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Moran P, Chandler A, Dudgeon P, Kirtley OJ, Knipe D, Pirkis J, Sinyor M, Allister R, Ansloos J, Ball MA, Chan LF, Darwin L, Derry KL, Hawton K, Heney V, Hetrick S, Li A, Machado DB, McAllister E, McDaid D, Mehra I, Niederkrotenthaler T, Nock MK, O'Keefe VM, Oquendo MA, Osafo J, Patel V, Pathare S, Peltier S, Roberts T, Robinson J, Shand F, Stirling F, Stoor JPA, Swingler N, Turecki G, Venkatesh S, Waitoki W, Wright M, Yip PSF, Spoelma MJ, Kapur N, O'Connor RC, Christensen H. The Lancet Commission on self-harm. Lancet 2024; 404:1445-1492. [PMID: 39395434 DOI: 10.1016/s0140-6736(24)01121-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 05/24/2024] [Accepted: 05/26/2024] [Indexed: 10/14/2024]
Affiliation(s)
- Paul Moran
- Centre for Academic Mental Health, Population Health Sciences Department, Bristol Medical School, University of Bristol, Bristol, UK; NIHR Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust, Bristol, UK.
| | - Amy Chandler
- School of Health in Social Science, University of Edinburgh, Edinburgh, UK
| | - Pat Dudgeon
- Poche Centre for Indigenous Health, School of Indigenous Studies, University of Western Australia, Perth, WA, Australia
| | | | - Duleeka Knipe
- Centre for Academic Mental Health, Population Health Sciences Department, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jane Pirkis
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - Mark Sinyor
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | | | - Jeffrey Ansloos
- Ontario Institute for Studies in Education, University of Toronto, Toronto, ON, Canada
| | - Melanie A Ball
- Midlands Partnership University NHS Foundation Trust, Stafford, UK
| | - Lai Fong Chan
- Department of Psychiatry, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | | | - Kate L Derry
- Poche Centre for Indigenous Health, School of Indigenous Studies, University of Western Australia, Perth, WA, Australia
| | - Keith Hawton
- Centre for Suicide Research, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Veronica Heney
- Institute for Medical Humanities, Durham University, Durham, UK
| | - Sarah Hetrick
- Department of Psychological Medicine, University of Auckland, Auckland, New Zealand
| | - Ang Li
- Department of Psychology, Beijing Forestry University, Beijing, China
| | - Daiane B Machado
- Centre of Data and Knowledge Integration for Health (CIDACS), Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Brazil; Department of Global Health and Social Medicine, Harvard University, Boston, MA, USA
| | | | - David McDaid
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | | | - Thomas Niederkrotenthaler
- Department of Social and Preventive Medicine, Center for Public Health, Medical University of Vienna, Vienna, Austria
| | - Matthew K Nock
- Department of Psychology, Harvard University, Boston, MA, USA
| | - Victoria M O'Keefe
- Center for Indigenous Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Maria A Oquendo
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, United States
| | - Joseph Osafo
- Department of Psychology, University of Ghana, Accra, Ghana
| | - Vikram Patel
- Department of Global Health and Social Medicine, Harvard University, Boston, MA, USA
| | - Soumitra Pathare
- Centre for Mental Health Law & Policy, Indian Law Society, Pune, India
| | - Shanna Peltier
- Ontario Institute for Studies in Education, University of Toronto, Toronto, ON, Canada
| | - Tessa Roberts
- Unit for Social and Community Psychiatry, Centre for Psychiatry & Mental Health, Wolfson Institute of Population Health, Faculty of Medicine and Dentistry, Queen Mary University of London, London, United Kingdom
| | - Jo Robinson
- Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia; Orygen, Melbourne, VIC, Australia
| | - Fiona Shand
- Black Dog Institute, Sydney, NSW, Australia; Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Fiona Stirling
- School of Health and Social Sciences, Abertay University, Dundee, UK
| | - Jon P A Stoor
- Department of Epidemiology and Global Health, Umeå University, Umeå, Sweden; Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway
| | - Natasha Swingler
- Orygen, Melbourne, VIC, Australia; Royal Children's Hospital, Melbourne, VIC, Australia
| | - Gustavo Turecki
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - Svetha Venkatesh
- Applied Artificial Intelligence Institute, Deakin University, Geelong, VIC, Australia
| | - Waikaremoana Waitoki
- Faculty of Māori and Indigenous Studies, The University of Waikato, Hamilton, New Zealand
| | - Michael Wright
- School of Allied Health, Curtin University, Perth, WA, Australia
| | - Paul S F Yip
- Hong Kong Jockey Club Centre for Suicide Research and Prevention and Department of Social Work and Social Administration, University of Hong Kong, Hong Kong Special Administrative Region, China
| | - Michael J Spoelma
- Black Dog Institute, Sydney, NSW, Australia; Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Navneet Kapur
- Centre for Mental Health and Safety and National Institute for Health Research Greater Manchester Patient Safety Research Collaboration, Manchester Academic Health Sciences Centre, The University of Manchester, Manchester, UK; Mersey Care NHS Foundation Trust, Prescot, UK
| | - Rory C O'Connor
- Suicidal Behaviour Research Lab, School of Health & Wellbeing, University of Glasgow, Glasgow, UK
| | - Helen Christensen
- Black Dog Institute, Sydney, NSW, Australia; Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
