Emotion regulation deficits across the spectrum of self-harm

Unveiling convergent and divergent intrinsic brain network alternations in depressed adolescents engaged in non-suicidal self-injurious behaviors with and without suicide attempts

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.

The Role of Emotion Dysregulation in Understanding Suicide Risk: A Systematic Review of the Literature

Suicide prevention represents a global imperative, and efforts to identify potential risk factors are intensifying. Among these, emotional regulation abilities represent a transdiagnostic component that may have an impactful influence on suicidal ideation and behavior. Therefore, the present systematic review aimed to investigate the association between emotion dysregulation and suicidal ideation and/or behavior in adult participants. The review followed PRISMA guidelines, and the research was performed through four major electronic databases (PubMed/MEDLINE, Scopus, PsycInfo, and Web of Science) for relevant titles/abstracts published from January 2013 to September 2023. The review included original studies published in peer-reviewed journals and in English that assessed the relationship between emotional regulation, as measured by the Difficulties in Emotional Regulation Scale (DERS), and suicidal ideation and/or behavior. In total, 44 studies were considered eligible, and the results mostly revealed significant positive associations between emotion dysregulation and suicidal ideation, while the findings on suicide attempts were more inconsistent. Furthermore, the findings also confirmed the role of emotion dysregulation as a mediator between suicide and other variables. Given these results, it is important to continue investigating these constructs and conduct accurate assessments to implement effective person-centered interventions.

The Effect of Mental Health Status and Family Function on Nonsuicidal Self-Injury: A Longitudinal Analysis of Chinese Children and Adolescents

Background

Nonsuicidal self-injury (NSSI) is an overwhelming social problem in children and adolescents. Focusing on the change of NSSI behavior, including onset, cessation, and maintenance, is crucial to developing effective prevention and intervention strategies. This study explored the effect of mental health status (depressive and anxiety symptoms) and family function on NSSI.

Methods

The study sample comprised 7554 children and adolescents based on the first two rounds of the Chengdu Positive Child Development (CPCD) dataset in China. Depressive and anxiety symptoms measured mental health status. The self-reported questionnaires also assessed NSSI behaviors and family function. The interrelationship between NSSI behaviors, mental health status, and family function was evaluated. Logistic regression and linear regression were performed to examine the interrelationship between mental health status, family function and NSSI behaviors. Sensitivity analysis was performed.

Results

In this study, 2167 (28.69%) participants reported NSSI at baseline and 2101 (27.81%) at follow-up. Depression, anxiety, and family function were salient influential factors in the prevalence, onset, and cessation of NSSI. Parents' accompaniment showed a significant effect on the prevalence of NSSI.

Conclusion

Depression, anxiety, family function, and parents' accompaniment are all associated with NSSI behaviors. Strategies targeting mental health status and family function could effectively protect children and adolescents from NSSI behaviors.

The Relation between Neuroticism and Non-Suicidal Self-Injury Behavior among College Students: Multiple Mediating Effects of Emotion Regulation and Depression

Background: Non-suicidal self-injury (NSSI) behavior among college students is a focus of attention in current society. In the information era, the Internet serves as a public health concern and as an effective pathway for prevention. In order to reduce NSSI behavior, we explore its influence factors, especially the relations between neuroticism, emotion regulation (ER), depression, and NSSI behavior. Methods: A total of 450 college students were surveyed with the Big Five Inventory-2, Emotion Regulation Questionnaire, Self-Rating Depression Scale, and Adolescent Non-Suicidal Self-Injury Assessment Questionnaire. Results: Regression analysis showed that neuroticism significantly negatively predicted emotion regulation, while it positively predicted depression and NSSI. Multiple mediation modeling demonstrated that neuroticism and emotion regulation had no significant direct effects on NSSI. However, neuroticism could indirectly affect NSSI through four pathways of multiple mediating effects, including depression, cognitive reappraisal-depression, expressive suppression-depression, and cognitive reappraisal-expressive suppression-depression. Conclusions: Neuroticism positively predicts depression and NSSI behavior, and affects NSSI through the mediating effect of ER and depression. Therefore, amelioration of neuroticism from the perspectives of emotion regulation and depression is recommended, so as to reduce NSSI behavior among college students with highly neurotic personalities.

Correlates of Non-suicidal Self-Injury in Adolescent Psychiatric Patients in China

BACKGROUND

Non-suicidal self-injury (NSSI) has attracted more and more attention from schools, mental health workers and even the whole society in China. The aim of this study was to explore influencing factors and clinical characteristics of NSSI in adolescent psychiatric patients in China, and provide valuable information for the intervention and treatment of NSSI.

METHODS

The sample included 157 adolescents, 114 were female (72.6%), aged 12-18 years (M = 15.39, SD = 1.81). Assessments were performed using Childhood Trauma Questionnaire-Short Form, the Revised Olweus Bully/Victim Questionnaire, the modified version of Adolescents Self-Harm Scale, Montgomery-Asberg Depression Rating Scale, Brief Psychiatric Rating Scale, the Young Mania Rating Scale and the Mini International Neuropsychiatric Interview. Clinical characteristics were collected from electronic medical record system.

RESULTS

Adolescent patients with NSSI experienced more adverse life events including peer bullying, childhood trauma and romantic relationship trouble. They had more times of hospitalization, higher dosage of psychotic medication, and more severe depressive symptoms.

CONCLUSIONS

It is very necessary to evaluate negative life events, including childhood trauma, peer bullying etc., in adolescent patients with NSSI. It has important clinical implications for evaluating the risk factors of NSSI and giving effective intervention treatment. Timely and effective treatment of these patients' depressive symptoms will also contribute to the relief of NSSI.