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Calvo N, Lugo-Marín J, Oriol M, Pérez-Galbarro C, Restoy D, Ramos-Quiroga JA, Ferrer M. Childhood maltreatment and non-suicidal self-injury in adolescent population: A systematic review and meta-analysis. CHILD ABUSE & NEGLECT 2024; 157:107048. [PMID: 39332140 DOI: 10.1016/j.chiabu.2024.107048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 09/03/2024] [Accepted: 09/11/2024] [Indexed: 09/29/2024]
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) is highly prevalent among adolescents. However, knowledge about the possible factors that might precede and influence its development remains scarce. OBJECTIVE Our goal is to examine the impact of adverse childhood events, and more specifically of different types of childhood maltreatment (CM) in adolescent NSSI. This involves performing a systematic review and meta-analysis of the different CM subtypes (physical and emotional neglect, physical and emotional abuse, sexual abuse) in clinical and non-clinical samples of adolescents with NSSI. PARTICIPANTS AND METHODS A digital search of the PsycInfo, PubMed and Web of Science platforms for articles published up to June 2022 was performed. The search terms were "self harm", "non-suicidal self-injury", "childhood maltreatment" and "adolescents". RESULTS Forty-six articles that fit the research objectives were included in the study, which covered a total of 1,505,430 adolescents, of whom 560,337 belonged to the NSSI group, while 945,093 were in the control group. The results describe strong positive associations between all CM subtypes and NSSI, especially with emotional abuse (odds ratio [OR] 2.91, 95 % CI 2.37-3.56) and sexual abuse (OR 2.72, 95 % CI 2.12-3.48), in clinical and non-clinical samples of adolescents. CONCLUSIONS The experience of CM, and especially emotional and/or sexual abuse, seems to be associated with a greater risk of developing NSSI in adolescence. Therefore, early identification and detection of children who have suffered or are suffering these forms of CM are of vital importance for instigating psychotherapeutic treatments that can minimize the risk of developing NSSI in adolescence.
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Affiliation(s)
- Natalia Calvo
- Psychiatry Department, Hospital Universitari Vall d'Hebron, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Psychiatry, Mental Health and Addictions Group, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Psychiatry and Legal Medicine Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Grup TLP Barcelona, Spain
| | - Jorge Lugo-Marín
- Psychiatry Department, Hospital Universitari Vall d'Hebron, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Psychiatry, Mental Health and Addictions Group, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Psychiatry and Legal Medicine Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Monterrat Oriol
- Psychiatry Department, Hospital Universitari Vall d'Hebron, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Citlalli Pérez-Galbarro
- Psychiatry Department, Hospital Universitari Vall d'Hebron, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Damià Restoy
- Psychiatry Department, Hospital Universitari Vall d'Hebron, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
| | - Josep-Antoni Ramos-Quiroga
- Psychiatry Department, Hospital Universitari Vall d'Hebron, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Psychiatry, Mental Health and Addictions Group, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Psychiatry and Legal Medicine Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Grup TLP Barcelona, Spain
| | - Marc Ferrer
- Psychiatry Department, Hospital Universitari Vall d'Hebron, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Barcelona, Spain; Psychiatry, Mental Health and Addictions Group, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Spain; Psychiatry and Legal Medicine Department, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Grup TLP Barcelona, Spain
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Fielding-Miller R, McDougal L, Frost E, Masuku S, Shabalala F. Association between sexual violence and depression is mediated by perceived social support among female university students in the kingdom of Eswatini. BMC Public Health 2024; 24:2526. [PMID: 39289704 PMCID: PMC11406860 DOI: 10.1186/s12889-024-20040-8] [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: 11/17/2022] [Accepted: 09/10/2024] [Indexed: 09/19/2024] Open
Abstract
BACKGROUND Gender-based violence is a tool that primarily functions to maintain gendered power hierarchies. Manifestations of gender-based violence, sexual assault and street harassment have been shown to have significant effects on mental wellbeing in the global North, however there is little research centering the experiences and consequences of gendered harassment in the Africa region. METHODS We analyzed a cross-sectional random sample of 372 women attending a major university in Eswatini in 2017 to measure the prevalence of street harassment among female university students and assess the relationship between experiences of sexual assault, sexualized street harassment, and mental health outcomes in this population. RESULTS We found that in the previous 12 months, women reported experiencing high levels of sexual assault (20%), street harassment (90%), and depression (38%). Lifetime sexual assault, past 12 months sexual assault, and street harassment were all significantly associated with symptoms of depression. We created a structural model to test hypothesized causal pathways between street harassment, previous experiences of sexual assault, and symptoms of depression, with social support as a potential mediator. We found that a history of sexual violence significantly mediated the association between street harassment and depression, and that social support mediated a large proportion of the association between both forms of gender-based violence and depression. CONCLUSION Sexualized street harassment is associated with increased depressive symptomology for nearly all women, however the effects are especially pronounced for women who have previous experiences of sexual violence. Sexualized street harassment functions as a tool to maintain gendered power hierarchies by reminding women of ongoing threat of sexual violence even in public spaces. Social support and solidarity among women is a potentially important source of resiliency against the physical and mental harms of all forms of gender based violence.
