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Hiew Y, Powell NL, Wong QY, Fong ZH, Fong YJ, Chee TT. Factors associated with informal and formal help-seeking among Asian adolescents with nonsuicidal self-injury. Clin Child Psychol Psychiatry 2024:13591045241241109. [PMID: 38565258 DOI: 10.1177/13591045241241109] [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] [Indexed: 04/04/2024]
Abstract
Although nonsuicidal self-injury (NSSI) is prevalent among adolescents and is associated with an increased risk of adverse outcomes, many adolescents with NSSI do not seek help. However, there is a lack of research on the factors that may increase the likelihood of help-seeking, especially within Asia. To address this gap, the present study examined whether certain factors were associated with informal and formal help-seeking - specifically gender, severity of NSSI, functions of NSSI and authoritative parenting. 121 adolescents (Mage = 16.2 years, 71.1% female) were recruited from specialist outpatient clinics and inpatient psychiatric wards from a public hospital in Singapore. One caregiver per adolescent was also recruited. Data from self-report questionnaires were analysed using logistics regression analyses. The results suggest that the severity of NSSI increases the likelihood of informal help-seeking, while adolescents who have parents with more authoritative parenting style are less likely to seek informal help. Gender and functions of NSSI were not found to be associated with help-seeking. The findings from this study can guide professionals in their efforts to encourage help-seeking within Asian populations, as well as inform prevention and treatment programs for Asian adolescents with NSSI.
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Affiliation(s)
- Yvette Hiew
- Department of Psychology, National University of Singapore, Singapore
| | | | - Qiu Yan Wong
- Department of Psychology, National University of Singapore, Singapore
| | - Zhi Hui Fong
- Department of Psychological Medicine, National University Health System, Singapore
| | - Ying Jie Fong
- Department of Psychological Medicine, National University Health System, Singapore
| | - Tji Tjian Chee
- Department of Psychological Medicine, National University Health System, Singapore
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2
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Gao Y, Wang Y, Wang Z, Ma M, Li H, Wang J, Liu J, Qian H, Zhu P, Xu X. Family intimacy and adaptability and non-suicidal self-injury: a mediation analysis. BMC Psychiatry 2024; 24:210. [PMID: 38500067 PMCID: PMC10946147 DOI: 10.1186/s12888-024-05642-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 02/27/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Current research has been focusing on non-suicidal self-injury (NSSI) behaviors among adolescents with depression. Although family intimacy and adaptability are considered protective factors for NSSI, evidence supporting this relationship is lacking. OBJECTIVE This study aims to examine the mechanisms operating in the relationship between family intimacy and adaptability and NSSI behaviors among adolescents. METHODS A self-administered general demographic information questionnaire, the Behavioral Functional Assessment Scale for Non-Suicidal Self-Injury, the Family Intimacy and Adaptability Scale, the Connor-Davidson Resilience Scale, and the Self-Assessment of Depression Scale were distributed among adolescents with depression in three tertiary hospitals in Jiangsu Province. RESULTS The relationship between family intimacy and adaptability and NSSI was assessed among 596 adolescents with depression. The results revealed the following: (1) Family intimacy and adaptability were negatively correlated with NSSI behavior. (2) Psychological resilience and depression levels acted as chain mediators in the relationship between family intimacy and adaptability and NSSI behavior. CONCLUSIONS Enhancing psychological resilience, controlling depressive symptoms, and reducing depression severity among adolescents by improving their family intimacy and adaptability are conducive to preventing and mitigating their NSSI behaviors.
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Affiliation(s)
- Yuehong Gao
- The Fourth People's Hospital of Nantong, Nantong, China
| | - Yanchi Wang
- The Sixth People's Hospital of Nantong, Nantong, China
| | - Zhiping Wang
- The Fourth People's Hospital of Nantong, Nantong, China
| | - Mingzhen Ma
- The Fourth People's Hospital of Nantong, Nantong, China
| | | | - Jinhong Wang
- The Fourth People's Hospital of Nantong, Nantong, China
| | - Jianan Liu
- The Fourth People's Hospital of Nantong, Nantong, China
| | | | - Ping Zhu
- Suzhou Guangji Hospital, Su Zhou Shi, China
| | - Xujuan Xu
- Affiliated Hospital of Nantong University, Nantong, China.
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3
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Martin F, Ferrey A, Hobbs L, Lascelles K, van Even S, Oliver T. Understanding the impact of children's and young people's self-harm on parental well-being: a systematic literature review of qualitative and quantitative findings. Child Adolesc Ment Health 2024. [PMID: 38362819 DOI: 10.1111/camh.12692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/07/2023] [Indexed: 02/17/2024]
Abstract
BACKGROUND Self-harm in children and young people is increasing. Parents are vital in supporting young people; however, parents may experience distress linked to the self-harm. Previous reviews have highlighted the emotional impact and need for information and support, however, have not elucidated the relationships between these themes, nor examined the quantitative data examining parents' well-being. METHODS We conducted a mixed methods review, with qualitative meta-synthesis focusing on links between themes and quantitative synthesis of parental well-being findings, including pooled means. PsycInfo, Medline, EMBASE, AMED, CINHAL and Web of Science were searched to identify relevant records. References of included studies were also searched. Every abstract was screened by two authors. Data were extracted by one author and checked by another. RESULTS We identified 39 reports of 32 studies: 16 with qualitative data and 17 with quantitative data (one had both). Qualitative findings showed how parents' emotions were associated to their knowledge and beliefs about self-harm. Parents' emotions often evidenced the need to self-care, but emotions of guilt reduced engagement in self-care. How parents supported their young person was linked to their knowledge, and the management of their own emotions, and influenced if they could engage in self-care. Quantitative findings were mixed, however suggested poor general mental health amongst these parents. CONCLUSIONS Further good quality quantitative studies are needed, with measurement of psychological mechanisms that may underpin parental distress. Current evidence supports peer-support and interventions that go beyond information provision to address the connected factors of knowledge, emotion, self-care, and parenting behaviours.
