Autotraumatic Stress Disorders: Posttraumatic Stress Disorder Variants When the Victim Bears Responsibility for the Trauma

Understanding Comorbidity Between Non-Suicidal Self-Injury and Depressive Symptoms in a Clinical Sample of Adolescents: A Network Analysis

Background

Non-suicidal self-injury (NSSI) and depression often co-occur among adolescents with more severe clinical symptoms. This study examined the network structures of NSSI and depressive symptoms in adolescents.

Methods

Participants were recruited in the psychiatric outpatient clinics of three tertiary hospitals between April 10 and July 10, 2023. All participants been already found with self-injury behaviors in outpatient when enrolled. NSSI diagnostic criteria and Patient Health Questionnaire-9 (PHQ-9) were utilized to collect NSSI and depressive symptoms separately. We performed a network analysis to visualize the correlation between each symptom and to identify core and bridging symptoms in comorbidities.

Results

A total of 248 patients were enrolled in the study, with a mean age of 15.48 (SD = 1.62). Based on the PHQ-9 scores and grades, our results showed that the incidence of depression in adolescents with non-suicidal self-injury behavior was relatively high (N=235, 94.76%), with the majority having severe depression. The network analysis revealed that nodes D-6 "feeling bad, failing or letting yourself or your family down", D-1 "little interest or pleasure" and D-4 "feeling tired" were the most vital and most central symptoms. The most crucial bridging symptom is the node NSSI-8 "frequent thinking about self-injury", which connects the NSSI to the depression comorbid network.

Conclusion

This study offers a significant symptom-level conceptualization of the association between NSSI and depressive symptoms in a clinical sample of adolescents, which not only enhances our understanding of the comorbid but also identifies potential treatment targets to prevent and treat comorbidity between adolescent NSSI and depression.

Sleep, mental health, and access to health care of women truck drivers

BACKGROUND

The numbers of women in trucking are growing steadily, yet because they represent a minority group, little is known about their health issues. Most studies of truck drivers have focused on the mental and physical health, sleep, and health care access of male truck drivers.

PURPOSE

The purpose of this study was to characterize chronic stress, sleep, and mental health service and overall access to care among women truck drivers.

METHODOLOGY

Twenty-five female truck drivers were a subsample of participants from a larger parent study of truck drivers. After approval from the institutional review board, participants completed a 59-item Qualtrics survey; data were transferred from Qualtrics to SPSS v. 24 for analysis.

RESULTS

No acute sleepiness or excess daytime sleepiness was observed, but participants only slept 6 hr per night, and all experienced poor sleep quality. Although 28% of participants met or exceeded the threshold score for posttraumatic stress disorder (PTSD), only 8% sought care for feelings of upset or distress. Also, 80% of the women had health insurance, yet there were those who did not seek care because of job-related conflicts.

CONCLUSION/IMPLICATIONS

Participants were sleep deprived and experienced poor-quality sleep. Mental health and other health services utilization was low. Implications for practice include consideration of telehealth services to improve health care access and screening and referral as needed to mental health care providers by Department of Transportation medical examiners. Future research should include younger women truck drivers to determine the potential contribution of perimenopause/menopause to some of the health issues experienced by this group of workers.