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Petrovic J, Mills DJ, Heath NL. A self-determination theory perspective on the relationship between emotion regulation styles, mindfulness facets, and well-being in adults with self-injury. J Clin Psychol 2024; 80:2029-2044. [PMID: 38781560 DOI: 10.1002/jclp.23708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 04/11/2024] [Accepted: 05/11/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND The relevance of emotion regulation (ER) difficulties to nonsuicidal self-injury (NSSI; the deliberate destruction of one's bodily tissue without suicidal intent) has been repeatedly documented. Recently, specific mindfulness facets (i.e., awareness, nonjudging, describing) have been proposed as mechanisms that explain this relationship. The present study sought to extend this line of inquiry by exploring the mediating role of mindfulness facets in the relation between self-determination theory-based ER styles (i.e., integrative ER, suppressive ER, emotion dysregulation) and indices of positive and negative well-being (i.e., subjective vitality, NSSI difficulties), while controlling for gender, in adults with recent NSSI engagement. METHODS US adults with a history of more than one occurrence of NSSI within the last year (n = 222) completed online measures of ER styles, mindfulness facets, subjective vitality, and NSSI difficulties. RESULTS A mediation model indicated that the effects of ER styles on positive and negative well-being were explained by specific mindfulness facets (i.e., awareness, nonjudging, nonreactivity, describing). CONCLUSIONS The present study provides preliminary evidence that facets of dispositional mindfulness may be mechanisms through which ER styles impact positive and negative indices of well-being in adults with lived experience of NSSI.
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Affiliation(s)
- Julia Petrovic
- Department of Educational and Counselling Psychology (ECP), McGill University, Montréal, Québec, Canada
| | - Devin J Mills
- Department of Community, Family, and Addiction Sciences, Texas Tech University, Lubbock, Texas, USA
| | - Nancy L Heath
- Department of Educational and Counselling Psychology (ECP), McGill University, Montréal, Québec, Canada
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Nagy LM, Muehlenkamp JJ. Negative self-perceptions and severity of NSSI: Testing the benefits and barriers model. J Clin Psychol 2024; 80:1365-1376. [PMID: 38401145 DOI: 10.1002/jclp.23667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 01/18/2024] [Accepted: 02/10/2024] [Indexed: 02/26/2024]
Abstract
Nonsuicidal self-injury (NSSI) is theorized to be caused by negative associations with the self, including low self-esteem, but the mechanisms explaining why low self-esteem is related to more severe NSSI are unclear. The current study aimed to address this limitation by evaluating a mediation model, proposing that low self-esteem would relate to more severe NSSI through increasing self-punishment motivations. Data came from 468 undergraduate students with a history of NSSI who completed an online survey measuring NSSI characteristics and functions, self-esteem, and self-punishment motivations for NSSI. Mediation was tested using a structural equation model using bootstrapped 95% percentile-corrected confidence intervals in which NSSI severity was modeled as a latent variable composed of NSSI frequency, recency, and versatility of methods. The total model was significant and the indirect effect of self-esteem on NSSI severity through self-punishment motives was significant. Self-esteem also retained significant direct effects on NSSI severity, indicating partial mediation. These results provide support for the benefits and barriers model of NSSI, suggesting that negative self-views increase risk for more severe NSSI through self-punishment motivations. Clinical interventions that emphasize self-compassion and focus on modifying self-punishment motivations may help reduce NSSI behavior.
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Affiliation(s)
- Laura M Nagy
- Department of Psychology, High Point University, High Point, North Carolina, USA
| | - Jennifer J Muehlenkamp
- Department of Psychology, University of Wisconsin-Eau Claire, Eau Claire, Wisconsin, USA
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Orsolini L, Corona D, Cervelli AL, Ribuoli E, Longo G, Volpe U. The role of Theory of Mind in the transition towards suicidal attempts in youth NSSI: an exploratory pilot study. Front Psychiatry 2024; 15:1403038. [PMID: 38873534 PMCID: PMC11170150 DOI: 10.3389/fpsyt.2024.1403038] [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: 03/18/2024] [Accepted: 04/22/2024] [Indexed: 06/15/2024] Open
Abstract
Non-suicidal self-injury (NSSI) can both precede and co-occur with suicidal attempts (SA). Underlying mechanisms/factors leading to the transition to SA in NSSI youths have been proposed (including the role of social cognition), despite they should be yet confirmed. Therefore, the study aims at exploring the role of the Theory of Mind in the differentiation of a sample of NSSI youngsters (aged 15-24) according to the presence of SA. We divided the sample into 4 groups using the Deliberate Self Harm Inventory (DSHI) and Columbia Suicide Severity Rating Scale (C-SSRS): control group (notNSSInotSA), NSSI without SA (NSSInotSA), NSSI with SA (NSSIplusSA), and SA without NSSI (SAonly). NSSIplusSA patients displayed higher Reading the Mind in the Eyes Test (RMET) scores (indicative of ToM abilities) than both the NSSInotSA (p=0.0016) and SAonly groups (p=0.0198), while SAonly patients showed lower RMET scores compared to the control group (p=0.0214). Multiple regression models used to differentiate NSSInotSA and NSSIplusSA found a significant association between RMET and LOSCS-CSC (Level Of Self-Criticism Scale-Comparative Self-Criticism) (pC=0.0802, pD=0.0016, pG=0.0053). Our findings supported the hypothesis that a hypertrophic affective ToM may possibly be associated with the occurrence of SA in youth NSSI. Further larger and longitudinal studies should confirm these preliminary findings, by exploring all social cognition dimensions.
