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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; 363:436-444. [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] [MESH Headings] [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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Hertel C, Cavelti M, Lerch S, Mürner-Lavanchy I, Reichl C, Koenig J, Kaess M. Does personality dysfunction add incremental utility over general psychopathology when modeling previous suicide attempts in adolescent patients? J Affect Disord 2024; 361:465-471. [PMID: 38897305 DOI: 10.1016/j.jad.2024.06.038] [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: 09/14/2023] [Revised: 05/24/2024] [Accepted: 06/14/2024] [Indexed: 06/21/2024]
Abstract
BACKGROUND Identifying patients at risk for a suicide attempt (SA) is critical in adolescents with mental disorders. The current study aimed to 1) examine whether personality dysfunction (PD) is associated with previous SA, 2) explore the incremental utility of PD over psychiatric disorders in modeling previous SA. METHODS The sample comprised of n = 498 adolescent patients (mean age = 15.41 years, 79.12 % females, inpatient 48.8 %, outpatient 51.2 %). SA in the past year, PD according to the alternative DSM-5 model for personality disorders, and psychiatric diagnoses were assessed using semi-structured interviews. Logistic regression and principal component analysis examining the associations and specific patterns of PD and SA in the past year were conducted. Hierarchical (stepwise) logistic regression was applied to investigate the incremental utility of PD over that of psychiatric diagnoses to identify individuals with SA in the past year. RESULTS Including all facets of PD revealed a significant model with SA in the past year as outcome (χ2(12) = 106.65, McFaddens Pseudo-R2 = 0.17, p < 0.01). Adding PD to the model explained a significant amount of variance in past SA over that of psychiatric diagnoses (Pseudo-R2 = 0.18, Wald χ2 = 43.05, p < 0.01). LIMITATIONS As we only studied past SA and due to the cross-sectional design, no conclusion regarding the prediction of future SA can be drawn. DISCUSSION PD should routinely be assessed in adolescent patients since individuals with PD are more likely to have attempted suicide even when controlling for comorbid psychiatric disorders. PD may represent an important target for intervention in those with suicidal thoughts and behaviors.
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Affiliation(s)
- C Hertel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - M Cavelti
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - S Lerch
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - I Mürner-Lavanchy
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - C Reichl
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - J Koenig
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Faculty of Medicine, University Hospital Cologne, University of Cologne, Cologne, Germany
| | - M Kaess
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; Clinic of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany.
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Li Y, Wan Z, Gong X, Wen L, Sun T, Liu J, Xie X, Zhang C, Cai Z. The association between child maltreatment, cognitive reappraisal, negative coping styles, and non-suicidal self-injury in adolescents with major depressive disorder. BMC Psychiatry 2024; 24:592. [PMID: 39223473 DOI: 10.1186/s12888-024-06041-2] [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: 01/30/2024] [Accepted: 08/22/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) is a significant public health concern among adolescents with major depressive disorders (MDD). Although previous research has linked child maltreatment (CM) to NSSI, the precise mechanisms remain unclear. This study aims to investigate the association between CM, cognitive reappraisal (CR), negative coping styles (NC) and NSSI in adolescents with MDD, from the perspectives of both Latent Variable Theory and the Network Theory of Mental Disorder. METHODS A sample of 651 adolescents with MDD was recruited from January to December 2023. Data on CM, CR, NC, and NSSI were collected through paper-based self-reported questionnaires. Data analysis primarily involved structural equation modeling and network analysis. RESULTS The reporting rate of NSSI among adolescents with MDD was 48.2%. CM showed a significant positive correlation with NSSI. NSSI was affected by CM through three paths: the mediating role of CR, the mediating role of NC, and the chain mediating role of both CR and NC. Emotional abuse (EA) was the central node, while NSSI, EA, and "The urge to cry quietly when faced with troubles"(NC10) were the key bridge nodes. CONCLUSIONS This study is the first to use both structural equation modeling and network analysis to explore the explore the relationship between CM, CR, NC, and NSSI in adolescents with MDD, providing a theoretical basis for future early prevention and targeted interventions for adolescents with MDD.
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Affiliation(s)
- Yinglin Li
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Zhiying Wan
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Xuan Gong
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Li Wen
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Ting Sun
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Jingfang Liu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Xiangying Xie
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Chunlong Zhang
- Department of Nursing, 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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Cadorna G, Vera San Juan N, Staples H, Johnson S, Appleton R. Review: Systematic review and metasynthesis of qualitative literature on young people's experiences of going to A&E/emergency departments for mental health support. Child Adolesc Ment Health 2024; 29:266-275. [PMID: 37828704 DOI: 10.1111/camh.12683] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/03/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND There has been an increase in children and young people attending emergency departments for mental health reasons, including self-harm. Patients often report having poor experiences when attending emergency departments for mental health support. However, there has yet to be a review exploring the experiences of young people. Our aim in this study was to synthesise qualitative literature on young people's experiences of going to emergency departments for mental health support. METHODS A systematic review and metasynthesis were conducted. Five databases and grey literature were searched for relevant studies. Five articles met study criteria and were analysed using an iterative process of thematic synthesis. RESULTS The synthesis yielded four overarching themes: (a) emergency departments' inability to meet the mental health needs of young people, (b) emergency departments exacerbating patient distress, (c) patients feeling like a burden or undeserving of treatment and (d) consequences of poor emergency department experiences. CONCLUSIONS These findings (based on a still very limited literature) highlight the role that emergency departments have in relation to being a key point of contact with young people who self-harm. To properly engage with patients, emergency departments need to have the resources to provide compassionate care and follow clinical guidelines regarding assessments.
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Affiliation(s)
- Gianna Cadorna
- Division of Psychiatry, University College London, London, UK
| | - Norha Vera San Juan
- Institute for Global Health, University College London, London, UK
- Rapid Research Evaluation and Appraisal Lab, University College London, London, UK
| | - Heather Staples
- Division of Psychiatry, University College London, London, UK
| | | | - Rebecca Appleton
- NIHR Mental Health Policy Research Unit, Division of Psychiatry, University College London, London, UK
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Bilello D, Townsend E, Broome MR, Armstrong G, Burnett Heyes S. Friendships and peer relationships and self-harm ideation and behaviour among young people: a systematic review and narrative synthesis. Lancet Psychiatry 2024; 11:633-657. [PMID: 39025094 DOI: 10.1016/s2215-0366(24)00170-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 05/03/2024] [Accepted: 05/20/2024] [Indexed: 07/20/2024]
Abstract
Friendships and peer relationships have an important role in the experience of self-harm ideation and behaviour in young people, yet they typically remain overlooked. This systematic review and narrative synthesis explores the extant literature on this topic to identify important relationships between these constructs. We did a keyword search of peer-reviewed empirical articles relating to friendships and peer relationships and self-harm ideation and behaviour in young people (aged 11-25 years). We identified 90 articles with evidence primarily from adolescents aged 11-18 years, including mixed genders and a majority of White individuals. Findings highlight substantive relationships between the key constructs, showing that: characteristics of friends and peers, including their self-harm ideation and behaviour, relate to and predict ego self-harm ideation and behaviour; friends and peers are important sources of support; and evidence on causal mechanisms is scarce but highlights potential peer selection and influence processes. Studies of the friends and peers of young people with self-harm ideation and behaviour highlight that: friends' attitudes to self-harm and suicide influence their responses to peers with self-harm ideation and behaviour; and friends who are bereaved and friend supporters experience negative outcomes such as symptoms of depression, anxiety, PTSD, and grief, alongside difficult emotions. Despite substantial heterogeneity across samples, study designs, and definition or measurement of the primary constructs, this work presents an initial step in organising a complex literature on a crucially important topic, which can help to inform future research and evidence-based interventions.
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Affiliation(s)
- Delfina Bilello
- School of Psychology and Institute for Mental Health, University of Birmingham, Birmingham, UK; Self-Harm Research Group, University of Nottingham, Nottingham, UK.
| | - Ellen Townsend
- Self-Harm Research Group, University of Nottingham, Nottingham, UK
| | - Matthew R Broome
- School of Psychology and Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - Gregory Armstrong
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia
| | - Stephanie Burnett Heyes
- School of Psychology and Institute for Mental Health, University of Birmingham, Birmingham, UK
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Winstone L, Jamal S, Mars B. Cyberbullying Perpetration and Victimization as Risk Factors for Self-Harm: Results From a Longitudinal Cohort Study of 13-14-Year-Olds in England. J Adolesc Health 2024; 75:298-304. [PMID: 38864792 DOI: 10.1016/j.jadohealth.2024.04.004] [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: 10/11/2023] [Revised: 02/26/2024] [Accepted: 04/04/2024] [Indexed: 06/13/2024]
Abstract
PURPOSE Cyberbullying is a crucial issue that affects adolescent mental health, with evidence to suggest that adolescents who are victims of cyberbullying are at higher risk for self-harm. However, longitudinal evidence is lacking, meaning the direction of effects cannot be established. This study investigated longitudinal associations between levels of cyberbullying involvement (bully, victim, or both), frequency, and self-harm a year later in an adolescent sample. METHODS Data were collected from Year 9 students (13-14-year-olds; N = 1,195) enrolled in 19 schools in Southwest England using an online questionnaire with a 1-year follow-up period (October 2019-October 2020). Multivariable logistic regression analysis was conducted to test for associations between different levels of cyberbullying involvement at baseline and the likelihood of self-harm a year later, adjusting for key covariates. A secondary regression analysis also explored the associations between the frequency of cyberbullying involvement at baseline and subsequent self-harm. RESULTS Compared to those with no cyberbullying involvement, individuals who were both victims and perpetrators (adjusted odds ratio = 2.94, 95% confidence interval: 1.99-4.34) as well as victims only (adjusted odds ratio = 2.81, 95% confidence interval: 1.95-4.04) showed an increased risk of subsequent self-harm. In terms of frequency, associations were found between frequent and occasional cyberbullying and self-harm for both victims and perpetrators; however, associations for the perpetrator group attenuated to the null following adjustment for covariates. DISCUSSION Our findings highlight cyberbullying in early adolescence as a risk factor for subsequent self-harm. Cyberbullying prevention should be a priority for school mental health interventions, with consideration that most perpetrators of cyberbullying may also be victims.
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Affiliation(s)
- Lizzy Winstone
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom; NIHR Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom.
| | - Sarah Jamal
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Becky Mars
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom; NIHR Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
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Taylor PJ, Adeyemi I, Marlow K, Cottam S, Airnes Z, Hartley S, Howells V, Dunn BD, Elliott RA, Hann M, Latham C, Robinson C, Turpin C, Kellett S. The Relational Approach to Treating Self-Harm (RELATE): study protocol for a feasibility randomised controlled trial study of cognitive analytic therapy for adults who self-harm versus treatment at usual. Pilot Feasibility Stud 2024; 10:101. [PMID: 39026281 PMCID: PMC11256374 DOI: 10.1186/s40814-024-01526-z] [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: 07/13/2023] [Accepted: 07/01/2024] [Indexed: 07/20/2024] Open
Abstract
BACKGROUND Self-harm is a prevalent behaviour that has a major detrimental impact on a person's life. Psychological therapies have the potential to help, but evidence of effective interventions remains limited. Access and acceptability of interventions can also be a significant challenge, with individuals either being unable to access help or having to endure long waiting lists. Cognitive analytic therapy (CAT) is a time-limited and relationally-focused psychotherapy that may provide a valuable treatment option for people who self-harm. This protocol outlines the methodology for the first feasibility randomised controlled trial (RCT) of CAT for adults that self-harm. The trial will aim to determine the feasibility, acceptability and safety of undertaking larger-scale evaluations of CAT for self-harm within an RCT context. METHOD An RCT design with 1:1 allocation to CAT plus treatment as usual (TAU) or TAU alone. Participants will be adult outpatients with three or more instances of self-harm in the past year (target sample of n = 60). CAT will be 8 one-to-one weekly 60-min sessions plus a follow-up session up to 8 weeks after the last session. Assessments will occur at baseline, 12 weeks and 18 weeks after randomisation. Qualitative interviews with participants will gain insights into the feasibility and acceptability of CAT. Feasibility outcomes will be judged against progression criteria. DISCUSSION CAT may be an effective and accessible treatment option for people who self-harm, providing a more relationally orientated alternative to more behavioural therapies. The proposed feasibility RCT is an important first step in evaluating CAT as a treatment for self-harm. TRIAL REGISTRATION The trial was pre-registered (21/10/22) on ISR CTN (ISRCTN code: ISRCTN75661422).
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Affiliation(s)
- Peter James Taylor
- Division of Psychology & Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK.
| | - Isabel Adeyemi
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Katie Marlow
- Rotherham, Doncaster, and South Humber NHS Foundation Trust, Doncaster, UK
| | - Sarah Cottam
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Zerena Airnes
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | | | - Victoria Howells
- Rotherham, Doncaster, and South Humber NHS Foundation Trust, Doncaster, UK
| | | | - Rachel A Elliott
- Division of Psychology & Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Mark Hann
- Division of Psychology & Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Cameron Latham
- Division of Psychology & Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Catherine Robinson
- Division of Psychology & Mental Health, School of Health Sciences, University of Manchester, Manchester Academic Health Sciences Centre, Manchester, UK
| | - Clive Turpin
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Stephen Kellett
- Rotherham, Doncaster, and South Humber NHS Foundation Trust, Doncaster, UK
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Cha J, Lee E, van Dijk M, Kim B, Kim G, Murphy E, Talati A, Joo Y, Weissman M. Polygenic scores for psychiatric traits mediate the impact of multigenerational history for depression on offspring psychopathology. RESEARCH SQUARE 2024:rs.3.rs-4264742. [PMID: 39070622 PMCID: PMC11275997 DOI: 10.21203/rs.3.rs-4264742/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
A family history of depression is a well-documented risk factor for offspring psychopathology. However, the genetic mechanisms underlying the intergenerational transmission of depression remain unclear. We used genetic, family history, and diagnostic data from 11,875 9-10 year-old children from the Adolescent Brain Cognitive Development study. We estimated and investigated the children's polygenic scores (PGSs) for 30 distinct traits and their association with a family history of depression (including grandparents and parents) and the children's overall psychopathology through logistic regression analyses. We assessed the role of polygenic risk for psychiatric disorders in mediating the transmission of depression from one generation to the next. Among 11,875 multi-ancestry children, 8,111 participants had matching phenotypic and genotypic data (3,832 female [47.2%]; mean (SD) age, 9.5 (0.5) years), including 6,151 [71.4%] of European ancestry). Greater PGSs for depression (estimate = 0.129, 95% CI = 0.070-0.187) and bipolar disorder (estimate = 0.109, 95% CI = 0.051-0.168) were significantly associated with higher family history of depression (Bonferroni-corrected P < .05). Depression PGS was the only PGS that significantly associated with both family risk and offspring's psychopathology, and robustly mediated the impact of family history of depression on several youth psychopathologies including anxiety disorders, suicidal ideation, and any psychiatric disorder (proportions mediated 1.39%-5.87% of the total effect on psychopathology; FDR-corrected P < .05). These findings suggest that increased polygenic risk for depression partially mediates the associations between family risk for depression and offspring psychopathology, showing a genetic basis for intergenerational transmission of depression. Future approaches that combine assessments of family risk with polygenic profiles may offer a more accurate method for identifying children at elevated risk.
