiatry/Psychotherapy, Ulm University, Ulm, Germany
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17
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Bravo LG, Ford JD, Giscombe CW, Cooke AN, Stein GL, Gonzalez-Guarda RM, Jones CB, Briggs EC. Service utilization among adolescents seeking trauma-related care: Differences by risk for suicide and ethnoracial background. Res Nurs Health 2024; 47:161-171. [PMID: 38521980 DOI: 10.1002/nur.22380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 02/14/2024] [Accepted: 03/01/2024] [Indexed: 03/25/2024]
Abstract
Adolescents from ethnoracially minoritized backgrounds increasingly report high rates of attempted suicide, trauma exposure, and limited access to mental healthcare services. However, less is known regarding their use of services across different youth-serving systems. This study examines the associations and interactions between self-injurious thoughts and behaviors (SITBs), race/ethnicity, and service sector utilization (mental healthcare, general healthcare, school, and social services) among a sample of trauma-exposed and treatment-seeking adolescents. Participants were treatment-seeking adolescents (N = 4406) ages 12-17 from the National Child Traumatic Stress Network Core Data Set who had available data for SITBs, race/ethnicity, services utilized, and other key variables. Mixed effects logistic regression was used to examine main and interactive effects for whether adolescents' race/ethnicity and SITBs were associated with service utilization in each of the identified service sectors. SITBs were associated with adolescents' utilization of mental healthcare (OR = 1.38 p < 0.001), general healthcare (OR = 2.30; p < 0.001), and school services (OR = 1.38 p < 0.001). NH Black adolescents reporting SITBs were less likely to use mental health services than other NH Black youths (OR = 0.53; p = 0.004). Hispanic adolescents reporting SITBs were more likely to utilize healthcare services than other Hispanic youths (OR = 1.51; p = 0.039). Trauma-exposed adolescents reporting SITBs are more likely to utilize mental healthcare, general healthcare, and school-based services than other trauma-exposed adolescents. However, NH Black adolescents experiencing SITBs may face additional barriers to utilizing mental healthcare services. Findings can be used to develop nursing practices and policies to address barriers faced by adolescents reporting SITBs.
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Affiliation(s)
- Lilian G Bravo
- Division of General Internal Medicine & Health Services Research, University of California, Los Angeles School of Medicine, Los Angeles, CA, USA
- University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, NC, USA
| | - Julian D Ford
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT, USA
| | | | - Alison N Cooke
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Gabriela Livas Stein
- Department of Human Development and Family Sciences, University of Texas at Austin School of Human Ecology, Austin, TX, USA
| | | | - Cheryl B Jones
- University of North Carolina at Chapel Hill School of Nursing, Chapel Hill, NC, USA
| | - Ernestine C Briggs
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
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18
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Sigrist C, Jakob H, Beeretz CJ, Schmidt SJ, Kaess M, Koenig J. Diurnal variation of cardiac autonomic activity in adolescent non-suicidal self-injury. Eur Arch Psychiatry Clin Neurosci 2024; 274:609-628. [PMID: 36871247 PMCID: PMC10995014 DOI: 10.1007/s00406-023-01574-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 02/13/2023] [Indexed: 03/06/2023]
Abstract
Heart rate (HR) and vagally mediated heart rate variability (HRV) are two distinct biomarkers of cardiac autonomic activity. Decreased cardiac vagal activity (or decreased HRV) in particular has been linked with impairments in the functional flexibility of the central autonomic network (CAN), resulting in impaired stress and emotion regulatory capacities. Decreased HRV is widely used as trait marker of psychopathology. Repetitive engagement in non-suicidal self-injury (NSSI) in adolescence correlates with both deficits in stress and emotion regulation, as well as decreased HRV. Existing research has, however, focused on short-term recordings of HR and HRV under resting and phasic conditions. In this study, we examined whether diurnal variation of cardiac autonomic activity, indexed by cosinor parameters of HR and HRV derived from 48 h of ambulatory ECG recording under natural conditions over a weekend, are altered in female adolescents with NSSI disorder compared to controls (HC; N = 30 per study group). Several important confounds, including physical activity, were controlled for. Female adolescents with NSSI show higher rhythm-adjusted 24 h mean levels and greater respective amplitude of HR, as well as lower rhythm-adjusted 24 h mean levels and smaller respective amplitude of HRV. Peak levels in both HR and HRV in the NSSI group were reached approximately 1 h later compared to HC. Severity of exposure to early life maltreatment might be linked with altered amplitudes of 24 h HR and HRV. Diurnal rhythms of cardiac autonomic activity might hold promise as objective indicators of disordered stress and emotion regulation in developmental psychopathology, and as such should be investigated in future studies with rigorous assessment and control of potential confounds.
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Affiliation(s)
- Christine Sigrist
- Faculty of Medicine, Clinic and Policlinic for Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University of Cologne, University Hospital Cologne, Cologne, Germany.
| | - Hannah Jakob
- Clinic for Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Christoph J Beeretz
- Clinic for Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
| | - Stefanie J Schmidt
- Department of Clinical Psychology and Psychotherapy, University of Bern, Bern, Switzerland
| | - Michael Kaess
- Clinic for Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Julian Koenig
- Faculty of Medicine, Clinic and Policlinic for Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University of Cologne, University Hospital Cologne, Cologne, Germany
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Wang H, Xu S, Wang S, Wang Y, Chen R. Using decision tree to predict non-suicidal self-injury among young adults: the role of depression, childhood maltreatment and recent bullying victimization. Eur J Psychotraumatol 2024; 15:2322390. [PMID: 38445506 PMCID: PMC10919298 DOI: 10.1080/20008066.2024.2322390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/13/2024] [Indexed: 03/07/2024] Open
Abstract
Importance: Non-suicidal self-injury (NSSI) is a significant mental health issue requiring a deeper understanding of its underlying causes, such as childhood maltreatment, adult bullying victimization, and depression. Previous studies have not adequately addressed the cumulative risks of these factors on NSSI among college students. This population-based study investigates these cumulative risk factors.Design, setting, and participants: The cross-sectional study included 63 university's college students with a mean age of 19.6 years (N = 95,833).Main outcomes and measures: Two Chi-Square Automatic Interaction Detection (CHAID) decision tree models were used to classify subgroups based on childhood maltreatment and adult bullying victimization experiences and to investigate their cumulative risks of NSSI. Recursive partitioning algorithms determined each predictor variable's relative importance.Results: The CHAID model accurately predicted NSSI behaviours with an overall accuracy rate of 77.8% for individuals with clinically relevant depressive symptoms and 97.2% for those without. Among depressed individuals, childhood emotional abuse was the strongest NSSI predictor (Chi-Square, 650.747; adjusted P < .001), followed by sexual and physical abuse. For non-depressed individuals, emotional abuse in childhood was the strongest NSSI predictor (Chi-Square, 2084.171; adjusted P < .001), with sexual and verbal bullying in the past year representing the most significant proximal risks.Conclusions and relevance: Emotional abuse during childhood profoundly impacts individuals, increasing the risk of NSSI in both depressed and non-depressed individuals. Clinically relevant depressive symptoms have a moderating effect on the relationship between childhood maltreatment, adult bullying victimization, and NSSI. Identifying these factors can inform targeted interventions to prevent NSSI development among young adults.
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Affiliation(s)
- Huagen Wang
- Vanke School of Public Health, Tsinghua University, Beijing, People’s Republic of China
- Institute for Healthy China, Tsinghua University, Beijing, People’s Republic of China
| | - Shicun Xu
- Northeast Asian Research Center, Jilin University, Changchun, People’s Republic of China
- Department of Population, Resources and Environment, Northeast Asian Studies College, Jilin University, Changchun, People’s Republic of China
| | - Shihui Wang
- Vanke School of Public Health, Tsinghua University, Beijing, People’s Republic of China
- Institute for Healthy China, Tsinghua University, Beijing, People’s Republic of China
| | - Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, People's Republic of China
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, People’s Republic of China
| | - Runsen Chen
- Vanke School of Public Health, Tsinghua University, Beijing, People’s Republic of China
- Institute for Healthy China, Tsinghua University, Beijing, People’s Republic of China
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20
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Euteneuer F, Lass-Hennemann J, Pfundmair M, Salzmann S, Kuehl LK. Childhood emotional maltreatment and sensitivity to social rejection in emerging adults. CHILD ABUSE & NEGLECT 2024; 149:106604. [PMID: 38160496 DOI: 10.1016/j.chiabu.2023.106604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 11/20/2023] [Accepted: 12/12/2023] [Indexed: 01/03/2024]
Abstract
BACKGROUND Enhanced responsiveness to social rejection may be a transdiagnostic mechanism through which childhood emotional maltreatment predisposes individuals to interpersonal and mental health problems. To investigate this mechanism, as a first step, more detailed investigations are needed regarding the assumed association of childhood emotional maltreatment with rejection sensitivity in later life. OBJECTIVE The present work examines the hypothesis that among different subtypes of childhood maltreatment, in particular forms of emotional maltreatment (emotional abuse and neglect) relate to rejection sensitivity in emerging adults. PARTICIPANTS AND SETTING In study 1, 311 emerging adults (18-25 years) participated in a retrospective cross-sectional assessment. In study 2, 78 emerging adults (18-25 years) were included in an experiment (O-Cam paradigm) which involved the experience of social rejection (vs. inclusion). METHODS Study 1 investigates whether intensities of childhood emotional abuse and neglect have unique associations with trait rejection sensitivity, when considering all maltreatment subtypes (emotional abuse, sexual abuse, physical abuse, emotional neglect, physical neglect) simultaneously. Study 2 examined whether childhood emotional abuse and neglect moderate the experience of social rejection in terms of need depletion, sadness and anger after social rejection (vs. inclusion). RESULTS Study 1 indicates that emotional abuse and neglect have unique associations with rejection sensitivity. Study 2 results show that only a higher intensity of emotional abuse has extensive effects on need depletion and sadness after social rejection (vs. inclusion). CONCLUSIONS In particular, experiences of childhood emotional abuse may relate to rejection sensitivity in young adulthood.
