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Shen Y, Chen D, Guo J, Zheng Y, Zhang J, Zhan S, You J. Co-developmental trajectories of suicidal ideation and non-suicidal self-injury among Chinese adolescents: Transdiagnostic predictors and association with suicide attempts. Suicide Life Threat Behav 2024; 54:632-648. [PMID: 38529888 DOI: 10.1111/sltb.13074] [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: 10/07/2023] [Revised: 02/18/2024] [Accepted: 03/13/2024] [Indexed: 03/27/2024]
Abstract
INTRODUCTION Adolescent suicidal ideation (SI) and non-suicidal self-injury (NSSI) are crucial public health issues, yet their co-developmental trajectories during early adolescence and their associations with predictors and outcomes are unclear. This study aimed to (a) identify heterogeneous co-developmental trajectories of SI and NSSI, (b) explore associations between transdiagnostic predictors and trajectories, and (c) assess suicide attempt risk across trajectories. METHODS Four hundred fifty-three adolescents (Mage = 12.35 years, 48.3% boys) completed surveys at 6-month intervals across 2 years. At Time 1 (Nov 2020), participants completed surveys encompassing SI, and NSSI, along with family, peer, and individual predictors. Subsequent surveys (Times 2-4) measured SI and NSSI, with suicide attempts queried at Time 4. RESULTS Parallel process latent class growth models revealed three co-developmental groups (i.e., Stable low NSSI and SI; Moderate-NSSI and high-SI, parallel decreasing; High-NSSI and moderate-SI, parallel increasing). Multivariate logistic regression indicated that group membership was predicted by parental rejection, parental warmth, bullying victimization, depressive and anxiety symptoms, thwarted belongingness, and perceived burdensomeness. Adolescents in the "High-NSSI and moderate-SI, parallel increasing" group reported the highest suicide attempt frequency. CONCLUSION These findings underscore subgroup distinctions and transdiagnostic predictors in comprehending SI and NSSI progression, emphasizing the necessity of dynamic monitoring and tailored interventions for distinct subgroup characteristics.
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Affiliation(s)
- Yunhong Shen
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, & School of Psychology, South China Normal University, Guangzhou, China
| | - Danrui Chen
- Psychological Counseling Centre, Chang'an University, Xi'an, China
| | - Jiaqi Guo
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, & School of Psychology, South China Normal University, Guangzhou, China
| | - Yue Zheng
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, & School of Psychology, South China Normal University, Guangzhou, China
| | - Jiajing Zhang
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, & School of Psychology, South China Normal University, Guangzhou, China
| | - Shiting Zhan
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, & School of Psychology, South China Normal University, Guangzhou, China
| | - Jianing You
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, & School of Psychology, South China Normal University, Guangzhou, China
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Ren T, Wen Y, Ma L, Qiao D, Li G, Li H, Wang X, Liu Z. Psychosocial factors affect the occurrence of nonsuicidal self-injury in adolescents with major depressive disorder through chain mediation. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01858-0. [PMID: 38976048 DOI: 10.1007/s00406-024-01858-0] [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] [Received: 09/25/2023] [Accepted: 06/20/2024] [Indexed: 07/09/2024]
Abstract
In the adolescent group, about half of adolescents with major depressive disorder (MDD) have NSSI. Psychosocial factors are associated with the development of NSSI. Clarifying the relationship between psychosocial factors and NSSI in adolescents with MDD can help us achieve early prevent. Demographic data, Hamilton Depression Scale-24 (HAMA24), childhood trauma questionnaire, emotional intelligence scale and interpersonal reactivity index were collected from 187 adolescents with MDD. Use ANOVA, Chi-square test, Binary Logistic Regression, Pearson correlation analysis, Mediation effect analysis and the Structural Equation Model for data analysis. The results of ANOVA showed that there was significant difference between the two groups in HAMD24 total score, impulsiveness, emotional intelligence, and empathy (p < 0.05). In the regression analysis, women, depression degree, motor impulsiveness (MI), personal distress (PD) and appraisal of other's emotions empathy were the risk factors for MDD adolescents to produce NSSI behavior. Among the indicators that were significantly related to MDD and NSSI, MI and PD mediate the relationship between MDD and NSSI. The structural equation model showed that MDD, PD and MI had a direct impact on NSSI, but PD and MI had multiple intermediary effected in the relationship between MDD and NSSI. Emotional intelligence, emotional neglect and cognitive impulsiveness indirectly affected the occurrence of NSSI behavior. Impulsiveness, personal distress, emotional neglect, and emotional intelligence are important risk factors that affect NSSI behavior in adolescents with MDD, and they affect the occurrence of NSSI in adolescents with MDD through chain mediation.