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Affiliation(s)
| | | | | | - Bogyeom Kim
- Department of Psychology, Seoul National University
| | | | | | | | | | - Myrna Weissman
- Columbia University Vagelos College of Physicians and Surgeons
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Zhang B, You J, Rolls ET, Wang X, Kang J, Li Y, Zhang R, Zhang W, Wang H, Xiang S, Shen C, Jiang Y, Xie C, Yu J, Cheng W, Feng J. Identifying behaviour-related and physiological risk factors for suicide attempts in the UK Biobank. Nat Hum Behav 2024:10.1038/s41562-024-01903-x. [PMID: 38956227 DOI: 10.1038/s41562-024-01903-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 04/29/2024] [Indexed: 07/04/2024]
Abstract
Suicide is a global public health challenge, yet considerable uncertainty remains regarding the associations of both behaviour-related and physiological factors with suicide attempts (SA). Here we first estimated polygenic risk scores (PRS) for SA in 334,706 UK Biobank participants and conducted phenome-wide association analyses considering 2,291 factors. We identified 246 (63.07%) behaviour-related and 200 (10.41%, encompassing neuroimaging, blood and metabolic biomarkers, and proteins) physiological factors significantly associated with SA-PRS, with robust associations observed in lifestyle factors and mental health. Further case-control analyses involving 3,558 SA cases and 149,976 controls mirrored behaviour-related associations observed with SA-PRS. Moreover, Mendelian randomization analyses supported a potential causal effect of liability to 58 factors on SA, such as age at first intercourse, neuroticism, smoking, overall health rating and depression. Notably, machine-learning classification models based on behaviour-related factors exhibited high discriminative accuracy in distinguishing those with and without SA (area under the receiver operating characteristic curve 0.909 ± 0.006). This study provides comprehensive insights into diverse risk factors for SA, shedding light on potential avenues for targeted prevention and intervention strategies.
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Affiliation(s)
- Bei Zhang
- Institute of Science and Technology for Brain-Inspired Intelligence and Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, China
| | - Jia You
- Institute of Science and Technology for Brain-Inspired Intelligence and Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, China
| | - Edmund T Rolls
- Institute of Science and Technology for Brain-Inspired Intelligence and Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- Oxford Centre for Computational Neuroscience, Oxford, UK
- Department of Computer Science, University of Warwick, Coventry, UK
| | - Xiang Wang
- Medical Psychological Centre, The Second Xiangya Hospital, Central South University, Changsha, China
- Medical Psychological Institute, Central South University, Changsha, China
- China National Clinical Research Centre on Mental Disorders (Xiangya), Changsha, China
| | - Jujiao Kang
- Institute of Science and Technology for Brain-Inspired Intelligence and Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, China
| | - Yuzhu Li
- Institute of Science and Technology for Brain-Inspired Intelligence and Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, China
| | - Ruohan Zhang
- Department of Computer Science, University of Warwick, Coventry, UK
| | - Wei Zhang
- Institute of Science and Technology for Brain-Inspired Intelligence and Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, China
| | - Huifu Wang
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Shitong Xiang
- Institute of Science and Technology for Brain-Inspired Intelligence and Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, China
| | - Chun Shen
- Institute of Science and Technology for Brain-Inspired Intelligence and Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, China
| | - Yuchao Jiang
- Institute of Science and Technology for Brain-Inspired Intelligence and Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, China
| | - Chao Xie
- Institute of Science and Technology for Brain-Inspired Intelligence and Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, China
| | - Jintai Yu
- Institute of Science and Technology for Brain-Inspired Intelligence and Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China
| | - Wei Cheng
- Institute of Science and Technology for Brain-Inspired Intelligence and Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
- Key Laboratory of Computational Neuroscience and Brain Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, China.
- MOE Frontiers Centre for Brain Science, Fudan University, Shanghai, China.
- Fudan ISTBI-ZJNU Algorithm Centre for Brain-inspired Intelligence, Zhejiang Normal University, Jinhua, China.
| | - Jianfeng Feng
- Institute of Science and Technology for Brain-Inspired Intelligence and Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
- Key Laboratory of Computational Neuroscience and Brain Inspired Intelligence (Fudan University), Ministry of Education, Shanghai, China.
- Department of Computer Science, University of Warwick, Coventry, UK.
- MOE Frontiers Centre for Brain Science, Fudan University, Shanghai, China.
- Fudan ISTBI-ZJNU Algorithm Centre for Brain-inspired Intelligence, Zhejiang Normal University, Jinhua, China.
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Wang Z, Chen Y, Tao Z, Yang M, Li D, Jiang L, Zhang W. Quantifying the Importance of Non-Suicidal Self-Injury Characteristics in Predicting Different Clinical Outcomes: Using Random Forest Model. J Youth Adolesc 2024; 53:1615-1629. [PMID: 38300442 DOI: 10.1007/s10964-023-01926-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 12/03/2023] [Indexed: 02/02/2024]
Abstract
Existing research on non-suicidal self-injury (NSSI) among adolescents has primarily concentrated on general risk factors, leaving a significant gap in understanding the specific NSSI characteristics that predict diverse psychopathological outcomes. This study aims to address this gap by using Random Forests to discern the significant predictors of different clinical outcomes. The study tracked 348 adolescents (64.7% girls; mean age = 13.31, SD = 0.91) over 6 months. Initially, 46 characteristics of NSSI were evaluated for their potential to predict the repetition of NSSI, as well as depression, anxiety, and suicidal risks at a follow-up (T2). The findings revealed distinct predictors for each psychopathology. Specifically, psychological pain was identified as a significant predictor for depression, anxiety, and suicidal risks, while the perceived effectiveness of NSSI was crucial in forecasting its repetition. These findings imply that it is feasible to identify high-risk individuals by assessing key NSSI characteristics, and also highlight the importance of considering diverse NSSI characteristics when working with self-injurers.
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Affiliation(s)
- Zhenhai Wang
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
| | - Yanrong Chen
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
| | - Zhiyuan Tao
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
| | - Maomei Yang
- Tangxia No.2 Junior High School, Dongguan, Guangdong, China
| | - Dongjie Li
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
| | - Liyun Jiang
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
| | - Wei Zhang
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China.
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11
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Jackson DB, Testa A, Fix RL, Semenza DC, Nagata JM, Ganson KT. Police Contact, Non-Suicidal Self-Injury, and Suicidal Ideation: Findings From a National Sample of Canadian Adolescents and Young Adults. FAMILY & COMMUNITY HEALTH 2024; 47:202-208. [PMID: 38758023 DOI: 10.1097/fch.0000000000000408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Abstract
BACKGROUND AND OBJECTIVES The purpose of this research is to investigate associations between police contact, non-suicidal self-injury (NSSI), and suicidal ideation (SI) among a national sample of Canadian adolescents and young adults (ages 16-30). METHODS Data used in this study were obtained from the Canadian Study of Adolescent Health Behaviors (N = 940), a national survey of Canadians ages 16-30. RESULTS Police contact was associated with higher odds of NSSI (OR = 1.98, 95% CI = 1.37, 2.86). Those who reported police contact with intrusion (OR = 2.39, 95% CI = 1.49, 3.38) and police contact with harassment (OR = 3.98, 95% CI = 2.30, 6.88) had higher odds of NSSI relative to respondents with no contact. Finally, any police contact was associated with higher odds of SI (OR = 1.56, 95% CI = 1.04, 2.34) and respondents experiencing police stops with harassment had higher odds of SI compared to those who had never been stopped (OR = 2.48, 95% CI = 1.45, 4.24). CONCLUSIONS Distressing police contact heightens the risk of NSSI and SI among young people. Rigorous evaluation of trauma-informed, developmentally appropriate strategies for identifying and intervening on NSSI and SI following adverse police encounters should be prioritized.
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Affiliation(s)
- Dylan B Jackson
- Author Affiliations: Department of Population, Family, and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Dr Jackson); Department of Management, Policy and Community Health, University of Texas Health Science Center at Houston, Houston, Texas (Dr Testa); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Dr Fix); Department of Sociology, Anthropology, and Criminal Justice, Department of Urban-Global Health, School of Public Health, Rutgers University, Piscataway, New Jersey (Dr Semenza); Department of Pediatrics, University of California, San Francisco, San Francisco, California (Dr Nagata); and Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, ON, Canada (Dr Ganson)
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12
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Kirshenbaum JS, Pagliaccio D, Bitran A, Xu E, Auerbach RP. Why do adolescents attempt suicide? Insights from leading ideation-to-action suicide theories: a systematic review. Transl Psychiatry 2024; 14:266. [PMID: 38937430 PMCID: PMC11211511 DOI: 10.1038/s41398-024-02914-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 04/19/2024] [Accepted: 04/23/2024] [Indexed: 06/29/2024] Open
Abstract
Suicide is a leading cause of death among adolescents, and recent suicide theories have sought to clarify the factors that facilitate the transition from suicide ideation to action. Specifically, the Interpersonal Theory of Suicide (IPTS), Integrated Motivational-Volitional Model (IMV), and Three Step Theory (3ST) have highlighted risk factors central to the formation of suicidal ideation and suicidal behaviors, which is necessary for suicide death. However, these models were initially developed and tested among adults, and given core socioemotional and neurodevelopmental differences in adolescents, the applicability of these models remains unclear. Directly addressing this gap in knowledge, this systematic review aimed to (1) describe the evidence of leading ideation-to-action theories (i.e., IPTS, IMV, 3ST) as they relate to suicide risk among adolescents, (2) integrate ideation-to-action theories within prevailing biological frameworks of adolescent suicide, and (3) provide recommendations for future adolescent suicide research. Overall, few studies provided a complete test of models in adolescent samples, and empirical research testing components of these theories provided mixed support. Future research would benefit from integrating neurodevelopmental and developmentally sensitive psychosocial frameworks to increase the applicability of ideation-to-action theories to adolescents. Further, utilizing real-time monitoring approaches may serve to further clarify the temporal association among risk factors and suicide.
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Affiliation(s)
- Jaclyn S Kirshenbaum
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - David Pagliaccio
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Alma Bitran
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Elisa Xu
- Department of Psychiatry, Columbia University, New York, NY, USA
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA.
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY, USA.
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13
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Lu YL, Ge Y, Li M, Liang S, Zhang X, Sui Y, Yang L, Li X, Zhang Y, Yue W, Zhang H, Yan H. Cognitive Phenotype Shifts in Risk Taking: Interplay of Nonsuicidal Self-Injury Behaviors and Intensified Depression. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024:S2451-9022(24)00157-5. [PMID: 38871052 DOI: 10.1016/j.bpsc.2024.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 05/24/2024] [Accepted: 05/31/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND Nonsuicidal self-injury (NSSI) behavior is significantly prevalent in both adolescents and psychiatric populations, particularly in individuals with major depressive disorder. NSSI can be considered a result of risky decision making in response to negative emotions, where individuals choose self-harm over other less harmful alternatives, suggesting a potential decision-making deficit in those engaging in NSSI. This study delves into the complex relationship between NSSI and depression severity in decision making and its cognitive underpinnings. METHODS We assessed decision behaviors in 57 patients with major depressive disorder and NSSI, 42 patients with major depressive disorder without NSSI, and 142 healthy control participants using the Balloon Analog Risk Task, which involves risk taking, learning, and exploration in uncertain scenarios. Using computational modeling, we dissected the nuanced cognitive dimensions influencing decision behaviors. A novel statistical method was developed to elucidate interaction effects between NSSI and depression severity. RESULTS Contrary to common perceptions, we found that individuals with NSSI behaviors were typically more risk averse. There was also a complex interaction between NSSI and depression severity in shaping risk-taking behaviors. As depressive symptoms intensified, the individuals with NSSI began to perceive less risk and behave more randomly. CONCLUSIONS This research provides new insights into the cognitive aspects of NSSI and depression, highlighting the importance of considering the influence of comorbid mental disorders when investigating the cognitive underpinnings of such behaviors, especially in the context of prevalent cross-diagnostic phenomena such as NSSI behaviors.
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Affiliation(s)
- Yi-Long Lu
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Yuqi Ge
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China; NHC Key Laboratory of Mental Health (Peking University) and 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 (Peking University) and National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Shutian Liang
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Xiaoxi Zhang
- Department of Mental Health, Changzhi Medical College, Changzhi, China
| | - Yupeng Sui
- Department of Mental Health, Changzhi Medical College, Changzhi, China
| | - Lei Yang
- NHC Key Laboratory of Mental Health (Peking University) and 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 (Peking University) and National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Yuyanan Zhang
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China; NHC Key Laboratory of Mental Health (Peking University) and National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Weihua Yue
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China; NHC Key Laboratory of Mental Health (Peking University) and National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China; PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Hang Zhang
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China; PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China; Peking-Tsinghua Center for Life Sciences, Peking University, Beijing, China; State Key Laboratory of General Artificial Intelligence, Peking University, Beijing, China; Chinese Institute for Brain Research, Beijing, China.
| | - Hao Yan
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China; NHC Key Laboratory of Mental Health (Peking University) and National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.