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Kiekens G, Hasking P, Nock MK, Kleiman E, Kirtley OJ, Houben M, Boyes M, Bruffaerts R, Myin-Germeys I, Claes L. A Comparison of Affective-Cognitive States in Daily Life Between Emerging Adults With and Without Past-Year Nonsuicidal Self-Injury. Behav Ther 2024; 55:469-484. [PMID: 38670662 DOI: 10.1016/j.beth.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 07/25/2023] [Accepted: 08/15/2023] [Indexed: 04/28/2024]
Abstract
Although the literature suggests trait-like differences in affective and cognitive vulnerabilities between individuals with and without a history of nonsuicidal self-injury (NSSI), little is known about how these dispositional differences are experienced in the natural environment. The present study compares the intensity, inertia, interaction, and variability of affective (negative and positive affect) and cognitive states (rumination, self-criticism) in the everyday lives of individuals who do and do not engage in NSSI. Using experience sampling methodology (ESM), 60 emerging adults (ages = 18-22 years) with and without past-year NSSI (equally distributed) completed eight questionnaires per day for 12 days (in total, 96 questionnaires per participant), resulting in 4,587 assessments (median compliance = 83.3%; IQR = 71.9-91.7). In a dynamic structural equation modeling framework, dynamic parameters (i.e., mean intensity, carryover effects, spillover effects, and within-person variability) were evaluated using multilevel vector autoregressive models. Emerging adults who engage in NSSI experience higher intensity and greater variability of negative affect, rumination, and self-criticism, whereas those who do not engage in NSSI experience higher intensity and lower variability of positive affect. In addition, past-year NSSI predicted stronger affective-cognitive interactions over time, with stronger spillover effects of negative and positive affect on subsequent rumination and self-criticism in individuals who engage in NSSI. Depressive symptoms and trait levels of emotion dysregulation and self-criticism partially negated these differences. Our findings provide evidence that emerging adults who self-injure experience more negative affective-cognitive states in daily life and point to the potential relevance of boosting positive emotions to buffer negative cognitions.
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Paranjothy SM, Wade TD. A meta-analysis of disordered eating and its association with self-criticism and self-compassion. Int J Eat Disord 2024; 57:473-536. [PMID: 38366726 DOI: 10.1002/eat.24166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Revised: 01/23/2024] [Accepted: 01/27/2024] [Indexed: 02/18/2024]
Abstract
OBJECTIVE Future treatments for eating disorders (ED) need to be enhanced by targeting maintaining mechanisms. Literature suggests self-criticism and self-critical perfectionism act as key mechanisms exacerbating ED, and self-compassion protects against self-criticism. This meta-analysis examines associations between self-criticism and self-critical perfectionism on disordered eating (DE), and reviews how self-compassion and self-criticism relate to each other with respect to DE. METHOD Searches across three databases yielded 135 studies across 42,952 participants. Heterogeneity, publication bias, and quality assessments were analyzed. Moderation analyses between self-criticism measures, self-compassion measures, between clinical and nonclinical samples, and between cross-sectional and experimental studies were also conducted. RESULTS Random-effects models showed a medium positive link between self-criticism and DE (r = .37), and 10 subgroups pertaining to various measures of self-criticism utilized in literature showed small to large positive links with DE (r = .20-.52). Preliminary evidence also suggests negative relationships between self-compassion and DE (r = -.40 to -.43) and negative relationships between self-compassion and self-criticism (r = -.04 to -.88). DISCUSSION Greater levels of self-criticism is linked with greater levels of DE and reduced levels of self-compassion, suggesting a need to tackle self-criticism and nurture self-compassion in standard treatments for ED. Understanding these interactions better in conjunction with dismantling intervention studies can help develop more effective and efficient interventions targeting self-criticism and self-compassion for people with DE. PUBLIC SIGNIFICANCE STATEMENT Higher levels of self-criticism are linked with higher levels of DE and lower self-compassion. Self-compassion interventions could be more effective and efficient in reducing ED symptoms if self-criticism is tackled early in such treatments.