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Affiliation(s)
- Tian Ren
- Department of Psychiatry, First Hospital of Shanxi Medical University, NO. 85 Jiefang South Road, Taiyuan, China
| | - Yujiao Wen
- Department of Psychiatry, First Hospital of Shanxi Medical University, NO. 85 Jiefang South Road, Taiyuan, China
| | - Lu Ma
- Department of Psychiatry, First Hospital of Shanxi Medical University, NO. 85 Jiefang South Road, Taiyuan, China
| | - Dan Qiao
- Department of Psychiatry, First Hospital of Shanxi Medical University, NO. 85 Jiefang South Road, Taiyuan, China
| | - Gaizhi Li
- Department of Psychiatry, First Hospital of Shanxi Medical University, NO. 85 Jiefang South Road, Taiyuan, China
| | - Hong Li
- Department of Psychiatry, First Hospital of Shanxi Medical University, NO. 85 Jiefang South Road, Taiyuan, China
| | - Xiao Wang
- Department of Psychiatry, First Hospital of Shanxi Medical University, NO. 85 Jiefang South Road, Taiyuan, China
| | - Zhifen Liu
- Department of Psychiatry, First Hospital of Shanxi Medical University, NO. 85 Jiefang South Road, Taiyuan, China.
- Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder, First Hospital of Shanxi Medical University, Taiyuan, China.
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Gao Y, Liu J, Liu X, Wang Y, Qiu S. Dimensions of family stress and repetitive nonsuicidal self-injury in adolescence: Examining the interactive effects of impulsivity and emotion dysregulation. CHILD ABUSE & NEGLECT 2024; 152:106804. [PMID: 38636157 DOI: 10.1016/j.chiabu.2024.106804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 10/16/2023] [Accepted: 04/12/2024] [Indexed: 04/20/2024]
Abstract
BACKGROUND Repetitive non-suicidal self-injury (R-NSSI) in adolescence represents a significant risk factor for suicide. Although exposure to family stress is robustly associated with the risk of non-suicidal self-injury (NSSI), studies have not examined the potential mechanisms linking different forms of family stress and R-NSSI. OBJECTIVE This study examined how unique dimensions of family stress (threat and deprivation) relate to R-NSSI via interactions between impulsivity and emotion dysregulation. PARTICIPANTS AND SETTING The current sample included 3801 middle-school adolescents (42.2 % girls, Mage = 13.21 years). METHODS We conducted a two-wave study with 6-month intervals. Participants completed self-report measures assessing family stress, impulsivity, emotion dysregulation, and NSSI. RESULTS Moderate mediation analyses showed that threat was indirectly associated with NSSI frequency through the interaction of impulsivity and emotion dysregulation in the R-NSSI group and indirectly through impulsivity in the occasional NSSI (O-NSSI) group. Deprivation did not predict subsequent NSSI frequency in either group. CONCLUSIONS These findings lend empirical support to dimensional models of adversity and suggest that adolescents who experience threat-related family stress may have greater impulsivity and are more likely to report R-NSSI in the context of emotion dysregulation.
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Affiliation(s)
- Yemiao Gao
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Jinmeng Liu
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Xia Liu
- Institute of Developmental Psychology, Faculty of Psychology, Beijing Normal University, Beijing, China.
| | - Yumeng Wang
- Faculty of Psychology, Beijing Normal University, Beijing, China
| | - Shaojie Qiu
- Faculty of Psychology, Beijing Normal University, Beijing, China
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Peng B, Wang R, Zuo W, Liu H, Deng C, Jing X, Hu H, Zhao W, Qin P, Dai L, Chen Z, Zhang Y, Liu XA. Distinct correlation network of clinical characteristics in suicide attempters having adolescent major depressive disorder with non-suicidal self-injury. Transl Psychiatry 2024; 14:134. [PMID: 38443348 PMCID: PMC10914800 DOI: 10.1038/s41398-024-02843-w] [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: 07/20/2023] [Revised: 02/16/2024] [Accepted: 02/19/2024] [Indexed: 03/07/2024] Open
Abstract
Suicidal behavior and non-suicidal self-injury (NSSI) are common in adolescent patients with major depressive disorder (MDD). Thus, delineating the unique characteristics of suicide attempters having adolescent MDD with NSSI is important for suicide prediction in the clinical setting. Here, we performed psychological and biochemical assessments of 130 youths having MDD with NSSI. Participants were divided into two groups according to the presence/absence of suicide attempts (SAs). Our results demonstrated that the age of suicide attempters is lower than that of non-attempters in participants having adolescent MDD with NSSI; suicide attempters had higher Barratt Impulsiveness Scale (BIS-11) impulsivity scores and lower serum CRP and cortisol levels than those having MDD with NSSI alone, suggesting levels of cortisol and CRP were inversely correlated with SAs in patients with adolescent MDD with NSSI. Furthermore, multivariate regression analysis revealed that NSSI frequency in the last month and CRP levels were suicidal ideation predictors in adolescent MDD with NSSI, which may indicate that the increased frequency of NSSI behavior is a potential risk factor for suicide. Additionally, we explored the correlation between psychological and blood biochemical indicators to distinguish suicide attempters among participants having adolescent MDD with NSSI and identified a unique correlation network that could serve as a marker for suicide attempters. Our research data further suggested a complex correlation between the psychological and behavioral indicators of impulsivity and anger. Therefore, our study findings may provide clues to identify good clinical warning signs for SA in patients with adolescent MDD with NSSI.