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14
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Planellas Kirchner I, Calderon Garrido C. Do Cybervictimizations Predict Suicide-Related Behaviors in Adolescents? Mediating Role of the "Escaping" Coping Strategy. JOURNAL OF INTERPERSONAL VIOLENCE 2024:8862605241256384. [PMID: 38855834 DOI: 10.1177/08862605241256384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2024]
Abstract
The high prevalence of suicide-related behaviors (SRB) among adolescents is a concerning issue that calls for the identification of explanatory and mediating factors involved. This study examines, by gender: (1) the percentage of adolescents reporting SRB, cyberbullying, and cybersexual harassment; (2) the association between cyberbullying and cybersexual harassment with SRB; (3) the predictive power of cybervictimization in SRB; and (4) the mediating role of Escaping coping strategy between cybervictimization and SRB. One thousand and twenty-seven adolescents (62.5% girls) aged 13 to 18 years (M = 15.59, SD = 1.28) participated in the study and completed the Youth Self Report (for SRB), Juvenile Victimization Questionnaire (for cybervictimization), and Adolescent Coping Orientation for Problem Experiences, Spanish (for coping). About 16% of respondents (19% of girls and 8.9% of boys) reported SRB, about 18% reported Cyberbullying (20.8% of girls and 13.0% of boys), and near 23% reported Cybersexual harassment (28.7% of girls and 12.5% of boys). There is a significant association between cybervictimization and SRB, with the presence of cybervictimization increasing the likelihood of SRB by three to four times (especially in boys), and significantly predicting SRB. Escaping coping strategy partially mediates the relationship between cybervictimization and SRB only in girls. The findings that cybervictimization predicts SRB and that Escaping coping mediates this relationship provide insights for the implementation of prevention and intervention policies.
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15
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Lu J, Jin Y, Liang S, Wang Q, Li X, Li T. Risk factors and their association network for young adults' suicidality: a cross-sectional study. BMC Public Health 2024; 24:1378. [PMID: 38778312 PMCID: PMC11112863 DOI: 10.1186/s12889-024-18860-9] [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: 01/06/2024] [Accepted: 05/15/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Understanding the intricate influences of risk factors contributing to suicide among young individuals remains a challenge. The current study employed interpretable machine learning and network analysis to unravel critical suicide-associated factors in Chinese university students. METHODS A total of 68,071 students were recruited between Sep 2016 and Sep 2020 in China. Students reported their lifetime experiences with suicidal thoughts and behaviors, categorized as suicide ideation (SI), suicide plan (SP), and suicide attempt (SA). We assessed 36 suicide-associated factors including psychopathology, family environment, life events, and stigma. Local interpretations were provided using Shapley additive explanation (SHAP) interaction values, while a mixed graphical model facilitated a global understanding of their interplay. RESULTS Local explanations based on SHAP interaction values suggested that psychoticism and depression severity emerged as pivotal factors for SI, while paranoid ideation strongly correlated with SP and SA. In addition, childhood neglect significantly predicted SA. Regarding the mixed graphical model, a hierarchical structure emerged, suggesting that family factors preceded proximal psychopathological factors, with abuse and neglect retaining unique effects. Centrality indices derived from the network highlighted the importance of subjective socioeconomic status and education in connecting various risk factors. CONCLUSIONS The proximity of psychopathological factors to suicidality underscores their significance. The global structures of the network suggested that co-occurring factors influence suicidal behavior in a hierarchical manner. Therefore, prospective prevention strategies should take into account the hierarchical structure and unique trajectories of factors.
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Affiliation(s)
- Junsong Lu
- Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310013, China
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, 518712, China
| | - Yan Jin
- Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310013, China
- School of Humanities and Social Science, The Chinese University of Hong Kong, Shenzhen, Guangdong, 518712, China
| | - Sugai Liang
- Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310013, China
| | - Qiang Wang
- Mental Health Centre & Psychiatric Laboratory, State Key Laboratory of Biotherapy, West China Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Xiaojing Li
- Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310013, China.
- Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-machine Integration, State Key Laboratory of Brain-machine Intelligence, Zhejiang University, 1369 West Wenyi Road, Hangzhou, 311121, China.
- NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University, Hangzhou, 310058, China.
| | - Tao Li
- Affiliated Mental Health Centre & Hangzhou Seventh People's Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310013, China.
- Liangzhu Laboratory, MOE Frontier Science Center for Brain Science and Brain-machine Integration, State Key Laboratory of Brain-machine Intelligence, Zhejiang University, 1369 West Wenyi Road, Hangzhou, 311121, China.
- NHC and CAMS Key Laboratory of Medical Neurobiology, Zhejiang University, Hangzhou, 310058, China.
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16
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Kim H, Son Y, Lee H, Kang J, Hammoodi A, Choi Y, Kim HJ, Lee H, Fond G, Boyer L, Kwon R, Woo S, Yon DK. Machine Learning-Based Prediction of Suicidal Thinking in Adolescents by Derivation and Validation in 3 Independent Worldwide Cohorts: Algorithm Development and Validation Study. J Med Internet Res 2024; 26:e55913. [PMID: 38758578 PMCID: PMC11143390 DOI: 10.2196/55913] [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: 12/29/2023] [Revised: 03/24/2024] [Accepted: 03/25/2024] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Suicide is the second-leading cause of death among adolescents and is associated with clusters of suicides. Despite numerous studies on this preventable cause of death, the focus has primarily been on single nations and traditional statistical methods. OBJECTIVE This study aims to develop a predictive model for adolescent suicidal thinking using multinational data sets and machine learning (ML). METHODS We used data from the Korea Youth Risk Behavior Web-based Survey with 566,875 adolescents aged between 13 and 18 years and conducted external validation using the Youth Risk Behavior Survey with 103,874 adolescents and Norway's University National General Survey with 19,574 adolescents. Several tree-based ML models were developed, and feature importance and Shapley additive explanations values were analyzed to identify risk factors for adolescent suicidal thinking. RESULTS When trained on the Korea Youth Risk Behavior Web-based Survey data from South Korea with a 95% CI, the XGBoost model reported an area under the receiver operating characteristic (AUROC) curve of 90.06% (95% CI 89.97-90.16), displaying superior performance compared to other models. For external validation using the Youth Risk Behavior Survey data from the United States and the University National General Survey from Norway, the XGBoost model achieved AUROCs of 83.09% and 81.27%, respectively. Across all data sets, XGBoost consistently outperformed the other models with the highest AUROC score, and was selected as the optimal model. In terms of predictors of suicidal thinking, feelings of sadness and despair were the most influential, accounting for 57.4% of the impact, followed by stress status at 19.8%. This was followed by age (5.7%), household income (4%), academic achievement (3.4%), sex (2.1%), and others, which contributed less than 2% each. CONCLUSIONS This study used ML by integrating diverse data sets from 3 countries to address adolescent suicide. The findings highlight the important role of emotional health indicators in predicting suicidal thinking among adolescents. Specifically, sadness and despair were identified as the most significant predictors, followed by stressful conditions and age. These findings emphasize the critical need for early diagnosis and prevention of mental health issues during adolescence.
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Affiliation(s)
- Hyejun Kim
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- Department of Applied Information Engineering, Yonsei University, Seoul, Republic of Korea
| | - Yejun Son
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- Department of Precision Medicine, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Hojae Lee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, Republic of Korea
| | - Jiseung Kang
- Division of Sleep Medicine, Harvard Medical School, Boston, MA, United States
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA, United States
| | - Ahmed Hammoodi
- Department of Business Administration, Kyung Hee University School of Management, Seoul, Republic of Korea
| | - Yujin Choi
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- Department of Korean Medicine, Kyung Hee University College of Korean Medicine, Seoul, Republic of Korea
| | - Hyeon Jin Kim
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, Republic of Korea
| | - Hayeon Lee
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Guillaume Fond
- Assistance Publique-Hôpitaux de Marseille (APHM), CEReSS-Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France
| | - Laurent Boyer
- Assistance Publique-Hôpitaux de Marseille (APHM), CEReSS-Health Service Research and Quality of Life Center, Aix-Marseille University, Marseille, France
| | - Rosie Kwon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Selin Woo
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Republic of Korea
| | - Dong Keon Yon
- Center for Digital Health, Medical Science Research Institute, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- Department of Precision Medicine, Kyung Hee University College of Medicine, Seoul, Republic of Korea
- Department of Regulatory Science, Kyung Hee University, Seoul, Republic of Korea
- Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea
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17
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Li L, Liang Z, Li G, Xu H, Yang X, Liu X, Zhang X, Wang J, Zhang Z, Zhou Y. Unveiling convergent and divergent intrinsic brain network alternations in depressed adolescents engaged in non-suicidal self-injurious behaviors with and without suicide attempts. CNS Neurosci Ther 2024; 30:e14684. [PMID: 38739217 PMCID: PMC11090151 DOI: 10.1111/cns.14684] [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: 12/11/2023] [Revised: 01/28/2024] [Accepted: 02/19/2024] [Indexed: 05/14/2024] Open
Abstract
AIMS Limited understanding exists regarding the neurobiological mechanisms underlying non-suicidal self-injury (NSSI) and suicide attempts (SA) in depressed adolescents. The maturation of brain network is crucial during adolescence, yet the abnormal alternations in depressed adolescents with NSSI or NSSI+SA remain poorly understood. METHODS Resting-state functional magnetic resonance imaging data were collected from 114 depressed adolescents, classified into three groups: clinical control (non-self-harm), NSSI only, and NSSI+SA based on self-harm history. The alternations of resting-state functional connectivity (RSFC) were identified through support vector machine-based classification. RESULTS Convergent alterations in NSSI and NSSI+SA predominantly centered on the inter-network RSFC between the Limbic network and the three core neurocognitive networks (SalVAttn, Control, and Default networks). Divergent alterations in the NSSI+SA group primarily focused on the Visual, Limbic, and Subcortical networks. Additionally, the severity of depressive symptoms only showed a significant correlation with altered RSFCs between Limbic and DorsAttn or Visual networks, strengthening the fact that increased depression severity alone does not fully explain observed FC alternations in the NSSI+SA group. CONCLUSION Convergent alterations suggest a shared neurobiological mechanism along the self-destructiveness continuum. Divergent alterations may indicate biomarkers differentiating risk for SA, informing neurobiologically guided interventions.
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Affiliation(s)
- Linling Li
- Guangdong Provincial Key Laboratory of Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, International Health Science Innovation Center, Shenzhen University Medical School, Shenzhen University, Shenzhen, China
| | - Zhen Liang
- Guangdong Provincial Key Laboratory of Biomedical Measurements and Ultrasound Imaging, School of Biomedical Engineering, International Health Science Innovation Center, Shenzhen University Medical School, Shenzhen University, Shenzhen, China
| | - Guohua Li
- Department of Psychiatric Rehabilitation, Shenzhen Mental Health Center/Shenzhen Kangning Hospital, Shenzhen, China
| | - Hong Xu
- Department of Psychiatric Rehabilitation, Shenzhen Mental Health Center/Shenzhen Kangning Hospital, Shenzhen, China
| | - Xing Yang
- Department of Psychiatric Rehabilitation, Shenzhen Mental Health Center/Shenzhen Kangning Hospital, Shenzhen, China
| | - Xia Liu
- Department of Psychiatric Rehabilitation, Shenzhen Mental Health Center/Shenzhen Kangning Hospital, Shenzhen, China
| | - Xin Zhang
- Department of Psychiatric Rehabilitation, Shenzhen Mental Health Center/Shenzhen Kangning Hospital, Shenzhen, China
| | - Jianhong Wang
- Department of Psychiatric Rehabilitation, Shenzhen Mental Health Center/Shenzhen Kangning Hospital, Shenzhen, China
| | - Zhiguo Zhang
- Department of Computer Science and Technology, Harbin Institute of Technology, Peng Cheng Laboratory, Shenzhen, China
| | - Yongjie Zhou
- Department of Psychiatric Rehabilitation, Shenzhen Mental Health Center/Shenzhen Kangning Hospital, Shenzhen, China
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Lin K, Ramos S, Sun J. Urbanization, self-harm, and suicidal ideation in left-behind children and adolescents in China: a systematic review and meta-analysis. Curr Opin Psychiatry 2024; 37:225-236. [PMID: 38415715 DOI: 10.1097/yco.0000000000000927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/29/2024]
Abstract
PURPOSE OF REVIEW Economic development and urbanisation have prompted many Chinese parents to move from rural to urban regions for better job opportunities. Their children, who remain behind in rural regions, become left-behind children (LBC). With absent parents, children and adolescents are unable to maintain the secure attachment required for healthy social and emotional development, increasing the risk of mental illness. This study aimed to compare risk of self-harm and suicidal ideation in LBC and non-LBC in China. RECENT FINDINGS Greater risks for poor mental health outcomes including worse depression, loneliness and anxiety have been identified in LBC in cross-sectional studies. Previous studies have also identified higher prevalence of bullying victimization, poorer school performance and worse school attendance amongst LBC. SUMMARY Findings indicate that prolonged separation from parents put LBC at greater risks of poor mental health. Policy changes to allow children to migrate with their parents and policies to reduce inequalities in job opportunities between urban and rural regions are needed.
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Affiliation(s)
| | | | - Jing Sun
- School of Medicine and Dentistry
- Institute for Integrated and Intelligent Systems, Griffith University, Gold Coast
- Rural Health Research Institute, Charles Sturt University, Leeds Parade, Australia
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Pagliaccio D, Bitran A, Kirshenbaum JS, Alqueza KL, Durham K, Chernick LS, Joyce K, Lan R, Porta G, Brent DA, Allen NB, Auerbach RP. Testing the interpersonal theory of suicide in adolescents: A multi-wave longitudinal study. J Child Psychol Psychiatry 2024; 65:668-679. [PMID: 37474206 PMCID: PMC10799188 DOI: 10.1111/jcpp.13868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/19/2023] [Indexed: 07/22/2023]
Abstract
BACKGROUND Suicide is a major public health crisis among youth. Several prominent theories, including the Interpersonal Theory of Suicide (IPTS), aim to characterize the factors leading from suicide ideation to action. These theories are largely based on findings in adults and require testing and elaboration in adolescents. METHODS Data were examined from high-risk 13-18-year-old adolescents (N = 167) participating in a multi-wave, longitudinal study; 63% of the sample exhibited current suicidal thoughts or recent behaviors (n = 105). The study included a 6-month follow-up period with clinical interviews and self-report measures at each of the four assessments as well as weekly smartphone-based assessments of suicidal thoughts and behaviors. Regression and structural equation models were used to probe hypotheses related to the core tenets of the IPTS. RESULTS Feelings of perceived burdensomeness were associated with more severe self-reported suicidal ideation (b = 0.58, t(158) = 7.64, p < .001). Similarly, burdensomeness was associated with more frequent ideation based on weekly smartphone ratings (b = 0.11, t(1460) = 3.41, p < .001). Contrary to IPTS hypotheses, neither feelings of thwarted belongingness, nor interactions between burdensomeness and thwarted belongingness were significantly associated with ideation (ps > .05). Only elevated depression severity was associated with greater odds of suicide events (i.e., suicide attempts, psychiatric hospitalizations, and/or emergency department visits for suicide concerns) during the follow-up period (OR = 1.83, t(158) = 2.44, p = .01). No effect of acquired capability was found. CONCLUSIONS Perceptions of burdensomeness to others reflect a critical risk factor for suicidal ideation among high-risk adolescents. Null findings with other IPTS constructs may suggest a need to adopt more developmentally sensitive models or measures of interpersonal and acquired capability risk factors for youth. Refining methods and theoretical models of suicide risk may help improve the identification of high-risk cases and inform clinical intervention.