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Affiliation(s)
- Frank Euteneuer
- Clinical Psychology and Psychotherapy, Department of Psychology, Medical School Berlin, Berlin, Germany; Division of Translational Clinical Stress Research, Institute of Neuroscience and Biopsychology for Clinical Application, Medical School Berlin, Berlin, Germany.
| | - Johanna Lass-Hennemann
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Saarland University, Saarbrücken, Germany
| | - Michaela Pfundmair
- Faculty of Intelligence, Federal University of Administrative Sciences, Berlin, Germany
| | - Stefan Salzmann
- Medical Psychology, Department of Medicine, Health and Medical University, Erfurt, Germany; Division of Clinical Psychology and Psychotherapy, Department of Psychology, University of Marburg, Marburg, Germany
| | - Linn Kristina Kuehl
- Clinical Psychology and Psychotherapy, Department of Psychology, Medical School Berlin, Berlin, Germany; Division of Translational Clinical Stress Research, Institute of Neuroscience and Biopsychology for Clinical Application, Medical School Berlin, Berlin, Germany
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21
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Shi X, Meng Y, Cheng B, Long L, Yin L, Ye A, Yi X, Ran M. Association between traumatic events with suicidality among adolescents: A large-scale cross-sectional study of 260,423 participants. Psychiatry Res 2024; 333:115762. [PMID: 38310687 DOI: 10.1016/j.psychres.2024.115762] [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: 07/23/2023] [Revised: 01/22/2024] [Accepted: 01/26/2024] [Indexed: 02/06/2024]
Abstract
Traumatic events have significant negative impacts throughout one's life. We aimed to comprehensively examine the early associations between traumatic events and suicidality among adolescents. In a cross-sectional sample of 260,423 adolescents in Deyang, China in September 2021, we assessed individual traumatic events, cumulative types, and patterns, alongside suicide risk scores and ideation, attempts, or plans. Linear and Poisson regression models adjusted for demographic confounders evaluated the association. Robust associations existed between interpersonal violence-related traumatic events and higher suicidality, with physical abuse demonstrating the strongest correlation. Moreover, suicide risk scores displayed a clear trend, indicating a progressively stronger association with suicidality as cumulative traumatic event types increased. Four distinct traumatic patterns emerged, including low traumas, high physical abuse, high death/serious injuries of a loved one, and multiple traumas, with the latter showing the strongest association with suicidality. Notably, the stratified analysis showed these associations were more pronounced in females, urban residents, only children, left-behind children, and those aged 13-15, while weaker in participants from families with intact parental relationships and middle socioeconomic status. Understanding the role of demographic factors and traumatic patterns in identifying at-risk youth can enable early detection and targeted interventions for suicide-related concerns.
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Affiliation(s)
- Xinyi Shi
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China
| | - Yajing Meng
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China.
| | - Bochao Cheng
- Department of Radiology, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Lu Long
- Department of Epidemiology and Biostatistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Li Yin
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China
| | - Anhong Ye
- Mental Health Center, Zigong Hospital Affiliated to Southwest Medical University, Zigong, Sichuan, PR China
| | - Xingjian Yi
- Department of Psychosomatic Medicine, Dazhou Yuanda United Hospital, Dazhou, Sichuan, PR China
| | - Maosheng Ran
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, Sichuan, PR China
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22
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Ying W, Shen Y, Ou J, Chen H, Jiang F, Yang F, Li J, Qian X, Luo W, Wang G, Dong H. Identifying clinical risk factors correlated with addictive features of non-suicidal self-injury among a consecutive psychiatric outpatient sample of adolescents and young adults. Eur Arch Psychiatry Clin Neurosci 2024; 274:291-300. [PMID: 37314538 DOI: 10.1007/s00406-023-01636-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 06/03/2023] [Indexed: 06/15/2023]
Abstract
Non-suicidal self-injury (NSSI) is an issue primarily of concern in adolescents and young adults. Recent literature suggests that persistent, repetitive, and uncontrollable NSSI can be conceptualized as a behavioral addiction. The study aimed to examine the prevalence of NSSI with addictive features and the association of this prevalence with demographic and clinical variables using a cross-sectional and case-control design. A total of 548 outpatients (12 to 22 years old) meeting the criteria for NSSI disorder of DSM-5 were enrolled and completed clinical interviews by 4 psychiatrists. NSSI with addictive features were determined by using a single-factor structure of addictive features items in the Ottawa self-injury inventory (OSI). Current suicidality, psychiatric diagnosis, the OSI, the revised Chinese Internet Addiction Scale, the Childhood Trauma Questionnaire, and the 20-item Toronto Alexithymia Scale were collected. Binary logistic regression analyses were used to explore associations between risk factors and NSSI with addictive features. This study was conducted from April 2021 to May 2022. The mean age of participants was 15.93 (SD = 2.56) years with 418 females (76.3%), and the prevalence of addictive NSSI was 57.5% (n = 315). Subjects with addictive NSSI had a higher lifetime prevalence of nicotine and alcohol use, a higher prevalence of current internet addiction, suicidality, and alexithymia, and were more likely to have physical abuse/neglect, emotional abuse, and sexual abuse than NSSI subjects without addictive features. Among participants with NSSI, the strongest predictors of addictive features of NSSI were female (OR = 2.405, 95% CI 1.512-3.824, p < 0.0001), alcohol use (OR = 2.179, 95% CI 1.378-3.446, p = 0.001), current suicidality (OR = 3.790, 95% CI 2.351-6.109, p < 0.0001), and psysical abuse in childhood (OR = 2.470, 95% CI 1.653-3.690, p < 0.0001). Nearly 3 out of 5 patients (12-22 years old) with NSSI met the criteria of NSSI with addictive features in this psychiatric outpatients sample. Our study demonstrated the importance of the necessity to regularly assess suicide risk, and alcohol use, as well as focus more on females and subjects who had physical abuse in childhood to prevent addictive NSSI.
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Affiliation(s)
- Wang Ying
- Mental Health Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Yidong Shen
- Department of Psychiatry, and National Clinical Research Center for Mental. Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Jianjun Ou
- Department of Psychiatry, and National Clinical Research Center for Mental. Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Hui Chen
- Department of Psychiatry, and National Clinical Research Center for Mental. Disorders, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Furong Jiang
- Mental Health Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Fangru Yang
- Mental Health Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jianling Li
- Mental Health Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Xiao Qian
- Mental Health Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Wenfeng Luo
- Mental Health Center of Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Gang Wang
- Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, China
| | - Huixi Dong
- Mental Health Center of Xiangya Hospital, Central South University, Changsha, Hunan, China.
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23
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Gong X, Zhang L. Childhood Maltreatment and Non-Suicidal Self-Injury in Adolescents: Testing a Moderated Mediating Model. JOURNAL OF INTERPERSONAL VIOLENCE 2024; 39:925-948. [PMID: 38229266 DOI: 10.1177/08862605231197747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/18/2024]
Abstract
There is a wealth of evidence to suggest that childhood maltreatment is a major risk factor contributing to non-suicidal self-injury (NSSI) among adolescents. However, how and under what conditions childhood maltreatment is related to NSSI remains largely unclear. This study examined the indirect effect of depressive symptoms in the relation between childhood maltreatment and non-suicidal self-injury, as well as the moderating role of cognitive reappraisal and emotion reactivity in those associations. A sample of 1,984 Chinese adolescents (Mage = 12.84, SD = 1.27, 47.9% girls) completed self-report questionnaires. The results of path analysis showed that childhood maltreatment was significantly related to NSSI and that depressive symptoms play an indirect effect in the relation between them. Cognitive reappraisal mitigated the effect of childhood maltreatment on depressive symptoms, and emotion reactivity strengthened the effect of depressive symptoms on non-suicidal self-injury. The results further showed that the indirect effect of depressive symptoms was more prominent for youths with lower levels of cognitive reappraisal and greater emotion reactivity. Interventions that enhance cognitive reappraisal and reduce emotion reactivity may interrupt the pathway from childhood maltreatment to NSSI via depressive symptoms.
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24
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Suhail Usmani S, Mehendale M, Yousif Shaikh M, Sudan S, Guntipalli P, Ouellette L, Sajid Malik A, Siddiqi N, Walia N, Shah K, Saeed F, De Berardis D, Shoib S. Understanding the Impact of Adverse Childhood Experiences on Non-suicidal Self-Injury in Youth: A Systematic Review. ALPHA PSYCHIATRY 2024; 25:150-164. [PMID: 38798814 PMCID: PMC11117420 DOI: 10.5152/alphapsychiatry.2024.231139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 01/24/2024] [Indexed: 05/29/2024]
Abstract
Objective Non-suicidal self-injury (NSSI), defined as a deliberate destruction of one's own body without a suicidal intent, is a global public health issue. Adverse childhood events (ACEs) have been shown to be associated with various mental illnesses; however, to date the impact of such events on NSSI in youth has not been reviewed. Methods We conducted a systematic review, searched 5 databases for published articles evaluating ACE and NSSI in youth less than or equal to 21 years of age. After screening 247 articles, we included 21 unique articles in this systematic review. Results Increasing ACE score, physical, sexual or emotional abuse, parental neglect and substance use, parental separation or dysfunctional family, and death of a close family member had statistically significant correlation with NSSI. Conclusion Non-suicidal self-injury is an impairing diagnosis with far reaching psychiatric manifestations and repercussions. Practitioners having high clinical suspicion for ACEs in youth with NSSI must intervene early by administering the ACEs questionnaire. Effective treatment of NSSI in those with ACEs with psychotherapy significantly improves outcomes and prevents suicide in youth.