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Affiliation(s)
- Faith Martin
- School of Psychology, Cardiff University, Cardiff, UK
| | - Anne Ferrey
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK
| | - Laura Hobbs
- School of Applied Sciences, University of the West of England, Bristol, UK
| | | | | | - Thomas Oliver
- School of Social Sciences, University of the West of England, Bristol, UK
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Simone AC, Hamza CA. An examination of nonsuicidal self-injury disclosures in a high-risk university sample. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-10. [PMID: 38039418 DOI: 10.1080/07448481.2023.2283735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Accepted: 11/03/2023] [Indexed: 12/03/2023]
Abstract
Objective: There is a lack of research examining factors that promote the disclosure of nonsuicidal self-injury (NSSI) among post-secondary students. However, elucidating which factors facilitate disclosures among students - particularly students with high risk NSSI - is important given that disclosure may facilitate access to care. Methods: Participants included 149 post-secondary students with recent NSSI (81% women, Mage = 19.96) who reported on their disclosures, as well as several potential correlates of disclosure. Results: Eighty-seven percent of respondents had disclosed NSSI, often to several informal sources. Students with higher willingness to disclose personally distressing information, perceived levels of social support, stressful experiences, and frequency of NSSI engagement were more likely to disclose NSSI to more types of sources and more unique individuals. Conclusion: Results suggest that disclosure is an ongoing process rather than a single event, and underscore the importance of teaching effective NSSI disclosure responses to campus community members.
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Affiliation(s)
- Ariana C Simone
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, ON, Canada
| | - Chloe A Hamza
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, ON, Canada
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5
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Li Y, Li X, Li Y, Xiao Y, Li C, Chen J, Li Y, Luo L, Su D, Jia J, Cheng H, Liu T, Du N. The effects of family environment cognition and its difference perceived by adolescents and their parents on the treatment effect of non-suicidal self-injury behaviors in adolescents: a 1-year prospective cohort study. Front Psychiatry 2023; 14:1183916. [PMID: 37772066 PMCID: PMC10523313 DOI: 10.3389/fpsyt.2023.1183916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 08/29/2023] [Indexed: 09/30/2023] Open
Abstract
Introduction Family environment is the primary environment for adolescent growth and development, which is believed to have an important impact on the occurrence of non-suicidal self-injury (NSSI) behavior in adolescents. This study aimed to explore the effects of family environment cognition and cognitive differences perceived by adolescents and their parents on the treatment effects of NSSI in adolescents and to provide more potential perspectives for NSSI treatment. Methods A one-year prospective longitudinal sub-cohort investigation was carried out among 199 adolescents engaged in NSSI and one of their important guardians from the Longitudinal Psychosomatic Disease Study (LoPDS). The NSSI behaviors of adolescents were evaluated at 3 months, 6 months and 1 year after enrollment. The family environment scale (FES) and NSSI Behavior Questionnaire were used as assessment tools for family environment and adolescents NSSI behaviors. Multiple linear regression was used to investigate the role of family environment perception difference in the treatment effect of adolescent NSSI. Results After one year of follow-up, the perceived self-injury impulse score in recent 2 weeks, self-injury impulse frequency in recent 2 weeks, total number of self-injury in recent 2 weeks decreased significantly. The higher the adolescent family cohesion (Beta: 1.130, 95% CI: 0.886,1.373; p=0.032), parental family expressiveness (Beta: 0.818, 95% CI: 0.375,1.260; p=0.037) and parental family active-recreational orientation score (Beta: 0.609, 95% CI: 0.236,0.981; p=0.048), the better the treatment effect. However, higher adolescent family conflict (Beta: -0.838, 95% CI: -1.377,-0.298; p=0.024) were associated with lower treatment outcomes. The greater the cognitive difference between parents and adolescents in family cohesion (Beta: -1.307, 95% CI: -2.074,-0.539; p=0.014) and family conflict(Beta: -0.665, 95% CI: -0.919,-0.410; p=0.037), the worse the therapeutic effect of NSSI might be. Discussion There were certain differences in the cognition of family relationships between parents and adolescents, and subjective family relationship cognition and cognitive differences had a significant effect on the treatment effect of NSSI in adolescents. Helping them identify the cause of cognitive differences and conducting systematic family therapy from the points of difference may be another perspective to improve the treatment effect of NSSI in adolescents.
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Affiliation(s)
- Yalan Li
- The Fourth People’s Hospital of Chengdu, Psychosomatic Medical Center, Chengdu, China
| | - Xin Li
- Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Yunge Li
- The Fourth People’s Hospital of Chengdu, Psychosomatic Medical Center, Chengdu, China
| | - Yu Xiao
- The Fourth People’s Hospital of Chengdu, Psychosomatic Medical Center, Chengdu, China
| | - Chunya Li
- The Fourth People’s Hospital of Chengdu, Psychosomatic Medical Center, Chengdu, China
| | - Jia Chen
- The Fourth People’s Hospital of Chengdu, Psychosomatic Medical Center, Chengdu, China
| | - Yao Li
- The Fourth People’s Hospital of Chengdu, Psychosomatic Medical Center, Chengdu, China
| | - Lishi Luo
- The Fourth People’s Hospital of Chengdu, Psychosomatic Medical Center, Chengdu, China
| | - Ding Su
- The Fourth People’s Hospital of Chengdu, Psychosomatic Medical Center, Chengdu, China
| | - Juan Jia
- The Fourth People’s Hospital of Chengdu, Psychosomatic Medical Center, Chengdu, China
| | - Haofei Cheng
- The Fourth People’s Hospital of Chengdu, Psychosomatic Medical Center, Chengdu, China
| | - Tianjiao Liu
- Chengdu Women’s and Children’s Central Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China
| | - Na Du
- The Fourth People’s Hospital of Chengdu, Psychosomatic Medical Center, Chengdu, China
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6
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Farkas BF, Takacs ZK, Kollárovics N, Balázs J. The prevalence of self-injury in adolescence: a systematic review and meta-analysis. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-023-02264-y. [PMID: 37486387 DOI: 10.1007/s00787-023-02264-y] [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: 11/20/2022] [Accepted: 07/18/2023] [Indexed: 07/25/2023]
Abstract
In the past 10 years, there has been a growing interest in self-injurious behavior (SIB) among adolescents. The lifetime prevalence of SIB is between 16 and 22% in community sample with females more likely to engage in SIB. There are conflicting results about the global distribution of the prevalence of SIB and whether the SIB has increased in the 21st century. Our aim in the current study was to conduct a systematic search of and meta-analysis on the prevalence of SIB in adolescents over the past 5 years' worth of published papers and to examine gender, continental, and year differences. We conducted a systematic search in June 2020 of six databases (PubMed, Scopus, Web of Science, OVID Medline, PsycINFO, EBSCO) with three main search terms: "self-injurious behavior," "prevalence," and "adolescence." Article inclusion criteria were (a) written in English; (b) published between January 1, 2015, and June 18, 2020; and (c) focused on a community sample. Titles and abstracts of the articles were screened first. Then, the relevant full texts were read, and those that met the inclusion criteria were collected. We used Comprehensive Meta-Analysis software was used to conduct the analyses. After the screening process 97, articles were included in the meta-analysis. The age of the samples ranged from 11.00 to 18.53 years. The overall average prevalence of nonsuicidal self-injury in the studies was 16%. There was a significant gender difference: females reported a higher prevalence than males (19.4% and 12.9%, respectively). A significantly higher prevalence was found among Asian articles than those from other continents (19.5% and 14.7%, respectively). The prevalence of SIB did not change significantly between 2013 and 2018. The current research draws attention to the high prevalence of SIB among adolescents, especially among females and those living in Asia. It is important to address this behavior, both in terms of prevention and intervention.