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Affiliation(s)
- Rebecca Fielding-Miller
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, USA.
- Center on Gender Equity and Health, Division of Infectious Disease and Global Public Health, School of Medicine, University of California, San Diego, USA.
| | - Lotus McDougal
- Center on Gender Equity and Health, Division of Infectious Disease and Global Public Health, School of Medicine, University of California, San Diego, USA
| | - Elizabeth Frost
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, USA
| | - Sakhile Masuku
- Department of Community Health Nursing, University of Eswatini, Kwaluseni, Eswatini
| | - Fortunate Shabalala
- Department of Community Health Nursing, University of Eswatini, Kwaluseni, Eswatini
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Rice T, Sher L. Identifying and Managing Suicidality in Children and Adolescents with Chronic Pain: Evidence-Based Treatment Strategies. Psychol Res Behav Manag 2022; 15:3561-3574. [PMID: 36505667 PMCID: PMC9733630 DOI: 10.2147/prbm.s371832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 11/22/2022] [Indexed: 12/07/2022] Open
Abstract
Children and adolescents with chronic pain are at an increased risk of suicidality. This narrative review article aims to inform clinical practice in the assessment and management of suicidality in youth with chronic pain. The article begins with a survey of the background and prevalence of youth with chronic pain. A review of the current evidence behind the increased risk of suicidality in youth with chronic pain follows. Contextualization of this data with general tenets of child and adolescent suicide risk and risk assessment is provided. Suicidology theory including the interpersonal theory of suicide is overviewed to help clinicians to conceptualize the reviewed data. Guiding parameters for the suicide risk assessment and management planning is presented. Concluding recommendations are made to guide clinical practice in the assessment and management of suicidality in youth with chronic pain.
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Affiliation(s)
- Timothy Rice
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA,Correspondence: Timothy Rice, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, 1090 Amsterdam Avenue, 13th Floor, Suite A, Office 5, New York, NY, 10025, USA, Tel +1 212 523 5635, Fax +1 212 523 5650, Email
| | - Leo Sher
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Lamlé P, Keuch L, Pukas L, Reinsch J, Röder H, Clausner H, Watzke S. Suicidal ideations among students attending vocational school in Germany: a cross-sectional study to identify prevalence and associated risk factors. J Public Health (Oxf) 2022. [DOI: 10.1007/s10389-022-01745-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
Abstract
Abstract
Aim
Even though students attending vocational school are very vulnerable to the development of mental health problems, few studies identify the correlation between suicidal ideations and vocational education. Therefore, this study aimed to identify the prevalence and associated risk factors for suicidal ideations among vocational students in Germany.
Methods
We conducted a cross sectional survey with a total of 555 pupils. The pupils received a standardized questionnaire, assessing sociodemographic data, the use of protective factors, possible risk factors, traits for neuroticism and depressive symptoms. For our study, we excluded item 9 from the Beck depression index (BDI-II) to identify the prevalence of suicidal ideation.
Results
Our results show that the prevalence of suicidal ideation among students attending vocational school is 23.2%. A combination of feeling lonely, male sex, low importance of religion, little time for hobbies and BMI scores outside the norm show the highest risk for suicidal ideation and can be identified as significant predictors.
Conclusion
This cross-sectional study highlights the mental burden vocational students in Germany are confronted with and underlines the necessity of paying special attention to this group of young adults. Furthermore, it emphasizes the necessity of further studies on this topic, especially including larger student populations. The results should be used to decrease the significant loss of life caused by suicidal behavior in young adults.