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Affiliation(s)
- David Pagliaccio
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY
| | - Alma Bitran
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY
| | - Jaclyn S. Kirshenbaum
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY
| | - Kira L. Alqueza
- School of Special Education, School Psychology, and Early Childhood Studies, University of Florida, Gainesville, FL
| | - Katherine Durham
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY
| | - Lauren S. Chernick
- Department of Emergency Medicine, Columbia University Irving Medical Center, New York, NY
| | - Karla Joyce
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Ranqing Lan
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY
| | - Giovanna Porta
- UPMC Western Psychiatric Hospital, Pittsburgh, Pennsylvania
| | - David A. Brent
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | | | - Randy P. Auerbach
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, New York, NY
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY
- Sackler Institute for Developmental Psychobiology at Columbia University, New York, NY, USA
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20
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Dempsey RC, Dodd AL, Gooding PA, Jones SH. The Types of Psychosocial Factors Associated with Suicidality Outcomes for People Living with Bipolar Disorder: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:525. [PMID: 38791740 PMCID: PMC11120682 DOI: 10.3390/ijerph21050525] [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: 02/06/2024] [Revised: 04/19/2024] [Accepted: 04/20/2024] [Indexed: 05/26/2024]
Abstract
Bipolar Disorder is associated with high rates of suicidal thoughts, behaviors, and outcomes, yet the lived experience of suicidality and Bipolar Disorder is not particularly well understood. Understanding the role of psychosocial aetiologies in suicidality outcomes for those living with Bipolar Disorder is key for developing appropriately targeted interventions focusing on factors that are amenable to change. In line with PRISMA guidance, we conducted a scoping review to identify the types of psychosocial factors studied in relation to the experience of suicidality for people living with Bipolar Disorder diagnoses. Systematic literature searches identified a sample of 166 articles from which key study data were extracted and charted. A narrative synthesis of the reviewed literature is presented ordered by the factors investigated across studies, a frequency count of the types of psychological/social aetiologies studied, and a brief overview of the key findings for each aetiology. Most of the identified literature took the form of quantitative cross-sectional studies, with only one qualitative study and 18 quantitative prospective studies. The most studied aetiologies were trauma (specifically early adverse experiences and childhood traumas) and stressful life events, impulsivity (primarily subjective self-reported trait impulsivity), social support and functioning, and personality/temperament factors. Only six studies in the final sample reported basing their research questions and/or hypotheses on an explicit theoretical model of suicide. The literature was primarily focused on using self-report measurements of key aetiologies and on factors which lead to worsened suicidality rather than focusing on potentially protective or buffering factors. Future research needs to better justify the aetiologies investigated in relation to suicidality outcomes for people living with Bipolar Disorder, including a firmer basis in theory and hypothesis testing, more prospective designs, and the use of alternative assessments of psychosocial aetiologies in addition to self-report questionnaires.
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Affiliation(s)
- Robert C. Dempsey
- Department of Psychology, Faculty of Health and Education, Manchester Metropolitan University, Manchester M15 6BH, UK
| | - Alyson L. Dodd
- Department of Psychology, Faculty of Health & Life Sciences, Northumbria University, Newcastle upon Tyne NE1 8ST, UK
| | - Patricia A. Gooding
- Division of Psychology & Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester M13 9PL, UK
| | - Steven H. Jones
- Spectrum Centre for Mental Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster LA1 4YW, UK
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21
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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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22
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Ehlers CL, Gilder DA, Benedict J, Wills DN, Phillips E, Gonzales C, Karriker-Jaffe KJ, Bernert RA. Social zeitgeber and sleep loss as risk factors for suicide in American Indian adolescents. Transcult Psychiatry 2024; 61:273-284. [PMID: 38311923 DOI: 10.1177/13634615241227679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
American Indians / Alaska Natives (AI/AN) bear a high burden of suicide, the reasons for which are not completely understood, and rates can vary by tribal group and location. This article aims to identify circumstances reported by a community group of American Indian adolescent participants to be associated with their depression and/or suicide. American Indian adolescents (n = 360) were recruited from contiguous reservations and were assessed with a semi-structured diagnostic interview. Twenty percent of the adolescents reported suicidal thoughts (ideation, plans), an additional 8% reported a history of suicide attempts, and three deaths due to suicide were reported. Suicidal behaviors and major depressive disorder (MDD) co-occurred and were more common among female adolescents. The distressing events that adolescents most often reported were: death in the family, family disruption, peer relationship problems, and school problems. All of these events were significantly associated with suicidal behaviors, however those with suicidal acts were more likely to report death in the family. Those with MDD but no suicidal behaviors were more likely to report disruptions in the family. Disruptions in falling asleep were also associated with suicidal behaviors and having experienced a death in the family. Disruptions in important relationships, particularly through death or divorce, may be interpreted as a loss or disruption in "social zeitgebers" that may in turn disturb biological rhythms, such as sleep, thus potentially increase the risk for MDD and/or suicide. Prevention programs aimed at ameliorating the impact of disruptions in important relationships may potentially reduce suicidal behaviors in AI/AN adolescents.
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Affiliation(s)
- Cindy L Ehlers
- Neurosciences Department, The Scripps Research Institute, USA
| | - David A Gilder
- Neurosciences Department, The Scripps Research Institute, USA
| | | | - Derek N Wills
- Neurosciences Department, The Scripps Research Institute, USA
| | - Evie Phillips
- Neurosciences Department, The Scripps Research Institute, USA
| | - Cathy Gonzales
- Neurosciences Department, The Scripps Research Institute, USA
- Pala Band of Mission Indians, Pala, CA, USA
| | | | - Rebecca A Bernert
- Department of Psychiatry and Behavioral Sciences, Stanford University, USA
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23
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Wang Z, Li D, Chen Y, Tao Z, Jiang L, He X, Zhang W. Understanding the subtypes of non-suicidal self-injury: A new conceptual framework based on a systematic review. Psychiatry Res 2024; 334:115816. [PMID: 38412712 DOI: 10.1016/j.psychres.2024.115816] [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: 07/07/2023] [Revised: 02/17/2024] [Accepted: 02/23/2024] [Indexed: 02/29/2024]
Abstract
Non-suicidal self-injury (NSSI) is a significant public health problem, but there is no consistent evidence of its risk factors. One possibility is that there are subtypes NSSI that have different risk factors and clinical symptoms. In this review we evaluated the evidence of subtypes to determine if there were consistent subtypes of NSSI that emerged across studies. Four databases (Medline; Embase; PsycINFO; Web of Science) were searched to identify studies that used data-driven approaches and were published before November 9, 2022. There were 21 studies with 23 unique samples for review. Most of the included studies used NSSI symptoms or personal characteristics as the subtyping indicators, revealing 2-5 subtypes of NSSI. Variations in subtyping indicators, sample characteristics, and statistical methods may have contributed to the inconsistent number and characteristics of subtypes across studies. A new conceptual framework is proposed to integrate these diverse findings, highlighting the important roles of NSSI function and psychological pain in differentiating NSSI subtypes. This framework sheds light on the differences among self-injurers and offers insights for future endeavors to address the complexities of NSSI.
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Affiliation(s)
- Zhenhai Wang
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
| | - Dongjie Li
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
| | - Yanrong Chen
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
| | - Zhiyuan Tao
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
| | - Liyun Jiang
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
| | - Xu He
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
| | - Wei Zhang
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China.
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24
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Guo X, Wang L, Li Z, Feng Z, Lu L, Jiang L, Zhao L. Factors and pathways of non-suicidal self-injury in children: insights from computational causal analysis. Front Public Health 2024; 12:1305746. [PMID: 38532971 PMCID: PMC10963487 DOI: 10.3389/fpubh.2024.1305746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 02/23/2024] [Indexed: 03/28/2024] Open
Abstract
Background Non-suicidal self-injury (NSSI) has become a significant public health issue, especially prevalent among adolescents. The complexity and multifactorial nature of NSSI necessitate a comprehensive understanding of its underlying causal factors. This research leverages the causal discovery methodology to explore these causal associations in children. Methods An observational dataset was scrutinized using the causal discovery method, particularly employing the constraint-based approach. By integrating machine learning and causal inference techniques, the study aimed to determine direct causal relationships associated with NSSI. The robustness of the causal relationships was evaluated using three methods to construct and validate it: the PC (Peter and Clark) method, Fast Causal Inference (FCI) method, and the GAE (Graphical Autoencoder) method. Results Analysis identified nine nodes with direct causal relationships to NSSI, including life satisfaction, depression, family dysfunction, sugary beverage consumption, PYD (positive youth development), internet addiction, COVID-19 related PTSD, academic anxiety, and sleep duration. Four principal causal pathways were identified, highlighting the roles of lockdown-induced lifestyle changes, screen time, positive adolescent development, and family dynamics in influencing NSSI risk. Conclusions An in-depth analysis of the factors leading to Non-Suicidal Self-Injury (NSSI), highlighting the intricate connections among individual, family, and pandemic-related influences. The results, derived from computational causal analysis, underscore the critical need for targeted interventions that tackle these diverse causative factors.
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Affiliation(s)
- Xinyu Guo
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Linna Wang
- College of Computer Science, Sichuan University, Chengdu, Sichuan, China
| | - Zhenchao Li
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Ziliang Feng
- College of Computer Science, Sichuan University, Chengdu, Sichuan, China
| | - Li Lu
- College of Computer Science, Sichuan University, Chengdu, Sichuan, China
| | - Lihua Jiang
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
- Teaching and Research Section of General Practice, The General Practice Medical Center, West China Hospital of Sichuan University, Chengdu, China
| | - Li Zhao
- Department of Health Policy and Management, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
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25
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Akgül S, Pehlivantürk Kızılkan M, Yıldırım A, Derman O. Prevalence of suicide attempt, suicide ideation and self-harm at diagnosis in adolescents with eating disorders. Int J Psychiatry Clin Pract 2024; 28:63-67. [PMID: 38592409 DOI: 10.1080/13651501.2024.2337796] [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: 08/02/2023] [Accepted: 03/27/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Data concerning the suicide prevalence of eating disorder (ED) subtypes and predictive factors are lacking in youth. This study aimed to examine suicide attempts (SA), suicide ideation (SI) and self-harm (SH) upon diagnosis in adolescents with EDs. METHODS The prevalence of SA, SI and SH in ED subtypes was evaluated by retrospectively assessing the Home, Education/Employment, Eating, Activities, Drugs, Sexuality, Suicidal ideation and Safety (HEEADSSS) instrument of adolescents diagnosed with an ED. Clinical predictors of SI in anorexia nervosa (AN) and atypical AN (AAN) were assessed. RESULTS Among all participants (398), 41 (10.3%) reported SA, 126 (31.7%) SI and 60 (15.1%) SH. While SA did not differ statistically between ED subgroups (p = .123), they were two times more prevalent in the bulimia nervosa (BN) group (17.5%) than in the AN group (8.5%). In the BN group, SI was 2.3 times more prevalent than in the AN group (p = .001). The AN and ARFID groups exhibited substantially less SH (p = .036). Having a higher body mass index (BMI) was the only significant predictor of SI. CONCLUSIONS This study demonstrates that adolescents with EDs are at an increased risk for suicidality, highlighting the need for close screening, particularly in those with BN, AN-BP and AN with a higher BMI.
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Affiliation(s)
- Sinem Akgül
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
| | | | - Ayşegül Yıldırım
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
| | - Orhan Derman
- Department of Pediatrics, Division of Adolescent Medicine, Hacettepe University, Ankara, Turkey
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26
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Trosman I, Ivanenko A. Classification and Epidemiology of Sleep Disorders in Children and Adolescents. Psychiatr Clin North Am 2024; 47:47-64. [PMID: 38302213 DOI: 10.1016/j.psc.2023.06.004] [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: 02/03/2024]
Abstract
Sleep disturbances are common in children and adolescents but still remain unrecognized and undertreated. Several classification systems of sleep disorders are available, which include recent attempts to develop more specific nosologic categories that reflect developmental aspects of sleep. The prevalence of sleep disorders has been studied across various samples of healthy, typically developing children and those with special medical, psychiatric, and neurodevelopmental needs. Sleep disorders are highly prevalent in children and adolescents with psychiatric disorders, making it important for mental health professionals to be aware of sleep problems and to address them in the context of psychiatric comorbidities.
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Affiliation(s)
- Irina Trosman
- Division of Pulmonary and Sleep Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Avenue Box 43, Chicago, IL 60611-2991, USA
| | - Anna Ivanenko
- Division of Child and Adolescent Psychiatry, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA.
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27
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Takahashi M, Imahara K, Miyamoto Y, Myojo K, Yasuda M. Association between the Big Five personality traits and suicide-related behaviors in Japanese institutionalized youths. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2024; 3:e186. [PMID: 38868476 PMCID: PMC11114335 DOI: 10.1002/pcn5.186] [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: 01/11/2024] [Revised: 02/25/2024] [Accepted: 03/05/2024] [Indexed: 06/14/2024]
Abstract
Aim Inmates in correctional institutions experience higher rates of suicide attempt (SA), suicidal ideation (SI), and nonsuicidal self-injury (NSSI) than the general population. This study aimed to examine the association between the Big Five personality traits and suicide-related behavior, and to estimate the prevalence rate of such behaviors among Japanese institutionalized youth. Methods The participants were 436 youths who had been admitted to four juvenile classification homes (JCHs) between September 2021 and March 2023; they were asked to respond to a self-report questionnaire after obtaining informed consent. Results A total of 8.1% and 19.3%, 29.4% and 44.7%, and 46.3% and 75.3% of males and females had experienced SA, SI, and NSSI in their lifetime, respectively. Females reported significantly higher instances of suicide-related behaviors than males considering all suicide-related behaviors. Logistic regression analyses revealed that neuroticism significantly increased the odds ratios for SA, SI, and NSSI on controlling for sex, age, and number of admissions to JCHs. For NSSI, the odds ratio for agreeableness was significantly lower than 1, indicating a lower probability of NSSI. Conclusion The findings of our study demonstrate that neuroticism, one of the Big Five traits, was consistently and significantly associated with all suicide-related behaviors, including SA, SI, and NSSI, among youth offenders, while agreeableness was found as a protective factor only against NSSI. The results of this study might help correctional officers identify justice-involved youth at higher risk for suicide and allow the development of early interventions to prevent suicide.