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Grants
- 32371213 National Natural Science Foundation of China (National Science Foundation of China)
- This work was supported by grants from the National Natural Science Foundation of China (NSFC) (32371213 to X.A.L, 32000710 to Z.X.C, U20A2016 to Z.X.C), the STI2030-Major Projects (2022ZD0207100, Z.X.C), Shenzhen Medical Research Funds (D2301002 to P.W.Q and X.A.L), the Guangdong Basic and Applied Basic Research Foundation (2023A1515011743 to X.A.L, 2019A1515110190 to Z.X.C), the Shenzhen Science and Technology Program (KCXFZ20211020163549011 to X.A.L), Shenzhen Key Basic Research Project (JCYJ20200109115641762 to Z.X.C), Shenzhen governmental grant (ZDSYS20190902093601675 to Z.X.C), and CAS Key Laboratory of Brain Connectome and Manipulation (2019DP173024 to X.A.L and Z.X.C),Supported by Shenzhen Key Medical Discipline Construction Fund(No.SZXK041),Supported by Shenzhen Fund for Guangdong Provincial High-level Clinical Key Specialties(No.SZGSP013).
- Shenzhen Key Medical Discipline Construction Fund (No.SZXK041); the Shenzhen Fund for Guangdong Provincial High-level Clinical Key Specialties (No. SZGSP013 to B.P)
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Affiliation(s)
- Bo Peng
- Department of Depressive Disorders, Shenzhen Kangning Hospital, Shenzhen, Guangdong, China
- Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Ruoxi Wang
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, 518055, China
| | - Wenlong Zuo
- CAS Key Laboratory of Quantitative Engineering Biology, Shenzhen Institute of Synthetic Biology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
| | - Haitao Liu
- Shenzhen Longgang District Maternity & Child Healthcare Hospital, Shenzhen, Guangdong, China
| | - Chunshan Deng
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, 518055, China
| | - Xiaoyuan Jing
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, 518055, China
| | - Hongtao Hu
- Department of Depressive Disorders, Shenzhen Kangning Hospital, Shenzhen, Guangdong, China
- Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Weitan Zhao
- Department of Depressive Disorders, Shenzhen Kangning Hospital, Shenzhen, Guangdong, China
- Shenzhen Mental Health Center, Shenzhen, Guangdong, China
| | - Peiwu Qin
- Institute of Biopharmaceutical and Health Engineering, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, 518055, China
- Tsinghua-Berkeley Shenzhen Institute, Tsinghua Shenzhen International Graduate School, Tsinghua University, Shenzhen, 518055, China
| | - Lei Dai
- CAS Key Laboratory of Quantitative Engineering Biology, Shenzhen Institute of Synthetic Biology, Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences, Shenzhen, 518055, China
- University of the Chinese Academy of Sciences, 100049, Beijing, China
| | - Zuxin Chen
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, 518055, China.
- University of the Chinese Academy of Sciences, 100049, Beijing, China.
| | - Yingli Zhang
- Department of Depressive Disorders, Shenzhen Kangning Hospital, Shenzhen, Guangdong, China.
- Shenzhen Mental Health Center, Shenzhen, Guangdong, China.
| | - Xin-An Liu
- Guangdong Provincial Key Laboratory of Brain Connectome and Behavior, CAS Key Laboratory of Brain Connectome and Manipulation, Brain Cognition and Brain Disease Institute (BCBDI), Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, 518055, China.
- University of the Chinese Academy of Sciences, 100049, Beijing, China.