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Affiliation(s)
- Sarah Marie Paranjothy
- Flinders University, Blackbird Initiative, Flinders University Institute for Mental Health and Wellbeing, Adelaide, South Australia, Australia
| | - Tracey D Wade
- Flinders University, Blackbird Initiative, Flinders University Institute for Mental Health and Wellbeing, Adelaide, South Australia, Australia
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Lassri D, Gewirtz-Meydan A. From trauma to intimacy: Examining the link between childhood maltreatment and adult sexual functioning - The mediating role of self-criticism. CHILD ABUSE & NEGLECT 2024; 149:106663. [PMID: 38350402 DOI: 10.1016/j.chiabu.2024.106663] [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: 05/29/2023] [Revised: 01/15/2024] [Accepted: 01/21/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND Childhood maltreatment has been linked to negative sexual functioning, but the underlying mechanisms for this association are poorly understood. OBJECTIVE Addressing this gap, this study investigates the mediating role of self-criticism in the association between childhood maltreatment and adult sexual functioning. PARTICIPANTS AND SETTING Two independent studies were conducted, each utilizing a distinct dataset to enhance the robustness and generalizability of the findings. The sample in Study 1 included 914 participants, while the sample in Study 2 consisted of 451 women. Both samples completed self-report online questionnaires; however, in Study 2, we purposefully oversampled for child sexual abuse survivors. METHODS This study employed a mediation model using PROCESS. RESULTS Study 1 confirmed the negative association between childhood maltreatment and sexual functioning, as well as the positive association between childhood maltreatment and self-criticism. Self-criticism was also negatively associated with sexual functioning. The mediation analysis revealed that self-criticism significantly mediated the association between childhood maltreatment and sexual functioning. Study 2 built upon these findings by oversampling childhood sexual abuse survivors and incorporating comprehensive measures of sexual functioning. The results in Study 2 replicated the findings of Study 1, providing a more representative understanding of the link between childhood maltreatment and sexual functioning. CONCLUSIONS The findings highlight the importance of self-criticism as a potential mechanism underlying the negative impact of childhood maltreatment on sexual functioning in adulthood. This knowledge can inform interventions and therapeutic approaches aimed at addressing self-criticism and improving sexual well-being in individuals with a history of childhood maltreatment.
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Affiliation(s)
- Dana Lassri
- The Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Israel.
| | - Ateret Gewirtz-Meydan
- School of Social Work, Faculty of Social Welfare & Health Sciences, University of Haifa, Israel. agewirtz-@univ.haifa.ac.il
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Seong E, Lee KH, Lee JS, Kim S, Seo DG, Yoo JH, Han DH, Hwang H, Choi CH, Kim JW. Depression and posttraumatic stress disorder in adolescents with nonsuicidal self-injury: comparisons of the psychological correlates and suicidal presentations across diagnostic subgroups. BMC Psychiatry 2024; 24:138. [PMID: 38373899 PMCID: PMC10877746 DOI: 10.1186/s12888-024-05533-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Accepted: 01/18/2024] [Indexed: 02/21/2024] Open
Abstract
BACKGROUND Nonsuicidal self-injury (NSSI) combined with suicide ideation increases the risk of suicidal behaviors. Depression and posttraumatic stress disorder (PTSD) are comorbidities of NSSI compounding this relationship. The present study compared diagnostic subgroups of NSSI based on current depression and PTSD on psychological correlates (i.e., vulnerabilities and impairment) and suicidal presentations (i.e., suicidal cognitions and behaviors) in a psychiatric sample of adolescents. METHODS Eighty-seven adolescents meeting DSM-5 criteria for NSSI and 104 age-range-matched nonclinical controls (NC) participated. Participants completed self-report measures on psychological vulnerabilities and impairment (e.g., emotion regulation difficulties, negative cognitions). Adolescents with NSSI also completed clinical interviews on psychiatric diagnoses and a recent self-injurious behavior (SIB). Scores on the psychological correlates of NSSI were compared between adolescents with NSSI and NC, and across three diagnostic subgroups of NSSI (A: NSSI+/depression-/PTSD-, n = 14; B: NSSI+/depression+/PTSD-, n = 57; C: NSSI+/depression+/PTSD+, n = 14). Differences between NSSI diagnostic subgroups were tested on the motives for SIB and accompanying suicidal presentations (e.g., desire, intent, motive, lethality). RESULTS Common comorbidities of NSSI included depression, panic disorder, generalized anxiety disorder, and PTSD. The NSSI subgroup classification was significantly associated with panic disorder, which was controlled for in the subsequent group comparisons. Overall, adolescents who engage in NSSI with vs. without depression reported more psychological vulnerabilities and impairment and a greater degree of suicidal thoughts/desire in SIB (i.e., groups B, C >A), which remained significant after controlling for panic disorder. An increased odds of the suicidal motive for SIB was found in adolescents with all three conditions (i.e., group C: NSSI+/depression+/PTSD+) compared to those with NSSI but neither depression nor PTSD (i.e., group A: NSSI+/depression-/PTSD-); however, this was not significant after controlling for panic disorder. CONCLUSIONS Psychological underpinnings of adolescent NSSI in clinical contexts may be largely associated with concurrent depression. Suicidal motives in adolescents who engage in NSSI in the presence of depression and PTSD may be confounded by the co-occurrence of panic disorder. This study warrants the importance of attending to the comorbid depression with NSSI in adolescents as it is related to an increase in suicidal desire accompanying SIB.