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Affiliation(s)
| | - Kasumi Imahara
- Osaka Juvenile Classification HomeMinistry of JusticeOsakaJapan
| | - Yukiko Miyamoto
- Nagoya Juvenile Classification HomeMinistry of JusticeNagoyaAichiJapan
| | - Kayoko Myojo
- Kyoto Juvenile Classification HomeMinistry of JusticeKyotoJapan
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28
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Fernandes SN, Zuckerman E, Miranda R, Baroni A. When Night Falls Fast: Sleep and Suicidal Behavior Among Adolescents and Young Adults. Psychiatr Clin North Am 2024; 47:273-286. [PMID: 38302212 DOI: 10.1016/j.psc.2023.06.017] [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: 02/03/2024]
Abstract
Sleep disturbances have been linked to suicidal ideation and behaviors in adolescents. Specifically, insomnia and nightmares are associated with current suicide risk and predict future ideation. Associations between hypersomnia, sleep apnea, and suicide remain inconclusive. Potential biological mechanisms underlying these relationships include executive functioning deficits and hyperarousal. Related psychological factors may include thwarted belongingness, perceived burdensomeness, and negative appraisals. Assessing suicide risk in patients with sleep disturbances, and vice versa, is needed. Therapeutic interventions such as cognitive behavior therapy for insomnia and imagery rehearsal treatment, as well as pharmacologic treatments, show promise in treating sleep disorders and suicidal behavior.
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Affiliation(s)
- Sara N Fernandes
- New York State Psychiatric Institute, Columbia University Irving Medical Center, 1051 Riverside Drive, Room 1600C, New York, NY 10032, USA
| | - Emily Zuckerman
- Department of Child and Adolescent Psychiatry, NYU Langone Health, One Park Avenue, 7th Floor, New York, NY 10016, USA
| | - Regina Miranda
- Department of Psychology, Hunter College and The Graduate Center, City University of New York, 695 Park Avenue, Room 611HN, New York, NY 10065, USA
| | - Argelinda Baroni
- Department of Child and Adolescent Psychiatry, NYU Grossman School of Medicine, One Park Avenue, 7th Floor, New York, NY 10016, USA.
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29
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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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Seong E, Lee KH, Lee JS, Kim S, Seo DG, Yoo JH, Han DH, Hwang H, Choi CH, Kim JW. Depression and posttraumatic stress disorder in adolescents with nonsuicidal self-injury: comparisons of the psychological correlates and suicidal presentations across diagnostic subgroups. BMC Psychiatry 2024; 24:138. [PMID: 38373899 PMCID: PMC10877746 DOI: 10.1186/s12888-024-05533-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 01/18/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Nonsuicidal self-injury (NSSI) combined with suicide ideation increases the risk of suicidal behaviors. Depression and posttraumatic stress disorder (PTSD) are comorbidities of NSSI compounding this relationship. The present study compared diagnostic subgroups of NSSI based on current depression and PTSD on psychological correlates (i.e., vulnerabilities and impairment) and suicidal presentations (i.e., suicidal cognitions and behaviors) in a psychiatric sample of adolescents. METHODS Eighty-seven adolescents meeting DSM-5 criteria for NSSI and 104 age-range-matched nonclinical controls (NC) participated. Participants completed self-report measures on psychological vulnerabilities and impairment (e.g., emotion regulation difficulties, negative cognitions). Adolescents with NSSI also completed clinical interviews on psychiatric diagnoses and a recent self-injurious behavior (SIB). Scores on the psychological correlates of NSSI were compared between adolescents with NSSI and NC, and across three diagnostic subgroups of NSSI (A: NSSI+/depression-/PTSD-, n = 14; B: NSSI+/depression+/PTSD-, n = 57; C: NSSI+/depression+/PTSD+, n = 14). Differences between NSSI diagnostic subgroups were tested on the motives for SIB and accompanying suicidal presentations (e.g., desire, intent, motive, lethality). RESULTS Common comorbidities of NSSI included depression, panic disorder, generalized anxiety disorder, and PTSD. The NSSI subgroup classification was significantly associated with panic disorder, which was controlled for in the subsequent group comparisons. Overall, adolescents who engage in NSSI with vs. without depression reported more psychological vulnerabilities and impairment and a greater degree of suicidal thoughts/desire in SIB (i.e., groups B, C >A), which remained significant after controlling for panic disorder. An increased odds of the suicidal motive for SIB was found in adolescents with all three conditions (i.e., group C: NSSI+/depression+/PTSD+) compared to those with NSSI but neither depression nor PTSD (i.e., group A: NSSI+/depression-/PTSD-); however, this was not significant after controlling for panic disorder. CONCLUSIONS Psychological underpinnings of adolescent NSSI in clinical contexts may be largely associated with concurrent depression. Suicidal motives in adolescents who engage in NSSI in the presence of depression and PTSD may be confounded by the co-occurrence of panic disorder. This study warrants the importance of attending to the comorbid depression with NSSI in adolescents as it is related to an increase in suicidal desire accompanying SIB.
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Affiliation(s)
- Eunice Seong
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Kyung Hwa Lee
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Jong-Sun Lee
- Department of Psychology, Kangwon National University, 1 Gangwondaehak-gil, Chuncheon, Gangwon-do, 24341, Republic of Korea
| | - Sojung Kim
- Department of Psychology, Yeungnam University, 280 Daehak-ro, Gyeongsan, Gyeongbuk, 38541, Republic of Korea
| | - Dong Gi Seo
- Department of Psychology, Hallym University, 1 Hallymdaehak-gil, Chuncheon, Gangwon-do, 24252, Republic of Korea
| | - Jae Hyun Yoo
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Doug Hyun Han
- Department of Psychiatry, Chung-Ang University College of Medicine, 84 Heukseok-ro, Dongjak-gu, Seoul, 06973, Republic of Korea
| | - Hyunchan Hwang
- Department of Psychiatry, Chung-Ang University College of Medicine, 84 Heukseok-ro, Dongjak-gu, Seoul, 06973, Republic of Korea
| | - Chi-Hyun Choi
- Seoul Alpha Neuropsychiatric Clinic, 511 Nonhyeon-ro, Gangnam-gu, Seoul, 06131, Republic of Korea
| | - Jae-Won Kim
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
- Department of Psychiatry, Institute of Human Behavioral Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
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Mota MSSD, Ulguim HB, Jansen K, Cardoso TDA, Souza LDDM. Are big five personality traits associated to suicidal behaviour in adolescents? A systematic review and meta-analysis. J Affect Disord 2024; 347:115-123. [PMID: 37956831 DOI: 10.1016/j.jad.2023.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 08/05/2023] [Accepted: 11/01/2023] [Indexed: 11/15/2023]
Abstract
BACKGROUND Suicidal behaviour is one of the main causes of death worldwide, especially among teenagers, and its development is potentially associated with the development of personality. The aim of this systematic review and meta-analysis is to describe the association between the Big Five Personality Traits and suicidal behaviour in adolescents. METHODS Seven databases were systematically searched between June 2022 and July 2022 with no language or year restrictions. We searched for a combination of the following search items (suicid* OR suicidal behaviour OR suicidal ideation OR suicide attempts OR self injury OR self-destructive behaviour OR self-harm OR suicidal risk) AND (personality OR personality traits OR temperament OR neuroticism OR extraversion OR agreeableness OR openness to experience OR conscientiousness) AND (adolescents OR youth OR teenagers OR young adults). Meta-analysis procedures were performed using the R software. A random-effect-model was performed for the models through the incorporation of τ2, based on the DerSimonion Lard method. RESULTS Seven studies met all inclusion criteria and were included in this systematic review. Our meta-analysis showed that higher neuroticism are both associated and a risk factor for suicidal behaviour. Higher levels of openness to experience and agreeableness, and lower levels of extraversion and conscientiousness, were linked to suicidal behaviour, especially self-harm. LIMITATIONS Due to the heterogeneity of the studies, we were only able to perform meta-analysis regarding neuroticism. CONCLUSION The present study may help professionals to identify adolescents in higher risk for suicidal behaviour, enabling the development of early interventions to prevent suicidality in this population.
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Affiliation(s)
- Manuela Silva Silveira da Mota
- Program of Graduate Studies in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil; Chronobiology and Sleep Laboratory, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Graduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Helena Bohm Ulguim
- Program of Graduate Studies in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Karen Jansen
- Program of Graduate Studies in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil
| | - Taiane de Azevedo Cardoso
- Program of Graduate Studies in Health and Behavior, Catholic University of Pelotas, Pelotas, RS, Brazil; Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia
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Bakken V, Lydersen S, Skokauskas N, Sund AM, Kaasbøll J. Protective factors for suicidal ideation: a prospective study from adolescence to adulthood. Eur Child Adolesc Psychiatry 2024:10.1007/s00787-024-02379-w. [PMID: 38356041 DOI: 10.1007/s00787-024-02379-w] [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: 08/17/2023] [Accepted: 01/08/2024] [Indexed: 02/16/2024]
Abstract
Adolescent suicidality is associated with negative outcomes in adulthood. Suicide prevention has traditionally focused on identifying risk factors, yet suicide rates have remained stable. With suicidality often going undetected-especially suicidal ideation, further knowledge about protective factors is needed. The main objective of this study was to investigate potential protective factors for suicidal ideation from adolescence to adulthood. The study employed longitudinal population survey data, "Youth and Mental Health Study" consisting of self-reports at two-time points (mean age 14.9, SD = 0.6 and 27.2, SD = 0.6) (n = 2423 and n = 1198). Protective factors (at individual, social and environmental level) were selected based on a priori knowledge. Internal consistency of scales was analyzed using McDonald's omega. We used a linear mixed model with suicidal ideation as the dependent variable, time-points, a protective factor variable and their interaction as covariates, and individual participant as random effects. We adjusted for sex and also conducted separate analyses for males and females. The Benjamini-Hochberg procedure was used to adjust p-values for multiple hypotheses. Investigated protective factors were associated with temporal change in suicidal ideation (significant interactions). For both sexes, less emotion-orientated coping, higher self-perception scores, greater levels of physical activity and higher school wellbeing/connectedness were protective factors for suicidal ideations. Secure attachment and higher family function were protective factors for females only. The effects in adolescence were mostly maintained in adulthood. In this study, several protective factors for suicidal ideation persisted into adulthood, with distinct differences between males and females.
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Affiliation(s)
- Victoria Bakken
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
| | - Stian Lydersen
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Norbert Skokauskas
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Anne Mari Sund
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Jannike Kaasbøll
- Regional Centre for Child and Youth Mental Health and Child Welfare (RKBU), Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Health Research, SINTEF, Trondheim, Norway
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Wen X, Qu D, Liu D, Shu Y, Zhao S, Wu G, Wang Y, Cui Z, Zhang X, Chen R. Brain structural and functional signatures of multi-generational family history of suicidal behaviors in preadolescent children. Mol Psychiatry 2024; 29:484-495. [PMID: 38102486 DOI: 10.1038/s41380-023-02342-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 11/21/2023] [Accepted: 11/24/2023] [Indexed: 12/17/2023]
Abstract
Parent-child transmission of suicidal behaviors has been extensively studied, but the investigation of a three-generation family suicide risk paradigm remains limited. In this study, we aimed to explore the behavioral and brain signatures of multi-generational family history of suicidal behaviors (FHoS) in preadolescents, utilizing a longitudinal design and the dataset from Adolescent Brain and Cognitive DevelopmentSM Study (ABCD Study®), which comprised 4 years of data and includes a total of 9,653 preadolescents. Our findings revealed that multi-generational FHoS was significantly associated with an increased risk of problematic behaviors and suicidal behaviors (suicide ideation and suicide attempt) in offspring. Interestingly, the problematic behaviors were further identified as a mediator in the multi-generational transmission of suicidal behaviors. Additionally, we observed alterations in brain structure within superior temporal gyrus (STG), precentral/postcentral cortex, posterior parietal cortex (PPC), cingulate cortex (CC), and planum temporale (PT), as well as disrupted functional connectivity of default mode network (DMN), ventral attention network (VAN), dorsal attention network (DAN), fronto-parietal network (FPN), and cingulo-opercular network (CON) among preadolescents with FHoS. These results provide compelling longitudinal evidence at the population level, highlighting the associations between multi-generational FHoS and maladaptive behavioral and neurodevelopmental outcomes in offspring. These findings underscore the need for early preventive measures aimed at mitigating the familial transmission of suicide risk and reducing the global burden of deaths among children and adolescents.
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Affiliation(s)
- Xue Wen
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Diyang Qu
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Dongyu Liu
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Yinuo Shu
- Chinese Institute for Brain Research, Beijing, China
| | - Shaoling Zhao
- Chinese Institute for Brain Research, Beijing, China
| | - Guowei Wu
- Chinese Institute for Brain Research, Beijing, China
| | - Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Zaixu Cui
- Chinese Institute for Brain Research, Beijing, China.
| | - Xiaoqian Zhang
- Wulituo Hospital of Shijingshan District, Beijing, China.
| | - Runsen Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China.
- Institute for Healthy China, Tsinghua University, Beijing, China.
