1
|
Wei Q, Liu J, Yin W, Pan S, Dai C, Zhou L, Jiang X, Wang C, Wu J. Association between childhood emotional abuse and non-suicidal self-injury among Guangxi adolescents in China: A moderated mediation model. J Affect Disord 2024:S0165-0327(24)01171-6. [PMID: 39029701 DOI: 10.1016/j.jad.2024.07.111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 06/25/2024] [Accepted: 07/16/2024] [Indexed: 07/21/2024]
Abstract
BACKGROUND Childhood Emotional Abuse (CEA) is a known risk factor for Non Suicidal Self-injury (NSSI), which could have devastating repercussions. This study aimed to establish whether Parent-Child Attachment (PCA) and depressive symptoms mediated the CEA-NSSI relationship, as well as whether school connectedness moderated both the direct and indirect relationships between CEA and NSSI. METHODS Between November and December 2022, 7447 Chinese adolescents in high schools were surveyed through multi-stage cluster random sampling. The participants completed self-reported questionnaires that assessed CEA, PCA, depressive symptoms, school connectedness, and NSSI. Relationships between these variables were examined through moderated mediation analysis using SPSS macro-PROCESS. RESULTS After controlling for sociodemographic variables, we found that CEA correlated positively with NSSI through two different pathways: the mediating role of depressive symptoms and the chain-mediating role of both PCA and depressive symptoms. Moreover, school connectedness could moderate the direct and indirect relationships between CEA and NSSI. LIMITATIONS The study's cross-sectional design does not allow for causal inferences. CONCLUSIONS Overall, PCA, depressive symptoms, and school connectedness could affect the CEA-NSSI relationship.
Collapse
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.
| |
Collapse
|
2
|
Bahali K, Durcan G, Topal M, Önal BS, Bilgiç A, Tanıdır C, Aytemiz T, Yazgan Y. Parental attachment and childhood trauma in adolescents engaged in non-suicidal self-injury. Early Interv Psychiatry 2024; 18:173-180. [PMID: 37438893 DOI: 10.1111/eip.13452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 06/06/2023] [Accepted: 07/02/2023] [Indexed: 07/14/2023]
Abstract
AIM In this study, it was aimed to compare parental attachment and childhood traumas in adolescents with NSSI with healthy peers. METHODS Fifty adolescents aged 14-18 years with lifetime NSSI and 56 healthy peers were included in the study. Inventory of Statements About Self-injury (ISAS), The Parental Bonding Instrument (PBI) and Child Trauma Questionnaire (CTQ-28) scales were used. RESULTS Eighty-two percentage of the NSSI group and 70% of the control group were girls. The mean age was 15.6 ± 1.1 years in the NSSI group and 15.3 ± 0.9 years in the control group. There was no significant difference between the groups in terms of age and gender. The NSSI group had more negative scores than the control group in terms of childhood traumas and attachment characteristics to both mother and father. The analyses showed that mother PBI care/control and sexual abuse score had a relationship with both ISAS Autonomic Functions and ISAS Social Functions scores. CONCLUSIONS These results suggest that secure attachment with the mother may be protective for both the autonomic and social functions of the NSSI. Therefore, interventions for dysfunctional parental attachment may prevent the development of NSSI.