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Wang YJ, Li X, Ng CH, Xu DW, Hu S, Yuan TF. Risk factors for non-suicidal self-injury (NSSI) in adolescents: A meta-analysis. EClinicalMedicine 2022; 46:101350. [PMID: 35330803 PMCID: PMC8938878 DOI: 10.1016/j.eclinm.2022.101350] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 02/10/2022] [Accepted: 02/28/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) in adolescents is a significant mental health problem around the world. Here, we performed a meta-analysis to systematically delineate the risk factors for NSSI. METHOD We searched Medline, Embase, Web of Science and Cochrane for relevant articles and abstracts published prior to 12 November 2021. Pooled odds ratios (ORs) and 95% confident intervals (CIs) were used to assess various risk factors, and publication bias was assessed by Egger's test, the trim and fill method and meta-regression. This study is registered with PROSPERO, CRD42021265885. RESULTS A total of 25 articles were eventually included in the analysis. Eighty risk factors were identified and classified into 7 categories: mental disorders (ORs, 1·89; 95% CI, 1·60-2·24), bullying (ORs, 1·98; 95% CI, 1·32-2·95), low health literacy (ORs, 2·20; 95% CI, 1·63-2·96), problem behaviours (ORs, 2·36; 95% CI, 2·00-2·77), adverse childhood experiences (ORs, 2·49; 95% CI, 1·85-3.34), physical symptoms (ORs, 2·85; 95% CI, 1·36-5·97) and the female gender (ORs, 2·89; 95% CI, 2·43-3·43). The range of heterogeneity (I2) was from 20·3% to 99·2%. CONCLUSION This meta-analysis found that mental disorders, low health literacy, adverse childhood experiences, bullying, problem behaviours, the female gender and physical symptoms appear to be risk factors for NSSI.
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Affiliation(s)
- Yu-Jing Wang
- Zhejiang Provincial Clinical Research Center for Mental Disorders, School of Mental Health and The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
| | - Xi Li
- Zhejiang Provincial Clinical Research Center for Mental Disorders, School of Mental Health and The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
| | - Chee H. Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, VIC, SA
| | - Dong-Wu Xu
- Zhejiang Provincial Clinical Research Center for Mental Disorders, School of Mental Health and The Affiliated Wenzhou Kangning Hospital, Wenzhou Medical University, Wenzhou, Zhejiang 325000, China
- Corresponding author.
| | - Shaohua Hu
- Department of Psychiatry, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- The Key Laboratory of Mental Disorders Management in Zhejiang Province, Hangzhou, China
- Brain Research Institute of Zhejiang University, Hangzhou, China
- Zhejiang Engineering Center for Mathematical Mental Health, Hangzhou, China
- MOE Frontier Science Center for Brain Science and Brain-Machine Integration, Zhejiang University, Hangzhou, China
- Corresponding author at: The Key Laboratory of Mental Disorders’ Management in Zhejiang Province, Hangzhou, China.
| | - Ti-Fei Yuan
- Shanghai Key Laboratory of Psychotic disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Co-innovation Center of Neuroregeneration, Nantong University, Nantong, China
- Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People's Hospital Affiliated to Tongji University School of Medicine, Shanghai, China
- Corresponding author at: Shanghai Key Laboratory of Psychotic disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
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Bresin K, Mekawi Y. Different Ways to Drown Out the Pain: A Meta-Analysis of the Association Between Nonsuicidal Self-Injury and Alcohol Use. Arch Suicide Res 2022; 26:348-369. [PMID: 32780651 DOI: 10.1080/13811118.2020.1802378] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE There is a significant overlap in the motivations for nonsuicidal self-injury (NSSI) and alcohol use. Moreover, several theories would predict that more frequent alcohol use is likely associated with more NSSI engagement. Still, the size and direction of this association has not been well documented in the literature. METHOD To address this gap, the goal of this article was to conduct a meta-analysis of the relation between alcohol use and NSSI. RESULTS Across 57 samples and 141,669 participants, we found that there was a significant positive association between NSSI and alcohol use, odds ratio = 1.78, 95% confidence interval [1.53, 2.07], k = 64, m = 52. Moderator analyses found that this effect was stronger for younger samples and samples with more severe alcohol use problems. CONCLUSIONS These results help establish a link between NSSI and alcohol use. Implications and future directions for NSSI research and intervention are discussed.HighlightsThere are several reasons to think that NSSI and alcohol use are linked.No reviews or meta-analyses have been conducted.We found a significant and small effect linking greater NSSI with greater alcohol use.
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Suicide Behavior Among Vocational High School Students: The Role of School-Related Factors. SCHOOL MENTAL HEALTH 2021. [DOI: 10.1007/s12310-021-09435-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Hinze V, Crane C, Ford T, Buivydaite R, Qiu L, Gjelsvik B. The relationship between pain and suicidal vulnerability in adolescence: a systematic review. THE LANCET. CHILD & ADOLESCENT HEALTH 2019; 3:899-916. [PMID: 31606322 PMCID: PMC6842327 DOI: 10.1016/s2352-4642(19)30267-6] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 07/16/2019] [Accepted: 07/19/2019] [Indexed: 02/02/2023]
Abstract
Leading suicide theories and research in adults suggest that pain can exacerbate the suicidal risk of an individual. Although pain and suicidality (including suicidal ideation, behaviour, and death by suicide) both increase in prevalence during adolescence, the relationship between these factors remains unclear. We aimed to systematically review the empirical evidence for such an association in adolescence. We included 25 observational studies published between January 1961 and December 2018, exploring the potential association between pain and suicidality in adolescents aged 10-19 years. Across various samples and manifestations of pain and suicidality, we found that pain approximately doubles the suicidal risk in adolescents, with a few studies suggesting that pain can predict suicidality longitudinally. Although depression was an important factor, it did not fully explain the association between pain and suicidality. Evidence for associations between pain characteristics and suicidality is sparse and inconclusive, and potentially hides developmental differences between adolescents and adults. Identification of psychological mediators and moderators is required to develop interventions tailored to the needs of adolescents experiencing pain. This study is registered with the PROSPERO database, number CRD42018097226.