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Affiliation(s)
- Sadia Suhail Usmani
- Department of Internal Medicine, Insight Hospital and Medical Center, Chicago, IL, USA
| | - Meghana Mehendale
- Department of Psychiatry, Smolensk State Medical University, Smolensk Oblast, Russia
| | - Mahnoor Yousif Shaikh
- Department of Psychiatry, Dow University of Health Sciences, Karachi, Sindh, Pakistan
| | - Sourav Sudan
- Department of Internal Medicine, Government Medical College, Baskshi Nagar, Jammu, Jammu and Kashmir, India
| | - Prathima Guntipalli
- Department of Internal Medicine, Texas Woman’s University, Southwestern Medical Ave., Dallas, TX, USA
| | - Lara Ouellette
- Department of Psychiatry, Texas Medical Center Library, Houston, TX, USA
| | - Anem Sajid Malik
- Department of Internal Medicine, King Edward Medical University, Nila Gumbad Chowk, Neela Gumbad, Lahore, Punjab, Pakistan
| | - Naila Siddiqi
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Namrata Walia
- Department of Psychiatry, University of Texas Health Sciences Center, Houston, TX, USA
| | - Kaushal Shah
- Department of Psychiatry, Wake Forest University School of Medicine Program, Winston-Salem, NC, USA
- Department of Psychiatry, Oklahoma State University, Tulsa, OK, USA
- Department of Psychiatry, Griffin Memorial Hospital, Norman, OK, USA
| | - Fahimeh Saeed
- Department of Psychiatry, Psychosis Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | | | - Sheikh Shoib
- Department of Psychiatry, DH Pulwama, Kashmir, India
- Department of Psychiatry, Sharda University, Greater Noida, Uttar Pradesh, India
- Department of Psychiatry, Mind wellness Center, Nawab Bazar Srinagar, India
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25
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Rong F, Wang M, Peng C, Cheng J, Wang Y, Yu Y. Specific and cumulative effects of childhood maltreatment on nonsuicidal self-injury in Chinese adolescents: The moderating effect of sleep disturbance. CHILD ABUSE & NEGLECT 2024; 149:106627. [PMID: 38227985 DOI: 10.1016/j.chiabu.2023.106627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 12/03/2023] [Accepted: 12/31/2023] [Indexed: 01/18/2024]
Abstract
BACKGROUND Numerous studies have examined the relationship between childhood maltreatment (CM) and nonsuicidal self-injury (NSSI). However, few studies have explored both the specific and cumulative effects of CM on NSSI. Additionally, the impact of sleep disturbance on the association between CM and NSSI remains unclear. OBJECTIVES To comprehensively explore the effects of CM on NSSI, and to determine whether these effects are moderated by sleep disturbance. PARTICIPANTS AND SETTING A retrospective study was conducted in April 2021 among a representative sample of 21,340 students aged 11-20 years in China. METHODS All participants completed questionnaires assessing CM, sleep disturbance, and NSSI. Adjusted multivariate logistic regression models were utilized to evaluate the associations between CM and NSSI, as well as the impact of sleep disturbance. RESULTS The findings revealed that 13.0 % of adolescents reported occasional NSSI, while 25.2 % reported repetitive NSSI. Except for sexual abuse, all subtypes of CM were significantly associated with increased odds of both occasional and repetitive NSSI. A significant dose-response relationship was observed between cumulative CM and repetitive NSSI. Stratification analyses by sleep disturbance indicated that adolescents reporting sleep disturbance had a higher risk of developing repetitive NSSI, irrespective of the type of CM experienced. Furthermore, a dose-response relationship was identified between cumulative CM and repetitive NSSI among adolescents reporting sleep disturbance. CONCLUSION This study demonstrated that CM increases the risk of NSSI among Chinese adolescents, and sleep disturbance plays a moderating role. Interventions targeting sleep disturbance may hold significance in reducing NSSI.
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Affiliation(s)
- Fajuan Rong
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mengni Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chang Peng
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Junhan Cheng
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yizhen Yu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China..
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26
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Ruan QN, Liu L, Shen GH, Wu YW, Yan WJ. Alexithymia and peer victimisation: interconnected pathways to adolescent non-suicidal self-injury. BJPsych Open 2024; 10:e46. [PMID: 38344860 PMCID: PMC10897695 DOI: 10.1192/bjo.2023.653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/20/2023] [Accepted: 12/22/2023] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND The prevalence of non-suicidal self-injury (NSSI) among adolescents underscores the importance of understanding the complex factors that drive this behaviour. Framed within broader constructs of emotional regulation theories, alexithymia and peer victimisation are thought to interact to influence NSSI behaviours. AIM This research addresses whether alexithymia and peer victimisation serve as risk factors for NSSI and, if so, how these factors interact with each other. METHOD This quantitative study analysed data from 605 adolescents, using a range of validated self-report measures including the Toronto Alexithymia Scale. Statistical analyses including one-way analysis of variance, multiple regression and structural equation modelling were employed to scrutinise the relationships among the variables. RESULTS Alexithymia and peer victimisation significantly predicted NSSI behaviours. Specifically, the 'difficulty in identifying feelings' subscale of alexithymia emerged as a noteworthy predictor of NSSI (P < 0.001). Peer victimisation mediated the relationship between alexithymia and NSSI, explaining approximately 24.50% of alexithymia's total effect on NSSI. In addition, age was a significant predictor of NSSI, but gender and education years were not (P > 0.05). These relationships were found to be invariant across genders. CONCLUSIONS This study enriches our understanding of the interplay between alexithymia, peer victimisation and NSSI, particularly within the Chinese context. Its findings have significant implications for a rethinking of alexithymia's theoretical construct and interventions targeting emotional literacy and peer dynamics among adolescents. Future research could benefit from a longitudinal design to establish causality.
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Affiliation(s)
| | - Linhui Liu
- Lishui Second People's Hospital, Affiliated to Wenzhou Medical University, Lishui, China
| | | | - Yu-Wei Wu
- Student Affairs Division, Wenzhou Business College, Wenzhou, China
| | - Wen-Jing Yan
- Wenzhou Medical University, Wenzhou, China; and Zhejiang Provincial Clinical Research Centre for Mental Illness, Affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou, China
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27
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Eggart V, Mortazavi M, Kirchner SK, Keeser D, Brandstetter L, Hasan A, Wagner E. Association of Four Medication Classes and Non-suicidal Self-injury in Adolescents with Affective Disorders - A Retrospective Chart Review. PHARMACOPSYCHIATRY 2024; 57:4-12. [PMID: 37722411 DOI: 10.1055/a-2153-4370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/20/2023]
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) behaviour is frequently observed in children and adolescents with psychiatric conditions. Affected individuals are regularly treated with psychotropic drugs, although the impact of these agents on NSSI behaviour remains elusive. METHODS We performed a retrospective chart review from clinical routine data in a large cohort (N=1140) of adolescent inpatients with primary affective and non-affective psychiatric disorders according to ICD-10 (mean age=15.3±1.3 years; 72.6% female). Four separate mixed regression models compared the frequency of NSSI between treatment periods without any medication and four medication categories (benzodiazepines, selective serotonin reuptake inhibitors (SSRIs), high- and low-potency antipsychotics). RESULTS In those individuals with affective disorders as the primary diagnosis, periods without medication were associated with significantly lower NSSI/day compared to all four other medication conditions (benzodiazepines p<10-8, antidepressants/SSRIs p=0.0004, high-potency antipsychotics p=0.0009, low-potency antipsychotics p<10 -4). In individuals with a primary diagnosis other than an affective disorder, NSSI was significantly lower during the period without medication compared to the treatment periods with benzodiazepines (p=0.005) and antidepressants/SSRIs (p=0.01). However, NSSI rates in the no-medication condition were comparable to NSSI rates under high-potency (p=0.89) and low-potency antipsychotics (p=0.53). CONCLUSIONS The occurrence of NSSI correlates with the treatment with a psychotropic drug in children and adolescents with psychiatric disorders. Due to the retrospective design, it remains elusive to what extent psychotropic drugs might alter the frequency of NSSI in adolescents or if NSSI might indicate a transdiagnostic feature of more pronounced disease severity.
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Affiliation(s)
- Vincent Eggart
- Department Rottmannshöhe, Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, KBO-Heckscher-Klinikum gGmbH, Munich, Germany
| | - Matin Mortazavi
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Sophie-Kathrin Kirchner
- Department of Psychiatry, Psychotherapy and Psychosomatics of the University Augsburg, Bezirkskrankenhaus Augsburg, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Daniel Keeser
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Lisa Brandstetter
- Department Rottmannshöhe, Child and Adolescent Psychiatry, Psychotherapy and Psychosomatics, KBO-Heckscher-Klinikum gGmbH, Munich, Germany
| | - Alkomiet Hasan
- Department of Psychiatry, Psychotherapy and Psychosomatics of the University Augsburg, Bezirkskrankenhaus Augsburg, Medical Faculty, University of Augsburg, Augsburg, Germany
| | - Elias Wagner
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
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Liu J, Yao Y, Deng X, Xu X, He W. How does emotional abuse affect adolescents' non-suicidal self-injury urges? A moderated chain mediation model. CHILD ABUSE & NEGLECT 2024; 147:106535. [PMID: 37980785 DOI: 10.1016/j.chiabu.2023.106535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 10/24/2023] [Accepted: 11/02/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND Studying non-suicidal self-injury (NSSI) among adolescents has high clinical significance. Its urges have been identified as a potential predictor of NSSI behavior and may serve as a crucial intervention target. OBJECTIVE This study uses a moderated chain mediation model to explore the relationship between emotional abuse and adolescent NSSI urges. Additionally, we examine the mediating roles of ego depletion and self-esteem and the moderating effect of resilience. PARTICIPANTS AND SETTING We recruited 1129 Chinese adolescents (age M = 16.68; SD = 0.78; 49.4 % men) from secondary vocational schools in China. METHODS We assessed emotional abuse, ego depletion, self-esteem, and NSSI urges in a longitudinal investigation across two time points (T1: March 2023, T2: June 2023). RESULTS After controlling for age, sex, NSSI urges and self-esteem at T1, our study validates a moderated chain mediation model and finds that the mediating effect via self-esteem is 0.026 (95%CI = [0.011,0.046]), and the chain mediating effect via ego depletion and self-esteem is 0.031 (95%CI = [0.022,0.045]), whereas the direct effect of emotional abuse T1 on NSSI urges T2 is not significant (DE = 0.082, 95%CI = [-0.002, 0.167]) and the mediating effect via ego depletion is also not significant (IE = -0.003, 95%CI = [-0.022, 0.015]). Resilience moderates the impact of emotional abuse on ego depletion (β = 0.09, p < 0.01). CONCLUSIONS These findings suggest that ego depletion and self-esteem are potential mechanisms related to emotional abuse and adolescents' NSSI urges, whereas resilience can play a moderating role in reducing ego depletion.
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Affiliation(s)
- Jie Liu
- School of Psychology, Shanghai Normal University, Shanghai 200234, China
| | - Yan Yao
- Pinghu Vocational Secondary School, China
| | - Xun Deng
- School of Psychology, Shanghai Normal University, Shanghai 200234, China
| | - Xiongwei Xu
- School of Education, Shanghai Normal University, Shanghai 200234, China.
| | - Wen He
- School of Psychology, Shanghai Normal University, Shanghai 200234, China.