Collapse
Affiliation(s)
- Kayhan Bahali
- Department of Psychology, Istanbul Gelisim University, Istanbul, Turkey
| | - Gizem Durcan
- Department of Child and Adolescent Psychiatry, Medical Faculty of Cerrahpasa, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Melike Topal
- Department of Child and Adolescent Psychiatry, University of Health Sciences, Basaksehir Cam ve Sakura Research and Training Hospital, Istanbul, Turkey
| | - Bedia Sultan Önal
- Department of Child and Adolescent Psychiatry, Medical Faculty, Giresun University, Giresun, Turkey
| | - Ayhan Bilgiç
- Faculty of Medicine, Izmir University of Economics, İzmir, Turkey
| | - Canan Tanıdır
- Department of Psychology, Istanbul Gelisim University, Istanbul, Turkey
| | - Tuğçe Aytemiz
- Child and Adolescent Psychology Laboratory, University of Health Sciences, Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Istanbul, Turkey
| | - Yankı Yazgan
- Department of Child and Adolescent Psychiatry, Güzel Günler Clinic, Istanbul, Turkey
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| |
Collapse
|
3
|
Porras-Segovia A, Pascual-Sanchez A, Greenfield G, Creese HM, Saxena S, Hargreaves D, Nicholls D. Early Risk Factors for Self-Injurious Thoughts and Behaviours: A UK Population-Based Study of 219,581 People. Behav Sci (Basel) 2023; 14:16. [PMID: 38247668 PMCID: PMC10812924 DOI: 10.3390/bs14010016] [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: 11/07/2023] [Revised: 12/13/2023] [Accepted: 12/21/2023] [Indexed: 01/23/2024] Open
Abstract
Mental disorders are a major problem among young people. To identify early risk factors of self-injurious thoughts and behaviours (SITB) among young adults with mental health problems, this case-control study drew data from the Clinical Practice Research Datalink (CPRD), a primary care database covering 8% of the UK population. We explored the role of early factors (presenting at 8-14 years old) for suicidal ideation, suicide attempts, and non-suicidal self-injury (NSSI) in young adulthood (age 18-25 years) by performing logistic regressions. Our sample consisted of 219,581 participants, of which 6.51% had at least one SITB in young adulthood. Early risk factors for SITB included early NSSI, suicidal ideation, sexual abuse, behavioural problems, and mood and psychotic symptoms. Frequency of GP visits had a protective effect. Lack of access to mortality data, ethnicity, and socioeconomic status was a limitation of the current study. In conclusion, early symptoms in late childhood/early adolescence can be the start of long-standing problems going into adult life. The training of primary care providers in suicide risk assessment and proper co-ordination with child and adolescent mental health services are crucial for suicide prevention.
Collapse
Affiliation(s)
- Alejandro Porras-Segovia
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London W12 7T, UK
- Health Research Institute Fundación Jiménez Díaz, 28040 Madrid, Spain
- Department of Psychiatry, University Hospital Rey Juan Carlos, 28933 Madrid, Spain
| | - Ana Pascual-Sanchez
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London W12 7T, UK
- CAMHS Enhanced Treatment Service, South London and Maudsley NHS Foundation Trust, London SE5 8AZ, UK
| | - Geva Greenfield
- Department of Primary Care and Public Health, Imperial College London, London SW7 2AZ, UK (H.-M.C.)
| | - Hanna-Marie Creese
- Department of Primary Care and Public Health, Imperial College London, London SW7 2AZ, UK (H.-M.C.)
| | - Sonia Saxena
- Department of Primary Care and Public Health, Imperial College London, London SW7 2AZ, UK (H.-M.C.)
| | - Dougal Hargreaves
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London W2 1PG, UK
| | - Dasha Nicholls
- Division of Psychiatry, Department of Brain Sciences, Imperial College London, London W12 7T, UK
| |
Collapse
|
4
|
Chen Y, Fu W, Ji S, Zhang W, Sun L, Yang T, He K, Zhou Y. Relationship between borderline personality features, emotion regulation, and non-suicidal self-injury in depressed adolescents: a cross-sectional study. BMC Psychiatry 2023; 23:293. [PMID: 37118709 PMCID: PMC10148398 DOI: 10.1186/s12888-023-04800-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 04/18/2023] [Indexed: 04/30/2023] Open
Abstract
OBJECTIVE Non-suicidal self-injury (NSSI) is common among adolescents and has been linked to mental disorders and suicide in addition to physical injuries. According to the empirical avoidance model, adolescents with NSSI have stronger emotional affect and poorer emotional regulation than those without NSSI, and these constitute core features of borderline personality disorder (BPD). The relationship between borderline personality features, emotional regulation, and NSSI in the population is unclear. This study explored these associations to provide a theoretical basis for the treatment of NSSI in the future. METHODS Depressed adolescents (n = 1192) were evaluated using Chinese versions of the Function Assessment of Self-mutilation Scale, Emotional Regulation Questionnaire for Children and Adolescents, and Borderline Personality Features Scale for Children. RESULTS The majority of depressed adolescents (71.3%, 850/1192) had demonstrated NSSI in the past year, with cutting or scratching being the most common form (57.4%). Pearson correlation analysis with NSSI as a fixed factor (NSSI = 1, no NSSI = 2) revealed a negative correlation between NSSI and borderline personality features (r = -0.314, P < 0.01) but a positive correlation between NSSI and emotional regulation capacity (r = 0.159, P < 0.01), which was positively correlated with the expression suppression dimension (r = 0.079, p < 0.01); however, there was no significant correlation between the cognitive reappraisal dimension and expression suppression (r = 0.022, p > 0.05). The occurrence of NSSI was also positively correlated with borderline personality features in general (r = 0.314, p < 0.01). These results were statistically significant. Emotional regulation played a mediating role between borderline personality traits and NSSI in adolescents with depression (effect value = 0.151). CONCLUSION Borderline personality features and emotional regulation ability were significantly correlated with NSSI in depressed adolescents. Borderline personality symptoms not only directly influenced NSSI risk in adolescents with depression, but also indirectly influenced NSSI risk through emotional regulation.