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Affiliation(s)
- Verena Hinze
- Department of Psychiatry, University of Oxford, Oxford, UK.
| | | | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | | | - Lin Qiu
- Department of Psychiatry, University of Oxford, Oxford, UK; Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Bergljot Gjelsvik
- Department of Psychiatry, University of Oxford, Oxford, UK; Department of Psychology, University of Oslo, Oslo, Norway
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Childhood maltreatment and non-suicidal self-injury: a systematic review and meta-analysis. Lancet Psychiatry 2018; 5:51-64. [PMID: 29196062 PMCID: PMC5743605 DOI: 10.1016/s2215-0366(17)30469-8] [Citation(s) in RCA: 156] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 10/16/2017] [Accepted: 10/16/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND Non-suicidal self-injury is being increasingly recognised as a prominent public health concern. Identification of early and modifiable risk factors is necessary to advance the screening and intervention efforts, particularly early detection of at-risk individuals. We aimed to examine childhood maltreatment, including its specific subtypes, in relation to non-suicidal self-injury. METHODS We did a comprehensive meta-analysis of childhood maltreatment (overall, sexual abuse, physical abuse and neglect, and emotional abuse and neglect) in association with non-suicidal self-injury. We also provided a qualitative review of mediators and moderators of this association. We identified relevant articles published from inception to Sept 25, 2017, through a systematic search of Embase, MEDLINE, and PsycINFO. We extracted continuous and categorical data and assessed for potential moderators using ten study characteristics. We generated random-effects models for analysis and evaluated for publication bias. FINDINGS We identified 71 publications that met eligibility criteria. Overall childhood maltreatment was associated with non-suicidal self-injury (odds ratio 3·42, 95% CI 2·74-4·26), and effect sizes for maltreatment subtypes ranged from 1·84 (1·45-2·34) for childhood emotional neglect to 3·03 (2·56-3·54) for childhood emotional abuse. Publication bias was not evident, except in the case of childhood emotional neglect. Across multiple maltreatment subtypes, we found stronger associations with non-suicidal self-injury in non-clinical samples. INTERPRETATION With the exception of childhood emotional neglect, childhood maltreatment and its subtypes are associated with non-suicidal self-injury. Screening of childhood maltreatment history in non-suicidal self-injury risk assessments might hold particular value in community settings, and increased attention to childhood emotional abuse is warranted. FUNDING National Institute of Mental Health.
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Wilhelm K, Korczak V, Tietze T, Reddy P. Clinical pathways for suicidality in emergency settings: a public health priority. AUST HEALTH REV 2017; 41:182-184. [PMID: 27333074 DOI: 10.1071/ah16008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 05/01/2016] [Indexed: 11/23/2022]
Abstract
Rates of self-harm in Australia are increasing and constitute a concerning public health issue. Although there are standard treatment pathways for physical complaints, such as headache, abdominal pain and chest pain, in Emergency Medicine, there is no national pathway for self-harm or other psychiatric conditions that present to the emergency department. Herein we outline the difference between clinical practice guidelines and clinical pathways, discuss pathways we have identified on self-harm in Australia and overseas and discuss their applicability to the Australian context and the next steps forward in addressing this public health issue.
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Affiliation(s)
- Kay Wilhelm
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Randwick, NSW 2031, Australia
| | - Viola Korczak
- St Vincent's Urban Mental Health and Wellbeing Research Institute, St Vincent's Hospital, Victoria Street, Darlinghurst, NSW 2010, Australia.
| | - Tad Tietze
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Randwick, NSW 2031, Australia
| | - Prasuna Reddy
- St Vincent's Urban Mental Health and Wellbeing Research Institute, St Vincent's Hospital, Victoria Street, Darlinghurst, NSW 2010, Australia.
