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Lebed O, Sabina C, Pacanowski CR, Jaremka LM. Are child maltreatment and intimate partner violence associated with adult disordered eating? Int J Eat Disord 2023; 56:1667-1673. [PMID: 37283219 DOI: 10.1002/eat.23972] [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: 09/23/2022] [Revised: 04/05/2023] [Accepted: 04/05/2023] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Disordered eating is one of the most prevalent mental health concerns (Galmiche et al., 2019, Quick & Byrd-Bredbenner, 2013, Neumark-Sztainer et al., 2006). Studies show that child maltreatment increases the likelihood of disordered eating symptoms in adulthood (Caslini et al., 2016, Hazzard et al., 2019). However, these studies overlook abuse experiences later in life, such as intimate partner violence which may also be a significant contributing factor (Bundock et al., 2013). The proposed study will help identify whether childhood maltreatment and IPV are independent predictors and/or if the combination of the two are synergistic risk factors for adult disordered eating. METHOD We use data from 14,332 people from Wave III of the National Longitudinal Study of Adolescent to Adult Health (Add Health). Participants completed questionnaires assessing child maltreatment, intimate partner violence, and disordered eating symptoms. We will perform a series of logistic regression models to examine a) whether child maltreatment and intimate partner violence are independently associated with disordered eating and b) whether exposure to the combination of both child maltreatment and intimate partner violence is associated with worse outcomes for adult disordered eating compared to exposure to only one or none at all. We also propose a supplemental analysis to establish the robustness of these effects when accounting for the highest parental education, federal poverty percentage level, race/ethnicity, gender, and age. PUBLIC SIGNIFICANCE Disordered eating is a serious mental health concern, especially in an emerging adult population. Child maltreatment is consistently associated with disordered eating in adulthood. However, the independent or synergistic role of more recent abuse experiences, such as intimate partner violence, remains largely unknown. The proposed study provides insight into how both childhood abuse and intimate partner violence may be associated with disordered eating independently or in combination.
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Affiliation(s)
- Olga Lebed
- Department of Psychological and Brain Sciences, University of Delaware, Newark, Delaware, USA
| | - Chiara Sabina
- School of Social Work, Rutgers University, New Brunswick, New Jersey, USA
| | - Carly R Pacanowski
- Behavioral Health and Nutrition, University of Delaware, Newark, Delaware, USA
| | - Lisa M Jaremka
- Department of Psychological and Brain Sciences, University of Delaware, Newark, Delaware, USA
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2
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Thum CC, Dahlan R, Wong YJ. Using the modified socio-ecological model to address stigma against non-suicidal self-injury among adolescents in Malaysia. Front Psychiatry 2023; 14:1204704. [PMID: 37398591 PMCID: PMC10307976 DOI: 10.3389/fpsyt.2023.1204704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 06/02/2023] [Indexed: 07/04/2023] Open
Affiliation(s)
- Chern Choong Thum
- Hospital Sultan Abdul Aziz Shah, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Rahima Dahlan
- Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia
| | - Yen Jun Wong
- School of Pharmacy, Monash University Malaysia, Subang Jaya, Selangor, Malaysia
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3
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Reas DL, Wisting L, Lindvall Dahlgren C. Co-occurrence of nonsuicidal self-injury and eating disorder pathology in adolescents. Int J Eat Disord 2023; 56:439-445. [PMID: 36524669 PMCID: PMC10107669 DOI: 10.1002/eat.23826] [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: 05/02/2022] [Revised: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Little is known about the co-occurrence of nonsuicidal self-injurious (NSSI) behaviors and eating disorder (ED) pathology in community samples of adolescents. METHODS A total of 1558 Norwegian upper secondary school students (Grades 11, 12, and 13) completed the Deliberate Self-Harm Inventory and a measure of ED pathology. RESULTS Adolescents (53.1% F, 46.9% M) were a mean age of 17.1 years. A higher level of ED pathology was reported (12.1 vs. 5.3, p < .001) among adolescents who had a history of NSSI. Significantly higher levels of ED pathology were found among females who reported hitting themselves until bruised, head banging, severe scratching, and burning with a lighter, but not cutting, or the other forms of self-injury. Of adolescents with a history of NSSI, 60% of females and 15% of males scored above a cutoff for ED pathology. Of adolescents scoring above a cutoff for ED pathology, 42.5% of females and 37.1% of males had engaged in lifetime NSSI. DISCUSSION Adolescents-in particular, females- with a history of NSSI reported significantly greater ED pathology. Notably, a higher proportion of males with ED pathology reported lifetime self-injury than vice versa, underscoring the importance of carefully screening for the presence of self-harm among males with ED pathology. PUBLIC SIGNIFICANCE STATEMENT Over 1500 upper secondary school students with an average age of 17 years completed an online survey assessing current ED pathology and lifetime NSSI. Adolescents, particularly females, with a history of self-harm reported significantly more ED pathology. Findings also indicated the need to carefully screen for self-harm among males with ED pathology. Parents, schools, and health professionals should be aware that self-harm and ED pathology commonly co-occur and warrant assessment.