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Affiliation(s)
| | - Zsofia K Takacs
- Faculty of Education and Psychology, Institute of Education, Eötvös Loránd University, Budapest, Hungary
- School of Health in Social Sciences, University of Edinburgh, Edinburgh, UK
| | - Nóra Kollárovics
- Mental Health Sciences Doctoral School, Semmelweis University, Budapest, Hungary
| | - Judit Balázs
- Department of Developmental and Clinical Child Psychology, Faculty of Education and Psychology, Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
- Oslo New University College, Oslo, Norway
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7
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Xu H, Xiao W, Xie Y, Xu S, Wan Y, Tao F. Association of parent-child relationship quality and problematic mobile phone use with non-suicidal self-injury among adolescents. BMC Psychiatry 2023; 23:304. [PMID: 37127572 PMCID: PMC10152594 DOI: 10.1186/s12888-023-04786-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 04/13/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND Non-suicidal self-injury behavior (NSSI) is a common mental health threat among adolescents. Poor parent-child relationship (PCR) and problematic mobile phone use (PMPU) are risk factors for NSSI. We aimed to explore the impact of PCR quality, PMPU, and their interaction effects on NSSI among adolescents in China, as well as the sex difference. METHOD A survey was conducted among school students in 4 provinces in China between 2017 and 2018. The study included 14,500 valid participants. The students' general demographic characteristics was collected, and further data on PCR quality, PMPU, and NSSI were obtained through self-rated questionnaire. Chi-square test, binomial logistic regression models, and the Andersson Excel were used for data analysis. RESULTS The 12-month prevalence of NSSI was 27.3%. Lower PCR quality and PMPU were significantly associated with NSSI, respectively. The low PCR + yes PMPU group had the greatest association with NSSI, followed by the high PCR + yes PMPU group, low PCR + no PMPU group. Moreover, in low father-child relationship + yes PMPU group, females had a higher risk of NSSI than males; in high mother-child relationship + yes PMPU group, females had a higher risk of NSSI than males. Additive interaction analysis indicated that mother-child relationship quality and PMPU were associated with increased risks of NSSI, in the subgroup of males. CONCLUSIONS The findings underline the importance of simultaneously studying the quality of PCR and PMPU for a comprehensive understanding of NSSI behavior, and especially highlights the significance of maternal relationship quality.
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Affiliation(s)
- Huiqiong Xu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Wan Xiao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Yang Xie
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Shaojun Xu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Yuhui Wan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China.
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, 81 Meishan Road, Hefei, 230032, Anhui, China.
| | - Fangbiao Tao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No 81 Meishan Road, Hefei, 230032, Anhui, China.
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, 230032, Anhui, China.
- NHC Key Laboratory of Study on Abnormal Gametes and Reproductive Tract, No 81 Meishan Road, Hefei, 230032, Anhui, China.
- Anhui Provincial Key Laboratory of Population Health and Aristogenics, 81 Meishan Road, Hefei, 230032, Anhui, China.
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8
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Yan H, Yue W. Risk factors, theoretical models, and biological mechanisms of nonsuicidal self-injury: a brief review. INTERDISCIPLINARY NURSING RESEARCH 2023; 2:112-120. [PMID: 37645376 PMCID: PMC10461723 DOI: 10.1097/nr9.0000000000000023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 06/07/2023] [Indexed: 08/31/2023]
Abstract
Nonsuicidal self-injury (NSSI) refers to the direct, deliberate infliction of harm to one's body tissue without the intention to die. The prevalence of NSSI has increased significantly globally in recent years and has become an important public health problem affecting the health of people, especially adolescents. The occurrence of NSSI in adolescents is the result of the interaction of different factors. Many scholars have proposed various theoretical models to explain the mechanism of NSSI behavior based on previous research on the influencing factors of NSSI. Moreover, advances have been made in genetic and neuroimaging mechanisms related to NSSI. Understanding the genetic and neuroimaging mechanisms of NSSI is important for both describing and treating the disorder. This literature review discusses the progress made on the risk factors, theoretical models, and biological mechanisms of NSSI.