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Esposito C, Dragone M, Affuso G, Amodeo AL, Bacchini D. Prevalence of engagement and frequency of non-suicidal self-injury behaviors in adolescence: an investigation of the longitudinal course and the role of temperamental effortful control. Eur Child Adolesc Psychiatry 2023; 32:2399-2414. [PMID: 36123505 PMCID: PMC10682258 DOI: 10.1007/s00787-022-02083-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Accepted: 09/10/2022] [Indexed: 11/30/2022]
Abstract
Non-suicidal self-injury (NSSI) is among the most frequent maladaptive behaviors reported in adolescence, with prevalence rates around 18-22% in community samples worldwide. The onset of NSSI typically occurs between early and middle adolescence, with a peak during middle adolescence (14-15 years) and a subsequent decline during late adolescence. This study investigated the growth curves of NSSI across four years during adolescence, analyzing simultaneously the probability of engagement in NSSI at least once (i.e., prevalence) and the frequency of engagement once initiated (i.e., severity). Furthermore, the study examined the predicting role of effortful control on NSSI over time (time-varying effects), net of other key risk factors for NSSI, such as anxiety-depression and bullying victimization. A sample of 430 Italian adolescents enrolled in Grade 9 at baseline was involved in the study. Based on the Latent Growth Curve Zero-inflated Poisson methodology, the results indicated a negative quadratic trend of both NSSI prevalence, with an increase between T1 and T3 followed by a decrease in the subsequent wave, and NSSI frequency once initiated, with a peak at T2 followed by a decline over time. The results also showed that adolescents who reported low effortful control abilities had a heightened probability of involvement in NSSI at each time point, whereas no significant association was found with NSSI frequency once initiated. Findings from this study offer important insights into the developmental course of NSSI and point out the need for future in-depth investigations of the mechanisms that might underlie NSSI prevalence and severity throughout adolescence.
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Affiliation(s)
- Concetta Esposito
- Department of Humanities, University of Naples "Federico II", Naples, Italy.
| | - Mirella Dragone
- Department of Humanities, University of Naples "Federico II", Naples, Italy
| | - Gaetana Affuso
- Department of Psychology, University of Campania "L. Vanvitelli", Caserta, Italy
| | - Anna Lisa Amodeo
- Department of Humanities, University of Naples "Federico II", Naples, Italy
| | - Dario Bacchini
- Department of Humanities, University of Naples "Federico II", Naples, Italy
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Gao Q, Guo J, Wu H, Huang J, Wu N, You J. Different profiles with multiple risk factors of nonsuicidal self-injury and their transitions during adolescence: A person-centered analysis. J Affect Disord 2021; 295:63-71. [PMID: 34416619 DOI: 10.1016/j.jad.2021.08.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 08/02/2021] [Accepted: 08/03/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Nonsuicidal self-injury (NSSI) is a serious public health concern among adolescents. However, adolescents with different combinations of NSSI risk factors may constitute different subgroups that vary in subsequent risks of NSSI engagement, and the membership in these subgroups may change during early adolescence. Gender differences related to risk profiles and transition patterns may also exist. This study thus aimed to address these three questions. METHODS A total of 2,942 participants ranging from 12 to 17 years old (55.2% females; Mage = 14.60, SD = 1.21) completed a series of questionnaires about NSSI and its risk factors on three occasions, every six months. Latent profile and latent transition analyses were used to examine NSSI risk profiles (subgroups), their transition patterns, and gender differences. RESULTS Three distinct risk profiles were identified: Low-risk profile, Medium-risk profile, and High-risk profile. The profile membership was fairly stable over one year, and the shift across profiles represented a "resilient" pattern. Regarding gender differences, boys were less likely to be in either the Medium- or the High-risk groups, but more likely to transition from the Medium- to the Low-risk group, relative to girls. LIMITATIONS This study relied upon self-report measures. Additional research is needed to investigate the generalizability of the results to other populations, and to examine more predictors of class membership and transitions. CONCLUSIONS The results highlight the importance of considering subgroup differences in understanding NSSI risks. Differentiated interventions with multi-pronged approaches tailoring to different risk classes and gender groups may therefore prove more efficient and effective.
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Affiliation(s)
- Qianqian Gao
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, & School of Psychology, South China Normal University, Guangzhou, 510631, PR China.
| | - Jiaqi Guo
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, & School of Psychology, South China Normal University, Guangzhou, 510631, PR China.
| | - Huijiao Wu
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, & School of Psychology, South China Normal University, Guangzhou, 510631, PR China.
| | - Jialing Huang
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, & School of Psychology, South China Normal University, Guangzhou, 510631, PR China.
| | - Nini Wu
- Department of Psychology, School of Education, Guangdong University of Education, No.351 XinGangZhong Road, 510303 Guangzhou, PR China.
| | - Jianing You
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, & School of Psychology, South China Normal University, Guangzhou, 510631, PR China.