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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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Xie X, Li Y, Liu J, Zhang L, Sun T, Zhang C, Liu Z, Liu J, Wen L, Gong X, Cai Z. The relationship between childhood maltreatment and non-suicidal self-injury in adolescents with depressive disorders. Psychiatry Res 2024; 331:115638. [PMID: 38035534 DOI: 10.1016/j.psychres.2023.115638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 11/21/2023] [Accepted: 11/25/2023] [Indexed: 12/02/2023]
Abstract
This study aims to explore the core symptoms of Non-Suicidal Self-Injury (NSSI) in adolescents with depressive disorders and the relationship between childhood maltreatment (CM) and NSSI symptoms by using network analysis. A total of 689 adolescents with depressive disorders participated in the survey. The Chinese version of the Adolescent Non-Suicidal Self-Injury Assessment Questionnaire (ANSAQ) and the Short Form of the Childhood Trauma Questionnaire (CTQ-SF) were employed to measure NSSI and the symptoms of CM, respectively. Using network analysis, the NSSI network and the CM-NSSI network were constructed to identify the most central symptoms and the bridge symptoms within the networks. Within the NSSI network, "Intentional scratches", " Intentionally hitting hard objects with your head ", " Intentionally hitting oneself with fists or harder objects ", and " Intentional pinching " were identified as the primary symptoms of NSSI. "emotional abuse", "sexual abuse", and " Intentionally cut yourself " emerged as three key bridge symptoms linking CM with NSSI. This research is the first to investigate the symptom network of CM-NSSI in a sample of adolescents with depressive disorders, providing a foundation for subsequent NSSI prevention and the development of targeted intervention strategies.
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Affiliation(s)
- Xiangying Xie
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Yinglin Li
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Jingfang Liu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Lili Zhang
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Ting Sun
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Chunlong Zhang
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Zhongchun Liu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China
| | - Jie Liu
- Virginia Commonwealth University Health System, Richmond, United States
| | - Li Wen
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan 430060, China.
| | - Xuan Gong
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan 430060, China.
| | - Zhongxiang Cai
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan 430060, China.
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Karmakar S, Duggal C. Trauma-Informed Approach to Qualitative Interviewing in Non-Suicidal Self-Injury Research. QUALITATIVE HEALTH RESEARCH 2024; 34:33-47. [PMID: 37924212 DOI: 10.1177/10497323231207746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2023]
Abstract
Non-suicidal self-injury (NSSI) is recognized as a public health concern owing to its chronic nature, association with suicide risk, and its growing prevalence rates across the globe. Including individuals living with NSSI in research is crucial as it offers opportunities to give primacy to participant voices and insights, further guiding therapeutic interventions. Research has established an association between history of traumatic events and adverse childhood experiences with subsequent risk of NSSI. When planning a qualitative research study with individuals with potential trauma history, researchers need to be aware of and sensitive to potential re-traumatization and distressing emotions that participants may experience during interviews, as well as complex trauma reactions that may affect individuals after study participation. The article emphasizes that researchers be cognizant of the multifaceted nature of trauma and how it can impact individuals and communities and be sensitive in their approach to interviewing vulnerable groups such as individuals with experiences of NSSI. The authors propose adopting a trauma-informed approach to ethically plan and conduct qualitative interviews exploring NSSI experiences. Trauma-informed recommendations for preparing and carrying out specific steps during different stages of NSSI interviews are detailed.
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Affiliation(s)
- Sushmita Karmakar
- School of Human Ecology, Tata Institute of Social Sciences, Mumbai, India
| | - Chetna Duggal
- School of Human Ecology, Tata Institute of Social Sciences, Mumbai, India
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Navarro-Mateu F, Salmerón D, Vilagut G, Husky M, Ballesta M, Chirlaque MD, Huerta JM, Martínez S, Navarro C, Alonso J, Nock M, Kessler RC. Childhood adversities and suicidal behavior in the general population. The cross-sectional PEGASUS-Murcia Project. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2024; 17:11-18. [PMID: 33099026 DOI: 10.1016/j.rpsm.2020.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2020] [Revised: 09/30/2020] [Accepted: 10/05/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION The aim of the present study is to estimate the lifetime prevalence of suicidal ideation, plans, and attempts in a regional representative sample and the association of these outcomes with sociodemographic factors, prior mental disorders, and childhood adversities. MATERIAL AND METHODS The PEGASUS-Murcia project is a cross-sectional survey of a representative sample of adults in Murcia that is part of the WHO World Mental Health Survey Initiative. The Composite International Diagnostic Interview (CIDI 3.0) was administered face-to-face to 2621 participants (67.4% response rate). The main outcomes were suicidal ideation, plans, and attempts. Lifetime prevalence, age of onset, and risk factors (sociodemographic variables, mental disorders, and childhood adversities) were examined using multiple discrete-time survival models. RESULTS Lifetime prevalence of suicidal ideation, plans and attempts were 8.0% (standard error, SE: 1.1), 2.1% (SE: 0.3), and 1.2% (SE: 1.1), respectively. Prevalence of any childhood adversities was 22.1% (SE: 1.3) in the total sample and, even higher, among those with suicide related outcomes (ranging between 36.8% and 53.7%). Female sex, younger age, prior (to onset of the outcome) lifetime prevalence of mood disorders, number of mental disorders, and exposure to childhood adversity were associated with significantly increased odds of suicidal ideation and plans. CONCLUSIONS Lifetime prevalence estimates of suicidality are similar to those in community epidemiological surveys. Childhood adversities and mental disorders, especially mood disorders, are important risk factors for suicidality. Early detection of these adversities and disorders should be targeted in suicide prevention programs.
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Affiliation(s)
- Fernando Navarro-Mateu
- Unidad de Docencia, Investigación y Formación en Salud Mental (UDIF-SM), Servicio Murciano de Salud, Departamento de Psicología Básica y Metodología, Universidad de Murcia, Spain; IMIB-Arrixaca, Murcia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain
| | - Diego Salmerón
- IMIB-Arrixaca, Murcia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Departamento de Ciencias Sociosanitarias, Universidad de Murcia, Murcia, Spain.
| | - Gemma Vilagut
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; IMIM-Institut Hospital del Mar d'Investigacions Médiques, Barcelona, Spain
| | - Mathilde Husky
- Laboratoire de Psychologie, Université de Bordeaux, Burdeos, France
| | - Mónica Ballesta
- Departamento de Ciencias Sociosanitarias, Universidad de Murcia, Murcia, Spain; Servicio de Epidemiología, Consejería de Sanidad y Política Social, Murcia, Spain
| | - María Dolores Chirlaque
- IMIB-Arrixaca, Murcia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Departamento de Ciencias Sociosanitarias, Universidad de Murcia, Murcia, Spain; Servicio de Epidemiología, Consejería de Sanidad y Política Social, Murcia, Spain
| | - José María Huerta
- IMIB-Arrixaca, Murcia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Servicio de Epidemiología, Consejería de Sanidad y Política Social, Murcia, Spain
| | | | - Carmen Navarro
- IMIB-Arrixaca, Murcia, Spain; CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; Departamento de Ciencias Sociosanitarias, Universidad de Murcia, Murcia, Spain; Servicio de Epidemiología, Consejería de Sanidad y Política Social, Murcia, Spain
| | - Jordi Alonso
- CIBER de Epidemiología y Salud Pública (CIBERESP), Spain; IMIM-Institut Hospital del Mar d'Investigacions Médiques, Barcelona, Spain; Departamento de Salud y Ciencias Experimentales, Universidad Pompeu Fabra, Barcelona, Spain
| | - Matthew Nock
- Department of Psychology, Harvard University, Cambridge, USA
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, USA
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Liu J, Li JT, Zhou M, Liu HF, Fan YY, Mi S, Tang YL. Non-suicidal self-injury in adolescents with mood disorders and the roles of self-compassion and emotional regulation. Front Psychiatry 2023; 14:1214192. [PMID: 38179248 PMCID: PMC10764550 DOI: 10.3389/fpsyt.2023.1214192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Accepted: 11/30/2023] [Indexed: 01/06/2024] Open
Abstract
Objective We aimed to investigate the characteristics and psychological mechanism of non-suicidal self-injury (NSSI) in adolescents with mood disorders. We examined how self-compassion and emotional regulation affected NSSI and tested the mediating role of self-compassion in the link between emotional regulation and NSSI. Method We recruited outpatient and inpatient adolescent patients with bipolar and related disorders or depressive disorders (DSM-5), with a focus on NSSI. We also recruited healthy controls from the community. We collected demographic and clinical data. The Adolescent Self-injury Questionnaire, Self-compassion Scale (SCS), and Emotion Regulation Questionnaire (ERQ) were used to assess the frequency and severity of NSSI, level of self-compassion, and emotional regulation. Results In total, we recruited 248 adolescent patients with mood disorders (N = 196 with NSSI, and 52 without NSSI) and 212 healthy controls. NSSI was significantly associated with the female sex, lower levels of education and less use of cognitive reappraisal strategies, lower levels of self-warmth, and higher levels of self-coldness. Multivariate analysis of variance showed that there were significant differences in the scores of ERQ, cognitive reassessment score, and the scores of SCS among the three groups, but no statistical differences in expressive suppression score among the three groups. Self-warmth had a mediating effect between cognitive reappraisal and NSSI behavior. Conclusion NSSI is prevalent among adolescent patients with mood disorders in clinical settings, especially among girls and those with lower levels of education and less cognitive reappraisal strategies. More clinical attention is needed. Self-compassion and its factors may mediate the association between emotional regulation and NSSI. Clinical implications and future research directions were discussed.