Collapse
Affiliation(s)
- Yang Chen
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, 230022, China
| | - Wenxian Fu
- Anhui Mental Health Center, Hefei, 230022, China
| | - Sifan Ji
- Anhui Mental Health Center, Hefei, 230022, China
| | - Wei Zhang
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230022, China
| | - Lingmin Sun
- School of Mental Health and Psychological Sciences, Anhui Medical University, Hefei, 230022, China
| | - Tingting Yang
- Psychological counseling department, Hefei Fourth People's Hospital, Anhui, 230000, China
| | - Kongliang He
- Affiliated Psychological Hospital of Anhui Medical University, Hefei, 230022, China.
- Psychological counseling department, Hefei Fourth People's Hospital, Anhui, 230000, China.
| | - Yongjie Zhou
- Shenzhen Mental Health Center, Shenzhen, Guangdong, China.
| |
Collapse
|
5
|
Wang S, Shi X, Wang Z, Li Z, Wang A, Hu X, Li Z. Joint developmental trajectories and correlates of internalizing and externalizing problems among Chinese adolescents. J Clin Psychol 2023; 79:558-572. [PMID: 35975877 DOI: 10.1002/jclp.23436] [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: 05/24/2021] [Revised: 05/11/2022] [Accepted: 08/07/2022] [Indexed: 01/19/2023]
Abstract
BACKGROUND Internalizing and externalizing problems are the most prevalent health problems among adolescents. However, few studies have examined co-occurring internalizing and externalizing problems from a longitudinal perspective. METHODS A total of 1051 seventh-grade students from two junior high schools were recruited at baseline. Among them, 932 valid participants were reassessed 1 year and 2 years later. Data were analyzed using parallel-process latent class growth analysis and multinominal logistic regression. RESULTS Four joint trajectories of internalizing and externalizing problems were identified. Compared with the low-risk group, adolescents in the moderate and chronic co-occurring group had lower resilience, higher levels of insecure attachment, family conflicts, and academic pressure. Adolescents in the pure internalizing group had higher levels of family conflicts and academic pressure compared with the low-risk group. CONCLUSIONS Co-occurrence of symptoms is very high in adolescents. More individualized intervention programs should be provided to these specific groups.
Collapse
Affiliation(s)
- Shuo Wang
- Department of Psychology, Hebei University, Hebei, China
| | - Xuliang Shi
- Department of Psychology, Hebei University, Hebei, China
| | - Zhen Wang
- School of Public Administration, Xinhua College of Sun Yat-sen University, Guangdong, China
| | - Zihan Li
- Department of Psychology, Hebei University, Hebei, China
| | - Anqi Wang
- Department of Psychology, Hebei University, Hebei, China
| | - Xinhui Hu
- Department of Psychology, Hebei University, Hebei, China
| | - Zhipeng Li
- Department of Psychology, Hebei University, Hebei, China
| |
Collapse
|
6
|
Liu J, Liu X, Wang H, Gao Y. Friend support buffers the relationship between maltreatment and nonsuicidal self-injury in adolescence. Suicide Life Threat Behav 2022; 52:802-811. [PMID: 35352850 DOI: 10.1111/sltb.12864] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Revised: 01/02/2022] [Accepted: 01/03/2022] [Indexed: 01/31/2023]
Abstract
BACKGROUND Prior studies have mostly focused on the risk factors for nonsuicidal self-injury (NSSI), but only a few studies have emphasized the related protective factors. The present study examined whether maltreatment and behavioral problems were risk factors for NSSI. Moreover, we also sought to understand whether and how friend support provides a buffer against NSSI. METHOD A total of 436 adolescents completed self-report surveys that addressed maltreatment, behavioral problems, friend support, and NSSI at three different time points. RESULTS There were significant positive correlations between maltreatment and NSSI. In the mediation analyses, we found that maltreatment was indirectly associated with NSSI via behavioral problems. Friend support demonstrated a long-term buffering effect on NSSI. Specifically, friend support had a protective effect on NSSI not only under high maltreatment levels, but also under high behavioral problem levels. CONCLUSION These findings contribute to the understanding of the influences of both maltreatment, behavioral problems (risk factors), and friend support (protective factors) on NSSI. In the context of intervention and education, it is important to consider the value of friend support when discussing NSSI.