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Nonsuicidal self-injury in undergraduate students with major depressive disorder: The role of psychosocial factors. J Affect Disord 2021; 290:102-108. [PMID: 33993076 DOI: 10.1016/j.jad.2021.04.083] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 12/29/2020] [Accepted: 04/25/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Nonsuicidal self-injury (NSSI) is related to childhood abuse, family relationships, interpersonal relationships, personality, but the interaction between them is still unclear, and how they interact in major depressive disorder (MDD). METHODS Collected data from 444 undergraduate degree students with MDD participated. Used the Eysenck Personality Questionnaire, Childhood Trauma Questionnaire, Interpersonal Relationship Comprehensive Diagnostic Scale, and Family Assessment Device to assess the patients' psychosocial factors. NSSI behavior was assessed through interviews. Use the Chi-square test, Wilcoxon rank-sum test, Kruskal-Wallis H-test, Distance Correlation, Structural Equation Mode for data analysis. RESULTS Overall, 34.2% of patients with MDD had a history of NSSI. MDD patients with a history of NSSI had significant differences in psychoticism, neuroticism, emotional abuse, physical abuse, sexual abuse, emotional neglect, troubles in conversation, ability to make friends and family roles. Among these factors, psychoticism was most related to NSSI, and child abuse, interpersonal relationships and family roles played a variety of roles in mediating the relationship with NSSI. CONCLUSIONS Psychosocial factors affect the occurrence of NSSI through chain intermediary effects.
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Wu R, Huang J, Ying J, Gao Q, Guo J, You J. Behavioral inhibition/approach systems and adolescent nonsuicidal self-injury: The chain mediating effects of difficulty in emotion regulation and depression. PERSONALITY AND INDIVIDUAL DIFFERENCES 2021. [DOI: 10.1016/j.paid.2021.110718] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Resting state prefrontal cortex oxygenation in adolescent non-suicidal self-injury - A near-infrared spectroscopy study. NEUROIMAGE-CLINICAL 2021; 31:102704. [PMID: 34091351 PMCID: PMC8182302 DOI: 10.1016/j.nicl.2021.102704] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 05/07/2021] [Accepted: 05/18/2021] [Indexed: 12/02/2022]
Abstract
Resting prefrontal cortex (PFC) oxygenation is decreased in adolescents with non-suicidal self-injury (NSSI) compared to healthy controls. Lower PFC oxygenation (full sample) is associated with greater adverse childhood experiences and less health-related quality of life (HRQoL). On the group-level, patients show no alterations of resting state functional connectivity within the PFC. Among other clinical variables, increased PFC connectivity (full sample) is associated with greater borderline personality pathology.
Introduction Neural alterations in limbic and prefrontal circuits in association with self-injurious behavior have been studied primarily in adult borderline personality disorder (BPD). In adolescent patients, research is still sparse. Here, we used resting functional near-infrared spectroscopy (NIRS) to examine oxygenation of the prefrontal cortex (PFC) and its association with symptom severity in adolescents engaging in non-suicidal self-injury (NSSI) and matched healthy controls (HC). Methods Adolescents (12–17 years) with recurrent episodes of NSSI (n = 170) and healthy controls (n = 43) performed a low-demanding resting-state vanilla baseline task. Mean oxygenation of the PFC and functional connectivity within the PFC, were measured using an 8-channel functional NIRS system (Octamon, Artinis, The Netherlands). Various clinical variables derived from diagnostic interviews and self-reports were included in statistical analyses to explore potential associations with PFC oxygenation and connectivity. Results Adolescents with NSSI showed significantly decreased PFC oxygenation compared to HC, as indexed by oxygenated hemoglobin. Lower PFC oxygenation was associated with greater adverse childhood experiences and less health-related quality of life (HRQoL). While there was no evidence for alterations in PFC connectivity in adolescents engaging in NSSI compared to HC, increased PFC connectivity in the full sample was associated with greater adverse childhood experience, greater BPD pathology, greater depression severity and psychological burden in general, as well as lower HRQoL. Conclusion This study is the first to examine PFC oxygenation using NIRS technology in adolescents engaging in NSSI. Overall, results indicate small effects not specific to NSSI. Clinical implications of these findings and recommendations for further research are discussed.