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Affiliation(s)
- Eunice Seong
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Kyung Hwa Lee
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea
| | - Jong-Sun Lee
- Department of Psychology, Kangwon National University, 1 Gangwondaehak-gil, Chuncheon, Gangwon-do, 24341, Republic of Korea
| | - Sojung Kim
- Department of Psychology, Yeungnam University, 280 Daehak-ro, Gyeongsan, Gyeongbuk, 38541, Republic of Korea
| | - Dong Gi Seo
- Department of Psychology, Hallym University, 1 Hallymdaehak-gil, Chuncheon, Gangwon-do, 24252, Republic of Korea
| | - Jae Hyun Yoo
- Department of Psychiatry, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 222 Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea
| | - Doug Hyun Han
- Department of Psychiatry, Chung-Ang University College of Medicine, 84 Heukseok-ro, Dongjak-gu, Seoul, 06973, Republic of Korea
| | - Hyunchan Hwang
- Department of Psychiatry, Chung-Ang University College of Medicine, 84 Heukseok-ro, Dongjak-gu, Seoul, 06973, Republic of Korea
| | - Chi-Hyun Choi
- Seoul Alpha Neuropsychiatric Clinic, 511 Nonhyeon-ro, Gangnam-gu, Seoul, 06131, Republic of Korea
| | - Jae-Won Kim
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Seoul National University Hospital, 101 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
- Department of Psychiatry, Institute of Human Behavioral Medicine, Seoul National University College of Medicine, 103 Daehak-ro, Jongno-gu, Seoul, 03080, Republic of Korea.
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Zaccari V, Mancini F, Rogier G. State of the art of the literature on definitions of self-criticism: a meta-review. Front Psychiatry 2024; 15:1239696. [PMID: 38439797 PMCID: PMC10910096 DOI: 10.3389/fpsyt.2024.1239696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 01/24/2024] [Indexed: 03/06/2024] Open
Abstract
Background Several authors have developed important theoretical models on an important transdiagnostic factor in psychopathology: self-criticism (SC). Currently, there are substantial variations in the theoretical definition of SC. The lack of awareness of similarities and differences between models may in turn impact the comparison between empirical results, limiting their clinical implications. Purpose The purpose of this study was to identify current trends in the field of SC and to explore whether these were approached and shaped by different conceptualizations of SC. Methods Core components of the most influential models of SC were identified. A meta-review was conducted searching for systematic reviews and/or meta-analyses in the following databases: PsycINFO, PsycARTICLES, MEDLINE, Scopus, Web of Science, and PubMed (all years up to 28 April 2023). Results Contributions were heterogeneous with respect to the definition of SC and the theoretical framework. Almost all systematic reviews poorly addressed the multidimensionality of SC. In addition, discrepancies between the definitions of SC provided and their operationalizations emerged. Conclusions The lack of dialogue between the different theoretical perspectives emerged from key contributions in the field of SC. Potential research questions to answer to stimulate this dialogue are proposed.
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Affiliation(s)
- Vittoria Zaccari
- School of Cognitive Psychotherapy, Rome, Italy
- Department of Human Sciences, Guglielmo Marconi University, Rome, Italy
| | - Francesco Mancini
- School of Cognitive Psychotherapy, Rome, Italy
- Department of Human Sciences, Guglielmo Marconi University, Rome, Italy
| | - Guyonne Rogier
- Department of Educational Sciences, University of Genoa, Genoa, Italy
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Robillard CL, Turner BJ, Helps CE. Testing a diathesis-stress model during the transition to university: Associations between self-criticism, stress, and internalizing problems. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023; 71:1834-1844. [PMID: 34314640 DOI: 10.1080/07448481.2021.1947837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Revised: 06/08/2021] [Accepted: 06/20/2021] [Indexed: 06/13/2023]
Abstract
ObjectiveTo test a diathesis-stress model whereby self-criticism interacts with monthly perceived stress to predict same-month or next-month internalizing problems, including depression, anxiety, nonsuicidal self-injury (NSSI), and suicidal ideation, in students transitioning to university. Participants: 704 students (73% female, Mage = 17.97) were recruited during their first month of university in 2017 and 2018. Methods: Students completed surveys assessing self-criticism, perceived stress, and internalizing problems from September to April. Results: Self-criticism predicted higher depression and anxiety, as well as odds of NSSI and suicidal ideation, in students' first month on campus. Consistent with a diathesis-stress model, self-criticism strengthened the associations between stress and same-month depression and anxiety. Conclusions: Self-critical students are at elevated risk of internalizing problems during the transition to university, particularly when they feel more stressed than usual. These findings elucidate which students should be targeted in interventions and when interventions should be delivered to curtail internalizing problems.