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Affiliation(s)
- Deborah Lynn Reas
- Division of Mental Health and Addiction, Regional Department of Eating Disorders, Oslo University Hospital, Oslo, Norway
| | - Line Wisting
- Division of Mental Health and Addiction, Regional Department of Eating Disorders, Oslo University Hospital, Oslo, Norway
| | - Camilla Lindvall Dahlgren
- Division of Mental Health and Addiction, Regional Department of Eating Disorders, Oslo University Hospital, Oslo, Norway.,Department of Psychology, Oslo New University College, Oslo, Norway
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4
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Park H, In S, Hur JW. Association of socioeconomic status with nonsuicidal self-injury and suicidal ideation in young Korean adults. Int J Soc Psychiatry 2022; 68:1127-1134. [PMID: 35699657 DOI: 10.1177/00207640221104691] [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: 12/29/2022]
Abstract
OBJECTIVE Although nonsuicidal self-injury (NSSI) in youth is an important mental health concern worldwide, limited studies have investigated its sociodemographic correlates in early adulthood. This study explored associations between socioeconomic status (SES) and self-harm behaviors, including NSSI and suicidal ideation, in a community-based sample of young adults. METHODS A total of 414 Korean young adults engaged in NSSI and 200 controls completed online self-report questionnaires assessing sociodemographic and clinical characteristics, using logistic regression to estimate the odds ratio and analyzed risk factors for NSSI, especially the independent influence of SES on NSSI risk. Multivariate regression was performed to identify the role of socioeconomic disadvantage in suicidal ideation in NSSI people. RESULTS Logistic regression showed that low SES significantly increased NSSI risk. Multivariable regression also revealed that lower SES was related to more severe suicidal ideation in young adults with NSSI after controlling for gender and the higher-severity NSSI index, including the number of NSSI methods used and NSSI intrapersonal functions. CONCLUSIONS This is the first study to directly address socioeconomic gradients of a general population of young adults with NSSI and its effects, and socioeconomic status should be considered preemptively when defining suicide risks of this group and when intervening in self-injurious behaviors.
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Affiliation(s)
- Heyeon Park
- Division of General Studies & Teaching Profession, Dongduk Women's University, Seoul, South Korea
| | - Sunwoo In
- Department of Psychology, Chung-Ang University, Seoul, South Korea
| | - Ji-Won Hur
- School of Psychology, Korean University, Seoul, South Korea
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Abstract
Co-occurrence of nonsuicidal self-injury (NSSI) and suicide attempts (SA) might occur because they share common risk factors, or alternatively because one leads to the other. Using search terms salient to NSSI and SA, we screened 555 studies to identify 17 that presented temporal data about NSSI and SA. Much of the evidence indicates that NSSI predates SA, especially among females and individuals with depressive symptoms, or diagnosed with borderline personality disorder or mood disorders. However, in some studies, associated risk factors likely accounted for the effect. Greater NSSI frequency to a threshold increases risk for later SA. Findings suggest that the behaviors have common predisposing factors, but that there is also a potent gateway effect whereby NSSI precedes SA.