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Peer Acceptance and Nonsuicidal Self-injury among Chinese Adolescents: A Longitudinal Moderated Mediation Model. J Youth Adolesc 2019; 48:1806-1817. [DOI: 10.1007/s10964-019-01093-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2019] [Accepted: 07/24/2019] [Indexed: 01/02/2023]
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Hamza CA, Willoughby T. Impulsivity and nonsuicidal self-injury: A longitudinal examination among emerging adults. J Adolesc 2019; 75:37-46. [DOI: 10.1016/j.adolescence.2019.07.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Revised: 07/06/2019] [Accepted: 07/09/2019] [Indexed: 01/06/2023]
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Cognition and self-injurious thoughts and behaviors: A systematic review of longitudinal studies. Clin Psychol Rev 2019; 69:97-111. [DOI: 10.1016/j.cpr.2018.07.002] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 07/08/2018] [Accepted: 07/12/2018] [Indexed: 12/11/2022]
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Abdelraheem M, McAloon J, Shand F. Mediating and moderating variables in the prediction of self-harm in young people: A systematic review of prospective longitudinal studies. J Affect Disord 2019; 246:14-28. [PMID: 30572208 DOI: 10.1016/j.jad.2018.12.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2018] [Revised: 12/03/2018] [Accepted: 12/08/2018] [Indexed: 10/27/2022]
Abstract
BACKGROUND Self-harm is widespread amongst young people. A growing body of research has explored factors that predict self-harm in young people, however, a systematic review of mediators and moderators of those factors has not yet been offered. This review aims to fill this gap by synthesising research about mediators and moderators of factors that prospectively predict self-harm in young people. METHOD A systematic review of research trials published up until 2018 was undertaken. Electronic databases Scopus (Elsevier), CINAHL, PsychINFO (EBSCO) and Medline were searched. Included studies utilised prospective longitudinal designs with participants aged 25 years or younger and self-harm outcome measures with published or reported psychometric properties. The aim of the review was to identify mediators and moderators of factors that predict self-harm in young people. RESULTS Of the 25 studies that met inclusion criteria, 22 reported at least one positive finding of a mediator or moderator. Specifically, 15 significant mediators and 20 significant moderators were identified in relation to a broad range of predictors of self-harm. Predictors were classified as adverse childhood experiences and parenting factors, psychological and psychiatric factors, social factors and intrapersonal factors. A number of potentially modifiable mediators and moderators were identified including interpersonal difficulties, impulsivity, self-esteem and self-compassion. Gender was the most commonly reported moderator. LIMITATIONS Included studies were assessed as limited by the heterogeneity of the mediators and moderators assessed, and by methodological factors including study durations, population characteristics, and the definition and assessment of self-harm. In addition, replication research was limited. Therefore it was difficult to integrate results and draw firm conclusions. CONCLUSIONS This review allowed us to explore diverse relationships between factors predictive of self-harm in young people and to identify a number of potentially modifiable mediators and moderators. Our findings have important implications for future research and treatment efforts as the identification of mediators and moderators is demonstrated to assist in identifying high risk individuals as well informing potential targets for treatment.
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Affiliation(s)
- Mona Abdelraheem
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology, Ultimo, NSW, Australia
| | - John McAloon
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology, Ultimo, NSW, Australia.
| | - Fiona Shand
- Black Dog Institute, University of New South Wales, Randwick, NSW, Australia
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Zinchuk MS, Avedisova AS, Guekht AB. Nonsuicidal self-injury behavior in non-psychotic disorders: epidemiology, social and clinical risk factors. Zh Nevrol Psikhiatr Im S S Korsakova 2019; 119:108-119. [DOI: 10.17116/jnevro2019119031108] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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15
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Maxfield BL, Pepper CM. Impulsivity and Response Latency in Non-Suicidal Self-Injury: The Role of Negative Urgency in Emotion Regulation. Psychiatr Q 2018; 89:417-426. [PMID: 29018995 DOI: 10.1007/s11126-017-9544-5] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Impulsivity is thought to be a contributing factor in non-suicidal self-injury (NSSI), yet the research is limited and inconsistent. In particular, little is known about how impulsivity is associated with response latency between initial urge and later self-injury, emotion regulation processes, or severity of NSSI. In this study, we tested group differences between participants with and without a history of NSSI on a questionnaire measure of impulsivity. In addition, we tested hypothesized correlations between impulsivity and relevant variables within the NSSI sample using questionnaires and self-reported response latency between urge and injury. Participants included 159 undergraduate students, 84 with an NSSI history and 75 without an NSSI history. Results indicated greater impulsivity on facets of Urgency and (lack of) Perseverance for the NSSI group. Within the NSSI sample, facets of impulsivity were associated with difficulties in emotion regulation and NSSI severity, but not response latency. In addition, response latency, a possible behavioral marker of impulsivity, was not associated with emotion regulation processes or NSSI frequency. These results suggest that higher scores on self-report measures of impulsivity, but not behavioral response latency measures, are associated with emotion regulation processes in individuals who self-injure.
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Affiliation(s)
- Brooke L Maxfield
- Department of Psychology, University of Wyoming, 3415 1000 E. University Ave, Laramie, WY, 82071, USA
| | - Carolyn M Pepper
- Department of Psychology, University of Wyoming, 3415 1000 E. University Ave, Laramie, WY, 82071, USA.
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Whitlock JL, Baetens I, Lloyd-Richardson E, Hasking P, Hamza C, Lewis S, Franz P, Robinson K. Helping schools support caregivers of youth who self-injure: Considerations and recommendations. SCHOOL PSYCHOLOGY INTERNATIONAL 2018. [DOI: 10.1177/0143034318771415] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Non-suicidal self-injury (NSSI) is a significant international mental health concern, with consequences for not only youth who self-injure, but for their entire family system. Helping caregivers respond productively to their child’s self-injury is a vital part of effectively addressing NSSI. This paper will assist school-based mental health practitioners and other personnel support caregivers of youth who self-injure by reviewing current literature, highlighting common challenges faced by school-based professionals, and providing evidenced-informed recommendations for supporting caregivers of youth who self-injure. We posit that schools can best support caregivers by having clear and well-articulated self-injury protocols and by engaging caregivers early. Once engaged, helping caregivers to navigate first conversations, keep doors open, know what to expect, seek support for themselves and understand and address safety concerns will ultimately benefit youth who self-injure and the school systems that support them. We also review recommendations for working with youth whose caretakers are unwilling or unable to be engaged.