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Affiliation(s)
- Huiru Yan
- School of Nursing and Sixth Hospital, Peking University, Beijing, China
- Institute of Mental Health, Peking University Sixth Hospital and Research Unit of Diagnosis and Treatment of Mood Cognitive Disorder of Chinese Academy of Medical Sciences, Beijing, China
- National Clinical Research Center for Mental Disorders and NHC Key Laboratory of Mental Health and (Peking University Sixth Hospital), Beijing, China
| | - Weihua Yue
- Institute of Mental Health, Peking University Sixth Hospital and Research Unit of Diagnosis and Treatment of Mood Cognitive Disorder of Chinese Academy of Medical Sciences, Beijing, China
- National Clinical Research Center for Mental Disorders and NHC Key Laboratory of Mental Health and (Peking University Sixth Hospital), Beijing, China
- PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
- Chinese Institute for Brain Research, Beijing, China
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9
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Yan H, Zhang Y, Lu Z, Li M, Ge Y, Mei D, Kang Z, Sun Y, Li Q, Yan H, Yang L, Song P, Shi C, Shang S, Yue W. High-risk group and functional subtypes of non-suicidal self-injury in young adults with mental disorders. Front Psychiatry 2023; 14:1098178. [PMID: 36911108 PMCID: PMC9996010 DOI: 10.3389/fpsyt.2023.1098178] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 02/06/2023] [Indexed: 02/25/2023] Open
Abstract
BACKGROUND Identifying high-risk groups of non-suicidal self-injury (NSSI) with multiple risk factors and different functional subtypes contribute to implementing person-centered interventions. METHODS We investigated NSSI profiles among a sample of 258 psychiatric inpatients aged 18-25 years. All participants completed well-validated measures of internal personal and external environmental characteristics. One-hundred and ninety patients reported a lifetime history of NSSI and completed an additional NSSI assessment. A k-means cluster analysis was conducted to extract characteristics of risk factors and functional subtypes. Independent sample t-test, analysis of variance and χ 2 test were used to test the difference of demographic statistical factors, risk factors and functional scores among groups with different frequency of NSSI. RESULTS The clustering of risk factors analyses supported 4-clusters. The proportion of repeat NSSI patients was the highest (67.1%) in the group with unfavorable personal and unfavorable environmental characteristics. Functional subtype clustering analyses supported 5-clusters. Among patients with repeated NSSI, those with depression were mainly accompanied by the "Sensation Seeking" subtype (39.7%), bipolar disorder mainly supported the "Anti-suicide" subtype (37.9%), and eating disorders were mostly "Social Influence" subtype (33.3%). There was an interaction between functional subtypes and mental disorders. LIMITATIONS All participants were in treatment in a psychiatric service and the results may not be generalizable to a community sample. The data included retrospective self-report which may be inaccurate due to recall bias. CONCLUSION It is necessary to identify high-risk groups of NSSI who with unfavorable personal and environmental characteristics and clinical interventions need to consider the heterogeneity of patients' functional subtypes of NSSI.
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Affiliation(s)
- Huiru Yan
- School of Nursing & Sixth Hospital, Peking University, Beijing, China.,Research Unit of Diagnosis and Treatment of Mood Cognitive Disorder (2018RU006), Peking University Sixth Hospital, Institute of Mental Health, Chinese Academy of Medical Sciences, Beijing, China.,NHC Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Yuyanan Zhang
- Research Unit of Diagnosis and Treatment of Mood Cognitive Disorder (2018RU006), Peking University Sixth Hospital, Institute of Mental Health, Chinese Academy of Medical Sciences, Beijing, China.,NHC Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Zhe Lu
- Research Unit of Diagnosis and Treatment of Mood Cognitive Disorder (2018RU006), Peking University Sixth Hospital, Institute of Mental Health, Chinese Academy of Medical Sciences, Beijing, China.,NHC Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Mingzhu Li
- Research Unit of Diagnosis and Treatment of Mood Cognitive Disorder (2018RU006), Peking University Sixth Hospital, Institute of Mental Health, Chinese Academy of Medical Sciences, Beijing, China.,NHC Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Yuqi Ge
- Research Unit of Diagnosis and Treatment of Mood Cognitive Disorder (2018RU006), Peking University Sixth Hospital, Institute of Mental Health, Chinese Academy of Medical Sciences, Beijing, China.,NHC Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Dongli Mei
- School of Nursing & Sixth Hospital, Peking University, Beijing, China.,Research Unit of Diagnosis and Treatment of Mood Cognitive Disorder (2018RU006), Peking University Sixth Hospital, Institute of Mental Health, Chinese Academy of Medical Sciences, Beijing, China.,NHC Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Zhewei Kang
- Research Unit of Diagnosis and Treatment of Mood Cognitive Disorder (2018RU006), Peking University Sixth Hospital, Institute of Mental Health, Chinese Academy of Medical Sciences, Beijing, China.,NHC Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Yaoyao Sun
- Research Unit of Diagnosis and Treatment of Mood Cognitive Disorder (2018RU006), Peking University Sixth Hospital, Institute of Mental Health, Chinese Academy of Medical Sciences, Beijing, China.,NHC Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Qianqian Li
- Research Unit of Diagnosis and Treatment of Mood Cognitive Disorder (2018RU006), Peking University Sixth Hospital, Institute of Mental Health, Chinese Academy of Medical Sciences, Beijing, China.,NHC Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Hao Yan
- Research Unit of Diagnosis and Treatment of Mood Cognitive Disorder (2018RU006), Peking University Sixth Hospital, Institute of Mental Health, Chinese Academy of Medical Sciences, Beijing, China.,NHC Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Lei Yang
- Research Unit of Diagnosis and Treatment of Mood Cognitive Disorder (2018RU006), Peking University Sixth Hospital, Institute of Mental Health, Chinese Academy of Medical Sciences, Beijing, China.,NHC Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Peihua Song
- Research Unit of Diagnosis and Treatment of Mood Cognitive Disorder (2018RU006), Peking University Sixth Hospital, Institute of Mental Health, Chinese Academy of Medical Sciences, Beijing, China.,NHC Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Chuan Shi
- Research Unit of Diagnosis and Treatment of Mood Cognitive Disorder (2018RU006), Peking University Sixth Hospital, Institute of Mental Health, Chinese Academy of Medical Sciences, Beijing, China.,NHC Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China
| | - Shaomei Shang
- School of Nursing & Sixth Hospital, Peking University, Beijing, China
| | - Weihua Yue
- Research Unit of Diagnosis and Treatment of Mood Cognitive Disorder (2018RU006), Peking University Sixth Hospital, Institute of Mental Health, Chinese Academy of Medical Sciences, Beijing, China.,NHC Key Laboratory of Mental Health, National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing, China.,PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China.,Chinese Institute for Brain Research, Beijing, China
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10
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Meheli S, Banerjee D. Revisiting Social Stigma in Non-suicidal Self-injury: A Narrative Review. CONSORTIUM PSYCHIATRICUM 2022; 3:6-18. [PMID: 39044918 PMCID: PMC11262124 DOI: 10.17816/cp196] [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: 06/26/2022] [Accepted: 09/23/2022] [Indexed: 11/08/2022] Open
Abstract
Non-suicidal self-injury (NSSI) is highly prevalent in our community. Yet, there is a significant discrepancy between the number of individuals engaging in NSSI and those who seek treatment for NSSI. This discrepancy can be due to the high social stigma associated with the behavior. The impact of NSSI stigma is significant and can impair the quality of life in the individuals engaging in NSSI, delay help-seeking, reduce access to mental health care and further fuel misinformation. Even though the symptomatology, risks, and demographics of NSSI have received attention in terms of research, there is limited literature on NSSI stigma and its consequences. With that background set, this review provides a bird's-eye view of the different levels of stigma in NSSI (public, self, and health care), associated discrimination, the various aspects of such stigmatization (NSSI-related language, physical scarring, misinformation, the media), and, finally, the collaborative clinical-outreach interventions for mitigating NSSI-associated social stigma. If NSSI is indeed recognized as a clinical disorder, future research would need to focus on these constructs of stigma and treat them with the same importance as the one given to clinical studies of intervention and symptomatology in NSSI.