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Affiliation(s)
- Jing Liu
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Jia-ting Li
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Man Zhou
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Hui-feng Liu
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yang-yang Fan
- Faculty of Economics and Management, East China Normal University, Shanghai, China
| | - Si Mi
- Beijing Key Laboratory of Mental Disorders, National Clinical Research Center for Mental Disorders & National Center for Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Yi-lang Tang
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
- Mental Health Service Line, Atlanta VA Medical Center, Decatur, GA, United States
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Lu J, Gao W, Wang Z, Yang N, Pang WIP, In Lok GK, Rao W. Psychosocial interventions for suicidal and self-injurious-related behaviors among adolescents: a systematic review and meta-analysis of Chinese practices. Front Public Health 2023; 11:1281696. [PMID: 38164448 PMCID: PMC10757980 DOI: 10.3389/fpubh.2023.1281696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 11/17/2023] [Indexed: 01/03/2024] Open
Abstract
Background Suicidal and self-injurious-related behaviors (SSIRBs) are a serious public health challenge in China. However, a comprehensive systematic review of psychosocial interventions for SSIRBs among Chinese adolescents has not been performed. To fill this gap, this systematic review and meta-analysis aimed to examine psychosocial interventions for SSIRBs among Chinese adolescents. Methods Eight international (PubMed, EMBASE, Cochrane Library, ScienceDirect, Clinical Trial, CINAHL, PsycINFO, and Web of Science) and four Chinese (Wanfang, SinoMed, CEPS, and CNKI) databases were searched from inception to 31 January 2023. Data extraction and quality assessment were independently conducted by two groups of researchers. Qualitative synthesis and meta-analysis were both used. Results The initial search yielded 16,872 titles. Of the 649 full texts reviewed, 19 intervention articles focusing on SSIRBs met the inclusion criteria. Thirteen out of the 19 included studies involved cognitive-behavioral therapy (CBT). Seven non-suicidal self-injury (NSSI) studies assessing self-injurious behaviors were included (six short-term studies and three long-term studies). Compared with long-term interventions [-1.30 (95% CI: -1.84, -0.76)], short-term psychosocial interventions had a higher standardized mean difference (SMD) value [1.86 (95% CI: -2.72, -0.99)]. Meta-regression showed an inverse relationship between the treatment response and sample size (slope = 0.068, Z = 2.914, p = 0.004) and proportion of females (slope = 1.096, Z = 5.848, p < 0.001). Subgroup analyses showed that compared with the "less than 1 month" group [-0.494 (-0.783, -0.205)], in the "immediate postintervention" group, the pooled estimate was significantly lower [-2.800 (-4.050, -1.550), p < 0.001]. Conclusion Our review systematically summarized the key characteristics and effectiveness of existing psychosocial interventions for SSIRBs among Chinese adolescents. Short-term psychosocial interventions for NSSI were significantly effective in reducing self-injurious behavior scores, especially in the immediate postintervention period. More favorable treatment responses could be observed in both male and small samples.
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Affiliation(s)
- Junjie Lu
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong, China
| | - Wanting Gao
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong, China
| | - Zexin Wang
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao, Macao SAR, China
| | - Nan Yang
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao, Macao SAR, China
| | - Weng Ian Phoenix Pang
- Faculty of Health Sciences and Sports, Macao Polytechnic University, Macao, Macao SAR, China
| | - Grace Ka In Lok
- Macao Polytechnic University, Peking University Health Science Center-Macao Polytechnic University Nursing Academy, Macao, Macao SAR, China
| | - Wenwang Rao
- Department of Preventive Medicine, Shantou University Medical College, Shantou, Guangdong, China
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Deng H, Zhang X, Zhang Y, Yan J, Zhuang Y, Liu H, Li J, Xue X, Wang C. The pooled prevalence and influential factors of non-suicidal self-injury in non-clinical samples during the COVID-19 outbreak: A meta-analysis. J Affect Disord 2023; 343:109-118. [PMID: 37802326 DOI: 10.1016/j.jad.2023.09.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 09/22/2023] [Accepted: 09/30/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND COVID-19 has had an enormous impact on the mental health of people around the world, particularly adolescents. Non-suicidal self-injury (NSSI) is one of the most prominent and dangerous behaviors associated with suicide. However, few meta-analyses of the NSSI prevalence have ever been conducted since the COVID-19 outbreak. Here, we conducted a meta-analysis to estimate the pooled prevalence and elucidate the influencing factors for NSSI. METHODS We searched PubMed, Web of Science, Embase, APA PsycINFO, CNKI and Wanfang Database for relevant literature published before April 2022. Pooled prevalence and 95 % confidence interval (CI) were used to assess NSSI prevalence. Subgroup and meta-regression analyses were performed to clarify the potential influencing factors. RESULTS A total of 15 studies with 24,055 participants were eventually included. The results showed that the pooled overall prevalence of NSSI among overall samples during the COVID-19 pandemic was 22.5 % (95 % CI: 17.2 % to 28.9 %). Subgroup and meta-regression analyses revealed that the crucial influencing factors for NSSI included gender, age, regional distribution, and suicidal ideation. Specifically, the NSSI prevalence among adolescents and adults during the pandemic was 32.40 % and 15.70 %, respectively. Most importantly, gender is a significant influencing factor for NSSI among adolescents. CONCLUSIONS The pooled prevalence of NSSI during the COVID-19 outbreak has surged to alarming heights, especially among adolescents. The prevalence of NSSI may be influenced by complex factors such as gender and age. Therefore, it is critical to pay attention to NSSI behaviors in the adolescent population, particularly male adolescents who appear to be susceptible.
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Affiliation(s)
- Hu Deng
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China.
| | - Xueqian Zhang
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China; Department of Psychology, Chengde Medical University, Chengde, China
| | - Yiyue Zhang
- Department of Psychology, School of Humanities and Social Sciences, Beihang University, Beijing, China
| | - Jingyi Yan
- Department of Psychology, Chengde Medical University, Chengde, China
| | - Yunyue Zhuang
- Department of Psychology, Chengde Medical University, Chengde, China
| | - Huaqing Liu
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Jiuju Li
- Peking University HuiLongGuan Clinical Medical School, Beijing Huilongguan Hospital, Beijing, China
| | - Xiao Xue
- Department of Psychiatry, Beijing First Hospital of Integrated Chinese and Western Medicine, Beijing, China
| | - Chundi Wang
- Department of Psychology, School of Humanities and Social Sciences, Beihang University, Beijing, China.
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Reichl C, Rockstroh F, Lerch S, Fischer-Waldschmidt G, Koenig J, Kaess M. Frequency and predictors of individual treatment outcomes (response, remission, exacerbation, and relapse) in clinical adolescents with nonsuicidal self-injury. Psychol Med 2023; 53:7636-7645. [PMID: 37282585 PMCID: PMC10755228 DOI: 10.1017/s0033291723001447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 03/23/2023] [Accepted: 05/01/2023] [Indexed: 06/08/2023]
Abstract
BACKGROUND Nonsuicidal self-injury (NSSI) is prevalent in adolescent clinical samples. There is evidence that NSSI can be treated effectively but data on individual treatment outcomes is limited. The goal of this study was to examine response, remission, exacerbation, and relapse rates over one and two years, respectively, among a clinical sample of adolescents with NSSI. Furthermore, we aimed to identify clinically relevant predictors of NSSI trajectories. METHODS The sample consists of n = 203 adolescents (12-17 y., 94% female) from a specialized outpatient clinic for risk-taking and self-harming behavior with NSSI on at least five days in the six months before first assessment. Assessments were completed at baseline and one (FU1) and two (FU2) years later using structured clinical interviews and self-report questionnaires. RESULTS At FU1, 75% reported a reduction in NSSI frequency by at least 50% (treatment response); among those, one third (25% of the entire sample) achieved a remission (0 NSSI); an exacerbation (⩾50% more NSSI) was observed in 11% of patients. Of those in remission, 41% relapsed one year later. Predictors of non-response or non-remission were inpatient treatment and depressive symptoms. Adolescents with lower NSSI frequency at baseline had a higher risk of exacerbation. Due to limited sample size at FU2 no prediction model for relapse was established. CONCLUSIONS While most adolescents presenting with NSSI achieved significant improvement, more attention should be paid to the rather low rates of full remission. Prediction and early detection of individuals who deteriorate during or relapse after treatment is critical.
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Affiliation(s)
- Corinna Reichl
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Franziska Rockstroh
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Stefan Lerch
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Gloria Fischer-Waldschmidt
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Julian Koenig
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
- Department of Child and Adolescent Psychiatry, University of Cologne, Faculty of Medicine and University Hospital Cologne, Psychosomatics and Psychotherapy, Cologne, Germany
| | - Michael Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Department of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
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Xiao Z, Murat Baldwin M, Wong SC, Obsuth I, Meinck F, Murray AL. The Impact of Childhood Psychological Maltreatment on Mental Health Outcomes in Adulthood: A Systematic Review and Meta-Analysis. TRAUMA, VIOLENCE & ABUSE 2023; 24:3049-3064. [PMID: 36123796 PMCID: PMC10594835 DOI: 10.1177/15248380221122816] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Childhood emotional abuse (CEA) and childhood emotional neglect (CEN) are the least well-studied forms of childhood maltreatment due to challenges in their definition and in detection. However, the available evidence suggests associations with multiple adulthood mental health problems in clinical and non-clinical populations. This systematic review and meta-analysis (PROSPERO registration number CRD42020197833) explored the associations between CEA and CEN and a range of adulthood mental health problems based on systematic searches of eight databases. In total, 79 English and 11 Chinese studies met our inclusion criteria. Results suggested that CEA and CEN had positive associations with various adulthood mental health problems (d = 0.02-1.84), including depression, anxiety, substance abuse, suicidal ideation or attempts, personality disorders, eating disorders, and other psychological symptoms in the general population and across different geographic regions. Furthermore, findings suggested that compared with the non-clinical population, individuals in clinical populations were more likely to have experienced emotional abuse and neglect during childhood. The review highlights the need for more research on emotional abuse and emotional neglect. Furthermore, future research should include more populations from non-western countries and non-college populations. They further underline the importance of addressing issues related to CEA/CEN experiences in the prevention and treatment of mental health issues in adulthood.