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Huang YH, Liu HC, Tsai FJ, Sun FJ, Huang KY, Chiu YC, Huang YH, Huang YP, Liu SI. Correlation of impulsivity with self-harm and suicidal attempt: a community study of adolescents in Taiwan. BMJ Open 2017; 7:e017949. [PMID: 29217724 PMCID: PMC5728252 DOI: 10.1136/bmjopen-2017-017949] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES The aim of this study was to investigate differences and similarities in risk factors for deliberate self-harm (DSH) and suicidal attempt (SA), and the role of impulsivity among a group of community adolescents. SETTING This is a cross-sectional study conducted at high schools in Northern Taiwan. DATA AND PARTICIPANTS We recruited grade 1 students from 14 high schools. A total of 5879 participants (mean age 16.02 years, female adolescents: 57.7%) completed the online assessment. OUTCOME MEASURES Participants completed online questionnaires about sociodemographic data, suicidality, history of DSH and SA, depressed mood, self-esteem, social support, family discord, impulsivity (Barratt Impulsiveness Scale Version 11 (BIS-11)) and the use of alcohol, tobacco and illicit drugs. A subsample was interviewed about lifetime SA, and the results were compared with those from the online questionnaires. RESULTS In our sample, 25% of the students had lifetime DSH and 3.5% had lifetime SA. Two hundred and seventy-two students received face-to-face interviews. The concordance between the online questionnaires and interviews in terms of ascertaining cases of SA was moderate (concordance rate 82.76%; kappa value 0.59). Similar risk factors for DSH/SA among the whole sample included female gender, lower academic performance, depression, substance use (tobacco and alcohol) and low self-esteem. The BIS-11 score was correlated with DSH. Factor 3 score of the BIS-11 (novelty seeking) was correlated with DSH in both boys and girls, whereas factor 2 score (lack of self-control) was correlated with SA in boys. Social support was a protective factor against SA among the female adolescents. Gender modulated the association of impulsivity and DSH/SA. Associations between impulsivity and DSH and SA were particularly strong among boys. CONCLUSIONS Risk factors for DSH and SA were similar, but not identical. Early identification of those at risk and appropriate interventions may be helpful.
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Affiliation(s)
- Yu-Hsin Huang
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
- Department of Psychiatry, MacKay Memorial Hospital, Taipei, Taiwan
- Suicide Prevention Centre, MacKay Memorial Hospital, Taipei, Taiwan
- MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
| | - Hui-Ching Liu
- Department of Psychiatry, MacKay Memorial Hospital, Taipei, Taiwan
- Suicide Prevention Centre, MacKay Memorial Hospital, Taipei, Taiwan
- MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
| | - Fang-Ju Tsai
- Department of Psychiatry, En Chu Kong Hospital, New Taipei City, Taiwan
- Department of Psychiatry, College of Medicine, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Fang-Ju Sun
- MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan
| | - Kuo-Yang Huang
- Department of Psychiatry, Taiwan Adventist Hospital, Taipei, Taiwan
| | - Yu-Ching Chiu
- Department of Psychiatry, Cardinal Tien Hospital, New Taipei City, Taiwan
| | - Yen-Hsun Huang
- Department of Psychiatry, Taipei City Psychiatric Center, Taipei City Hospital, Taipei, Taiwan
| | - Yo-Ping Huang
- Department of Electrical Engineering, National Taipei University of Technology, Taipei, Taiwan
| | - Shen-Ing Liu
- Department of Medicine, MacKay Medical College, New Taipei City, Taiwan
- Department of Psychiatry, MacKay Memorial Hospital, Taipei, Taiwan
- Suicide Prevention Centre, MacKay Memorial Hospital, Taipei, Taiwan
- MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan
- Department of Medical Research, MacKay Memorial Hospital, Taipei, Taiwan
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Benatov J, Nakash O, Chen-Gal S, Brunstein Klomek A. The Association Between Gender, Ethnicity, and Suicidality Among Vocational Students in Israel. Suicide Life Threat Behav 2017; 47:647-659. [PMID: 28220963 DOI: 10.1111/sltb.12332] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 09/17/2016] [Indexed: 11/27/2022]
Abstract
Gender and ethnicity are significant factors when evaluating suicidal risk, especially among ethnically diverse populations. In the current study we explored the association between gender, ethnicity, and suicide ideation and attempts among Arab and Jewish vocational education and training high school students in Israel. Students (N = 3,554) completed a self-report survey evaluating suicide ideation and attempts, depression, anxiety, somatization, and sense of belonging. Hierarchical generalized linear modeling indicated that female Arab adolescents had elevated levels of suicide ideation, higher rates of suicide attempts, and greater psychological distress than Arab males and Jewish students. Furthermore, female Arab adolescents were found to be more susceptible to suicide ideation when depression levels were high. These results are discussed in the context of the double-jeopardy Arab young women face, as members of a minority ethnic group in Israel and their status as women within the patriarchal Arab culture.