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11
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Marital Satisfaction, Family Functioning, and Children’s Mental Health—The Effect of Parental Co-Viewing. CHILDREN 2022; 9:children9020216. [PMID: 35204935 PMCID: PMC8870432 DOI: 10.3390/children9020216] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/24/2022] [Accepted: 02/04/2022] [Indexed: 11/17/2022]
Abstract
Using 318 household data concerning children during middle childhood (8–13), we examined the association among each parent’s marital satisfaction, the child’s perceived family functioning, and the child’s anxiety and depression. Second, we investigated whether the other parent could buffer or facilitate this chain effect by co-viewing programs via various devices with their child so as to improve the child’s perceived family functioning. Results verified the mediation effect that maternal marital satisfaction was positively associated with the child’s perceived family functioning, which, in turn, decreased the child’s depression. In addition, the results indicated that increased paternal co-viewing enhanced the positive association between maternal marital satisfaction and the child’s perceived family functioning and then decreased the child’s depression. The theoretical and practical implications are discussed within the framework of family systems theory, parental media interventions, and the different roles of the father and mother in family functionality.
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12
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Townsend ML, Miller CE, Matthews EL, Grenyer BFS. Parental Response Style to Adolescent Self-Harm: Psychological, Social and Functional Impacts. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182413407. [PMID: 34949017 PMCID: PMC8703416 DOI: 10.3390/ijerph182413407] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/15/2021] [Accepted: 12/17/2021] [Indexed: 11/16/2022]
Abstract
Adolescent self-harm is a significant public health issue. We aimed to understand how parent stress response styles to their child's self-harm affects their wellbeing and functioning and the wider family. Thirty-seven participants in Australia (parents; 92% female) completed a mixed methods survey regarding their adolescent child's self-harm. We conducted Pearson zero-order correlations and independent t-tests to examine the impact of parent response style on their quality of life, health satisfaction, daily functioning, and mental health. We also used thematic analysis to identify patterns of meaning in the data. Two-thirds of participants reported mental ill health and reduced functional capacity due to their adolescent's self-harm. Parents with a more adaptive response style to stress had better mental health. Qualitative analyses revealed parents experienced sustained feelings of distress and fear, which resulted in behavioural reactions including hypervigilance and parental mental health symptoms. In the wider family there was a change in dynamics and parents reported both functional and social impacts. There is a need to develop psychological support for the adolescent affected and parents, to support more adaptive response styles, and decrease the negative effects and facilitate the wellbeing of the family unit.
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Affiliation(s)
- Michelle L. Townsend
- School of Psychology, University of Wollongong, Wollongong, NSW 2522, Australia; (C.E.M.); (E.L.M.); (B.F.S.G.)
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW 2522, Australia
- Correspondence:
| | - Caitlin E. Miller
- School of Psychology, University of Wollongong, Wollongong, NSW 2522, Australia; (C.E.M.); (E.L.M.); (B.F.S.G.)
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Emily L. Matthews
- School of Psychology, University of Wollongong, Wollongong, NSW 2522, Australia; (C.E.M.); (E.L.M.); (B.F.S.G.)
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW 2522, Australia
| | - Brin F. S. Grenyer
- School of Psychology, University of Wollongong, Wollongong, NSW 2522, Australia; (C.E.M.); (E.L.M.); (B.F.S.G.)
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW 2522, Australia
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13
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Kelada L, Molloy CJ, Hibbert P, Wiles LK, Gardner C, Klineberg E, Braithwaite J, Jaffe A. Child and caregiver experiences and perceptions of asthma self-management. NPJ Prim Care Respir Med 2021; 31:42. [PMID: 34504105 PMCID: PMC8429661 DOI: 10.1038/s41533-021-00253-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 08/19/2021] [Indexed: 02/07/2023] Open
Abstract
Asthma is the most common chronic condition of childhood. Self-management is integral to good asthma control. This qualitative paper explores how children with asthma and their parents perceive asthma, their experience with asthma, and how they manage symptoms, preventions and medications within and outside the home. We undertook 15 focus groups with 41 school-aged (6-11 years) children with asthma and 38 parents. Parents and their children attended the same focus groups. We used thematic analysis to analyse the transcripts. Our findings show the impact asthma can have on children's social and emotional wellbeing and highlight how reliant school-aged children are on their parents to effectively manage their asthma. Parents reported being unsure when their child's symptoms warranted visiting their doctor or hospital. Schools were identified as a source of difficulty regarding asthma management; families reported that children may be self-conscious about their asthma and using their inhaler at school. School policies and teachers' lack of asthma knowledge were reported to exacerbate children's reluctance to use their inhaler at school. Our results have implications for the design and implementation of children's self-management interventions for their asthma, particularly when they are at school and away from their parents.