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Affiliation(s)
| | | | | | | | - Franziska Meinck
- University of Edinburgh, UK
- North-West University, Vanderbijlpark, South Africa
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Ge Y, Xiao Y, Li M, Yang L, Song P, Li X, Yan H. Maladaptive cognitive regulation moderates the mediating role of emotion dysregulation on the association between psychosocial factors and non-suicidal self-injury in depression. Front Psychiatry 2023; 14:1279108. [PMID: 38098637 PMCID: PMC10719840 DOI: 10.3389/fpsyt.2023.1279108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 11/10/2023] [Indexed: 12/17/2023] Open
Abstract
Introduction Non-suicidal self-injury (NSSI) is highly prevalent in depression, and is associated with psychosocial factors, emotion dysregulation, and strategies of cognitive emotion regulation. However, the internal combination and interactions of these risk factors in depression remain unclear. Methods Data from 122 patients with depression, including 56 with NSSI and 66 without NSSI, were analyzed. Self-rating scales were used to assess psychosocial factors, emotion dysregulation, and cognitive regulation strategies. Sparse partial least squares discriminant analysis (sPLS-DA) was employed to explore internal combinations in each profile. A moderated mediation model was applied to examine their interactional relationship. Results The results identified an NSSI-related psychosocial profile characterized by high neuroticism, childhood trauma, poor family functioning, and low psychological resilience. Emotion dysregulation, including high levels of alexithymia, anhedonia, and emotion regulation difficulties, mediated the association between this psychosocial profile and NSSI. The mediated effect was further moderated by maladaptive cognitive regulation strategies. Limitations Lack of sufficient information on NSSI frequency and severity. Relatively small sample size for discussing the impact of gender and age of depressive patients with NSSI. Conclusion These findings hold important implications for the prevention, treatment, and rehabilitation of NSSI.
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Affiliation(s)
- Yuqi Ge
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Yang Xiao
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Mingzhu Li
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Lei Yang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Peihua Song
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Xueni Li
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Hao Yan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- NHC Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
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Zinchuk MS, Druzhkova TA, Popova SB, Zhanina MY, Guekht AB, Gulyaeva NV. Early Adverse Family Experiences and Elevated Adrenocorticotropic Hormone Predict Non-Suicidal Self-Injury in Females with Non-Psychotic Mental Disorders and Suicidal Ideation. Biomedicines 2023; 11:3181. [PMID: 38137402 PMCID: PMC10740784 DOI: 10.3390/biomedicines11123181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 11/24/2023] [Accepted: 11/25/2023] [Indexed: 12/24/2023] Open
Abstract
Nonsuicidal self-injurious behavior (NSSI), prevalent in patients with non-psychotic mental disorders (NPMD), is associated with numerous adverse outcomes. Despite active research into the clinical and psychological aspects of NSSI, the underlying biological mechanisms remain obscure. Early adverse experiences are believed to induce long-lasting changes in neuroendocrine mechanisms of stress control playing a key role in NSSI development. The aim of the study was to evaluate parameters potentially predicting development of NSSI in female patients with NPMD and suicidal ideation. Eighty female patients over 18 years with NPMD and suicidal ideation (40 with and 40 without NSSI) and 48 age matching women without evidence of mental illness (healthy controls) were enrolled. Diagnostic interviews and self-report measures were used to assess childhood maltreatment, presence, frequency, and characteristics of suicidal and self-injurious thoughts and behaviors, the Beck Depression Inventory scale to assess severity of depression. Hypothalamic-pituitary-adrenal axis markers, hormones, and neurotrophic factors were measured in blood serum. The likelihood of developing NSSI in patients with NPMD and suicidal ideation was associated with early adverse family history and elevated adrenocorticotropic hormone levels. Dysregulation of hypothalamic-pituitary-adrenal axis as a result of early chronic stress experiences may represent critical biological mechanism promoting the development of NSSI behaviors in patients with NPMD.
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Affiliation(s)
- Mikhail S. Zinchuk
- Moscow Research and Clinical Center for Neuropsychiatry, 115419 Moscow, Russia; (M.S.Z.); (S.B.P.); (M.Y.Z.)
| | - Tatiana A. Druzhkova
- Moscow Research and Clinical Center for Neuropsychiatry, 115419 Moscow, Russia; (M.S.Z.); (S.B.P.); (M.Y.Z.)
| | - Sofya B. Popova
- Moscow Research and Clinical Center for Neuropsychiatry, 115419 Moscow, Russia; (M.S.Z.); (S.B.P.); (M.Y.Z.)
| | - Marina Y. Zhanina
- Moscow Research and Clinical Center for Neuropsychiatry, 115419 Moscow, Russia; (M.S.Z.); (S.B.P.); (M.Y.Z.)
- Department of Functional Biochemistry of Nervous System, Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, 117485 Moscow, Russia
| | - Alla B. Guekht
- Moscow Research and Clinical Center for Neuropsychiatry, 115419 Moscow, Russia; (M.S.Z.); (S.B.P.); (M.Y.Z.)
- Department of Neurology, Neurosurgery and Medical Genetics, Pirogov Russian National Research Medical University, 119049 Moscow, Russia
| | - Natalia V. Gulyaeva
- Moscow Research and Clinical Center for Neuropsychiatry, 115419 Moscow, Russia; (M.S.Z.); (S.B.P.); (M.Y.Z.)
- Department of Functional Biochemistry of Nervous System, Institute of Higher Nervous Activity and Neurophysiology, Russian Academy of Sciences, 117485 Moscow, Russia
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Xie X, Liu J, Gong X, Sun T, Li Y, Liu Z, Yang BX, Zhang L, Zhu K, Cai Z. Relationship Between Childhood Trauma and Nonsuicidal Self-Injury Among Adolescents with Depressive Disorder: Mediated by Negative Life Events and Coping Style. Neuropsychiatr Dis Treat 2023; 19:2271-2281. [PMID: 37905171 PMCID: PMC10613422 DOI: 10.2147/ndt.s431647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 10/12/2023] [Indexed: 11/02/2023] Open
Abstract
Purpose Nonsuicidal self-injury (NSSI) is related to childhood trauma, negative life events, and coping style, but the interaction among these factors and the mechanism by which they interact in adolescents with depressive disorder remain unclear. This paper explores how these factors interact to influence NSSI and provides evidence to develop prevention efforts and interventions for adolescents with depressive disorder with NSSI. Patients and Methods A cross-sectional design and convenient sampling method were used in this study. The Childhood Trauma Questionnaire, Adolescent Self-Rating Life Events Checklist, Trait Coping Style Questionnaire, and Adolescent Nonsuicidal Self-injury Assessment Questionnaire were completed by 540 adolescents with depressive disorder. Descriptive analysis, chi-square tests, t-tests, Pearson correlations, and serial mediation analyses were used in the data analysis. Results A total of 398 (79.442%) adolescents with depressive disorders reported experiences of NSSI. The results of serial mediation analyses determined that childhood trauma has a direct (estimate = 0.209, 95% CI: 0.063, 0.334) and indirect (estimate = 0.271, 95% CI: 0.199, 0.371) impact on NSSI. The indirect impact of childhood trauma on NSSI through negative life events alone (estimate = 0.096, 95% CI: 0.007, 0.169), coping styles alone (estimate = 0.088, 95% CI: 0.034, 0.183), and negative life events on coping styles (estimate = 0.086, 95% CI: 0.042, 0.162) was significant. Conclusion This study demonstrates that screening for childhood trauma should be considered when preventing and treating NSSI behavior in adolescents with depressive disorder. Managing negative life events and coping style may mitigate the negative impact of childhood trauma on NSSI behavior in adolescents with depressive disorder.
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Affiliation(s)
- Xiangying Xie
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
- School of Medicine, Yangtze University, Jingzhou, People’s Republic of China
| | - Jingfang Liu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
| | - Xuan Gong
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
| | - Ting Sun
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
| | - Yinglin Li
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
| | - Zhongchun Liu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
| | - Bing Xiang Yang
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
- School of Nursing, Wuhan University, Wuhan, People’s Republic of China
| | - Lili Zhang
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
| | - Kaimei Zhu
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
| | - Zhongxiang Cai
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, People’s Republic of China
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Goldbach RE, Neukel C, Panizza A, Reinken A, Krause-Utz A. Differentiating between intrapsychic symptoms and behavioral expressions of borderline personality disorder in relation to childhood emotional maltreatment and emotion dysregulation: an exploratory investigation. Eur J Psychotraumatol 2023; 14:2263317. [PMID: 37846822 PMCID: PMC10583625 DOI: 10.1080/20008066.2023.2263317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Accepted: 08/11/2023] [Indexed: 10/18/2023] Open
Abstract
BACKGROUND Borderline personality disorder (BPD) is a severe mental disorder, characterized by pronounced instability in emotions, self-image, and interpersonal relationships. Experiences of childhood maltreatment are among the risk factors for BPD. While self-damaging and aggressive acts often occur, not every person with the disorder shows markedly dysregulated behaviour. Internalized symptoms, such as shame, loneliness, and self-disgust tend to be more pervasive and persist after clinical remission. OBJECTIVE Here we investigated associations between BPD symptom severity, childhood maltreatment, and emotion regulation difficulties. We further explored if the Borderline Symptom List (BSL) could potentially be used to differentiate between internalized symptoms (intrapsychic strain) and externalized symptoms (dysregulated behaviours) in future research. METHOD 187 women with at least mild BPD symptoms (65% having a diagnosis of BPD) completed the BSL 23 including its 11-item supplement (BSL-S), the Childhood Trauma Questionnaire (CTQ), and Difficulties in Emotion Regulation Scale (DERS). Participants further underwent a semi-structured clinical interview to assess BPD criteria (International Personality Disorder Examination, IPDE). Multivariate models and regression-based bootstrapping analyses were performed to test direct and indirect effects. RESULTS Childhood trauma severity, especially emotional abuse, positively predicted BPD symptom severity. A significant indirect effect through emotion regulation difficulties was found (k2=.56). When exploring associations with BPD criteria (IPDE), the BSL-23 mean significantly correlated with separation anxiety, identity and mood problems, chronic emptiness, suicidal ideation, and dissociation, while the BSL-S correlated with self-harming impulsive behaviour and anger outbursts. CONCLUSIONS Findings complement previous research, highlighting the role of childhood maltreatment and emotion regulation difficulties in BPD. While our findings need to be seen as preliminary and interpreted with caution, they suggest that the BSL may be used to differentiate between internalized symptoms and behavioural expressions of BPD in future research. Such a distinction might help to deepen the understanding of this complex heterogenous disorder.