Collapse
Affiliation(s)
- Jinmeng Liu
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Xia Liu
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Hui Wang
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Yemiao Gao
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| |
Collapse
|
7
|
Zhou YM, Mak L, Zhao CX, He F, Huang XN, Tian XB, Yi-zheng, Sun J. Correlates of suicidal ideation in rural Chinese junior high school left-behind children: A socioecological resilience framework. Front Psychiatry 2022; 13:901627. [PMID: 35935415 PMCID: PMC9354399 DOI: 10.3389/fpsyt.2022.901627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 06/28/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Suicide is one of the top five causes of adolescent mortality around the world. The socioecological resilience framework in explaining the risk factors and protective factors for suicidal ideation in left-behind children (LBC) has not been well explored. The current study aims to compare the prevalence of suicidal ideation in LBC and non-LBC, and explore its correlations with resilience factors among LBC. Methodology This study was part of an epidemiological survey conducted by UNICEF exploring mental health outcomes in left-behind children. We implemented a cross-sectional study collecting data from 11 provinces and 1 municipal, with 5,026 participants (3,359 LBC, 1,667 controls) in year one junior high school living in impoverished areas of rural China. Data on suicidal ideation, self-harm, resilience factors including health-risk behaviors, psychological wellbeing as it was measured by the Strengths and Difficulties Questionnaire, peer relationship within the school environment, and family support were collected. Results Overall prevalence of suicidal ideation among LBC was 7.2% which is significantly different from 5.5% reported by NLBC (χ2 = 4.854, p = 0.028). LBC reported a higher prevalence of self-harm (16.4%) than NLBC (13.0%; χ2 = 10.232, p = 0.001), but there was no difference in the prevalence of suicide plan, suicide attempt or help-seeking. LBC had significantly poorer psychological feeling, and greater emotional and behavioral difficulties peer relationship in the school environment than controls. In the multiple logistic regression, history of self-harm was the greatest predictor for suicidal ideation among LBC (OR = 2.078, 95% CI: 1.394-3.100, p < 0.001). Health risk behavior including previous smoking attempt, poor psychological feeling, and emotional and behavior difficulties, and poor peer relationship within school environment, were also significant risk factors for suicidal ideation among LBC. Conclusion The prevalence of suicidal ideation and self-harm was greater among left-behind than non-left-behind children. Our results show resilience factors including previous self-harm, emotional and behavioral problems, smoking, and poor peer relationship are significantly associated with suicidal ideation in left-behind adolescents.
Collapse
Affiliation(s)
- Yu-ming Zhou
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, Beijing Institute for Brain Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Leona Mak
- Menzies Health Institute Queensland, School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
| | - Chun-xia Zhao
- United Nations Children's Fund (UNICEF China Office), Beijing, China
| | - Fan He
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, Beijing Institute for Brain Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Xiao-na Huang
- United Nations Children's Fund (UNICEF China Office), Beijing, China
| | - Xiao-bo Tian
- United Nations Children's Fund (UNICEF China Office), Beijing, China
| | - Yi-zheng
- Beijing Key Laboratory of Mental Disorders, The National Clinical Research Center for Mental Disorders, Beijing Institute for Brain Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
| | - Jing Sun
- Menzies Health Institute Queensland, School of Medicine and Dentistry, Griffith University, Gold Coast, QLD, Australia
| |
Collapse
|
8
|
Cerniglia L, Cimino S. Eating Disorders and Internalizing/Externalizing Symptoms in Adolescents before and during the COVID-19 Pandemic. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2022; 42:445-451. [PMID: 35579970 DOI: 10.1080/07315724.2022.2063206] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
OBJECTIVE This study aimed at assessing the prevalence of eating disorders and symptoms of dieting, food preoccupation, and oral control and internalizing/externalizing problems in a group of adolescents before and during the COVID-19 pandemic. METHODS A sample of N = 813 adolescents (age range = 14-15 years) was recruited in the general population and administered the SCOFF, EAT-26 and YSR questionnaires at two assessment points: before the COVID-19 pandemic outbreak and during it. RESULTS In males and females, the YSR scores at T1 were significantly lower than T2, especially for the subscales of Withdrawn, Somatic complaints, Anxious/depressed, Social problems. As for the EAT-26 scores, adolescents scored significantly lower at T1 for all four subscales of dieting, food preoccupation and oral control. The prevalence of eating disorders among males and females increased respectively from 13.2% to 18.4% and from 17.5 to 25.3 from T1 to T2. CONCLUSION This study confirms previous research showing an increase in eating disorders prevalence and higher psychopathological symptoms both in males and females adolescents during the pandemic.