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Affiliation(s)
- Lauren Kelada
- grid.1005.40000 0004 4902 0432School of Women’s and Children’s Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW Australia ,grid.414009.80000 0001 1282 788XKids Cancer Centre, Sydney Children’s Hospital, Randwick, NSW Australia
| | - Charlotte J. Molloy
- grid.1004.50000 0001 2158 5405Australian Institute of Health Innovation, Macquarie University, Sydney, NSW Australia ,grid.1026.50000 0000 8994 5086Australian Centre for Precision Health, Cancer Research Institute, School of Health Sciences, University of South Australia, Adelaide, SA Australia ,grid.430453.50000 0004 0565 2606South Australian Health and Medical Research Institute, Adelaide, SA Australia
| | - Peter Hibbert
- grid.1004.50000 0001 2158 5405Australian Institute of Health Innovation, Macquarie University, Sydney, NSW Australia ,grid.1026.50000 0000 8994 5086Australian Centre for Precision Health, Cancer Research Institute, School of Health Sciences, University of South Australia, Adelaide, SA Australia ,grid.430453.50000 0004 0565 2606South Australian Health and Medical Research Institute, Adelaide, SA Australia
| | - Louise K. Wiles
- grid.1004.50000 0001 2158 5405Australian Institute of Health Innovation, Macquarie University, Sydney, NSW Australia ,grid.1026.50000 0000 8994 5086Australian Centre for Precision Health, Cancer Research Institute, School of Health Sciences, University of South Australia, Adelaide, SA Australia ,grid.430453.50000 0004 0565 2606South Australian Health and Medical Research Institute, Adelaide, SA Australia
| | - Claire Gardner
- grid.1026.50000 0000 8994 5086Australian Centre for Precision Health, Cancer Research Institute, School of Health Sciences, University of South Australia, Adelaide, SA Australia ,grid.1014.40000 0004 0367 2697Caring Futures Institute, College of Nursing and Health Sciences, Flinders University, Adelaide, SA Australia
| | - Emily Klineberg
- grid.416088.30000 0001 0753 1056Ministry of Health, NSW Health, St Leonards, NSW Australia
| | - Jeffrey Braithwaite
- grid.1004.50000 0001 2158 5405Australian Institute of Health Innovation, Macquarie University, Sydney, NSW Australia
| | - Adam Jaffe
- grid.1005.40000 0004 4902 0432School of Women’s and Children’s Health, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW Australia ,grid.414009.80000 0001 1282 788XRespiratory Department, Sydney Children’s Hospital, Randwick, NSW Australia ,grid.414009.80000 0001 1282 788XAiming for Asthma Improvement in Children, Sydney Children’s Hospital, Randwick, NSW Australia
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14
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Simone AC, Hamza CA. Examining the disclosure of nonsuicidal self-injury to informal and formal sources: A review of the literature. Clin Psychol Rev 2020; 82:101907. [DOI: 10.1016/j.cpr.2020.101907] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 08/07/2020] [Accepted: 08/21/2020] [Indexed: 11/27/2022]
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15
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Non-suicidal self-injury in adolescence: Longitudinal evidence of recursive associations with adolescent depression and parental rejection. J Adolesc 2020; 84:36-44. [DOI: 10.1016/j.adolescence.2020.08.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Revised: 08/10/2020] [Accepted: 08/12/2020] [Indexed: 01/19/2023]
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16
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Duarte TA, Paulino S, Almeida C, Gomes HS, Santos N, Gouveia-Pereira M. Self-harm as a predisposition for suicide attempts: A study of adolescents' deliberate self-harm, suicidal ideation, and suicide attempts. Psychiatry Res 2020; 287:112553. [PMID: 31526562 DOI: 10.1016/j.psychres.2019.112553] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 09/02/2019] [Accepted: 09/02/2019] [Indexed: 01/09/2023]
Abstract
The aim of this study was to analyze the predictive risk factors for self-harm in adolescents with and without suicidal ideation. 600 adolescents answered a questionnaire about self-harm and suicidal behaviors. A logistic regression analysis was conducted. Over half of the individuals with deliberate self-harm (DSH) presented significant suicide risk. There was a direct association between DSH and suicide attempts, with almost the totality of the adolescents with suicide attempts also reporting DSH. According to the prediction model, suicidal ideation and diversity of DSH behaviors are significant predictors of suicide attempts, with an augmentation in the diversity of DSH behaviors and suicidal ideation predicting suicide attempts. Depression and anxiety appeared also as significant predictors of suicide attempts in adolescent self-harmers. Considering that the majority of the sample was not from a clinical setting, an alarming finding was that one third of the total sample was at suicide risk. These results place DSH as a key variable for early intervention.
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Affiliation(s)
- Tiago A Duarte
- Núcleo de Estudos de Suicídio (N.E.S.), Serviço de Psiquiatria e Saúde Mental do Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, E.P.E., Av. Prof. Egas Moniz, Lisbon 1649-035, Portugal; Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
| | - Sofia Paulino
- Núcleo de Estudos de Suicídio (N.E.S.), Serviço de Psiquiatria e Saúde Mental do Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, E.P.E., Av. Prof. Egas Moniz, Lisbon 1649-035, Portugal; Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Carolina Almeida
- Núcleo de Estudos de Suicídio (N.E.S.), Serviço de Psiquiatria e Saúde Mental do Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, E.P.E., Av. Prof. Egas Moniz, Lisbon 1649-035, Portugal; Centro Hospitalar Lisboa Ocidental, E.P.E., Lisbon, Portugal
| | - Hugo S Gomes
- Research Centre on Psychology (CIPsi), School of Psychology, University of Minho, Braga, Portugal
| | - Nazaré Santos
- Núcleo de Estudos de Suicídio (N.E.S.), Serviço de Psiquiatria e Saúde Mental do Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, E.P.E., Av. Prof. Egas Moniz, Lisbon 1649-035, Portugal; Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
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17
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Margola D, Fenaroli V, Sorgente A, Lanz M, Costa G. The Family Relationships Index (FRI). EUROPEAN JOURNAL OF PSYCHOLOGICAL ASSESSMENT 2019. [DOI: 10.1027/1015-5759/a000427] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Factor analysis of nested data is a challenge for researchers when they need to accurately identify the most appropriate latent configuration of self-report instruments. The present study used a multilevel framework to evaluate the factor structure underlying the 12-item three-factor Family Relationships Index (FRI), while adapting this instrument to the Italian context. By way of separating the two sources of variance (within and between families), results from 231 family members nested in 77 family triads supported a three-factor model (i.e., family cohesion, communication, and conflict resolution). Multilevel confirmatory factor analysis (MCFA) corroborated this model at the family level in particular. A one-factor model was also tested but resulted in being less suitable at both the individual (within) and family (between) level of analysis. Finally, we consider challenges in using such statistical techniques, while taking into account the FRI’s briefness and easiness to complete and score it in a practice-oriented assessment perspective.