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Affiliation(s)
- Christina L Robillard
- Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
| | - Brianna J Turner
- Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
| | - Carolyn E Helps
- Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
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Whitfield H, Hargreaves D, Nicholls D, Watt HC, Creese H. Risk factors of persistent adolescent thinness: findings from the UK Millennium Cohort Study. BMC Public Health 2023; 23:938. [PMID: 37226159 DOI: 10.1186/s12889-023-15850-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 05/09/2023] [Indexed: 05/26/2023] Open
Abstract
BACKGROUND Thinness during adolescence can increase the risk of adverse health outcomes across the life-course and impede development. There is limited research examining the prevalence and determinants of persistent adolescent thinness in the United Kingdom (UK). We used longitudinal cohort data to investigate determinants of persistent adolescent thinness. METHODS We analyzed data from 7,740 participants in the UK Millennium Cohort Study at ages 9 months, 7, 11, 14 and 17 years. Persistent thinness was defined as thinness at ages 11, 14 and 17; thinness was defined as an age- and sex-adjusted Body Mass Index (BMI) of less than 18.5 kg/m2. In total, 4,036 participants, classified either as persistently thin or at a persistent healthy weight, were included in the analyses. Logistic regression analyses were conducted to examine associations between 16 risk factors and persistent adolescent thinness by sex. RESULTS The prevalence of persistent thinness among adolescents was 3.1% (n = 231). Among males (n = 115), persistent adolescent thinness was significantly associated with non-white ethnicity, low parental BMI, low birthweight, low breastfeeding duration, unintended pregnancy, and low maternal education. Among females (n = 116), persistent adolescent thinness was significantly associated with non-white ethnicity, low birthweight, low self-esteem, and low physical activity. However, after adjusting for all risk factors, only low maternal BMI (OR: 3.44; 95% CI:1.13, 10.5), low paternal BMI (OR: 22.2; 95% CI: 2.35, 209.6), unintended pregnancy (OR: 2.49; 95% CI: 1.11, 5.57) and low self-esteem (OR: 6.57; 95% CI: 1.46,29.7) remained significantly associated with persistent adolescent thinness among males. After adjustment for all risk factors, not reaching the recommended physical activity levels (OR: 4.22; 95% CI: 1.82, 9.75) remained significantly associated with persistent adolescent thinness among females. No appreciable associations were found between persistent adolescent thinness and sex, premature birth, smoking during pregnancy, income, maternal postnatal depression, mother-infant attachment or socio-emotional difficulties (p > 0.05). CONCLUSION Persistent adolescent thinness is not rare and appears to be associated with both physical and mental health factors, with some sex specific differences. Healthy weight initiatives should consider the full weight spectrum. Further research is required to understand thinness at a population level, including among those whose BMI changes during child and adolescent development.
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Affiliation(s)
- H Whitfield
- School of Public Health, Imperial College London, London, UK.
| | - D Hargreaves
- School of Public Health, Imperial College London, London, UK
| | - D Nicholls
- Department of Brain Sciences, Imperial College London, London, UK
| | - H C Watt
- School of Public Health, Imperial College London, London, UK
| | - H Creese
- School of Public Health, Imperial College London, London, UK
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12
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Raffagnato A, Miscioscia M, Fasolato R, Iannattone S, Valentini P, Sale E, Gatta M. Symptomatic, Alexithymic, and Suicidality-Related Features in Groups of Adolescent Self-Harmers: A Case-Control Study. Eur J Investig Health Psychol Educ 2023; 13:883-896. [PMID: 37232705 DOI: 10.3390/ejihpe13050067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/12/2023] [Accepted: 05/15/2023] [Indexed: 05/27/2023] Open
Abstract
Non-suicidal self-injury (NSSI) is an increasing phenomenon among both clinical and nonclinical adolescent groups and is associated with several psychopathological symptoms, in addition to being one of the main risk factors for suicidality. Nevertheless, differences between clinical and nonclinical samples of self-harmers in symptom dimensions, alexithymia, suicidality, and NSSI-related variables are still scarcely investigated. The current study aimed to fill this gap by enrolling a sample of Italian girls (age range: 12-19 years) that included 63 self-harmers admitted to mental health outpatient services (clinical group), 44 self-harmers without admission to mental health services (subclinical group), and 231 individuals without an NSSI history (control group). Questionnaires investigating psychopathological symptoms, alexithymia, and NSSI-related variables were administered. The results highlighted that all symptom-related variables and alexithymic traits were more severe in the NSSI groups than in the control group; in particular, self-depreciation, anxiety, psychoticism, and pathological interpersonal relationships were distinguished between the clinical and subclinical groups. Compared to the subclinical group, the clinical group was characterized by higher NSSI frequency, NSSI disclosure, self-punishment as the main reason for engagement in NSSI, and suicidal ideation. These findings were then discussed in terms of clinical practice and primary and secondary prevention in the adolescent population.
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Affiliation(s)
- Alessia Raffagnato
- Department of Woman and Child's Health, Padua University Hospital, 35128 Padua, Italy
| | - Marina Miscioscia
- Department of Developmental Psychology and Socialization, University of Padua, 35131 Padua, Italy
| | - Rachele Fasolato
- Department of Woman and Child's Health, Padua University Hospital, 35128 Padua, Italy
| | - Sara Iannattone
- Department of General Psychology, University of Padua, 35131 Padua, Italy
| | - Perla Valentini
- Department of Communication Sciences, Humanistic and International Studies: History, Culture, Languages, Literature, Arts, Media, University of Urbino 'Carlo Bo', 61029 Urbino, Italy
| | - Eleonora Sale
- Department of Woman and Child's Health, Padua University Hospital, 35128 Padua, Italy
| | - Michela Gatta
- Department of Woman and Child's Health, Padua University Hospital, 35128 Padua, Italy
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Kim S, Woo S, Lee JS. Investigation of the Subtypes of Nonsuicidal Self-Injury Based on the Forms of Self-Harm Behavior: Examining Validity and Utility via Latent Class Analysis and Ecological Momentary Assessment. J Korean Med Sci 2023; 38:e132. [PMID: 37128876 PMCID: PMC10151622 DOI: 10.3346/jkms.2023.38.e132] [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: 08/22/2022] [Accepted: 01/19/2023] [Indexed: 05/03/2023] Open
Abstract
BACKGROUND This study aimed to empirically derive and validate subtypes of nonsuicidal self-injury (NSSI) based on the forms of self-harm behavior. METHODS Sixty young adults who exhibited repetitive NSSI completed a clinical interview and baseline measures, followed by a two-week ecological momentary assessment (EMA). A latent class analysis was administered to identify NSSI subtypes based on the forms of self-harm behavior. The subtypes were then compared to baseline clinical and EMA variables, including emotions and urges to self-harm. RESULTS The best-fitting model supported two subtypes: 1) substance abuse and suicide attempt subtype and 2) cutting and scratching subtype. The substance abuse and suicide attempt subtype reported a higher rate of engaging in lifetime suicide plans and suicide attempts and a higher number of lifetime suicide attempts. They also showed significantly higher severity of self-harm behavior, borderline personality traits, anger, posttraumatic symptoms, and difficulties in emotion regulation when compared to the cutting and scratching subtype. However, there was no inter-subtype difference in self-esteem. In the EMA data, anger toward others, feeling of rejection, loneliness, and helplessness were significantly high in the substance abuse and suicide attempt subtype. The variability of anger toward others was also higher in this subtype compared to the cutting and scratching subtype. Finally, in the two-week research period, the substance abuse and suicide attempt group showed a higher rate of reported urges to self-harm with or without suicidal intent. CONCLUSION Findings support the validity of the subtypes based on the forms of self-harm behavior, suggesting the clinical utility of addressing heterogeneity within individuals exhibiting self-harm for assessment and treatment.