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Affiliation(s)
- Roosmarijn E. Goldbach
- Department of Psychology, Faculty of Social and Behavioral Sciences, Leiden University, the Netherlands
| | - Corinne Neukel
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Germany
| | - Angelika Panizza
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health Mannheim, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Aischa Reinken
- Department of Psychology, Faculty of Social and Behavioral Sciences, Leiden University, the Netherlands
| | - Annegret Krause-Utz
- Department of Psychology, Faculty of Social and Behavioral Sciences, Leiden University, the Netherlands
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Geng S, Wang L, Sun J, Xu M, Zhang L, Yi Z, Ji J, Zhang X. Risk factors and protective factors for nonsuicidal self-injury in adolescents: A hospital- and school-based case-control study. Clin Child Psychol Psychiatry 2023; 28:1321-1332. [PMID: 37038624 DOI: 10.1177/13591045231169087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Abstract
OBJECTIVE Nonsuicidal Self-Injury (NSSI) in China has increasingly interested clinicians, although few studies have investigated its risk and protective factors. This study examined the risk factors of NSSI among Chinese adolescents. METHODS The researchers recruited adolescent participants with NSSI from a hospital outpatient clinic to form a case group and recruited adolescents without NSSI who provided informed consent from the school to form a control group. Participants completed a questionnaire, and data were analyzed using logistic regression. RESULTS A total of 138 cases and 276 controls participated in this study. Binary multivariate logistic regression analysis with adjusting for age and sex showed that domestic violence (OR = 8.615, 95%CI: 3.081-24.091), parental overconcern (OR = 6.995, 95%CI: 3.447-14.192), guilt (OR = 4.949, 95%CI: 2.227-10.996), and school bullying (OR = 21.676, 95%CI: 6.799-69.109) increased the risk of NSSI, while peer support (OR = 0.068, 95%CI: 0.030-0.150) and living in an urban environment (OR = 0.157, 95%CI: 0.056-0.437) decreased the risk of NSSI. CONCLUSION Some psychosocial factors were confirmed to be independent risk and protective factors for NSSI in this study. However, the clinical significance of the results needs to be interpreted with caution due to sample size limitations.
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Affiliation(s)
- Shuo Geng
- Department of Clinical Psychology, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lin Wang
- Sleep Medicine Center, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jinping Sun
- Department of Neurology, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Mingdong Xu
- Department of Clinical Psychology, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Li Zhang
- Department of Psychology, Qingdao University, Qingdao, China
| | - Zhi Yi
- Department of Pediatric Neurology, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jun Ji
- College of Computer Science and Technology, Qingdao University, Qingdao, China
| | - Xu Zhang
- Department of Clinical Psychology, the Affiliated Hospital of Qingdao University, Qingdao, China
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Duprey EB, Handley ED, Wyman PA, Ross AJ, Cerulli C, Oshri A. Child maltreatment and youth suicide risk: A developmental conceptual model and implications for suicide prevention. Dev Psychopathol 2023; 35:1732-1755. [PMID: 36097812 PMCID: PMC10008764 DOI: 10.1017/s0954579422000414] [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: 11/06/2022]
Abstract
Experiences of child abuse and neglect are risk factors for youth suicidal thoughts and behaviors. Accordingly, suicide risk may emerge as a developmental process that is heavily influenced by the rearing environment. We argue that a developmental, theoretical framework is needed to guide future research on child maltreatment and youth (i.e., adolescent and emerging adult) suicide, and to subsequently inform suicide prevention efforts. We propose a developmental model that integrates principles of developmental psychopathology and current theories of suicide to explain the association between child maltreatment and youth suicide risk. This model bears significant implications for future research on child maltreatment and youth suicide risk, and for suicide prevention efforts that target youth with child maltreatment experiences.
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Affiliation(s)
- Erinn B. Duprey
- Children’s Institute, University of Rochester, Rochester, NY, USA
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
| | - Elizabeth D. Handley
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
- Department of Psychology, University of Rochester, Rochester, NY, USA
| | - Peter A. Wyman
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
| | - Andrew J. Ross
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
- Department of Psychology, University of Rochester, Rochester, NY, USA
| | - Catherine Cerulli
- Mt. Hope Family Center, University of Rochester, Rochester, NY, USA
- Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA
- The Susan B. Anthony Center, University of Rochester, Rochester, NY, USA
| | - Assaf Oshri
- Department of Human Development and Family Science, University of Georgia, Athens, GA, USA
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Wu B, Zhang H, Chen J, Chen J, Liu Z, Cheng Y, Yuan T, Peng D. Potential mechanisms of non-suicidal self-injury (NSSI) in major depressive disorder: a systematic review. Gen Psychiatr 2023; 36:e100946. [PMID: 37655114 PMCID: PMC10465892 DOI: 10.1136/gpsych-2022-100946] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 07/25/2023] [Indexed: 09/02/2023] Open
Abstract
Background Non-suicidal self-injury (NSSI) is a frequent and prominent phenomenon in major depressive disorder (MDD). Even though its prevalence and risk factors are relatively well understood, the potential mechanisms of NSSI in MDD remain elusive. Aims To review present evidence related to the potential mechanisms of NSSI in MDD. Methods According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines, articles for this systematic review were searched on Medline (through PubMed), Embase (through Elsevier), PsycINFO (through OVID) and Web of Science databases for English articles, as well as China National Knowledge Infrastructure (CNKI), SinoMed, Wanfang Data, and the Chongqing VIP Chinese Science and Technology Periodical (VIP) Databases for Chinese articles published from the date of inception to 2 August 2022. Two researchers (BW, HZ) independently screened studies based on inclusion and exclusion criteria and assessed their quality. Results A total of 25 157 studies were searched. Only 25 of them were ultimately included, containing 3336 subjects (1535 patients with MDD and NSSI, 1403 patients with MDD without NSSI and 398 HCs). Included studies were divided into 6 categories: psychosocial factors (11 studies), neuroimaging (8 studies), stress and hypothalamic-pituitary-adrenal (HPA) axis (2 studies), pain perception (1 study), electroencephalogram (EEG) (2 studies) and epigenetics (1 study). Conclusions This systematic review indicates that patients with MDD and NSSI might have specific psychosocial factors, aberrant brain functions and neurochemical metabolisms, HPA axis dysfunctions, abnormal pain perceptions and epigenetic alterations.
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Affiliation(s)
- Baichuan Wu
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Huifeng Zhang
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jinghong Chen
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- General Psychiatry Editorial Office, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiaye Chen
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhifen Liu
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, Shanxi, China
| | - Yuqi Cheng
- Department of Psychiatry, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Tifei Yuan
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Daihui Peng
- Division of Mood Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Zhang L, Wang P, Liu L, Wu X, Wang W. Childhood maltreatment affects college students' nonsuicidal self-injury: Dual effects via trauma-related guilt, trauma-related shame, and prosocial behaviors. CHILD ABUSE & NEGLECT 2023; 141:106205. [PMID: 37116449 DOI: 10.1016/j.chiabu.2023.106205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 04/02/2023] [Accepted: 04/17/2023] [Indexed: 06/05/2023]
Abstract
BACKGROUND Few studies have explored the impact of trauma-related guilt, trauma-related shame and prosocial behaviors on the relationship between childhood maltreatment and college students' NSSI. OBJECTIVE The present study examined how trauma-related guilt, trauma-related shame, and prosocial behaviors mediate the relationship between childhood maltreatment and college students' NSSI. PARTICIPANTS AND SETTING The sample comprised 496 college students (40.7 % male participants, age = 18.98 ± 1.35 years) from five universities in China. METHODS This longitudinal study was conducted three times with a six-month interval. Childhood maltreatment was assessed at Time 1; trauma-related guilt, trauma-related shame, and prosocial behaviors were assessed at Time 2; and NSSI was assessed at Time 3. RESULTS The results suggested that prosocial behaviors mediated the relationship between childhood maltreatment and college students' NSSI (β = 0.021, 95 % CI = 0.005 to 0.049), and trauma-related shame played a mediating role in the relationship between childhood maltreatment and college students' NSSI (β = 0.030, 95 % CI = 0.004 to 0.077). In addition, trauma-related guilt and prosocial behaviors showed a serial mediating effect between childhood maltreatment and NSSI (β = -0.002, 95 % CI = -0.009 to -0.0003). Trauma-related shame and prosocial behaviors also showed a serial mediating effect between childhood maltreatment and NSSI (β = 0.002, 95 % CI = 0.0002 to 0.009). CONCLUSION Prosocial behaviors act as a protective factor of college students' NSSI. Trauma-related shame following childhood maltreatment could reduce prosocial behaviors, which may ultimately increase NSSI.
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Affiliation(s)
- Liying Zhang
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University
| | - Peizhong Wang
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University
| | - Luming Liu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University
| | - Xinchun Wu
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University
| | - Wenchao Wang
- Beijing Key Laboratory of Applied Experimental Psychology, National Demonstration Center for Experimental Psychology Education (Beijing Normal University), Faculty of Psychology, Beijing Normal University.
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Zhao K, Tong S, Hong L, Yang S, Yang W, Xu Y, Fan Z, Zheng J, Yao K, Zheng T. Childhood trauma, peer victimization, and non-suicidal self-injury among Chinese adolescents: a latent variable mediation analysis. BMC Psychiatry 2023; 23:436. [PMID: 37322505 PMCID: PMC10268482 DOI: 10.1186/s12888-023-04848-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 05/05/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Childhood and peer experiences can influence adolescents' perceptions of interpersonal relationships, which can, in turn, influence their emotional states and behavior patterns. Non-suicidal self-injury (NSSI) is now a common problem behavior among adolescents. The present study examined the role of childhood trauma and peer victimization in adolescents' NSSI. METHODS A cross-sectional survey was conducted among 1783 adolescents (1464 girls and 318 boys) in the psychiatric outpatient clinics or wards of 14 psychiatric hospitals or general hospitals in nine provinces in China. Data were collected using the Multidimensional Peer Victimization Scale (MPVS), Short-form Childhood Trauma Questionnaire(CTQ-SF), and Functional Assessment of Self-Mutilation (FASM). Structural equation modeling (SEM) with latent variables was used to demonstrate the mediating role of peer victimization in the association between childhoodtrauma and NSSI. RESULTS The SEM analysis demonstrated that peer victimization plays a partial mediating role in the relationship between childhood trauma and NSSI. In addition, several covariates (such as age, gender, education level, and place of residence) effectively regulated the relationship between peer victimization and NSSI. CONCLUSION In future studies of NSSI among Chinese adolescents, attention should be paid to the roles of childhood trauma and peer bullying; there is a temporal sequence between these two variables and, to some extent, childhood trauma can have an impact on bullying during adolescence which, in turn, influences NSSI behavior.