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Affiliation(s)
- Davide Margola
- Faculty of Psychology, Catholic University of Milan, Italy
| | | | | | | | - Giulio Costa
- Faculty of Psychology, Catholic University of Milan, Italy
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18
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Tschan T, Lüdtke J, Schmid M, In-Albon T. Sibling relationships of female adolescents with nonsuicidal self-injury disorder in comparison to a clinical and a nonclinical control group. Child Adolesc Psychiatry Ment Health 2019; 13:15. [PMID: 30923561 PMCID: PMC6419840 DOI: 10.1186/s13034-019-0275-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 02/28/2019] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Adolescents' nonsuicidal self-injury (NSSI) leads to distress that affects the whole family system, and siblings are reported to suffer from disrupted family communication and functioning. So far, no studies have examined the quality of relationships between adolescents with NSSI and their siblings. The aim of the present study was to examine the sibling relationship quality of adolescents with NSSI, adolescents with other mental disorders without NSSI (clinical controls, CC), and adolescents without current or past experience of mental disorders (nonclinical controls, NC). METHODS 139 female adolescents aged 13-20 years (mean age = 16.18 years, SD = 1.62, NSSI: n = 56, CC: n = 33, NC: n = 50) and 73 siblings aged 10-28 years (mean age = 16.88 years, SD = 4.02, 60.3% female) participated. Self-report measures were used to assess psychopathology and sibling relationship quality. RESULTS Siblings reported a wide range of negative emotional and familial consequences, such as feeling left alone with their sister's issues or a distressing family situation, as a result of their sister's NSSI. Siblings of adolescents with NSSI experienced significantly more coercion in the relationship with their sister compared to CC (d = 1.08) and NC (d = 0.67) siblings, indicating an imbalance of dominance and control in their relationship. Further, adolescents with NSSI reported significantly less warmth and empathy in the sibling relationship and higher rivalry scores between their siblings and themselves than NC adolescents, suggesting higher levels of parental favoritism among parents of adolescents with NSSI compared to NC parents (d = 0.93). Among siblings of adolescents with NSSI, high levels of warmth, conflict, and empathy were significantly associated with internalizing problems. For adolescents with NSSI a significant association was found between internalizing problems and coercion and externalizing problems and similarity. CONCLUSIONS Given the negative impact of NSSI on siblings' emotional well-being and family life, efforts should be made to offer siblings psychoeducation and support to help them cope with the emotional and familial consequences of their sister's NSSI. Given adequate support, siblings can in turn be a source of emotional support for their sister.
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Affiliation(s)
- Taru Tschan
- 0000 0001 0087 7257grid.5892.6Clinical Child and Adolescent Psychology, University of Koblenz-Landau, Ostbahnstraße 12, 76829 Landau, Germany
| | - Janine Lüdtke
- 0000 0004 1937 0642grid.6612.3Department of Child and Adolescent Psychiatry, University of Basel, 4056 Basel, Switzerland
| | - Marc Schmid
- 0000 0004 1937 0642grid.6612.3Department of Child and Adolescent Psychiatry, University of Basel, 4056 Basel, Switzerland
| | - Tina In-Albon
- 0000 0001 0087 7257grid.5892.6Clinical Child and Adolescent Psychology, University of Koblenz-Landau, Ostbahnstraße 12, 76829 Landau, Germany
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19
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Maternal criticism and non-suicidal self-injury in school-aged children. Psychiatry Res 2019; 273:89-93. [PMID: 30640056 PMCID: PMC9912120 DOI: 10.1016/j.psychres.2019.01.019] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 01/03/2019] [Accepted: 01/04/2019] [Indexed: 11/20/2022]
Abstract
Although non-suicidal self-injury (NSSI) is a significant public health concern in youth, most of the extant research on NSSI has focused on adults and, to a lesser extent, adolescents. Therefore, little is known about the correlates and potential risk factors for NSSI in school-aged children. One factor that may be particularly important to children is their exposure to maternal criticism. Thus, the goal of this study was to examine the association between maternal expressed emotion-criticism (EE-Criticism) and NSSI in children, and to determine whether this relation is similar for girls and boys. Participants were 204 children (ages 7-11; 39.7% female, 81.9% Caucasian) and their mothers. Participants completed interviews assessing the child's history of NSSI. Mothers completed the Five-Minute Speech Sample to determine levels of EE-Criticism toward their child. We found that girls exposed to high levels of EE-Criticism were more likely to have a lifetime history of NSSI than girls of mothers exhibiting low levels of EE-Criticism; however, the relation between EE-Criticism and NSSI was not significant for boys. These results are consistent with interpersonal models of risk for NSSI, but suggest that one interpersonal factor, maternal criticism, is more strongly related to NSSI in girls than in boys.
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20
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Victor SE, Hipwell AE, Stepp SD, Scott LN. Parent and peer relationships as longitudinal predictors of adolescent non-suicidal self-injury onset. Child Adolesc Psychiatry Ment Health 2019; 13:1. [PMID: 30622642 PMCID: PMC6317237 DOI: 10.1186/s13034-018-0261-0] [Citation(s) in RCA: 75] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 12/22/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescence is characterized by developmental changes in social relationships, which may contribute to, or protect against, psychopathology and risky behaviors. Non-suicidal self-injury (NSSI) is one type of risky behavior that typically begins during adolescence and is associated with problems in relationships with family members and peers. Prior research on social factors in adolescent NSSI has been limited, however, by a narrow focus on specific interpersonal domains, cross-sectional methods, retrospective self-report of childhood experiences, and a failure to predict NSSI onset among as-yet-unaffected youth. METHODS We investigated these relationships in 2127 urban-living adolescent girls with no NSSI history at age 13, who were participating in a longitudinal cohort study (Pittsburgh Girls Study). We used discrete-time survival analyses to examine the contribution of time-varying interpersonal risk factors, assessed yearly at ages 13-16, to NSSI onset assessed in the following year (ages 14-17), controlling for relevant covariates, such as depression and race. We considered both behavioral indicators (parental discipline, positive parenting, parental monitoring, peer victimization), and cognitive/affective indicators (quality of attachment to parent, perceptions of peers, and perceptions of one's own social competence and worth in relation to peers) of interpersonal difficulties. RESULTS Parental harsh punishment, low parental monitoring, and poor quality of attachment to parent predicted increased odds of subsequent adolescent NSSI onset, whereas positive parenting behaviors reduced the odds of next year NSSI onset. Youth who reported more frequent peer victimization, poorer social self-worth and self-competence, and more negative perceptions of peers were also at increased risk of NSSI onset in the following year. When tested simultaneously, no single parenting variable showed a unique association with later NSSI onset; in contrast, peer victimization and poor social self-worth each predicted increased odds of later NSSI onset in an omnibus model of peer and parent relationship characteristics. CONCLUSIONS In this urban sample of adolescent girls, both peer and parent factors predicted new onset NSSI, although only peer factors were associated with subsequent NSSI in combined multivariate models. Results further suggest that both behavioral and cognitive/affective indicators of interpersonal problems predict NSSI onset. These findings highlight the relevance of family and peer relationships to NSSI onset, with implications for prevention of NSSI onset among at-risk youth.