Collapse
Affiliation(s)
- Luca Cerniglia
- Faculty of Psychology, International Telematic University Uninettuno, Rome, Italy
| | - Silvia Cimino
- Department of Dynamic, Clinical Psychology and Health Studies, Sapienza University of Rome, Rome, Italy
| |
Collapse
|
9
|
Woo J, Wrath AJ, Adams GC. The Relationship Between Attachment and Self-Injurious Behaviors in the Child and Adolescent Population: A Systematic Review of the Literature. Arch Suicide Res 2022; 26:406-427. [PMID: 32780672 DOI: 10.1080/13811118.2020.1804024] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Adolescents have high rates of self-injurious behavior (SIB), with suicide being the second leading cause of death. A consistent relationship between individual attachment and SIB was previously found in adult population; however, no such review has been undertaken for the child and adolescent population. A systematic search of PubMED, OVID, and PsychINFO up to March 31, 2020 was performed. Twenty-two articles met the inclusion criteria. Of the 22 articles, 21 found a positive association between attachment insecurity and SIB. Our results show a consistent relationship between attachment insecurity and SIB in children and adolescents, complementing the results found in the adult literature. These findings make a case for preventive strategies aimed at reducing self-injurious behaviors in youth by targeting attachment security.
Collapse
|
10
|
Hermosillo-de-la-Torre AE, Arteaga-de-Luna SM, Acevedo-Rojas DL, Juárez-Loya A, Jiménez-Tapia JA, Pedroza-Cabrera FJ, González-Forteza C, Cano M, Wagner FA. Psychosocial Correlates of Suicidal Behavior among Adolescents under Confinement Due to the COVID-19 Pandemic in Aguascalientes, Mexico: A Cross-Sectional Population Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094977. [PMID: 34067094 PMCID: PMC8124170 DOI: 10.3390/ijerph18094977] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Revised: 04/28/2021] [Accepted: 05/02/2021] [Indexed: 12/13/2022]
Abstract
Background: Suicide and suicidal behaviors were already a global public health problem, producing preventable injuries and deaths. This issue may worsen due to the COVID-19 pandemic and may differentially affect vulnerable groups in the population, including children, adolescents, and young adults. The current study evaluated the association of affective variables (depression, hopelessness, and anxiety), drug use (alcohol, tobacco, and others), emotional intelligence, and attachment with suicidal behaviors. Methods: A state-wide survey included 8033 students (51% female, 49% male; mean age of 16 years) from science and technology high-schools using a standardized questionnaire that was distributed online. Multinomial logistic regression models tested associations between suicidal behaviors and several covariates. The analyses accommodated the complex structure of the sample. Results: Approximately 21% of all students reported a suicidal behavior (11% with a low-lethality suicide attempt, 6% with self-injuries, and 4% with a high-lethality suicide attempt). Variables associated with higher odds of suicidal behavior included: female sex, depression, hopelessness, anxiety, alcohol and tobacco use, childhood trauma, and having to self-rely as issues affecting attachment, and low self-esteem. Security of attachment was associated with lower odds of suicidal behavior. Conclusions: The complexity of suicidal behavior makes it clear that comprehensive programs need to be implemented.