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Okado I, Floyd FJ, Goebert D, Sugimoto-Matsuda J, Hayashi K. Applying ideation-to-action theories to predict suicidal behavior among adolescents. J Affect Disord 2021; 295:1292-1300. [PMID: 34706443 DOI: 10.1016/j.jad.2021.08.137] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 07/31/2021] [Accepted: 08/27/2021] [Indexed: 11/15/2022]
Abstract
BACKGROUND Although many risk factors for adolescent suicidal behavior have been identified, less is known about distinct risk factors associated with the progression from suicide ideation to attempts. Based on theories grounded in the ideation-to-action framework, we used structural equation modeling to examine risk and protective factors associated with the escalation from suicide ideation to attempts in adolescents. METHODS In this cross-sectional study, data from the 2013 and 2015 Hawaii High School Youth Risk Behavior Surveys (N = 8,113) were analyzed. The sample was 54.0% female and racially/ethnically diverse. Risk factors included depression, victimization, self-harm, violent behavior, disinhibition, and hard substance use, and protective factors included adult support, sports participation, academic achievement and school safety. RESULTS One in 6 adolescents (16.4%) reported suicide ideation, and nearly 1 in 10 (9.8%) adolescents had made a suicide attempt. Overall, disinhibition predicted the escalation to attempts among adolescents with suicide ideation, and higher academic performance was associated with lower suicide attempt risk. Depression and victimization were associated with suicide ideation. LIMITATIONS This study examined data from the Youth Risk Behavior Survey, and other known risk factors such as anxiety and family history of suicide were not available in these data. CONCLUSIONS Findings provide guidance for targets for clinical interventions focused on suicide prevention. Programs that incorporate behavioral disinhibition may have the greatest potential for reducing suicide attempt risk in adolescents with suicidal thoughts.
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Affiliation(s)
- Izumi Okado
- University of Hawaii at Manoa, Cancer Center, 701 Ilalo St. #422, Honolulu, Hawaii 96813, United States.
| | - Frank J Floyd
- University of Hawaii at Manoa, Cancer Center, 701 Ilalo St. #422, Honolulu, Hawaii 96813, United States
| | - Deborah Goebert
- University of Hawaii at Manoa, Cancer Center, 701 Ilalo St. #422, Honolulu, Hawaii 96813, United States
| | - Jeanelle Sugimoto-Matsuda
- University of Hawaii at Manoa, Cancer Center, 701 Ilalo St. #422, Honolulu, Hawaii 96813, United States
| | - Kentaro Hayashi
- University of Hawaii at Manoa, Cancer Center, 701 Ilalo St. #422, Honolulu, Hawaii 96813, United States
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Powers JT, Brausch AM, Muehlenkamp JJ. Explicit and implicit measurement of nonsuicidal self-injury in the prediction of concurrent and prospective self-injury. Suicide Life Threat Behav 2021; 51:665-672. [PMID: 33522014 PMCID: PMC8437310 DOI: 10.1111/sltb.12734] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 07/10/2020] [Accepted: 11/03/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The relationship between explicit nonsuicidal self-injury (NSSI) behavior and implicit identification with NSSI is important to understand considering the under-reported nature of NSSI and the subsequent elevated risk of more severe NSSI. It was expected that implicit assessment of NSSI at baseline would be associated with past-year NSSI frequency assessed at baseline and that it would more strongly associate with NSSI frequency than self-reported future likelihood of NSSI at a 6-month follow-up. METHOD Data were collected from 420 young adults (mean age = 19; 83% women, 87% White) with recent NSSI at baseline, and 324 were assessed at 6-month follow-up. Participants completed self-report measures and the Self-Injury Implicit Association Task (SI-IAT) at each time point. RESULTS Baseline implicit NSSI scores significantly predicted NSSI frequency at baseline but not at 6-month follow-up. However, explicit ratings were strongly and significantly associated with future NSSI frequency. CONCLUSIONS These findings suggest that although implicit identification with oneself and NSSI is important to understand, there are limitations regarding the possible utility of the SI-IAT in predicting future NSSI engagement and further research is needed to fully understand why NSSI continues to be such a strong predictor of future NSSI behavior, and suicidal ideation and behavior.