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Affiliation(s)
- Janis L. Whitlock
- Bronfenbrenner Center for Translational Research, Cornell University, USA
| | | | | | | | - Chloe Hamza
- Ontario Institute for Studies in Education at the University of Toronto, Canada
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17
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Mérida-López S, Extremera N, Rey L. Understanding the Links Between Self-Report Emotional Intelligence and Suicide Risk: Does Psychological Distress Mediate This Relationship Across Time and Samples? Front Psychiatry 2018; 9:184. [PMID: 29867607 PMCID: PMC5953343 DOI: 10.3389/fpsyt.2018.00184] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2017] [Accepted: 04/19/2018] [Indexed: 11/15/2022] Open
Abstract
Objective: In the last decades, increasing attention has been paid to examining psychological resources that might contribute to our understanding of suicide risk. Although Emotional Intelligence (EI) is one dimension that has been linked with decreased suicidal ideation and behaviors, we detected several gaps in the literature in this area regarding the research designs and samples involved. In this research, we aimed to test a mediator model considering self-report EI, psychological distress and suicide risk across samples adopting both cross-sectional and prospective designs in two independent studies. Method: In Study 1, our purpose was to examine the potential role of psychological distress as a mediator in the relationship between self-report EI and suicide risk in a community sample comprised of 438 adults (270 women; mean age: 33.21 years). In Study 2, we sought to examine the proposed mediator model considering a 2-month prospective design in a sample of college students (n = 330 in T1; n = 311 in T2; 264 women; mean age: 22.22 years). Results: In Study 1, we found that psychological distress partially mediated the effect of self-report EI on suicide risk. More interestingly, findings from Study 2 showed that psychological distress fully mediated the relationship between self-report EI and suicide risk at Time 2. Conclusion: These results point out the role of psychological distress as a mediator in the association between self-report EI and suicide risk. These findings suggest an underlying process by which self-report EI may act as a protective factor against suicidal ideation and behaviors. In line with the limitations of our work, plausible avenues for future research and interventions are discussed.
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Affiliation(s)
| | - Natalio Extremera
- Department of Social Psychology, University of Málaga, Málaga, Spain
| | - Lourdes Rey
- Department of Personality, Assessment and Psychological Treatment, University of Málaga, Málaga, Spain
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18
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Giner-Bartolome C, Mallorquí-Bagué N, Tolosa-Sola I, Steward T, Jimenez-Murcia S, Granero R, Fernandez-Aranda F. Non-suicidal Self-Injury in Eating Disordered Patients: Associations with Heart Rate Variability and State-Trait Anxiety. Front Psychol 2017; 8:1163. [PMID: 28736544 PMCID: PMC5500653 DOI: 10.3389/fpsyg.2017.01163] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 06/26/2017] [Indexed: 12/18/2022] Open
Abstract
Background: Non-suicidal self-injury (NSSI) is commonly present in individuals with eating disorders (EDs) and is often employed as a maladaptive emotion regulation strategy to avoid or abate negative emotions. One of the most prevalent negative emotions experienced by self-injurers is anxiety; however, this emotion has not been extensively studied in this population. Thus, the aim of our study was to investigate the influence of anxiety on NSSI in patients with ED from two different dimensions: state anxiety and trait anxiety. Methods: The study comprised a total of 66 females: 12 ED patients with NSSI, 32 ED patients without a history of NSSI, and 22 healthy controls. State and trait anxiety were assessed by means of State-Trait Anxiety Inventory (STAI-S-T) and physiological data [i.e., heart rate variability (HRV)] were collected. Results: STAI-trait scores were significantly higher in ED patients with NSSI than ED patients without NSSI. Furthermore, when conducting logistic regression analyses higher STAI-trait scores were associated with NSSI in ED patients. However, no differences in STAI-state scores and HRV were found between ED patients with and without NSSI. Discussion: The present findings suggest that anxiety as a trait is associated with the use of maladaptive strategies (i.e., NSSI) in ED patients. These results uphold the need to target trait anxiety in ED treatment in order to prevent possible NSSI behaviors.