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Affiliation(s)
- Ke Zhao
- Lishui Second People’s Hospital Afliated to Wenzhou Medical University, Lishui, 323000 China
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325000 China
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, Wenzhou, 325000 China
| | - Siyu Tong
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325000 China
| | - Lan Hong
- The Third Hospital of Quzhou, Quzhou, 324000 China
| | - Shang Yang
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325000 China
| | - Wenyun Yang
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325000 China
| | - Yao Xu
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325000 China
| | - Zilin Fan
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325000 China
| | - Jiaqi Zheng
- School of Mental Health, Wenzhou Medical University, Wenzhou, 325000 China
| | - Keqing Yao
- Shenzhen Mental Health Center, Shenzhen, Guangdong China
- Shenzhen Kangning Hospital, 77 Zhenbi Road, Pingshan District, Shenzhen, Guangdong 518118 China
| | - Tiansheng Zheng
- The Affiliated Kangning Hospital of Wenzhou Medical University Zhejiang Provincial Clinical Research Center for Mental Disorder, Wenzhou, 325000 China
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Cheng F, Shi L, Wang S, Jin Q, Xie H, Wang B, Zhang W. The relationship between childhood traumatic experience and suicidal tendency in non-suicidal self-injury behavior patients. BMC Psychiatry 2023; 23:401. [PMID: 37277735 DOI: 10.1186/s12888-023-04863-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/11/2023] [Indexed: 06/07/2023] Open
Abstract
BACKGROUND Individuals with non-suicidal self-injury (NSSI) behavior are usually prone to repeated, intentional, direct harm to their own bodies that is not allowed by society without suicidal ideation. Under this behavior guidance, childhood traumatic experience may easily cause a series of psychological comorbidity symptoms, such as anxiety and depression, finally leading to a suicidal tendency. METHODS A total of 311 adolescent NSSI behavioral patients were recruited at the Ningbo Kangning hospital, Zhejiang Province according to the DSM-5 diagnostic criteria. Demographic data, childhood abuse and neglect, internet addiction, self-esteem, anxiety, and suicidal tendency were evaluated. A structural equation model with a path induction mechanism was constructed to evaluate the relationship between distal and proximal factors related to suicidal tendencies due to childhood traumatic experiences in NSSI behavioral individuals. RESULTS Among the 311 subjects included in the survey, 250 (80.39%) suffered traumatic experiences, such as emotional abuse/physical abuse/sexual abuse/emotional neglect or physical neglect in their childhood, 303 (97.43%) had suicidal ideation, 271 (87.14%) showed the total score of self-esteem, 148 (47.59%) had different degrees of Internet addiction tendency, and 286 (91.96%) showed obvious anxiety. The established path model fit well (GFI = 0.996, RMSEA = 0.03), and the model showed that self-esteem, anxiety, and childhood traumatic experience had standardized coefficients of -0.235 (z = -4.742, p < 0.01), 0.322 (z = 6.296, p < 0.01), 0.205 (z = 4.047, p < 0.01), respectively, with suicidal ideation path, suggesting that self-esteem, Internet addiction, and anxiety showed significant mediating effects in the process of childhood traumatic experience affecting suicidal ideation. CONCLUSION In the context of childhood traumatic experience, it is often accompanied by a series of regulatory behaviors such as Internet addiction, self-esteem, and so on, which finally leads to anxiety, mental symptoms, and even suicidal tendencies. The results provide effective support for the structural equation modeling to evaluate the multi-level influence of NSSI behavior individuals and emphasize that childhood familial factors may lead to psychiatric comorbidity symptoms and suicidal behavior.
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Affiliation(s)
- Fang Cheng
- Department of Pediatric Psychology, Ningbo Kangning Hospital, Ningbo, 315201, Zhejiang, China
| | - Linwei Shi
- School of Mechanical Engineering and Automation, Fuzhou University, Fuzhou, 350116, China
| | - Shujun Wang
- Department of Pediatric Psychology, Ningbo Kangning Hospital, Ningbo, 315201, Zhejiang, China
| | - Qiong Jin
- Department of Pediatric Psychology, Ningbo Kangning Hospital, Ningbo, 315201, Zhejiang, China
| | - Huabing Xie
- Department of General Medicine, People's Hospital of Wuhan University, Wuhan, 430060, Hubei, China
| | - Beini Wang
- Department of Pediatric Psychology, Ningbo Kangning Hospital, Ningbo, 315201, Zhejiang, China.
| | - Wenwu Zhang
- Department of Pediatric Psychology, Ningbo Kangning Hospital, Ningbo, 315201, Zhejiang, China.
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Zheng X, Chen Y, Zhu J. Sleep problems mediate the influence of childhood emotional maltreatment on adolescent non-suicidal self-injury: The moderating effect of rumination. CHILD ABUSE & NEGLECT 2023; 140:106161. [PMID: 37002976 DOI: 10.1016/j.chiabu.2023.106161] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Revised: 02/01/2023] [Accepted: 03/24/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) is a highly serious public health problem among adolescents in China, and childhood emotional maltreatment has been found to be a risk factor for NSSI. OBJECTIVE Little is known about the longitudinal association between childhood emotional maltreatment and NSSI as well as its underlying mediating and moderating mechanisms. Thus, we hypothesized whether sleep problems mediated the association between childhood emotional maltreatment and NSSI, and whether this indirect effect was moderated by rumination. PARTICIPANTS AND SETTING A total of 1987 Chinese adolescents (56.1 % males; ages 10 to 14, M = 12.32, SD = 0.53) completed self-report questionnaires regarding childhood emotional maltreatment, sleep problems, rumination non-suicidal self-injury (NSSI) in three waves. METHODS Structural equation model was used to test a moderated mediation model, with gender, age and socioeconomic status and baseline measures as covariates. RESULTS Childhood emotional maltreatment was significantly associated with NSSI, and this association was mediated by sleep problems. Moderated mediation analyses revealed that rumination intensified the relation between childhood emotional maltreatment and sleep problems as well as the relation between sleep problems and NSSI. CONCLUSIONS Findings of this study demonstrate a relationship among childhood emotional maltreatment, sleep problems, rumination and NSSI. Interventions that target sleep problems and rumination may be beneficial for reducing NSSI for at-risk adolescents.
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Affiliation(s)
- Xiaoyu Zheng
- Center for Early Environment and Brain Development, School of Education, Guangzhou University, Guangzhou, China; Jing Hengyi School of Education, Hangzhou Normal University, Hangzhou, China
| | - Yuanyuan Chen
- School of Education, Guangzhou University, Guangzhou, Guangdong, China.
| | - Jianjun Zhu
- Center for Early Environment and Brain Development, School of Education, Guangzhou University, Guangzhou, China.
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Garbutt K, Rennoldson M, Gregson M. Shame and Self-Compassion Connect Childhood Experience of Adversity With Harm Inflicted on the Self and Others. JOURNAL OF INTERPERSONAL VIOLENCE 2023; 38:7193-7214. [PMID: 36541192 PMCID: PMC10170577 DOI: 10.1177/08862605221141866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Self-harm, suicide, and harm inflicted on others (e.g., victimization) remain key areas of public concern. Past research has explored the link between adverse childhood experiences (ACEs) and later self-harming and offending behaviors. However, research has not fully explored the interplay between ACEs and modifiable psychological factors, such as shame and self-compassion, that could be targeted to reduce the risk of harm and increase resilience and capacity for post-traumatic growth. The present study explored the relationship between ACEs, harm, shame, and self-compassion. A total of 1,111 adults participated. Approximately 49% were female, 45% male, and 2% nonbinary. Just under a third of the sample were incarcerated. We adopted a cross-sectional survey design and included current and retrospective data. The relationship between the variables was analyzed using Pearson product-moment correlation, and structural equation modeling was applied to explore the potential psychological pathways of causation. The model predicted just under 50% of the harm to self (i.e., self-harm) variance and just over a third (35%) of the harm to others (i.e., psychological and physical aggression) variance. ACEs, shame, and self-compassion had varying roles in mediating the relationship between ACEs and harm. The study increases our understanding of modifiable causal pathways between ACEs and later harming behaviors. Additionally, it indicates the importance of understanding the different dimensions of shame when considering ways to reduce the potential long-term negative consequences of ACEs.
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Zhou HY, Luo YH, Shi LJ, Gong J. Exploring psychological and psychosocial correlates of non-suicidal self-injury and suicide in college students using network analysis. J Affect Disord 2023:S0165-0327(23)00734-6. [PMID: 37257782 DOI: 10.1016/j.jad.2023.05.089] [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: 03/07/2023] [Revised: 05/23/2023] [Accepted: 05/24/2023] [Indexed: 06/02/2023]
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) and suicide are a serious health concern in young people. Remarkable progress has been made in understanding the correlates and risk factors for suicidality. However, it remains unclear the complex interplay between different factors and which factors are most saliently associated with NSSI and suicide risk and should be targeted for interventions. METHODS This study utilized network analysis to examine the interrelationship between NSSI, suicide and a variety of psychological (e.g., depression, psychotic-like experiences) and psychosocial (e.g., childhood maltreatment, family dysfunction, being bullied and social support) correlates in a sample of Chinese first year college students (n = 2328). RESULTS The severity of depressive symptoms was the only factor connected to both NSSI and suicide. Other psychiatric factors like psychotic experiences could only act in an indirect way via the bridging effect of depression. Emotional abuse, compared with other forms of childhood adversities, was found to be the most influential maltreatment form associated with suicidal ideation and attempts. Finally, social support showed the potential to lower the risk of self-injury and suicide in young people. LIMITATIONS Only a subset of risk and resilience factors of NSSI and suicide were included. Causal inference was impossible due to the cross-sectional design. CONCLUSIONS Our findings highlighted the importance of identifying risk groups with mental illnesses or negative childhood events, and providing additional support during the key time of transitioning into higher education.
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Affiliation(s)
- Han-Yu Zhou
- Shanghai Key Laboratory of Mental Health and Psychological Crisis Intervention, Affiliated Mental Health Center (ECNU), School of Psychology and Cognitive Science, East China Normal University, Shanghai, China; Shanghai Changning Mental Health Centre, Shanghai, China
| | - Yan-Hong Luo
- Department of Applied Psychology, Hunan university of Chinese medicine, Changsha, Hunan, China
| | - Li-Juan Shi
- School of Education, Hunan University of Science and Technology, Xiangtan, Hunan, China
| | - Jingbo Gong
- Shanghai Changning Mental Health Centre, Shanghai, China.
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