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Affiliation(s)
- Jeffrey T. Powers
- Department of Psychological Sciences, Western Kentucky University, Bowling Green, KY, USA
| | - Amy M. Brausch
- Department of Psychological Sciences, Western Kentucky University, Bowling Green, KY, USA
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Sorgi KM, Ammerman BA, Cheung JC, Fahlgren MK, Puhalla AA, McCloskey MS. Relationships between Non-Suicidal Self-Injury and Other Maladaptive Behaviors: Beyond Difficulties in Emotion Regulation. Arch Suicide Res 2021; 25:530-551. [PMID: 31994980 DOI: 10.1080/13811118.2020.1715906] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Non-suicidal self-injury (NSSI) co-occurs with both other maladaptive behaviors (e.g., aggression) and emotion dysregulation. However, the extent to which these maladaptive behaviors are linked to NSSI independent of emotion dysregulation is unclear. The present study examined relationships between NSSI and six other maladaptive behaviors among university undergraduates. When controlling for demographic variables, emotion dysregulation, and other maladaptive behaviors, binge eating, purging, illicit drug use, and physical aggression were each related to lifetime NSSI history and/or severity. No maladaptive behaviors were significantly related to the presence of current diagnostic-level NSSI in these multivariate analyses. Results suggest that some maladaptive behaviors may relate uniquely to NSSI risk independent of emotion dysregulation, highlighting the importance of considering such behaviors in self-injury assessment and treatment.
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Kentopp SD, Conner BT, Fetterling TJ, Delgadillo AA, Rebecca RA. Sensation seeking and nonsuicidal self-injurious behavior among adolescent psychiatric patients. Clin Child Psychol Psychiatry 2021; 26:430-442. [PMID: 33615846 DOI: 10.1177/1359104521994627] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The Benefits and Barriers model of NSSI postulates that engagement in NSSI is positively reinforced by potent benefits, however there are a host of barriers to engagement, any one of which is salient enough to prevent engagement. It is possible that individual differences in sensation seeking, a trait that describes optimal level of positive reinforcement, may alter the balance between the benefits and barriers of engagement in NSSI. There are significant associations between engagement in NSSI and sensation seeking in college undergraduates, a population with disproportionately high rates of NSSI. However, it is unclear whether these traits play a similar role in adolescents. We expected that higher levels of sensation seeking would positively relate to any NSSI history, lifetime frequency of NSSI, and earlier age at onset of NSSI among a sample of 200 adolescents in a psychiatric hospital. Consistent with previous research, results indicated that females were more likely to engage in NSSI than males. Additionally, increased sensation seeking was associated with greater likelihood of ever engaging in NSSI and a greater number of different NSSI methods tried. Though we expected sensation seeking would be significantly related to lifetime NSSI frequency and earlier onset of NSSI, it was not. Findings suggest that individual differences may alter relations between the benefits and barriers of NSSI and that measuring sensation seeking in adolescents, especially females, and especially those experiencing psychological distress, may identify those at highest risk for engaging in NSSI and may allow for targeted intervention with these individuals.
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Affiliation(s)
- Shane D Kentopp
- Department of Psychology, Colorado State University, Fort Collins, USA
| | - Bradley T Conner
- Department of Psychology, Colorado State University, Fort Collins, USA
| | | | | | - Rachel A Rebecca
- UCHealth Mountain Crest Behavioral Health Center, Fort Collins, CO, USA
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10
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Sellers CM, Díaz-Valdés A, Oliver MM, Simon KM, O'Brien KHM. The relationship between alcohol and cannabis use with nonsuicidal self-injury among adolescent inpatients: Examining the 90 days prior to psychiatric hospitalization. Addict Behav 2021; 114:106759. [PMID: 33338906 DOI: 10.1016/j.addbeh.2020.106759] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 11/22/2020] [Accepted: 11/26/2020] [Indexed: 01/18/2023]
Abstract
BACKGROUND This study examined the trajectories of alcohol use, cannabis use, suicide planning (SP), and nonsuicidal self-injury (NSSI) prior to hospitalization and examined the role of alcohol and cannabis use, independently and jointly, in predicting NSSI on a daily level and over time. METHODS Participants included 71 adolescents hospitalized for suicide risk (75% female; 25% male; Mage = 15.79). All participants drank alcohol at least once in the prior 90-days. We conducted mixed effect models to assess the trajectories of alcohol use, cannabis use, and NSSI over the 90-days prior hospitalization. To test the effect of SP, alcohol use, and cannabis use on NSSI, we conducted logistic random effect models, while controlling for demographics. RESULTS SP (OR = 4.47, p < 0.001) and suicide ideation (SI) (OR = 10.09, p < 0.001) significantly increased the odds of engaging in NSSI. Neither cannabis nor alcohol use independently predicted the odds of engaging in NSSI, however, the co-occurrence of alcohol and cannabis use increased the odds of engaging in NSSI on a given day (OR = 30.5, p < 0.05). CONCLUSIONS Study findings extend current knowledge about the longitudinal and day-to-day relationships between alcohol and cannabis use and NSSI. Results underscore the importance of developing interventions that address polysubstance use among suicidal adolescents engaging in NSSI.