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Affiliation(s)
- Sarah E. Victor
- 0000 0004 1936 9000grid.21925.3dDepartment of Psychiatry, University of Pittsburgh, Sterling Plaza Suite 408, Pittsburgh, PA 15213 USA
| | - Alison E. Hipwell
- 0000 0004 1936 9000grid.21925.3dDepartment of Psychiatry, University of Pittsburgh, Sterling Plaza Suite 408, Pittsburgh, PA 15213 USA
| | - Stephanie D. Stepp
- 0000 0004 1936 9000grid.21925.3dDepartment of Psychiatry, University of Pittsburgh, Sterling Plaza Suite 408, Pittsburgh, PA 15213 USA
| | - Lori N. Scott
- 0000 0004 1936 9000grid.21925.3dDepartment of Psychiatry, University of Pittsburgh, Sterling Plaza Suite 408, Pittsburgh, PA 15213 USA
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21
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Efe YS, Erdem E. A Comparison of Aggression and Self-injury Among Type 1 Diabetic and Healthy Adolescents: A Sample From Turkey. Arch Psychiatr Nurs 2018; 32:174-179. [PMID: 29579509 DOI: 10.1016/j.apnu.2017.10.012] [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: 10/30/2016] [Revised: 09/28/2017] [Accepted: 10/12/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Adolescents tend to have risky behaviors like aggression and self-injury due to the age period characteristics. The risk of aggression and self-injury may increase in adolescents with the addition of chronic diseases. OBJECTIVES This study was conducted descriptively to determine and compare the aggression and self-injury in those with type 1 diabetes mellitus (T1DM) and healthy counterparts. METHODS The study sample consisted of 60 adolescents with T1DM followed up in the child endocrinology polyclinic of a university hospital and 319 healthy counterparts, 15-18 aged, at 9th-12th grade at high school. In the study, the permission of the institution, Ethical Committee, the parent and adolescent consent, the data were collected using a questionnaire form, Aggression Questionnaire (AQ) and Inventory of Statements About Self-injury (ISAS). The descriptive statistics, Shapiro-Wilk, Mann-Whitney U, Student t, Chi-square, Spearman correlation tests were used for analyzing data. RESULTS The mean scores of AQ all subscales and the total scale of healthy adolescents were higher than adolescents with T1DM (p<0.05). Mean ISAS scores of adolescents with T1DM were higher than the healthy ones (p>0.05). The mean scores of autonomic function, social function and ISAS were positively moderately correlated with the mean scores of total aggression in both healthy and diabetic adolescents (p<0.05). CONCLUSIONS Considering the age period characteristics, training about anger-stress management and effective communication skill to adolescents and their parents may be recommended by health professionals.
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Affiliation(s)
- Yagmur Sezer Efe
- Department of Nursing, Faculty of Health Sciences, Erciyes University, Kayseri, Turkey.
| | - Emine Erdem
- Department of Nursing, Faculty of Health Sciences, Erciyes University, Kayseri, Turkey.
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Hasking PA, Heath NL, Kaess M, Lewis SP, Plener PL, Walsh BW, Whitlock J, Wilson MS. Position paper for guiding response to non-suicidal self-injury in schools. SCHOOL PSYCHOLOGY INTERNATIONAL 2016. [DOI: 10.1177/0143034316678656] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Around the world, school staff are increasingly expressing concern about nonsuicidal self-injury (NSSI) and how best to address this behavior in the school setting. However, there is a notable lack of informed guidance for schools, and clear inconsistencies in the practices school staff adopt. In this position paper we draw on our collective research and clinical expertise to provide best-practice guidelines for addressing NSSI in school settings. We outline the importance of a school protocol, and the key features all school protocols should contain. We also focus on how schools can minimize contagion of NSSI within their school environment. We believe these guidelines will be an important starting point for schools interested in developing an evidence-based approach to addressing NSSI.
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Affiliation(s)
| | | | - Michael Kaess
- Centre for Psychosocial Medicine, University Hospital, Heidelberg, Germany
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Ferrey AE, Hughes ND, Simkin S, Locock L, Stewart A, Kapur N, Gunnell D, Hawton K. Changes in parenting strategies after a young person's self-harm: a qualitative study. Child Adolesc Psychiatry Ment Health 2016; 10:20. [PMID: 27375774 PMCID: PMC4930574 DOI: 10.1186/s13034-016-0110-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2016] [Accepted: 06/23/2016] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND When faced with the discovery of their child's self-harm, mothers and fathers may re-evaluate their parenting strategies. This can include changes to the amount of support they provide their child and changes to the degree to which they control and monitor their child. METHODS We conducted an in-depth qualitative study with 37 parents of young people who had self-harmed in which we explored how and why their parenting changed after the discovery of self-harm. RESULTS Early on, parents often found themselves "walking on eggshells" so as not to upset their child, but later they felt more able to take some control. Parents' reactions to the self-harm often depended on how they conceptualised it: as part of adolescence, as a mental health issue or as "naughty behaviour". Parenting of other children in the family could also be affected, with parents worrying about less of their time being available for siblings. Many parents developed specific strategies they felt helped them to be more effective parents, such as learning to avoid blaming themselves or their child for the self-harm and developing new ways to communicate with their child. Parents were generally eager to pass their knowledge on to other people in the same situation. CONCLUSIONS Parents reported changes in their parenting behaviours after the discovery of a child's self-harm. Professionals involved in the care of young people who self-harm might use this information in supporting and advising parents.
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Affiliation(s)
- Anne E. Ferrey
- University Department of Psychiatry, Centre for Suicide Research, University of Oxford, Oxford, UK
| | | | - Sue Simkin
- University Department of Psychiatry, Centre for Suicide Research, University of Oxford, Oxford, UK
| | - Louise Locock
- Health Experiences Research Group, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK ,NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Anne Stewart
- Central Oxon CAMHS, Oxford Health NHS Foundation Trust, Oxford, UK
| | - Navneet Kapur
- Centre for Suicide Prevention, University of Manchester and Manchester Mental Health and Social Care Trust, Manchester, UK
| | - David Gunnell
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Keith Hawton
- University Department of Psychiatry, Centre for Suicide Research, University of Oxford, Oxford, UK ,Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, OX3 7JX UK
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