Non-Suicidal Self-Injury Among Incarcerated Adolescents: Prevalence, Personality, and Psychiatric Comorbidity

Introduction: Incarcerated adolescents represent a risk group for non-suicidal self-injury (NSSI), but research on this population has been limited and no studies have been conducted in Russia. To address this deficit, this study examined NSSI and the factors associated with it among youth in a juvenile correctional facility in Russia. Methods: NSSI and psychopathology were assessed using a psychiatric interview and self-report questionnaire in 368 incarcerated male adolescents aged 14-19 years (mean age 16.4 years, S.D. 0.9) from Northern Russia. Results: 18.2% (N = 67) of the study participants had a history of NSSI and also had higher rates of anxiety, post-traumatic stress disorder (PTSD), depression, community violence exposure and scored higher on most of the Youth Self-Report problem scales. In addition, 31.3% of the NSSI group reported previous suicidal ideation and had thought about a specific suicide method compared to 12.0% in the No-NSSI group. Adolescents with NSSI also differed significantly from the No-NSSI group on self-directedness (lower) and self-transcendence (higher) personality traits. Conclusion: NSSI is common in incarcerated adolescents in Russia and is associated with extensive psychiatric comorbidity, suicidal ideation and specific personality traits.

Nonsuicidal Self-injury: A Systematic Review

Objective: Nonsuicidal self-injury (NSSI) refers to the intentional self-inflicted destruction of body tissue without suicidal intention and for purposes not socially sanctioned. Our paper presents an up-to-date overview on nonsuicidal, self-injurious behaviors.

Method: In accordance with PRISMA guidelines, a systematic literature search was conducted across two databases, PubMed and PsycARTICLES, regarding the main features of NSSI with a focus on epidemiological and etiologic data, diagnostic criteria, and functions. All English articles, published between 1998 and 2016, were considered, and screened against a priori inclusion/exclusion criteria. The search terms include: self-harm, self-injury, NSSI, epidemiology, comorbidity, gender, functions and DSM. We also examined the references of the retrieved articles.

Results: NSSI is most common among adolescents and young adults, and the age of onset is reported to occur between 12 and 14 years. Comorbidity with borderline personality disorder (BPD) and eating disorders is often reported. DSM-5 includes NSSI as a condition requiring further study. This review gives an overview of the prevalence rates (7.5–46.5% adolescents, 38.9% university students, 4–23% adults) and main causes that appear to stem from childhood trauma, comorbidity with many other disorders and several functions of NSSI, and the potential independence of a NSSI disorder.

Conclusion: Over the years, interest in NSSI grew to such an extent that an ongoing debate was instigated on whether NSSI should be considered as a diagnosis in its own right and given its own category. This paper provides an up-to-date overview on self-injury, what is known about it and what remains to be done. Clearly, our understanding of the main issues of NSSI has increased in last two decades. However, future researches is needed to examine the developmental trajectories, cultural backgrounds and shed light on the risk factors and functions as well as clarify its role as an independent diagnostic entity.

The role of parental psychopathology and personality in adolescent non-suicidal self-injury

Adolescent non-suicidal self-injury (NSSI), a significant risk factor for suicidal behavior, is strongly associated with adolescent psychopathology and personality traits, particularly those characterized by poor self-regulation. Some parental psychopathology and personality traits have also been identified as risk factors for adolescent NSSI, but specific parental characteristics and mechanisms involved in this association have not been systematically examined. The current study comprehensively investigated the contribution of parental psychopathology and personality to adolescent NSSI using data from the baseline wave of the Adolescent Development of Emotion and Personality Traits (ADEPT) study of 550 adolescent girls (mean age = 14.39 years, SD = 0.63) and their biological parents. We first investigated whether parental lifetime psychiatric diagnoses, and personality and clinical (rumination, self-criticism, emotional reliance) traits were associated with adolescent NSSI. We also tested whether adolescent history of psychiatric illness, personality, and clinical traits mediated the associations between parental characteristics and adolescent NSSI. Parental substance use disorder, adult-ADHD symptoms, self-criticism, and lower agreeableness and conscientiousness were associated with offspring's NSSI. These associations were mediated through adolescent characteristics. In contrast, parental mood and anxiety disorders and neuroticism were unrelated to adolescent NSSI. The results suggest that parental traits and disorders characterized by self-regulatory difficulties and lack of support constitute risk factors for self-injury in adolescent girls, acting via adolescent traits. This demonstrates that parental influences play a significant role in the etiology of adolescent NSSI.

Self-harm and suicide attempts among young Chinese adolescents in Hong Kong: prevalence, correlates, and changes

OBJECTIVE

To examine the prevalence of and changes in self-harm and suicide attempts and to predict these behaviors in relation to family functioning and positive youth development.

DESIGN

We used quantitative data based on a large sample of adolescent participants. Participants had joined this study in a previous year when they were in Grade 7 (Wave 1). The present study focused on Wave 2 data and the comparison with Wave 1 data.

SETTING AND PARTICIPANTS

The participants consisted of 2,579 Grade 8 students from 28 secondary schools in Hong Kong. A multi-stage cluster random sampling was adopted.

MAIN OUTCOME MEASURE

Self-harm behavior, suicide attempt, the Chinese Family Assessment Instrument, the Chinese Positive Youth Development Scale.

RESULTS

Approximately 23.5% of Grade 8 students had engaged in self-harm behavior in the preceding 12 months. Girls showed more self-harm behavior compared with the boys. Nearly 4.0% of adolescents attempted suicide in the preceding 12 months. Perceived family functioning and positive youth development predicted self-harm and suicidal ideation. Among the 4 second-order positive youth development qualities, the construct "general positive youth development qualities" was the strongest predictor of self-harm and suicide attempts. Compared with the Wave 1 data, more suicidal symptoms were observed in Wave 2, although the prevalence of self-harm behavior was similar across time.

CONCLUSIONS

The prevalence of self-harm behavior among Chinese adolescents was high, but the level of suicidal behavior was low. Perceived family functioning and positive youth development can be regarded as protective factors for adolescents against self-harm and suicidal behaviors. General positive youth development quality is most important among the 4 second-order positive youth development qualities.

Deliberate self-harm and suicide in adolescents

Deliberate self-harm (DSH) is a widespread yet often hidden problem in adolescents and young adults. Though most DSH can be classified as "non-suicidal self-cutting", some do go on to commit suicide. In this paper, deliberate self-harm is examined, including its prevalence, etiology, management, and future research directions using self-cutting and self-burning as examples. This article reviews recent literature to help understand what is known about self-cutting behavior and its potential relationship to suicide as well as provide direction for research. Research shows that different ecological factors at the individual, family, peer, and societal levels are related to deliberate self-harm. Although there is an association between some self-injurers and drug abuse (including alcohol abuse) as well as eating disorders, there are various subgroups of self-cutters and most are not at high risk for suicide. However, all acts of self-injury should be taken seriously by health care professionals and comprehensive therapy offered to any adolescent with a history of DSH. Future research directions on deliberate self-harm are also discussed.