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Affiliation(s)
- Joy Benatov
- Psychology, College of Management Academic Studies, Rishon LeZion, Israel
| | - Ora Nakash
- School of Psychology, Interdisciplinary Center (IDC) Herzliya, Herzliya, Israel
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Abstract
For too long, medical/psychiatric and psychological studies, with focus on emotional sensitivity, personality traits, and correlation with psychopathology, have dominated research on self-injuring acts. The phenomenon thus has been defined as a predominantly medical issue. However, a large body of community prevalence studies show self-injuring acts to be a common phenomenon in society, and most of those who self-injure are unknown in psychiatric or other clinical settings. This article describes and analyzes the medicalization of self-injuring acts and argues a need to move research on self-injuring acts out of the medical paradigm. There is a need to explicitly explore the impact of social, cultural, structural, and gendered factors surrounding and influencing self-injuring acts. A non-medical approach, beyond the limits of the medical perspective, would feed research forward and create a more nuanced view on this widespread social phenomenon.
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Gholamrezaei M, De Stefano J, Heath NL. Nonsuicidal self-injury across cultures and ethnic and racial minorities: A review. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2015; 52:316-326. [PMID: 26644040 DOI: 10.1002/ijop.12230] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 10/01/2015] [Indexed: 11/08/2022]
Abstract
The field of nonsuicidal self-injury (NSSI) is dominated by research conducted with Caucasian-majority samples in Western countries such as United States, Canada, Australia and European countries. This article critically reviewed the empirical research on NSSI in non-Western countries and among ethnic/racial minority individuals who live in the West to give voice to and understand the patterns of NSSI among individuals who do not fall within the dominant Caucasian majority. The study found both similarities and differences between Western and non-Western data in terms of characteristics and functions of NSSI. Differences in gender patterns in regards to prevalence of NSSI and methods used as well as presence of a more relational functionality of NSSI rather than emotion regulation functionality were two points of divergence in the findings of these studies. In addition, the findings seem to indicate that the role of ethnicity/race is mediated by important factors such as socioeconomic status (SES) and gender. Existing gaps in the literature and suggestions for further research are discussed.
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Affiliation(s)
- Maryam Gholamrezaei
- Department of Educational and Counselling Psychology, McGill University, Montreal, Canada
| | - Jack De Stefano
- Department of Educational and Counselling Psychology, McGill University, Montreal, Canada
| | - Nancy L Heath
- Department of Educational and Counselling Psychology, McGill University, Montreal, Canada
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Calati R, Laglaoui Bakhiyi C, Artero S, Ilgen M, Courtet P. The impact of physical pain on suicidal thoughts and behaviors: Meta-analyses. J Psychiatr Res 2015; 71:16-32. [PMID: 26522868 DOI: 10.1016/j.jpsychires.2015.09.004] [Citation(s) in RCA: 128] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2015] [Revised: 08/11/2015] [Accepted: 09/10/2015] [Indexed: 11/25/2022]
Abstract
Although the relationship between physical pain and suicidal thoughts and behaviors has been explored in multiple epidemiologic and clinical studies, it is still far from being well understood. Consequently, we conducted a meta-analysis of studies comparing rates of suicidal thoughts and behaviors in individuals with and without physical pain. We searched MEDLINE and PsycINFO (May 2015) for studies comparing rates of current and lifetime suicidal thoughts and behaviors (death wish, suicide ideation, plan, attempt and death: DW, SI, SP, SA, SD) in individuals with any type of physical pain (headache, back, neck, chest, musculoskeletal, abdominal and pelvic pains, arthritis, fibromyalgia, medically unexplained pain, and other not specified pain) versus those without it. Data were analyzed with Cochrane Collaboration Review Manager Software (RevMan, version 5.3). We assessed the methodological quality of the studies with the STROBE statement. Of the 31 included studies, three focused on lifetime DW, twelve focused on current SI (six lifetime), six focused on current SP (two lifetime), nine focused on current SA (11 lifetime) and eight on SD. Individuals with physical pain were more likely to report lifetime DW (p = 0.0005), both current and lifetime SI (both p < 0.00001), SP (current: p = 0.0008; lifetime: p < 0.00001), and SA (current: p < 0.0001; lifetime: p < 0.00001). Moreover, they were more likely to report SD (p = 0.02). In all analyses, the between study heterogeneity was high. Moreover, the presence of publication bias has been detected in the main outcomes. Physical pain is a consistent risk factor for suicidal thoughts and behaviors. Further research is required to investigate the specific impact of: 1) chronic versus acute pain, 2) different types of pain (e.g., medically unexplained pain), and 3) risk factors for suicide in chronic pain patients.