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Affiliation(s)
- Sojung Kim
- Department of Psychiatry, Hanyang University Medical Center, Seoul, Korea
- Department of Psychology, Yeungnam University, Gyeongsan, Korea.
| | - Sungbum Woo
- Cultural Contents Technology Research Institute, Gachon University, Seongnam, Korea
- Department of Counseling Psychology, Hanyang Cyber University, Seoul, Korea
| | - Jong-Sun Lee
- Department of Psychology, Kangwon National University, Chuncheon, Korea
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14
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Petrovic J, Mettler J, Böke BN, Rogers MA, Hamza CA, Bloom E, Di Genova L, Romano V, Arcuri GG, Heath NL. The effectiveness and acceptability of formal versus informal mindfulness among university students with and without recent nonsuicidal self-injury: Protocol for an online, parallel-group, randomized controlled trial. Contemp Clin Trials 2023; 126:107109. [PMID: 36740043 DOI: 10.1016/j.cct.2023.107109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 01/22/2023] [Accepted: 01/25/2023] [Indexed: 02/05/2023]
Abstract
BACKGROUND Mindfulness-based programming comprising both formal (FM) and informal (IM) mindfulness practice is increasingly offered to university students. However, difficulties with emotion regulation, self-criticism, and a potentially complex relationship with their body may undermine the benefits of FM for students with a history of nonsuicidal self-injury (NSSI), given its requirement of sustained attention on thoughts, emotions, and bodily sensations. IM may be better tolerated by these students. This protocol describes a randomized controlled trial comparing a brief FM practice, a brief IM practice, and an active control task in university students with and without recent NSSI. METHODS Recruitment began in November 2022. An online, parallel-group, single-blind, randomized controlled trial will compare a 10-min, single-session FM practice, a 10-min, single session IM practice, and a 10-min, single session active control task in university students with and without recent NSSI. Outcomes will be assessed immediately pre-intervention and within five minutes post-intervention. The primary outcome will be state mindfulness. Secondary outcomes will be state stress, state well-being, and acceptability. Students with a history of NSSI are expected to report (i) greater improvements in state mindfulness, stress, and well-being, and (ii) greater acceptability in the IM condition, relative to the FM and control conditions. This distinction is not expected to occur in the no-NSSI comparison group. CONCLUSION This trial is the first to parse out the impacts of FM versus IM practice among university students with and without a history of self-injury. Findings will be relevant to academic and clinical audiences within university settings.
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Affiliation(s)
- Julia Petrovic
- Department of Educational and Counselling Psychology (ECP), McGill University, Canada.