Collapse
Affiliation(s)
- Alicia Edith Hermosillo-de-la-Torre
- Psychology Department, Universidad Autónoma de Aguascalientes [Autonomous University of Aguascalientes], Aguascalientes 20131, Mexico; (A.E.H.-d.-l.-T.); (S.M.A.-d.-L.); (D.L.A.-R.); (F.J.P.-C.)
| | - Stephania Montserrat Arteaga-de-Luna
- Psychology Department, Universidad Autónoma de Aguascalientes [Autonomous University of Aguascalientes], Aguascalientes 20131, Mexico; (A.E.H.-d.-l.-T.); (S.M.A.-d.-L.); (D.L.A.-R.); (F.J.P.-C.)
| | - Denise Liliana Acevedo-Rojas
- Psychology Department, Universidad Autónoma de Aguascalientes [Autonomous University of Aguascalientes], Aguascalientes 20131, Mexico; (A.E.H.-d.-l.-T.); (S.M.A.-d.-L.); (D.L.A.-R.); (F.J.P.-C.)
| | - Angélica Juárez-Loya
- Clinical and Health Psychology Department, Psychology Faculty, Universidad Nacional Autónoma de México (UNAM), Mexico City 04510, Mexico;
| | - José Alberto Jiménez-Tapia
- Instituto Nacional de Psiquiatría [National Institute of Psychiatry], Tlalpan 14370, Mexico; (J.A.J.-T.); (C.G.-F.)
| | - Francisco Javier Pedroza-Cabrera
- Psychology Department, Universidad Autónoma de Aguascalientes [Autonomous University of Aguascalientes], Aguascalientes 20131, Mexico; (A.E.H.-d.-l.-T.); (S.M.A.-d.-L.); (D.L.A.-R.); (F.J.P.-C.)
| | - Catalina González-Forteza
- Instituto Nacional de Psiquiatría [National Institute of Psychiatry], Tlalpan 14370, Mexico; (J.A.J.-T.); (C.G.-F.)
| | - Manuel Cano
- Department of Social Work, University of Texas at San Antonio, San Antonio, TX 78207, USA;
| | - Fernando A. Wagner
- School of Social Work, University of Maryland Baltimore, Baltimore, MD 21201, USA
- Correspondence: ; Tel.: +410-706-5696
| |
Collapse
|
11
|
Muzi S, Sansò A, Pace CS. What's Happened to Italian Adolescents During the COVID-19 Pandemic? A Preliminary Study on Symptoms, Problematic Social Media Usage, and Attachment: Relationships and Differences With Pre-pandemic Peers. Front Psychiatry 2021; 12:590543. [PMID: 33986698 PMCID: PMC8110826 DOI: 10.3389/fpsyt.2021.590543] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2020] [Accepted: 03/29/2021] [Indexed: 12/11/2022] Open
Abstract
Italian adolescents were confined at home for 3 months due to the COVID-19 pandemic, which exposed them to feelings of fear, uncertainty, and loneliness that may have increased their vulnerability to emotional-behavioral symptoms (e.g., anxiety) and binge-eating attitudes. Potential risk factors for these psychopathological symptoms are problematic social media usage and attachment insecurity. Therefore, this study aimed: (1) to assess emotional-behavioral symptoms, binge eating, problematic social media usage, and attachment representations of adolescents during the pandemic, comparing them with prepandemic similar samples; (2) to investigate relationships among variables, exploring the role of problematic social media usage and insecure attachment as risk factors for more psychopathological symptoms. Participants were 62 community adolescents aged 12-17 years, enrolled through schools, and assessed online through the following measures: Youth Self-Report for emotional-behavioral problems, Binge-Eating Scale for binge eating, Social Media Disorder Scale for problematic social media usage, and the Friends and Family Interview for attachment. The main results were: (1) 9.4% of adolescents showed clinical rates of emotional-behavioral symptoms and 4.8% of binge eating attitudes. The comparison with pre-pandemic samples revealed that pandemic teenagers showed lower internalizing, but higher other problems (e.g., binge drinking, self-destructive behaviors) and more problematic social media usage than pre-pandemic peers. No differences in binge-eating attitudes and attachment were revealed (76% secure classifications). (2) Problematic social media usage was related to more binge eating and emotional-behavioral problems, predicting 5.4% of both delinquent and attention problems. Attachment disorganization predicted 16.5% of internalizing problems, somatic complaints, and social and identity-related problems. In conclusion, confinement did not increase adolescents' internalizing symptoms -i.e., vulnerability to mood disorders of an anxious-depressive type- which even decreased. However, teenagers may have expressed their discomfort through other problems and symptoms of social media disorder. Further studies should explore the role of adolescents' problematic social media usage and attachment insecurity as risk factors for additional psychopathological symptoms.