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Warne N, Heron J, Mars B, Moran P, Stewart A, Munafò M, Biddle L, Skinner A, Gunnell D, Bould H. Comorbidity of self-harm and disordered eating in young people: Evidence from a UK population-based cohort. J Affect Disord 2021; 282:386-390. [PMID: 33421867 PMCID: PMC8150329 DOI: 10.1016/j.jad.2020.12.053] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 11/13/2020] [Accepted: 12/14/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Self-harm and eating disorders are often comorbid in clinical samples but their co-occurrence in the general population is unclear. Given that only a small proportion of individuals who self-harm or have disordered eating present to clinical services, and that both self-harm and eating disorders are associated with substantial morbidity and mortality, it is important to study these behaviours at a population level. METHODS We assessed the co-occurrence of self-harm and disordered eating behaviours in 3384 females and 2326 males from a UK population-based cohort: the Avon Longitudinal Study of Parents and Children (ALSPAC). Participants reported on their self-harm and disordered eating behaviours (fasting, purging, binge-eating and excessive exercise) in the last year via questionnaire at 16 and 24 years. At each age we assessed how many individuals who self-harm also reported disordered eating, and how many individuals with disordered eating also reported self-harm. RESULTS We found high comorbidity of self-harm and disordered eating. Almost two-thirds of 16-year-old females, and two-in-five 24-year old males who self-harmed also reported some form of disordered eating. Young people with disordered eating reported higher levels of self-harm at both ages compared to those without disordered eating. LIMITATIONS We were not able to measure whether participants identified their disordered eating as a method of self-harm. CONCLUSIONS Self-harm and disordered eating commonly co-occur in young people in the general population. It is important to screen for both sets of difficulties to provide appropriate treatment.
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Affiliation(s)
- Naomi Warne
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jon Heron
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK,Centre for Public Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Becky Mars
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK,NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK
| | - Paul Moran
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK,NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK,NIHR Applied Research Collaboration (ARC) West at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Anne Stewart
- Department of Psychiatry, University of Oxford, Oxford, UK,Oxford Health NHS Foundation Trust, Oxford UK
| | - Marcus Munafò
- NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK,School of Psychological Science, University of Bristol, Bristol, UK,MRC Integrative Epidemiology Unit, University of Bristol Medical School, Bristol, UK
| | - Lucy Biddle
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK,NIHR Applied Research Collaboration (ARC) West at University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Andy Skinner
- School of Psychological Science, University of Bristol, Bristol, UK,MRC Integrative Epidemiology Unit, University of Bristol Medical School, Bristol, UK
| | - David Gunnell
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK,NIHR Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK
| | - Helen Bould
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK; Gloucestershire Health and Care NHS Foundation Trust, Gloucester, UK.
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Bandel SL, Anestis MD. Non-suicidal self-injury among male service members: Descriptive information and a preliminary examination of external correlates. Psychiatry Res 2020; 285:112815. [PMID: 32036153 DOI: 10.1016/j.psychres.2020.112815] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 01/24/2020] [Accepted: 01/25/2020] [Indexed: 10/25/2022]
Abstract
Previous literature has identified nonsuicidal self-injury (NSSI) as a common and noteworthy behavior, particularly given its association with psychopathology and suicide. However, the research on NSSI among males has resulted in mixed findings. Additionally, few studies have examined NSSI among service members and only one study to date has examined NSSI specifically among male service members. The present study examined descriptive statistics and clinical correlates of NSSI among male service members. Results indicated that the most common method of NSSI among this group was burning oneself with a cigarette, followed closely by cutting, and burning oneself with a lighter. NSSI engagement was associated with common correlates of NSSI such as increased emotion dysregulation, depression, impulsivity, and capability for suicide as well as decreased distress tolerance and a greatly likelihood to have experienced recent suicidal ideation. NSSI was also associated with grit, narcissism, and masculinity, some of which may be particularly important and valued in military culture. Overall, results suggest important similarities and differences among NSSI in service members relative to previously studied samples. Future research should continue to examine NSSI among male service members to ensure treatments are effectively targeting and addressing aspects of the behavior.