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Mittermeier S, Seidel A, Scheiner C, Kleindienst N, Romanos M, Buerger A. Emotional dysregulation and its pathways to suicidality in a community-based sample of adolescents. Child Adolesc Psychiatry Ment Health 2024; 18:15. [PMID: 38245793 PMCID: PMC10800042 DOI: 10.1186/s13034-023-00699-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 12/20/2023] [Indexed: 01/22/2024] Open
Abstract
OBJECTIVE Effective suicide prevention for adolescents is urgently needed but difficult, as suicide models lack a focus on age-specific influencing factors such as emotional dysregulation. Moreover, examined predictors often do not specifically consider the contribution to the severity of suicidality. To determine which adolescents are at high risk of more severe suicidality, we examined the association between emotional dysregulation and severity of suicidality directly as well as indirectly via depressiveness and nonsuicidal self-injury. METHOD Adolescents from 18 high schools in Bavaria were included in this cross-sectional and questionnaire-based study as part of a larger prevention study. Data were collected between November 2021 and March 2022 and were analyzed from January 2023 to April 2023. Students in the 6th or 7th grade of high school (11-14 years) were eligible to participate. A total of 2350 adolescents were surveyed and data from 2117 students were used for the analyses after excluding incomplete data sets. Our main outcome variable was severity of suicidality (Paykel Suicide Scale, PSS). Additionally, we assessed emotional dysregulation (Difficulties in Emotion Regulation Scale, DERS-SF), depressiveness (Patient Health Questionnaire, PHQ-9) and nonsuicidal self-injury (Deliberate Self-Harm Inventory, DSHI). RESULTS In total, 2117 adolescents (51.6% female; mean age, 12.31 years [standard deviation: 0.67]) were included in the structural equation model (SEM). Due to a clear gender-specific influence, the model was calculated separately for male and female adolescents. For male adolescents, there was a significant indirect association between emotional dysregulation and severity of suicidality, mediated by depressiveness (β = 0.15, SE = .03, p = .008). For female adolescents, there was a significant direct path from emotional dysregulation to severity of suicidality and also indirect paths via depressiveness (β = 0.12, SE = .05, p = 0.02) and NSSI (β = 0.18, SE = .04, p < .001). CONCLUSIONS Our results suggest that gender-related risk markers in 11-14-year-olds need to be included in future suicide models to increase their predictive power. According to our findings, early detection and prevention interventions based on emotion regulation skills might be enhanced by including gender-specific adjustments for the co-occurrence of emotional dysregulation, depressiveness, and nonsuicidal self-injury in girls and the co-occurrence of emotional dysregulation and depressiveness in boys.
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Affiliation(s)
- Sabrina Mittermeier
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Wuerzburg, Margarete-Hoeppel-Platz 1, 97080, Wuerzburg, Germany.
- German Centre of Prevention Research, University of Wuerzburg, Wuerzburg, Germany.
| | - Alexandra Seidel
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Wuerzburg, Margarete-Hoeppel-Platz 1, 97080, Wuerzburg, Germany
- German Centre of Prevention Research, University of Wuerzburg, Wuerzburg, Germany
| | - Christin Scheiner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Wuerzburg, Margarete-Hoeppel-Platz 1, 97080, Wuerzburg, Germany
- German Centre of Prevention Research, University of Wuerzburg, Wuerzburg, Germany
| | - Nikolaus Kleindienst
- Institute of Psychosomatic Medicine and Psychotherapy, Medical Faculty Mannheim, Central Institute of Mental Health Mannheim, Heidelberg University, Heidelberg, Germany
| | - Marcel Romanos
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Wuerzburg, Margarete-Hoeppel-Platz 1, 97080, Wuerzburg, Germany
- German Centre of Prevention Research, University of Wuerzburg, Wuerzburg, Germany
| | - Arne Buerger
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital of Wuerzburg, Margarete-Hoeppel-Platz 1, 97080, Wuerzburg, Germany
- German Centre of Prevention Research, University of Wuerzburg, Wuerzburg, Germany
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Williams AJ, Cleare S, Borschmann R, Tench CR, Gross J, Hollis C, Chapman-Nisar A, Naeche N, Townsend E, Slovak P. Enhancing emotion regulation with an in situ socially assistive robot among LGBTQ+ youth with self-harm ideation: protocol for a randomised controlled trial. BMJ Open 2024; 14:e079801. [PMID: 38195171 PMCID: PMC10806609 DOI: 10.1136/bmjopen-2023-079801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Accepted: 12/08/2023] [Indexed: 01/11/2024] Open
Abstract
INTRODUCTION Purrble, a socially assistive robot, was codesigned with children to support in situ emotion regulation. Preliminary evidence has found that LGBTQ+ youth are receptive to Purrble and find it to be an acceptable intervention to assist with emotion dysregulation and their experiences of self-harm. The present study is designed to evaluate the impact of access to Purrble among LGBTQ+ youth who have self-harmful thoughts, when compared with waitlist controls. METHODS AND ANALYSIS The study is a single-blind, randomised control trial comparing access to the Purrble robot with waitlist control. A total of 168 LGBTQ+ youth aged 16-25 years with current self-harmful ideation will be recruited, all based within the UK. The primary outcome is emotion dysregulation (Difficulties with Emotion Regulation Scale-8) measured weekly across a 13-week period, including three pre-deployment timepoints. Secondary outcomes include self-harm (Self-Harm Questionnaire), anxiety (Generalised Anxiety Disorder-7) and depression (Patient Health Questionnaire-9). We will conduct analyses using linear mixed models to assess primary and secondary hypotheses. Intervention participants will have unlimited access to Purrble over the deployment period, which can be used as much or as little as they like. After all assessments, control participants will receive their Purrble, with all participants keeping the robot after the end of the study. After the study has ended, a subset of participants will be invited to participate in semistructured interviews to explore engagement and appropriation of Purrble, considering the young people's own views of Purrble as an intervention device. ETHICS AND DISSEMINATION Ethical approval was received from King's College London (RESCM-22/23-34570). Findings will be disseminated in peer review open access journals and at academic conferences. TRIAL REGISTRATION NUMBER NCT06025942.
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Affiliation(s)
- A Jess Williams
- Department of Informatics, King's College London, London, UK
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Seonaid Cleare
- Department of Informatics, King's College London, London, UK
- University of Glasgow, Glasgow, UK
| | - Rohan Borschmann
- Murdoch Children's Research Institute, Parkville, Victoria, Australia
- University of Oxford, Oxford, UK
| | | | - James Gross
- Stanford University, Stanford, California, USA
| | - Chris Hollis
- Division of Psychiatry, University of Nottingham, Nottingham, UK
| | | | | | - Ellen Townsend
- School of Psychology, University of Nottingham, Nottingham, UK
| | - Petr Slovak
- Department of Informatics, King's College London, London, UK
- University of Oxford, Oxford, UK
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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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Zhang Y, Wang D, Ma Z, Liu W, Su Y, Wang W, You Z, Fan F. Problematic internet use and suicide ideation among Chinese adolescents: The indirect effects of insomnia, nightmares, and social jetlag. J Affect Disord 2024; 344:347-355. [PMID: 37838270 DOI: 10.1016/j.jad.2023.10.081] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 09/12/2023] [Accepted: 10/09/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND Problematic Internet use (PIU) is related to suicide ideation (SI) in adolescents, but little is known about the potential mechanisms between them. This study aimed to examine the mediation roles of insomnia, nightmares, and social jetlag in the association of PIU with SI in adolescents. METHODS A total of 39,731 adolescents (mean age = 13.49 ± 0.76 years, 54.4 % males) from Shenzhen, China, participated in a cross-sectional survey. SI was assessed using the ninth item of the Patient Health Questionnaire-9. PIU was measured by the Revised Chinese Internet Addiction Scale. A self-administered questionnaire was used to assess insomnia symptoms, nightmare frequency, social jetlag, sleep duration, psychological distress, and social-demographical characteristics. Logistic regression and path analyses were performed to examine the associations between PIU, insomnia symptoms, nightmares, social jetlag, and SI. RESULTS The prevalence of PIU and SI were 14.9 % and 18.6 %, respectively. PIU, insomnia symptoms, frequent nightmares, and social jetlag were significantly associated with SI. Path analyses showed that the indirect effects of PIU on SI through insomnia symptoms, frequent nightmares, and social jetlag were significant. Conversely, social jetlag significantly mediated the pathway from SI to PIU. The mediation effect sizes of these sleep and circadian problems were slightly larger in females than in males. LIMITATIONS Cross-sectional design limited the capacity to infer causal relationships. CONCLUSIONS The associations between PIU and SI were mediated by sleep and circadian problems. These findings underscore the importance of assessing and intervening in sleep and circadian problems among adolescents with PIU or SI.
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Affiliation(s)
- Yifan Zhang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Dongfang Wang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Zijuan Ma
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Wenxu Liu
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Yunlin Su
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Wei Wang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Zhenli You
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China
| | - Fang Fan
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, South China Normal University, Guangzhou, China.
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Paladini G, Sciurpa E, Onorati R, Elhadidy HSMA, Giacomini G, Mamo C, Borraccino A. Gender and Age Influence on Emergency Department Visits for Non-Suicidal Self-Injuries in School Aged Children in Italy: An 11 Years Retrospective Cross-Sectional Study. Int J Public Health 2023; 68:1606370. [PMID: 38164389 PMCID: PMC10757917 DOI: 10.3389/ijph.2023.1606370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 11/30/2023] [Indexed: 01/03/2024] Open
Abstract
Objectives: Non-suicidal self-injury (NSSI) poses a threat in developmental ages, yet there is a scarcity of studies on NSSI trends, especially those in emergency departments (ED). Methods: The aim of this cross-sectional study is to describe trends in ED visits for NSSI among young people aged between 5 and 19 years in Italy from 2011 to 2021 in Piedmont. From the ministerial ED discharge information system, all occurring NSSIs were identified by medical report and/or ICD9CM code and reported as a population rate and a visit rate on all ED requests. Results: The general rate of ED visits remained stable, with around 210,000 (55% males) visits each year, along the whole period from 2011 to 2019, then halved during 2020 and 2021. The NSSI population and visits rates increased from 2013, peaking in 2019 at a rate of around 25 and 23 NSSI visits (girls) and 76 and 69 NSSI (boys) per 100,000 ED visits. In 2020 and 2021, the rate of NSSI visits increased, particularly in girls and among older adolescents. Conclusion: The gradual increase of NSSI over the last decade is a rising public health issue, which deserves wider attention to ensure early detection and prevention.
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Affiliation(s)
- Giovanni Paladini
- Department of Public Health Sciences and Pediatrics, University of Turin, Turin, Italy
| | - Elena Sciurpa
- Department of Public Health Sciences and Pediatrics, University of Turin, Turin, Italy
| | - Roberta Onorati
- Regional Public Health Observatory, Epidemiology Unit, Local Health Board TO3, Grugliasco, Italy
| | | | - Gianmarco Giacomini
- Department of Public Health Sciences and Pediatrics, University of Turin, Turin, Italy
| | - Carlo Mamo
- Regional Public Health Observatory, Epidemiology Unit, Local Health Board TO3, Grugliasco, Italy
| | - Alberto Borraccino
- Department of Public Health Sciences and Pediatrics, University of Turin, Turin, Italy
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Encina-Zúñiga E, Rodante D, Agrest M, Tapia-Munoz T, Vidal-Zamora I, Ardila-Gómez S, Alvarado R, Leiderman EA, Reavley N. Development of mental health first-aid guidelines for suicide risk: a Delphi expert consensus study in Argentina and Chile. BMC Psychiatry 2023; 23:928. [PMID: 38082256 PMCID: PMC10712185 DOI: 10.1186/s12888-023-05417-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/28/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Suicide continues to pose a significant global public health challenge and ranks as one of the leading causes of death worldwide. Given the prevalence of suicide risk in the community, there is a significant likelihood of encountering individuals who may be experiencing suicidal thoughts or plans, creating an opening for non-health professionals to offer support. This study aims to culturally adapt the original Australian Mental Health First Aid Guidelines for suicide risk to the Chilean and Argentine context. METHODS A two-round Delphi expert consensus study was conducted involving two panels, one comprising individuals with personal experience in suicide thoughts/attempts or caregiving for those with such experiences (n = 18), and the other consisting of professionals specialized in suicide assessment and support for individuals at risk (n = 25). They rated a total of 179 items mainly derived from guidelines developed by Australian experts and translated into Spanish (168), and new items included by the research team (11). The panel members were requested to assess each item utilizing a five-point Likert scale. During the second round, items that received moderate approval in the initial round were re-evaluated, and new items suggested by the local experts in the first round were also subjected to evaluation in the next round. Inclusion in the final guidelines required an 80% endorsement as "essential" or "important" from both panels. RESULTS Consensus of approval was reached for 189 statements. Among these, 139 statements were derived from the English-language guidelines, while 50 locally generated statements were accepted during the second round. A significant difference from the original guideline was identified concerning the local experts' reluctance to discuss actions collaboratively with adolescents. Furthermore, the local experts proposed the inclusion of an entirely new section addressing suicide risk in older individuals, particularly focusing on suicide methods and warning signs. CONCLUSIONS A Delphi expert consensus study was conducted to culturally adapt mental health first aid guidelines for assessing suicide risk in Chile and Argentina. This study involved professionals and individuals with lived experience. While many items were endorsed, some related to inquiring about suicide risk and autonomy, particularly for adolescents, were not. An additional section for older individuals was introduced. Future research should explore the implementation and impact of these adapted guidelines in training courses. This is vital for enhancing mental health support and implementing effective suicide prevention strategies in Chile and Argentina.
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Affiliation(s)
- Esteban Encina-Zúñiga
- Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Santiago, Chile.
- Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Chile, Santiago, Chile.
| | - Demián Rodante
- Facultad de Medicina, Instituto de Farmacología, Universidad de Buenos Aires, Buenos Aires, Argentina
- Fundación Foro para la salud mental, Buenos Aires, Argentina
| | - Martín Agrest
- Proyecto Suma, Güemes 4130 (1425), Ciudad Autónoma de Buenos Aires, Argentina
- Facultad de Psicología, Universidad de Buenos Aires, Instituto de Investigaciones, Buenos Aires, Argentina
| | - Thamara Tapia-Munoz
- Department of Behavioural Science and Health, University College London, London, UK
| | - Isidora Vidal-Zamora
- Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Chile, Santiago, Chile
| | - Sara Ardila-Gómez
- Facultad de Psicología, Universidad de Buenos Aires, Instituto de Investigaciones, Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Rosario, Santa Fe, Argentina
| | - Rubén Alvarado
- Escuela de Salud Pública, Facultad de Medicina, Universidad de Chile, Santiago, Chile
- Departamento de Salud Pública, Escuela de Medicina, Facultad de Medicina, Universidad de Valparaíso, Valparaíso, Chile
| | - Eduardo A Leiderman
- Departamento de Neurociencias, Facultad de Ciencias Sociales, Universidad de Palermo, Buenos Aires, Argentina
| | - Nicola Reavley
- Melbourne School of Population and Global Health, Centre for Mental Health, University of Melbourne, Victoria, Australia
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Ding L, Liu Y, Liu X. Risk Factors of Suicide Attempt among Adolescents with Suicide Ideation in Low- and Middle-Income Countries across the Globe. Issues Ment Health Nurs 2023; 44:1209-1215. [PMID: 37832147 DOI: 10.1080/01612840.2023.2258219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2023]
Abstract
Suicide is a serious public health problem for adolescents. Based on the framework of ideation-to-action, it is important to examine the factors associated with the translation from suicide ideation to suicide attempt. The present study aimed to investigate the risk factors of suicide attempts among adolescents with suicide ideation in low-income and middle-income countries (LMICs). We analyzed data of students aged 12-18 years who participated in the 2009-2013 Global School-based Health Surveys (GSHS) in 39 LMICs. The Chi-square test was used to compare the prevalence of suicide attempts among participants with suicide ideation, the multilevel logistic regression model was used to identify significant factors associated with suicide attempts among suicide ideators. Among 22,655 adolescents with suicide ideation, 55.1% of them reported having made a suicide attempt in the past year. Loneliness, anxiety, alcohol use, and drug use were risk factors for suicide attempts among suicide ideators. Strategies should be implemented to reduce the likelihood of adolescents acting on their suicidal thoughts, such as community psychological crisis line, school-based mental health and skills training programs, and family support for adolescents with psychological problems.