Collapse
Affiliation(s)
- Stefania Muzi
- Department of Education Sciences, School of Social Sciences, University of Genoa, Genoa, Italy
| | | | | |
Collapse
|
12
|
Rodríguez-Blanco L, Carballo-Belloso JJ, de León S, Baca-García E. A longitudinal study of adolescents engaged in Non-Suicidal Self Injury (NSSI): clinical follow-up from adolescence to young adulthood. Psychiatry Res 2021; 297:113711. [PMID: 33486275 DOI: 10.1016/j.psychres.2021.113711] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 01/02/2021] [Indexed: 10/22/2022]
Abstract
The main aim of the current study is to examine the demographic and clinical factors that predict a continuity of the use of Mental Health Services (MHS) in adulthood by subjects who have engaged in non-suicidal-self-injury behaviors (NSSI) and have been followed in MHS in their teen years. A cohort of 147 participants was selected from an original sample of 267 adolescent patients recruited from the Child and Adolescent Outpatient Psychiatric Services. Patients were divided into two groups: those who had engaged in NSSI (NSSI-group), and those who had not (non-NSSI-group). Rate of use of MHS in adulthood was calculated for both groups and univariate analyses and binary logistic regression analysis were applied. In the NSSI-group, two factors appeared to influence a continuity of the use of MHS in adulthood. Prosocial behavior was associated with a greater use of MHS in adulthood whereas behavioral problems were associated with less use. Only prosocial behavior was maintained in the regression model as a predictor. Our findings could have implications for clinical practice with NSSI patients and highlight the importance of working on specific areas that could prevent treatment abandonment in the transition from adolescence to adulthood.
Collapse
Affiliation(s)
- Lucía Rodríguez-Blanco
- Psychiatry Department, General Hospital of Villalba Carretera de Alpedrete a Moralzarzal M-608 Km 41, 28400, Collado Villalba. Madrid, Spain; Psychiatry Department, Autonomous University of Madrid. 4, Arzobispo Morcillo, 28029. Madrid, Spain.
| | - Juan Jose Carballo-Belloso
- Child and Adolescent Psychiatry Department, Universitary Hospital Gregorio Marañón. 46, Dr. Esquerdo, 28007. Madrid, Spain; CIBERSAM, Carlos III Institute of Health. Madrid, Spain 3-5, Monforte de Lemos, 28029. Madrid, Spain
| | - Santiago de León
- Signal Theory and Communications Department. Carlos III University. 30, Universiy Avenue, 28911. Leganés. Madrid
| | - Enrique Baca-García
- Psychiatry Department, General Hospital of Villalba Carretera de Alpedrete a Moralzarzal M-608 Km 41, 28400, Collado Villalba. Madrid, Spain; Psychiatry Department, Autonomous University of Madrid. 4, Arzobispo Morcillo, 28029. Madrid, Spain; CIBERSAM, Carlos III Institute of Health. Madrid, Spain 3-5, Monforte de Lemos, 28029. Madrid, Spain; Psychiatry Department, University Hospital Jiménez Díaz Foundationt. 2, Reyes Católicos Avenue, 28040. Madrid, Spain; Psychiatry Department, University Hospital Rey Juan Carlos. Gladiolo, s/n, 28933. Mostoles, Spain; Psychiatry Department, University Hospital Infanta Elena. 21, Reyes Católicos Avenue, 28342. Valdemoro, Spain; Psychiatry Department, Catholic University of the Maule. San Miguel Avenue, 3605. Talca, Chile; Psychiatry Department, University Hospital of Nimes, 4, Rue du Professeur Robert Debré, 30029. Nîmes, Francia
| |
Collapse
|
13
|
Evald TA, Møhl B. Before the damage is done: Early childhood hyperactivity difficulties in adolescents with deliberate self-harm - findings from the DALSC cohort. Scand J Child Adolesc Psychiatr Psychol 2021; 8:176-188. [PMID: 33598440 PMCID: PMC7879016 DOI: 10.21307/sjcapp-2020-018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Deliberate self-harm (DSH) is a growing issue among Danish adolescents, and a dramatic increase in the incidence of DSH has been observed since the turn of the millennium. The importance of early childhood factors on later development has been established, but research on the trajectories of DSH is still scarce, and longitudinal studies are much needed. METHOD Participants were 3,291 children and their mothers from The Danish Longitudinal Survey of Children (DALSC), a Danish population-based birth cohort from 1995. Logistic regression and mediation analyses were used to examine significant early childhood determinants of self-harming behavior in adolescence. RESULTS The study found that 17.9% of the children had a history with DSH at the age of 18 years. A significant relationship was found between the likelihood of DSH at the age of 18 years and hyperactivity difficulties assessed through the Strengths and Difficulties Questionnaire (SDQ) at 3 and 7 years of age. Using a mediation model, it is documented that difficulties in peer relationships at the age of 11 years is a partial mediator explaining 19% of the variation. LIMITATIONS i) a vague definition of self-harm in the questionnaires; ii) lack of sample representation as children of lower socio-economic groups have lower participation rates, and only Danish-ethnicity children have been sampled; iii) possibility of omitted variable bias. CONCLUSION The adolescents engaging in DSH are experiencing a more complex range of psychosocial problems than those who do not have experience with DSH. The main finding of the study is that hyperactivity as a risk factor for the development of DSH in adolescence can be identified as early as 3-7 years of age. This relationship between the very early occurring hyperactivity and later DSH, to the best of our knowledge, has not previously been described.