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13
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Abstract
Objective/Background: Poor sleep has been shown to have multiple negative outcomes during adolescence, in both academic and mental health domains. Several studies have identified the association between poor sleep and suicide risk in adolescents. However, onset of and engagement in nonsuicidal self-injury (NSSI) is also common in this age group, but this behavior has rarely been studied in association with sleep in adolescent samples. In the current study, it was expected that poorer sleep and more symptoms of insomnia would associate with a greater likelihood of recent NSSI engagement and greater NSSI severity. Participants: Data were collected from 387 community adolescents (mean age = 14.19, SD = 1.08), 9% of whom reported NSSI in the past 6 months. The gender breakdown was about even (52% female) and the majority of the sample was White (88.5%). Methods: Adolescent participants were recruited from middle and high schools for a study on mental health and risk behaviors. Researchers visited schools and administered self-report questionnaires to students in large groups. Measures assessed NSSI engagement and severity features, overall sleep quality, and insomnia symptoms. Results: Results indicated that greater insomnia symptoms, but not overall sleep quality, were significantly associated with greater likelihood of recent NSSI engagement. Sleep variables were not significantly associated with NSSI severity among adolescents with recent NSSI. Conclusions: Insomnia symptoms seem to be associated with recent engagement in NSSI. Adolescents who report symptoms of insomnia should also be assessed for self-harm behavior.
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Affiliation(s)
- Shelby L. Bandel
- Graduate Student in the Department of Psychological Sciences, Western Kentucky University, 1906 College Heights Blvd., Bowling Green, KY, 42101,
| | - Amy M. Brausch
- Associate Professor in the Department of Psychological Sciences at Western Kentucky University. To whom correspondences should be addressed at: Western Kentucky University, Department of Psychological Sciences, 1906 College Heights Blvd., Bowling Green, KY, 42101, , 270-745-4407 (office), 270-745-3475 (fax)
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14
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Ammerman BA, Jacobucci R, McCloskey MS. Reconsidering important outcomes of the nonsuicidal self-injury disorder diagnostic criterion A. J Clin Psychol 2019; 75:1084-1097. [PMID: 30735571 DOI: 10.1002/jclp.22754] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 12/24/2018] [Accepted: 01/17/2019] [Indexed: 11/08/2022]
Abstract
OBJECTIVE The nonsuicidal self-injury (NSSI) disorder diagnostic criteria have been the focus of empirical study. However, Criterion A (i.e., required frequency and timeframe) has received relatively limited attention. The current study aimed to examine the relationship between past 12-month NSSI frequency and eight NSSI behavior features among individuals with past 12-month and 1-month NSSI. METHOD Participants were 723 undergraduate students reporting at least 1 past 12-month NSSI act and completed online questionnaires. Decision trees and structural equation model trees were utilized to examine the relationship between NSSI frequency and behavior features. RESULTS Results highlight several potential subgroups: high (i.e., greater than 49 acts), moderate-to-high (i.e., 19-48 acts), low-to-moderate (i.e., 7-18 acts), and low (i.e., fewer than 6 acts) frequency subgroups. CONCLUSIONS Findings suggest that increasing the NSSI disorder criterion A frequency cutoff or requiring at least one past month NSSI act may better demarcate individuals with more severe NSSI behavior.
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Affiliation(s)
- Brooke A Ammerman
- Department of Psychology, University of Notre Dame, Notre Dame, Indiana
| | - Ross Jacobucci
- Department of Psychology, University of Notre Dame, Notre Dame, Indiana
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15
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Victor SE, Klonsky ED. Understanding the social context of adolescent nonsuicidal self-injury. J Clin Psychol 2018; 74:2107-2116. [PMID: 29931667 DOI: 10.1002/jclp.22657] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 05/18/2018] [Accepted: 06/05/2018] [Indexed: 11/10/2022]
Abstract
OBJECTIVE Research investigating the social context of adolescent nonsuicidal self-injury (NSSI) has been limited. We therefore examined social characteristics of NSSI, such as knowledge of friends' NSSI and the role friends play in continuing NSSI, and their relationships to other known NSSI correlates, such as suicidality. METHOD We assessed NSSI characteristics, including social features, in a community sample of 89 self-injuring adolescents. We also assessed psychosocial correlates of NSSI, including impulsivity, self-concept, and psychiatric symptoms. RESULTS Knowledge of friends' NSSI was relatively common among self-injurers. In addition, knowledge of friends' NSSI was associated with use of more NSSI methods, cutting behaviors, and suicidal ideation, but not with other NSSI correlates. However, teaching or encouragement of NSSI by friends was rare. CONCLUSIONS Knowledge of friends' NSSI may serve as marker of increased severity among adolescent self-injurers. These findings have implications for identifying and intervening with high-risk self-injuring youth.