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Affiliation(s)
- Raffaella Calati
- INSERM U1061, La Colombière Hospital, University of Montpellier UM1, Montpellier, France; Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; FondaMental Foundation, France.
| | - Camelia Laglaoui Bakhiyi
- INSERM U1061, La Colombière Hospital, University of Montpellier UM1, Montpellier, France; Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; Psychiatric Unit, CHU Casablanca, Hassan II University, Casablanca, Morocco
| | - Sylvaine Artero
- INSERM U1061, La Colombière Hospital, University of Montpellier UM1, Montpellier, France
| | - Mark Ilgen
- VA Center for Clinical Management Research (CCMR), VA Ann Arbor Healthcare System, Ann Arbor, MI, USA; University of Michigan Department of Psychiatry, Ann Arbor, MI, USA
| | - Philippe Courtet
- INSERM U1061, La Colombière Hospital, University of Montpellier UM1, Montpellier, France; Department of Psychiatric Emergency & Acute Care, Lapeyronie Hospital, CHU Montpellier, Montpellier, France; FondaMental Foundation, France
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Tseng FY, Yang HJ. Internet use and web communication networks, sources of social support, and forms of suicidal and nonsuicidal self-injury among adolescents: different patterns between genders. Suicide Life Threat Behav 2015; 45:178-91. [PMID: 25255896 DOI: 10.1111/sltb.12124] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2012] [Accepted: 05/28/2014] [Indexed: 11/30/2022]
Abstract
The relationships of Internet use, web communication, and sources of social support with adolescent self-injurious thoughts and behaviors (SITBs) in Taiwan were investigated. The study sample of 391 12 to 18-year-olds was selected from nine public high schools. Findings show that girls are more likely to have SITBs, except for suicide gestures. Web communication is a risk factor for SITBs in boys but not in girls. Family support is protective in both genders. Support from friends is protective and support from significant others was a risk factor for suicide plans in girls. Support from virtual social communities can have both positive and negative effects on adolescent SITBs, with different effects by gender.
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Affiliation(s)
- Fang-Yi Tseng
- School of Public Health, Chung Shan Medical University, Taichung City, Taiwan
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Liang S, Yan J, Zhang T, Zhu C, Situ M, Du N, Fu X, Huang Y. Differences between non-suicidal self injury and suicide attempt in Chinese adolescents. Asian J Psychiatr 2014; 8:76-83. [PMID: 24655633 DOI: 10.1016/j.ajp.2013.11.015] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2013] [Revised: 11/22/2013] [Accepted: 11/23/2013] [Indexed: 12/27/2022]
Abstract
PURPOSE Self-harm behaviors are predominant health risks among adolescents. This study aimed to elucidate the lifetime prevalence and differences in social psychological factors between non-suicidal self-injury (NSSI) and suicide attempt (SA) among Chinese adolescents. METHOD Data were collected from 2131 middle school students with a mean age of 13.92 (SD 1.63) years (49.1% girls). Participants were asked to self-report NSSI and SA over their lifetime. Post hoc tests pairwise comparisons and multinomial logistic regression analyses were conducted to investigate differences and similarities between subjects with NSSI and attempted suicide. RESULTS The prevalence of lifetime NSSI and SA endorsed by the participants were 23.2% and 3.2%, respectively, and the co-occurrence of these two behaviors (NSSI+SA) was reported to 2.3%. Boys were comparable with girls in the prevalence rate of NSSI, but not in the rate of SA. It revealed that single-child was not the risk factor for self-harm behavior in Mainland China, but lower higher family cohesion and adaptability. Factors that distinguished the NSSI+SA group from the NSSI only group were female gender, lower grade, impulsivity, health risk behaviors and family cohesion. Being female gender, single-parent family, depressive symptoms and impulsivity were factors differentiating attempted suicide from NSSI. CONCLUSIONS Our findings suggest that Chinese adolescents engaging both in NSSI and SA had severe suicidal attempts and were different from those who engaged in NSSI alone.
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Affiliation(s)
- Sugai Liang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Jing Yan
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Tao Zhang
- College of Public Health, Sichuan University, Chengdu 610041, China
| | - Cuizhen Zhu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Minging Situ
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Na Du
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Xueyin Fu
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China
| | - Yi Huang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
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Chan LF, Maniam T, Saini SM, Shah SA, Loh SF, Sinniah A, Idris ZH, Che Rus S, Hassan Nudin SS, Tan SMK. Sexual abuse and substance abuse increase risk of suicidal behavior in Malaysian youth. Asia Pac Psychiatry 2013; 5 Suppl 1:123-6. [PMID: 23857848 DOI: 10.1111/appy.12057] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The aim of this study was to determine the association between sexual abuse, substance abuse and socio-demographic factors with suicidal ideation (SI), plans (SP) and deliberate self-harm (DSH) and propose steps to prevent youth suicidal behavior. METHODS This was a cross-sectional study of 6786 adolescents aged 17-18 years, selected randomly from all Malaysian adolescents to undergo compulsory youth camps located in Selangor, Malaysia (2008-2009). Participants were assessed using self-administered questionnaires developed to reflect the local cultural setting. However, only 4581 subjects were analyzed after excluding incomplete data. RESULTS The rates of SI, SP and DSH were 7.6%, 3.2% and 6.3%, respectively. The multivariable-adjusted odds ratio showed that sexual abuse was associated with SI 1.99 (95% CI: 1.56-2.55), SP 1.57 (95% CI: 1.09-2.27) and DSH 2.26 (95% CI: 1.75-2.94); illicit drug use was associated with SI 4.05 (95% CI: 2.14-7.67), SP 2.62 (95% CI: 1.05-6.53) and DSH 2.06, (95% CI: 1.05-4.04); for alcohol use DSH was 1.34 (95% CI: 1.00-1.79). Being female was associated with all suicidal behaviors: SI 2.51 (95% CI: 1.91-3.30), SP 2.07 (95% CI: 1.39-3.08) and DSH 1.59 (95% CI: 1.19-2.11). DISCUSSION Given the well-founded concern of increasing risk of suicidal behavior among youth, preventive efforts should adopt a more comprehensive approach in dealing with sexual abuse and substance abuse, and their sequelae, especially in girls.