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Affiliation(s)
- Cristina Giner-Bartolome
- Department of Psychiatry, Bellvitge University Hospital-Bellvitge Biomedical Research Institute (IDIBELL)Barcelona, Spain.,CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos IIIBarcelona, Spain
| | - Núria Mallorquí-Bagué
- Department of Psychiatry, Bellvitge University Hospital-Bellvitge Biomedical Research Institute (IDIBELL)Barcelona, Spain.,CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos IIIBarcelona, Spain
| | - Iris Tolosa-Sola
- Department of Psychiatry, Bellvitge University Hospital-Bellvitge Biomedical Research Institute (IDIBELL)Barcelona, Spain
| | - Trevor Steward
- Department of Psychiatry, Bellvitge University Hospital-Bellvitge Biomedical Research Institute (IDIBELL)Barcelona, Spain.,CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos IIIBarcelona, Spain
| | - Susana Jimenez-Murcia
- Department of Psychiatry, Bellvitge University Hospital-Bellvitge Biomedical Research Institute (IDIBELL)Barcelona, Spain.,CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos IIIBarcelona, Spain.,Department of Clinical Sciences, School of Medicine, University of BarcelonaBarcelona, Spain
| | - Roser Granero
- CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos IIIBarcelona, Spain.,Departament de Psicobiologia i Metodologia, Universitat Autònoma de BarcelonaBarcelona, Spain
| | - Fernando Fernandez-Aranda
- Department of Psychiatry, Bellvitge University Hospital-Bellvitge Biomedical Research Institute (IDIBELL)Barcelona, Spain.,CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos IIIBarcelona, Spain.,Department of Clinical Sciences, School of Medicine, University of BarcelonaBarcelona, Spain
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19
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Giner-Bartolome C, Mallorquí-Bagué N, Tolosa-Sola I, Steward T, Jimenez-Murcia S, Granero R, Fernandez-Aranda F. Non-suicidal Self-Injury in Eating Disordered Patients: Associations with Heart Rate Variability and State-Trait Anxiety. Front Psychol 2017. [PMID: 28736544 DOI: 10.3389/fpsyg.2017.00473/full] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2023] Open
Abstract
Background: Non-suicidal self-injury (NSSI) is commonly present in individuals with eating disorders (EDs) and is often employed as a maladaptive emotion regulation strategy to avoid or abate negative emotions. One of the most prevalent negative emotions experienced by self-injurers is anxiety; however, this emotion has not been extensively studied in this population. Thus, the aim of our study was to investigate the influence of anxiety on NSSI in patients with ED from two different dimensions: state anxiety and trait anxiety. Methods: The study comprised a total of 66 females: 12 ED patients with NSSI, 32 ED patients without a history of NSSI, and 22 healthy controls. State and trait anxiety were assessed by means of State-Trait Anxiety Inventory (STAI-S-T) and physiological data [i.e., heart rate variability (HRV)] were collected. Results: STAI-trait scores were significantly higher in ED patients with NSSI than ED patients without NSSI. Furthermore, when conducting logistic regression analyses higher STAI-trait scores were associated with NSSI in ED patients. However, no differences in STAI-state scores and HRV were found between ED patients with and without NSSI. Discussion: The present findings suggest that anxiety as a trait is associated with the use of maladaptive strategies (i.e., NSSI) in ED patients. These results uphold the need to target trait anxiety in ED treatment in order to prevent possible NSSI behaviors.
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Affiliation(s)
- Cristina Giner-Bartolome
- Department of Psychiatry, Bellvitge University Hospital-Bellvitge Biomedical Research Institute (IDIBELL)Barcelona, Spain
- CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos IIIBarcelona, Spain
| | - Núria Mallorquí-Bagué
- Department of Psychiatry, Bellvitge University Hospital-Bellvitge Biomedical Research Institute (IDIBELL)Barcelona, Spain
- CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos IIIBarcelona, Spain
| | - Iris Tolosa-Sola
- Department of Psychiatry, Bellvitge University Hospital-Bellvitge Biomedical Research Institute (IDIBELL)Barcelona, Spain
| | - Trevor Steward
- Department of Psychiatry, Bellvitge University Hospital-Bellvitge Biomedical Research Institute (IDIBELL)Barcelona, Spain
- CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos IIIBarcelona, Spain
| | - Susana Jimenez-Murcia
- Department of Psychiatry, Bellvitge University Hospital-Bellvitge Biomedical Research Institute (IDIBELL)Barcelona, Spain
- CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos IIIBarcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of BarcelonaBarcelona, Spain
| | - Roser Granero
- CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos IIIBarcelona, Spain
- Departament de Psicobiologia i Metodologia, Universitat Autònoma de BarcelonaBarcelona, Spain
| | - Fernando Fernandez-Aranda
- Department of Psychiatry, Bellvitge University Hospital-Bellvitge Biomedical Research Institute (IDIBELL)Barcelona, Spain
- CIBER Fisiopatología Obesidad y Nutrición, Instituto de Salud Carlos IIIBarcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of BarcelonaBarcelona, Spain
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