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Affiliation(s)
- Sarah E Victor
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
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Abstract
Few studies have examined associations between pathological narcissism and self-harm, but those that do indicate that narcissistic vulnerability (not narcissistic grandiosity) relates to self-harm. The current study extends this literature by investigating how facets of pathological narcissism assessed by the Pathological Narcissism Inventory relate to specific nonsuicidal self-injury (NSSI) behaviors assessed by the Inventory of Statements About Self-Injury using statistical models appropriate for non-normally distributed count data. In a sample of 1,023 undergraduate students, results revealed that facets of both narcissistic vulnerability and narcissistic grandiosity were differentially related to the endorsement and frequency of specific NSSI behaviors and higher-order latent NSSI factors (repetitive and impulsive), even after accounting for levels of borderline pathology. The clinical implications of these results are discussed.
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Affiliation(s)
- Sindes Dawood
- Pennsylvania State University, University Park, Pennsylvania
| | | | | | - Aaron L Pincus
- Pennsylvania State University, University Park, Pennsylvania
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17
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Chesin MS, Galfavy H, Sonmez CC, Wong A, Oquendo MA, Mann JJ, Stanley B. Nonsuicidal Self-Injury Is Predictive of Suicide Attempts Among Individuals with Mood Disorders. Suicide Life Threat Behav 2017; 47:567-579. [PMID: 28211201 PMCID: PMC5724372 DOI: 10.1111/sltb.12331] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 08/06/2016] [Indexed: 11/28/2022]
Abstract
Nonsuicidal self-injury (NSSI) prior to age 18 was evaluated as a risk factor for adulthood suicide attempt (SA). Archival data from 222 mood-disordered participants were analyzed using multivariate Cox proportional hazards analysis. Participants with a youth SA were excluded. The hazards of SA among adult participants with a history of youth NSSI were twice than those of mood-disordered participants without youth NSSI (hazard ratio = 2.00, 95% confidence interval = 1.16-3.44, p = .01). Moreover, participants who had both youth and adult NSSI attempted suicide significantly earlier than participants who began NSSI as an adult. Youth NSSI is associated with persistent, elevated SA risk in adulthood.
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Affiliation(s)
- Megan S Chesin
- Department of Psychology, William Paterson University, Wayne, NJ, USA
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, USA
| | - Hanga Galfavy
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, USA
| | | | - Amanda Wong
- Department of Psychology, Rutgers University, New Brunswick, NJ, USA
| | - Maria A Oquendo
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, USA
| | - J John Mann
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, USA
| | - Barbara Stanley
- Molecular Imaging and Neuropathology Division, New York State Psychiatric Institute, New York, NY, USA
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18
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Baiden P, Stewart SL, Fallon B. The role of adverse childhood experiences as determinants of non-suicidal self-injury among children and adolescents referred to community and inpatient mental health settings. CHILD ABUSE & NEGLECT 2017; 69:163-176. [PMID: 28477476 DOI: 10.1016/j.chiabu.2017.04.011] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Revised: 03/31/2017] [Accepted: 04/09/2017] [Indexed: 06/07/2023]
Abstract
The objectives of this study were to examine the prevalence of, and determine the effect of adverse childhood experiences on non-suicidal self-injury among children and adolescents referred to community and inpatient mental health settings. Data for this study were obtained from the interRAI Child and Youth Mental Health dataset. A total of 2038 children and adolescents aged 8-18 years (M=12.49; SD=2.88, 61.1% males) were analyzed. Binary logistic regression was fitted to identify predictors of non-suicidal self-injury as a function of adverse childhood experiences, depression, and social support while simultaneously controlling for age, gender, type of patient, legal guardianship, marital status of parents/caregivers, history of foster family placement, and mental health diagnoses. Of the 2038 children and adolescents examined, 592 (29%) of this clinical sample engaged in non-suicidal self-injury. In the multivariate logistic regression model, children and adolescents who were physically abused had 49% higher odds of engaging in non-suicidal self-injury and children and adolescents who were sexually abused had 60% higher odds of engaging in non-suicidal self-injury, when compared to their non-abused counterparts. Other predictors of non-suicidal self-injury include: older age, female gender, inpatient status, depression, attention deficit-hyperactivity disorder, disruptive behavior disorder, and mood disorders. Children and adolescents who had some form of social support had a 26% decrease in the odds of engaging in non-suicidal self-injury. Assessment procedures for indicators of mental health, particularly among children and adolescents with a history of adverse childhood experiences, should also take into account non-suicidal self-injury. In addition to bolstering social support networks, addressing depression and related emotion regulation skills in childhood may help prevent future non-suicidal self-injury behaviors.