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Affiliation(s)
- Liwen Ding
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, China
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yuanyuan Liu
- Department of Epidemiology and Health Statistics, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xiang Liu
- Department of Health Behavior and Social Medicine, West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, Sichuan, China
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Gregersen M, Møllegaard Jepsen JR, Marie Brandt J, Søndergaard A, Birkehøj Rohd S, Veddum L, Bruun Knudsen C, Krogh Andreassen A, Klee Burton B, Hjorthøj C, Falkenberg Krantz M, Neergaard Greve A, Bliksted V, Mors O, Nordentoft M, Elgaard Thorup AA, Hemager N. Suicidal Ideation and Non-Suicidal Self-Injury Following Early Childhood Psychotic Experiences in Preadolescent Children at Familial High Risk of Schizophrenia or Bipolar Disorder-The Danish High Risk and Resilience Study, VIA 11. Schizophr Bull 2023; 49:1602-1613. [PMID: 37171862 PMCID: PMC10686355 DOI: 10.1093/schbul/sbad052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
BACKGROUND AND HYPOTHESIS Suicide is a leading cause of death in youth and is often preceded by suicidal ideation (SI) and non-suicidal self-injury (NSSI). Identifying early markers of risk for SI and NSSI could improve timely identification of at-risk individuals. STUDY DESIGN Children (mean age 11.9, SD 0.2) at familial high risk of schizophrenia (N = 171), or bipolar disorder (N = 104), and controls (N = 174) were assessed for psychotic experiences (PE), SI, NSSI, and Axis I mental disorders in face-to-face interviews in early and middle childhood (age 7 and 11). STUDY RESULTS Having 2 types of early childhood PE predicted middle childhood SI after accounting for previous SI, NSSI, and mental disorders (OR 2.8, 95% CI 1.1-6.9; P = .03). Two PE predicted NSSI (OR 3.0, 95% CI 1.2-7.7; P = .02) in excess of previous SI, NSSI, mental disorders, and familial risk. Persistent and incident PE predicted SI (OR 3.2, 95% CI, 1.1-8.8; P = .03; OR 3.8, 95% CI, 1.3-11.5; P = .02) in the fully adjusted model. Nineteen percent of children with persistent PE reported middle childhood SI vs 3.8% of those who never reported PE. In children with early childhood mental disorders, those who reported 2 PE had 4.4-fold increased odds of later SI (95% CI, 1.2-16.7; P = .03) after adjustments. PE were nondifferentially associated with outcomes across familial risk groups. CONCLUSIONS Early childhood PE index elevated risk for subsequent SI and NSSI beyond what can be attributed to presence of mental disorders. Mental health screenings and clinical assessments should include early childhood PE.
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Affiliation(s)
- Maja Gregersen
- CORE – Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark
| | - Jens Richardt Møllegaard Jepsen
- CORE – Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark
- Child and Adolescent Mental Health Center, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
- Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Julie Marie Brandt
- CORE – Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne Søndergaard
- CORE – Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Sinnika Birkehøj Rohd
- CORE – Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark
| | - Lotte Veddum
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark
| | - Christina Bruun Knudsen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark
| | - Anna Krogh Andreassen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark
| | - Birgitte Klee Burton
- Child and Adolescent Mental Health Center, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Child and Adolescent Psychiatry, Copenhagen University Hospital, Psychiatry Region Zealand, Roskilde, Denmark
| | - Carsten Hjorthøj
- CORE – Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark
- Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen, Denmark
| | - Mette Falkenberg Krantz
- Child and Adolescent Mental Health Center, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
| | - Aja Neergaard Greve
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark
| | - Vibeke Bliksted
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark
| | - Merete Nordentoft
- CORE – Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Anne Amalie Elgaard Thorup
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark
- Child and Adolescent Mental Health Center, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Nicoline Hemager
- CORE – Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark
- Child and Adolescent Mental Health Center, Mental Health Services in the Capital Region of Denmark, Copenhagen, Denmark
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Tintori A, Pompili M, Ciancimino G, Corsetti G, Cerbara L. The developmental process of suicidal ideation among adolescents: social and psychological impact from a nation-wide survey. Sci Rep 2023; 13:20984. [PMID: 38017031 PMCID: PMC10684516 DOI: 10.1038/s41598-023-48201-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/23/2023] [Indexed: 11/30/2023] Open
Abstract
Suicidal ideation is a multifactorial phenomenon that is increasingly prevalent among adolescents, especially following the impact of Covid 19 pandemic on their mental health. Its analysis necessitates an interdisciplinary approach that simultaneously considers sociological and psychological perspectives, especially looking at the role of interpersonal relationships and structural inequalities. The present study, based on a face-to-face survey conducted with a representative sample of 4288 adolescents, aims to identify the factors that most differentiate individuals with and without suicidal ideation, proposing a descriptive model of development process of this phenomenon with reference to the Italian context. We analysed variables related to socio-demographic status, relational status, social interactions, and psychological well-being using multiple correspondence analysis and logistic regression models. The results provide evidence for the existence of a direct association between negative psychological status and suicidal ideation but clarify that the psychological aspects are associated with sociodemographic characteristics and have their origins in the social sphere.
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Affiliation(s)
- Antonio Tintori
- Institute for Research on Population and Social Policies, National Research Council of Italy, 00185, Rome, Italy
| | - Maurizio Pompili
- Department of Psychiatry, Sant'Andrea Hospital, Sapienza University of Rome, 00189, Rome, Italy
| | - Giulia Ciancimino
- Institute for Research on Population and Social Policies, National Research Council of Italy, 00185, Rome, Italy.
| | - Gianni Corsetti
- Italian National Institute of Statistics, 00184, Rome, Italy
| | - Loredana Cerbara
- Institute for Research on Population and Social Policies, National Research Council of Italy, 00185, Rome, Italy
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43
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Pavarin RM, Lia L, Tugnoli S, Caracciolo S. Suicide Attempts in an Italian Population with Cannabis Use Disorders: Results of a Follow-Up Study. J Psychoactive Drugs 2023:1-8. [PMID: 38009854 DOI: 10.1080/02791072.2023.2287674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 10/23/2023] [Indexed: 11/29/2023]
Abstract
The relationship between cannabis use and suicidal behavior is complex, with no consensus in the literature. We used electronic health records of national health services to identify individuals who received a diagnosis of Cannabis Use Disorder in the Metropolitan area of Bologna from 2009 to 2019. In this cohort we identified accesses to Emergency Departments for suicide attempts from 2009 to 2019. The Crude Suicide Rate for 1,000 Person Years was 2.5, higher in females, in patients with Alcohol Use Disorders, with any psychiatric diagnosis, within one year from the first visit, and during the COVID-19 period. The risk was over 22 times higher than in the general population. Considering the high prevalence of cannabis use in the general population and the consequent risk of Cannabis Use Disorders, these data suggest the importance of a clinical evaluation for suicidal risk.
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Affiliation(s)
- Raimondo Maria Pavarin
- Epidemiological Monitoring Center on Addiction, Department of Mental Health and Pathological Addictions, Italian Society of Substance Abuse (SITD), Local Health Unit of Bologna, Bologna, Italy
| | - Loredana Lia
- Mental Health DSM-DP, Azienda USL Bologna, Bologna, Italy
| | - Stefano Tugnoli
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Stefano Caracciolo
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
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Shi Y, Song Y, Wang L, Liu J, Chen IJ. Early maladaptive schemas and the risk of nonsuicidal self-injury in college students: A retrospective study. Medicine (Baltimore) 2023; 102:e35584. [PMID: 38013353 PMCID: PMC10681388 DOI: 10.1097/md.0000000000035584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 09/20/2023] [Indexed: 11/29/2023] Open
Abstract
Early maladaptive schemas (EMSs) may be closely related to nonsuicidal self-injury (NSSI). The present study aimed to discuss the relationship between EMS and a personal history of NSSI. This was a retrospective study. A total of 1339 Chinese college students between 16 and 29 years old were asked to complete a questionnaire survey regarding their personal history of NSSI and EMSs. 116 college students reported a history of NSSI (NSSI group), who differed significantly in terms of all EMS-related scores than non-NSSI group(n = 1223). Logistic regression analysis showed that the scores in the disconnection/rejection schema domain exhibited by subjects who were the only child in their family could help differentiate between college students with or without NSSI. The emotional deprivation schema was significantly associated with the lifetime frequency of NSSI behaviors; the vulnerability to harm or illness schema was significantly associated with the internal emotion regulation function and pain associated with NSSI; and the enmeshment/underdeveloped self schema was significantly associated with the addictive features of NSSI. The self-sacrifice schema was significantly associated with the external emotion regulation function of NSSI; the enmeshment/underdeveloped self schema was positively related with the sensation-seeking function of NSSI; and the abandonment/instability schema was negatively related the sensation-seeking function of NSSI. The disconnection/rejection schema domain was highly related with NSSI behaviors. EMS is significantly associated with the history, functions, addictive features, and severity of NSSI. Every EMS is worthy of further investigation and discussion with patients in the context of NSSI behaviors during clinical therapy.
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Affiliation(s)
- Ying Shi
- Department of Psychology, School of Education, Soochow University, Dushuhu Campus, Suzhou City, China
| | - Yunping Song
- Department of Psychology, School of Education, Soochow University, Dushuhu Campus, Suzhou City, China
| | - Liling Wang
- Department of Psychology, School of Education, Soochow University, Dushuhu Campus, Suzhou City, China
| | - Jingyi Liu
- Department of Psychology, School of Education, Soochow University, Dushuhu Campus, Suzhou City, China
| | - I-Jun Chen
- Department of Psychology, School of Education, Soochow University, Dushuhu Campus, Suzhou City, China
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Dubruel A, Patel P, Kennedy A. The Recovery from Attempting Suicide. Arch Suicide Res 2023:1-13. [PMID: 37982802 DOI: 10.1080/13811118.2023.2281546] [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: 11/21/2023]
Abstract
A positive trajectory of life after an attempted suicide is extremely limited in research despite its advantage of aiding salutary outcomes. A systematic review of the qualitative research was conducted to explore the impact the attempt of taking your own life has had on your life and your work, to discover what changes participants have made to move toward a life worth living, and to understand how people can help better support individuals from attempted suicide attempts. A comprehensive search of online articles identified thirteen eligible studies. Three themes emerged: (1) rediscovering a life of meaning (2) contextual factors that facilitate a life worth living (3) internal changes. Limitations were discussed along with recommendations for future research.
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46
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Konno YT, Araújo Filho GM, Almeida JRS, Santos NB, Marques Filho AB, Fernandes BB, Parreira GS, Carvalho PH, Cenedesi LM. Recurrence of adolescent suicide attempt and self-harm (RASS study): Effectiveness of single therapeutic project. Clin Child Psychol Psychiatry 2023:13591045231213029. [PMID: 37929929 DOI: 10.1177/13591045231213029] [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: 11/07/2023]
Abstract
OBJECTIVES This retrospective cohort study aims to understand the effectiveness of the Singular Therapeutic Project (STP) implemented in a Child Psychosocial Care Center in preventing recurrence of self-harm and suicide attempt (SA), by comparing the group of patients who adhered to the STP with the group that did not adhere completely. METHOD Data were collected from the medical records of adolescents with self-harm or SA during the period from 2015 to 2019. The primary outcomes analyzed were recurrence of SA, self-harm, and hospitalization; and the secondary outcomes analyzed were demographics, diagnosis, number of appointments, and negative life events. RESULTS A total of 228 adolescents were included. After multivariate analysis, social service consultations decreased risk in 94.6% (HR .054, 95% CI: .004-.681) of the cases, but risk was increased by 23 times if there was an episode of self-harm among family members and/or friends (HR 23.641, 95% CI: 1.394-400.8). Additionally, in terms of SA, adherence to family interventions reduced the risk by 66.2% (HR .338, 95% CI: .125-.913). Victims of prejudice, racism, homophobia, transphobia presented a 3.7-fold increased risk (HR 3.766, 95% CI: 1.058-13.401). CONCLUSION The STP interventions were effective in reducing the recurrence of self-harm and SAs in adolescents.