Collapse
Affiliation(s)
- Therese A. Evald
- The Finance Committee, City Council of Copenhagen, Copenhagen, Denmark
| | - Bo Møhl
- Faculty of Humanities, Aalborg University, Aalborg, Denmark
| |
Collapse
|
14
|
Prospective Interpersonal and Intrapersonal Predictors of Initiation and Cessation of Non-Suicidal Self-Injury among Chinese Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249454. [PMID: 33348636 PMCID: PMC7766568 DOI: 10.3390/ijerph17249454] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/05/2020] [Accepted: 12/11/2020] [Indexed: 12/18/2022]
Abstract
(1) Purpose: Non-suicidal self-injury (NSSI) possibly emerges as well as remits in adolescence. To explore the development and transition of NSSI, this study examined the association between a wide range of interpersonal and intrapersonal predictors of NSSI initiation and cessation. (2) Methods: Chinese adolescents (N = 913) completed self-reported surveys at baseline and at a six-month follow-up. The sample included 625 adolescents who reported no NSSI and 288 adolescents who reported engagement in NSSI at baseline. (3) Results: Among the adolescents without NSSI at baseline, 24.3% engaged in NSSI at follow-up (NSSI initiation group). Among the adolescents with NSSI at baseline, 33.3% reported no NSSI at follow-up (NSSI cessation group). Loneliness, beliefs about adversity, problem behavior, and prosocial behavior were the significant factors in predicting subsequent NSSI initiation. None of the potential predicting factors were associated with subsequent NSSI cessation. (4) Conclusions: These results indicate the importance of intrapersonal factors in Chinese culture, which could be used to identify at-risk adolescents and to design interventions.
Collapse
|
15
|
Kiekens G, Claes L. Non-Suicidal Self-Injury and Eating Disordered Behaviors: An Update on What We Do and Do Not Know. Curr Psychiatry Rep 2020; 22:68. [PMID: 33037934 PMCID: PMC7547297 DOI: 10.1007/s11920-020-01191-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/25/2020] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW The current report aims to summarize recent advances about the relationship between non-suicidal self-injury (NSSI) and eating disordered (ED) behaviors and highlights meaningful directions for future research. RECENT FINDINGS While there is solid evidence indicating a robust cross-sectional association between NSSI and ED behaviors, emerging evidence suggests that the temporal relationship between these behaviors may be bidirectional. Shared functions and risk factors may explain why these behaviors often co-develop. At the same time, little is still known about the psychosocial consequences of comorbid NSSI and ED engagement, and there is a lack of intervention studies that target these behaviors simultaneously. It is well-established that NSSI and ED behaviors frequently co-occur. The field should now turn to longitudinal designs to advance our understanding of the longer-term developmental and the shorter-term momentary relationship of these behaviors in daily life. Providing insight into these areas will help guide the deployment of evidence-based interventions that match the needs of clients who report comorbid NSSI and ED behaviors.
Collapse
Affiliation(s)
- Glenn Kiekens
- Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, box 3720, 3000, Leuven, Belgium. .,Department of Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium.
| | - Laurence Claes
- grid.5596.f0000 0001 0668 7884Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, box 3720, 3000 Leuven, Belgium ,grid.5284.b0000 0001 0790 3681Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Antwerp, Belgium
| |
Collapse
|