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Affiliation(s)
- Philip Baiden
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON M5S 1V4, Canada.
| | - Shannon L Stewart
- Faculty of Education, Western University, 1137 Western Road, London, ON N6G 1G7, Canada
| | - Barbara Fallon
- Factor-Inwentash Faculty of Social Work, University of Toronto, 246 Bloor Street West, Toronto, ON M5S 1V4, Canada
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19
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Nonsuicidal Self-Injury in Adolescents Placed in Youth Welfare and Juvenile Justice Group Homes: Associations with Mental Disorders and Suicidality. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2017; 46:343-354. [DOI: 10.1007/s10802-017-0291-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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20
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Zhu L, Westers NJ, Horton SE, King JD, Diederich A, Stewart SM, Kennard BD. Frequency of Exposure to and Engagement in Nonsuicidal Self-Injury Among Inpatient Adolescents. Arch Suicide Res 2016; 20:580-90. [PMID: 26983456 DOI: 10.1080/13811118.2016.1162240] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
This study examined the relationship between frequency of exposure to non-suicidal self-injury (NSSI) and engagement in NSSI among adolescents. Ninety inpatient adolescents with a history of NSSI, ages 12 to 17, completed a structured interview. The majority of participants had learned about NSSI prior to initiating the behavior themselves. More frequent exposure to specific methods of NSSI was associated with greater frequency of using those same methods. Greater exposure to NSSI in the media and seeking out NSSI content were related to greater frequency of engagement in NSSI. Clinicians may help those who self-injure to become more knowledgeable and educated consumers of media to prevent NSSI behavior and contagion.
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21
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Burke TA, Hamilton JL, Cohen JN, Stange JP, Alloy LB. Identifying a physical indicator of suicide risk: Non-suicidal self-injury scars predict suicidal ideation and suicide attempts. Compr Psychiatry 2016; 65:79-87. [PMID: 26773994 PMCID: PMC4715861 DOI: 10.1016/j.comppsych.2015.10.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Revised: 10/26/2015] [Accepted: 10/28/2015] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND Suicide risk is challenging to quantify due to reliance on self-report, which is limited by individuals' lack of insight and the desire to conceal such intentions. Non-suicidal self-injury (NSSI) is one of the most robust predictors of suicidal ideation (SI) and suicide attempts (SA). Although NSSI often leads to permanent scarring, which can be assessed by objective physical examination, no research has examined whether scarring denotes tangible risk for SI and SA. The present study examined whether NSSI scar presence and number predict current SI and SA history. Further, we examined whether brooding would exacerbate the effects of NSSI scarring on SI or SA. METHODS Young adults (N=231; M=21.24 years; 78% female) completed self-report questionnaires assessing SA history, frequency of NSSI, presence/number of NSSI scars, brooding, current depressive symptoms, and SI. RESULTS NSSI scar presence and number predicted current SI and SA history after controlling for current depressive symptoms. Moreover, scar presence and number predicted current SI over and above the effects of SA history and NSSI frequency, method, and medical severity. Further, NSSI scar presence and number predicted SI more strongly among individuals with greater levels of brooding than among individuals with lower levels of brooding. CONCLUSIONS The presence and number of NSSI scars are objective physical indicators of risk for SI and SAs. Brooding may further heighten the risk of SI for individuals bearing NSSI scars.
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