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Affiliation(s)
- Yoichi T Konno
- Department of Psychiatry and Neurology, Faculdade de Medicina de Sao Jose do Rio Preto, Sao Jose do Rio Preto, Brazil
| | - Gerardo Md Araújo Filho
- Department of Psychiatry and Neurology, Faculdade de Medicina de Sao Jose do Rio Preto, Sao Jose do Rio Preto, Brazil
| | - José Robson Sr Almeida
- Department of Psychiatry and Neurology, Faculdade de Medicina de Sao Jose do Rio Preto, Sao Jose do Rio Preto, Brazil
| | - Nágila Bl Santos
- Department of Psychiatry and Neurology, Faculdade de Medicina de Sao Jose do Rio Preto, Sao Jose do Rio Preto, Brazil
| | - Altino B Marques Filho
- Department of Psychiatry and Neurology, Faculdade de Medicina de Sao Jose do Rio Preto, Sao Jose do Rio Preto, Brazil
| | - Bianca B Fernandes
- Department of Psychiatry and Neurology, Faculdade de Medicina de Sao Jose do Rio Preto, Sao Jose do Rio Preto, Brazil
| | - Gabriel S Parreira
- Department of Psychiatry and Neurology, Faculdade de Medicina de Sao Jose do Rio Preto, Sao Jose do Rio Preto, Brazil
| | - Pedro Hf Carvalho
- Department of Psychiatry and Neurology, Faculdade de Medicina de Sao Jose do Rio Preto, Sao Jose do Rio Preto, Brazil
| | - Loise Mt Cenedesi
- Department of Psychiatry and Neurology, Faculdade de Medicina de Sao Jose do Rio Preto, Sao Jose do Rio Preto, Brazil
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Zou H, Huang J, Zhang W, Wu J, Wu W, Huo L. The effect of cyberbullying victimization and traditional bullying victimization on suicidal ideation among Chinese female college students: The role of rumination and insomnia. J Affect Disord 2023; 340:862-870. [PMID: 37604242 DOI: 10.1016/j.jad.2023.08.099] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 08/17/2023] [Accepted: 08/18/2023] [Indexed: 08/23/2023]
Abstract
BACKGROUND The issue of college student suicide has emerged as a significant global public health concern. To date, there has been a lack of extensive research on the effects of distinct forms of bullying victimization (traditional bullying victimization and cyberbullying victimization) on suicidal ideation, as well as the differences between them. The present study aimed to investigate the relationship between two forms of bullying victimization and suicidal ideation among female college students, while also considering the potential mediating effects of rumination and insomnia. METHODS A total of 2106 female college students from Southern China participated in this study. The participants had a mean age of 19.83 years (SD = 1.04 years). Participants completed the MINI-C questionnaire, School Bullying Behavior Questionnaire, Cyberbullying Inventory (CBI), Ruminative Responses Scale (RRS), and Insomnia Severity Index (ISI). The mediation models were conducted using Model 4 and Model 6 of the Process macro program in SPSS. RESULTS The results showed that (1) the mediating effect of rumination in the relationship between different forms of bullying victimization and suicidal ideation was significant; (2) The mediating effect of insomnia in the relationship between traditional bullying victimization and suicidal ideation was not significant; the mediating effect between cyberbullying victimization and suicidal ideation was significant. (3) The chain mediating effect of rumination and insomnia in the relationship between different forms of bullying victimization and suicidal ideation were both significant. CONCLUSION This study endeavor represents the first attempt to investigate the relationship between two forms of bullying victimization and suicidal ideation.
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Affiliation(s)
- Hongyu Zou
- Key Laboratory of Brain, Cognition and Education Sciences, South China Normal University, Ministry of Education, 510631 Guangzhou, China; School of Psychology, South China Normal University, 510631 Guangzhou, China
| | - Junxuan Huang
- Key Laboratory of Brain, Cognition and Education Sciences, South China Normal University, Ministry of Education, 510631 Guangzhou, China; Institute for Brain Research and Rehabilitation, South China Normal University, 510631 Guangzhou, China
| | - Wei Zhang
- Key Laboratory of Brain, Cognition and Education Sciences, South China Normal University, Ministry of Education, 510631 Guangzhou, China; School of Psychology, South China Normal University, 510631 Guangzhou, China
| | - Jiefang Wu
- School of Marxism, Guangdong Food and Drug Vocational College, 510520 Guangzhou, China
| | - Wanchun Wu
- Key Laboratory of Brain, Cognition and Education Sciences, South China Normal University, Ministry of Education, 510631 Guangzhou, China; School of Psychology, South China Normal University, 510631 Guangzhou, China
| | - Lijuan Huo
- Key Laboratory of Brain, Cognition and Education Sciences, South China Normal University, Ministry of Education, 510631 Guangzhou, China; Institute for Brain Research and Rehabilitation, South China Normal University, 510631 Guangzhou, China.
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Lengvenyte A, Belzeaux R, Olié E, Hamzeh-Cognasse H, Sénèque M, Strumila R, Cognasse F, Courtet P. Associations of potential plasma biomarkers with suicide attempt history, current suicidal ideation and subsequent suicidal events in patients with depression: A discovery study. Brain Behav Immun 2023; 114:242-254. [PMID: 37648005 DOI: 10.1016/j.bbi.2023.08.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 08/22/2023] [Accepted: 08/26/2023] [Indexed: 09/01/2023] Open
Abstract
A growing body of evidences suggests that suicidal ideation (SI) and suicidal behaviors have biological bases. However, no biological marker is currently available to evaluate the suicide risk in individuals with SI or suicide attempt (SA). Moreover, the current risk assessment techniques poorly predict future suicidal events. The aim of this study was to examine the association of 39 new and already described peripheral cells and proteins (implicated in the immune system, oxidative stress and plasticity) with lifetime SA, past month SA, current SI, and future suicidal events (visit to the Emergency Department for SI or SA) in 266 treatment-seeking individuals with mood disorders. Equal parts of patients with and without past history of SA were recruited. All individuals at inclusion gave blood, were evaluated for SA recency, current SI, and were followed for two years afterwards. The 39 peripheral blood cellular and protein markers were entered separately for each outcome in Elastic Net models with 10-fold cross-validation, followed by single-analyte covariate-adjusted regression analyses for pre-selected analytes. Past month SA was associated with increased plasma levels of thrombospondin-2 and C-reactive protein, whereas current SI was associated with lower plasma serotonin levels. These associations were robust to adjustments for key covariates and corrections for multiple testing. The Cox proportional hazards regression showed that higher levels of thrombospondin-1 and of platelet-derived growth factor-AB predicted a future suicidal event. These two associations remained after adjustment for sex, age, and SA history, and outperformed the predictive value of past SA. Thrombospondins and platelet-derived growth factors have never been investigated in the context of suicide. Altogether, our results highlight the involvement in the suicidal process of platelet biological response and plasticity modifiers and also of inflammatory factors. They also suggest that SI and SA may have different biological correlates and that biomarkers associated with past SA or current SI do not automatically also predict future events.
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Affiliation(s)
- Aiste Lengvenyte
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; IGF, University of Montpellier, CNRS, INSERM, Montpellier, France; Faculty of Medicine, Institute of Clinical Medicine, Psychiatric Clinic, Vilnius University, Vilnius, Lithuania.
| | - Raoul Belzeaux
- INT-UMR7289, CNRS Aix-Marseille Université, Marseille, France; University Department of Adult Psychiatry, CHU Montpellier, Montpellier, France; Fondation Fondamental
| | - Emilie Olié
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; IGF, University of Montpellier, CNRS, INSERM, Montpellier, France; Fondation Fondamental
| | - Hind Hamzeh-Cognasse
- Université Jean Monnet, Mines Saint-Étienne, INSERM, U 1059 Sainbiose, Saint-Étienne, France
| | - Maude Sénèque
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; IGF, University of Montpellier, CNRS, INSERM, Montpellier, France
| | - Robertas Strumila
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; IGF, University of Montpellier, CNRS, INSERM, Montpellier, France; Faculty of Medicine, Institute of Clinical Medicine, Psychiatric Clinic, Vilnius University, Vilnius, Lithuania
| | - Fabrice Cognasse
- Université Jean Monnet, Mines Saint-Étienne, INSERM, U 1059 Sainbiose, Saint-Étienne, France; Etablissement Français du Sang Auvergne-Rhône-Alpes, Saint-Étienne, France
| | - Philippe Courtet
- Department of Emergency Psychiatry and Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; IGF, University of Montpellier, CNRS, INSERM, Montpellier, France; Fondation Fondamental
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Langjord T, Pedersen G, Bovim T, Christensen TB, Eikenæs IUM, Hove O, Kildahl AN, Mork E, Norheim AB, Ramleth RK, Ringen PA, Romm KL, Siqveland J, Schønning T, Stänicke L, Torgersen T, Pettersen M, Tveit T, Urnes Ø, Walby F, Kvarstein EH. Mental health disorders, functioning and health-related quality of life among extensively hospitalized patients due to severe self-harm - results from the Extreme Challenges project. Front Psychiatry 2023; 14:1258025. [PMID: 37920539 PMCID: PMC10619742 DOI: 10.3389/fpsyt.2023.1258025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 09/19/2023] [Indexed: 11/04/2023] Open
Abstract
Background Severe self-harm leading to extensive hospitalization generates extreme challenges for patients, families, and health services. Controversies regarding diagnoses and health care often follow. Most evidence-based treatments targeting self-harm are designed for borderline personality disorder (BPD). However, current knowledge about mental health status among individuals with severe self-harm is limited. Objectives To investigate psychopathology among patients extensively hospitalized due to severe or frequent self-harming behaviors. Method A cross sectional study (period 2019-2021) targeting psychiatric inpatients (>18 years) with frequent (>5) or long (>4 weeks) admissions last year due to self-harm. The target sample (N = 42, from 12 hospitals across all Norwegian health regions) was compared to individuals admitted to outpatient personality disorder (PD) treatment within specialist mental health services in the same period (N = 389). Clinicians performed interviews on self-harm and psychopathology, supplemented by self-report. Results The target sample were young adults, mainly female, with considerable hospitalization and self-harming behaviors, both significantly more extensive than the comparison group. The majority in both groups reported self-harm onset <18 years. The target sample reported increasing severity of self-harm acts and suicidal intention over time. Both samples had high levels of childhood trauma, impaired personality functioning, and a majority fulfilled criteria for PD. In the target sample, comorbid depression, PTSD, anxiety disorders, and substance use occurred more frequently and in 50%, psychosis/dissociative disorder/autism spectrum disorder/ADHD was reported (outpatient comparison sample: 9%). 35% in the target sample screened over cut-off for possible intellectual disability. The target sample reported poor psychosocial functioning and health-related quality of life - greater impairment than the outpatient comparison sample. Conclusion The study reveals that severe self-harm inpatients have complex psychopathology and highlights the importance of individualized and thorough assessment among patients with severe and/or repetitive self-harm.
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Affiliation(s)
- Tuva Langjord
- Section for Personality Psychiatry and Specialized Treatments, Department for National and Regional Functions, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Faculty of Social Sciences, Department of Psychology, University of Oslo, Oslo, Norway
| | - Geir Pedersen
- Network for Personality Disorders, Section for Personality Psychiatry and Specialized Treatments, Department for National and Regional Functions, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway
| | - Tone Bovim
- Regional Centre – Violence, Trauma and Suicide Prevention, Oslo, Norway
- Department of Acute Medicine, Oslo University Hospital, Oslo, Norway
| | | | - Ingeborg Ulltveit-Moe Eikenæs
- National Advisory Unit Personality Psychiatry, Section for Personality Psychiatry and Specialized Treatments, Department for National and Regional Functions, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Oddbjørn Hove
- Department of Research and Innovation, Helse Fonna Health Trust, Haugesund, Norway
| | - Arvid Nikolai Kildahl
- Norwegian Centre of Competence for Intellectual Disabilities and Mental Health, Department for National and Regional Functions, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Nevsom Norwegian Centre of Expertise for Neurodevelopmental Disorders and Hypersomnias, Oslo University Hospital, Oslo, Norway
| | - Erlend Mork
- Early Intervention in Psychosis Advisory Unit for Southeast Norway, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | | | - Ruth Kari Ramleth
- Department for Child and Adolescent Psychiatry, Oslo University Hospital, Oslo, Norway
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Petter Andreas Ringen
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Kristin Lie Romm
- Early Intervention in Psychosis Advisory Unit for Southeast Norway, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Johan Siqveland
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department for Research, Division of Mental Health and Addiction, Akershus University Hospital, Oslo, Norway
| | | | - Line Stänicke
- Faculty of Social Sciences, Department of Psychology, University of Oslo, Oslo, Norway
- Child and Adolescent Psychiatry, Nic Waal Institute, Lovisenberg Hospital, Oslo, Norway
| | - Terje Torgersen
- Department of Mental Health Care, St. Olavs Hospital, Trondheim, Norway
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Mona Pettersen
- Department of Health and Care Sciences, UiT The Arctic University of Norway, Tromsø, Norway
| | - Tone Tveit
- Division of Mental Health and Addiction, Bergen University Hospital, Bergen, Norway
| | - Øyvind Urnes
- National Advisory Unit Personality Psychiatry, Section for Personality Psychiatry and Specialized Treatments, Department for National and Regional Functions, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Fredrik Walby
- National Centre for Suicide Research and Prevention, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Elfrida Hartveit Kvarstein
- Section for Personality Psychiatry and Specialized Treatments, Department for National and Regional Functions, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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50
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van der Venne P, Mürner-Lavanchy I, Höper S, Koenig J, Kaess M. Physiological response to pain in female adolescents with nonsuicidal self-injury as a function of severity. J Affect Disord 2023; 339:64-73. [PMID: 37390927 DOI: 10.1016/j.jad.2023.06.041] [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: 01/05/2023] [Revised: 06/03/2023] [Accepted: 06/20/2023] [Indexed: 07/02/2023]
Abstract
BACKGROUND Preliminary evidence indicates altered hypothalamic-pituitary-adrenal (HPA) axis and autonomic nervous system (ANS) response to experimental pain in individuals with nonsuicidal self-injury (NSSI). This study investigated effects of NSSI severity and severity of psychopathology on the HPA axis and ANS response to pain. METHODS N = 164 adolescents with NSSI and n = 45 healthy controls received heat pain stimulation. Salivary cortisol, α-amylase and blood pressure were repeatedly assessed before and after painful stimulation. Heart rate (HR) and heart rate variability (HRV) were assessed continuously. NSSI severity and comorbid psychopathology were derived from diagnostic assessments. Main and interaction effects of time of measurement and NSSI severity, adjusted for severity of adverse childhood experiences, borderline personality disorder and depression, on HPA axis and ANS response to pain were examined using regression analyses. RESULTS Increasing NSSI severity predicted an increasing cortisol response (χ2(3) = 12.09, p = .007) to pain. After adjusting for comorbid psychopathology, greater NSSI severity predicted decreased α-amylase levels following pain (χ2(3) = 10.47, p = .015), and decreased HR (χ2(2) = 8.53, p = .014) and increased HRV(χ2(2) = 13.43, p = .001) response to pain. LIMITATIONS Future research should implement several NSSI severity indicators, potentially revealing complex associations with the physiological response to pain. Assessing physiological responses to pain in NSSI in a naturalistic setting presents a promising avenue for future research in NSI. CONCLUSIONS Findings indicate an increased pain-related HPA axis response and an ANS response characterized by reduced sympathetic and increased parasympathetic activity associated with NSSI severity. Results support claims for dimensional approaches to NSSI and its related psychopathology alongside shared, underlying neurobiological correlates.
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Affiliation(s)
- Patrice van der Venne
- Clinic of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany; Institute of Psychology, University of Heidelberg, Heidelberg, Germany
| | - Ines Mürner-Lavanchy
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Saskia Höper
- Clinic of Child and Adolescent Psychiatry, Centre for Psychosocial Medicine, Heidelberg University, Heidelberg, Germany; Institute of Psychology, University of Heidelberg, Heidelberg, Germany
| | - Julian Koenig
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland; University of Cologne, Faculty of Medicine and University Hospital Cologne, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Cologne, Germany
| | - Michael Kaess
- Clinic of 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.
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