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Affiliation(s)
- Lai Fong Chan
- Department of Psychiatry, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Adverse childhood experiences and suicidal behavior of adolescent psychiatric inpatients. Eur Child Adolesc Psychiatry 2013; 22:13-22. [PMID: 22842795 DOI: 10.1007/s00787-012-0311-8] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2012] [Accepted: 07/12/2012] [Indexed: 12/21/2022]
Abstract
The present study examines the association of adverse childhood experiences (ACEs) to suicidal behavior and mortality in 508 Finnish adolescents (aged 12-17 years) who required acute psychiatric hospitalization between April 2001 and March 2006. The Schedule for Affective Disorder and Schizophrenia for School-Age Children Present and Lifetime (K-SADS-PL) and the European Addiction Severity Index (EuropASI) were used to obtain information about ACEs, adolescents' suicidal behavior and psychiatric diagnoses. The cases of death were obtained from Statistics Finland. The results of our study indicated that, among girls, exposure to sexual abuse statistically significantly increased the risk of non-suicidal self-injury (NSSI) (OR, 1.8; 95 % CI, 1.0-3.2) and suicide attempts (OR, 2.3; 95 % CI, 1.0-4.5). The cumulative number of ACEs was also associated with an increased risk of NSSI (OR, 1.2; 95 % CI, 1.0- 1.4) and suicide attempts (OR, 1.2; 95 % CI, 1.0-1.4) in girls. Among all deceased adolescents, ACEs were most notable among those who had died due to accidents and injuries. Gender differences in the types of ACEs were noted and discussed.
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Muehlenkamp JJ, Claes L, Havertape L, Plener PL. International prevalence of adolescent non-suicidal self-injury and deliberate self-harm. Child Adolesc Psychiatry Ment Health 2012; 6:10. [PMID: 22462815 PMCID: PMC3348041 DOI: 10.1186/1753-2000-6-10] [Citation(s) in RCA: 569] [Impact Index Per Article: 47.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2011] [Accepted: 03/30/2012] [Indexed: 03/07/2023] Open
Abstract
BACKGROUND The behaviours of non-suicidal self-injury (NSSI) and deliberate self-harm (DSH) are prevalent among adolescents, and an increase of rates in recent years has been postulated. There is a lack of studies to support this postulation, and comparing prevalence across studies and nations is complicated due to substantial differences in the methodology and nomenclature of existing research. METHODS We conducted a systematic review of current (2005 - 2011) empirical studies reporting on the prevalence of NSSI and DSH in adolescent samples across the globe. RESULTS Fifty-two studies fulfilling the inclusion criteria were obtained for analysis. No statistically significant differences were found between NSSI (18.0% SD = 7.3) and DSH (16.1% SD = 11.6) studies. Assessment using single item questions led to lower prevalence rates than assessment with specific behaviour checklists. Mean prevalence rates have not increased in the past five years, suggesting stabilization. CONCLUSION NSSI and DSH have a comparable prevalence in studies with adolescents from different countries. The field would benefit from adopting a common approach to assessment to aide cross-cultural study and comparisons.
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Affiliation(s)
- Jennifer J Muehlenkamp
- Department of Psychology, University of Wisconsin, UW-Eau Claire, 105 Garfield Ave, Eau Claire, WI 54702, USA
| | - Laurence Claes
- Department of Psychology, Katholieke Universiteit Leuven, Tiensestraat 102, 3000 Leuven, Belgium
| | - Lindsey Havertape
- Department of Psychology, University of Wisconsin, UW-Eau Claire, 105 Garfield Ave, Eau Claire, WI 54702, USA
| | - Paul L Plener
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Ulm, Steinhoevelstr. 5, 89075 Ulm, Germany
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