| | - Jessica Mettler
- Department of Educational and Counselling Psychology (ECP), McGill University, Canada
| | - Bilun Naz Böke
- Department of Educational and Counselling Psychology (ECP), McGill University, Canada
| | | | - Chloe A Hamza
- Department of Applied Psychology & Human Development, Ontario Institute for Studies in Education (OISE), University of Toronto, Canada
| | - Elana Bloom
- Campus Wellness Support Services, Concordia University, Canada
| | | | - Vera Romano
- Student Wellness Hub, McGill University, Canada
| | | | - Nancy L Heath
- Department of Educational and Counselling Psychology (ECP), McGill University, Canada
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15
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Zirakbash A, Naderi F, Marashian FS, Makvandi B. Designing unified trans-diagnostic interventions and their efficacy on the common mechanisms of the comorbid obsessive personality disorder with anxiety, depression, and obsessive-compulsive disorder: A protocol study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2023; 12:35. [PMID: 37034852 PMCID: PMC10079187 DOI: 10.4103/jehp.jehp_1254_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/27/2022] [Accepted: 12/21/2022] [Indexed: 06/19/2023]
Abstract
BACKGROUND The immense comorbidity among disorders could be ascribed to common trans-diagnostic processes. The term trans-diagnostic has been of interest in both pathology and psychology. Trans-diagnostic treatments were created as opposed to treatments based on single-diagnosis treatments. It addresses the common underlying mechanisms in a range of comorbid disorders. Trans-diagnostic treatment is one of the new psychological treatments, and its efficacy has been proven on many psychological variables. The main focus of the current study is on designing unified trans-diagnostic interventions and their efficacy on the shared mechanisms of comorbid obsessive personality disorder with anxiety, depression, and obsessive-compulsive disorder. MATERIALS AND METHODS the sequential transformative strategy has two stages; qualitative and quantitative. In The first and qualitative section of the research, explanatory research will be carried out to investigate the trans-diagnostic intervention using a systematic review. To validate the trans-diagnostic intervention, and simultaneously with the trans-diagnostic intervention, a questionnaire has been prepared and given to 10 psychology experts and professionals in the treatment field concerning content validity by evaluators. CONCLUSION Designing unified trans-diagnosis interventions and their efficacy on the common mechanisms of comorbid obsessive personality disorder with anxiety, depression, and obsessive-compulsive disorder is an effective treatment method for helping those suffering from a personality disorder. Clinical psychologists, psychology experts, psychiatrists, and mental health experts are all the immediate beneficiaries of this study. Moreover, clients could benefit from this intervention with less money and time.
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Affiliation(s)
- Amin Zirakbash
- Ph.D Student, Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran
| | - Farah Naderi
- Professor, Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran
| | | | - Behnam Makvandi
- Associate, Department of Psychology, Ahvaz Branch, Islamic Azad University, Ahvaz, Iran
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16
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Parental pressure and intrapersonal risk factors in relation to non-suicidal self-injury outcomes in university students. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-04173-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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17
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de Valle MK, Wade TD. Targeting the link between social media and eating disorder risk: A randomized controlled pilot study. Int J Eat Disord 2022; 55:1066-1078. [PMID: 35708162 DOI: 10.1002/eat.23756] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/27/2022] [Accepted: 05/28/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Evaluate the feasibility, acceptability, and preliminary efficacy of a self-criticism intervention addressing the link between appearance-motivated social media use and eating disorder risk. Another condition, designed to help users curate their social media feed to reduce negative impacts on wellbeing, was also trialed as an active and credible comparison. METHOD University students aged 17-25 (N = 170) were screened and randomized (n = 130) to the self-criticism intervention, social media curation, or waitlist control group. The intervention comprised self-guided cognitive behavior therapy delivered in four modules over 1 week. Primary outcomes were feasibility and acceptability. Secondary outcomes were appearance motivations for social media use, appearance comparison, self-criticism, body image flexibility, and disordered eating (at baseline, one-week postrandomization, and two-weeks postrandomization). TRIAL REGISTRATION ACTRN12621000353897. RESULTS Participants completed an average of 82% of the intervention modules and 77% of the homework exercises within the week allocated. The intervention was well-accepted; participants reported a range of positive aspects, alongside suggested modifications to the intervention and study design to improve acceptability. Group by time interactions suggested groups changed at a different rate on three secondary outcomes; between-groups effect sizes suggested this was due to greater improvements in the self-criticism group than waitlist control. DISCUSSION This was the first study to evaluate an intervention for the link between appearance-related social media use and eating disorder risk for young adults. Positive findings relating to feasibility, acceptability, and preliminary efficacy suggest a larger randomized controlled trial, with modifications to the intervention and study design, is warranted. PUBLIC SIGNIFICANCE Appearance-related social media use has been linked to poorer body image and disordered eating, necessitating treatments that can disrupt this relationship. The self-criticism intervention evaluated in this study shows promise as a strategy to address this need. It is the first intervention focused on appearance-related social media use to be designed for and tested in young adults, who are at heightened risk of developing an eating disorder.
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Affiliation(s)
- Madelaine K de Valle
- Discipline of Psychology, Flinders University, Adelaide, South Australia, Australia
| | - Tracey D Wade
- Discipline of Psychology, Flinders University, Adelaide, South Australia, Australia
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18
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Kruzan KP, Muehlenkamp JJ, Claes L. Identity, self-blame, and body regard in NSSI: A test of moderated-mediation. Compr Psychiatry 2022; 116:152322. [PMID: 35533434 PMCID: PMC9219562 DOI: 10.1016/j.comppsych.2022.152322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 04/05/2022] [Accepted: 04/13/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Prior work suggests that an unstable identity is an important developmental factor impacting risk for non-suicidal self-injury (NSSI), partly because it can foster lowered self-esteem and self-blame coping styles. Theoretical models suggest that how one regards the self, including experiences of and reactions to one's body (e.g., body regard), impact how factors such as identity instability and coping styles influence NSSI behavior. This study tested whether body regard moderated the mediational effect of self-blame coping on the relationship between poor self-concept clarity and past-year NSSI. METHODS A sample of 1906 university students had complete data from an anonymous online questionnaires measuring self-concept clarity, self-blame coping, and past-year NSSI behaviors. RESULTS Past-year NSSI was reported by 23.5% of the sample. Moderated mediational regression analyses using the PROCESS macro for SPSS were run. Body regard significantly moderated the effects of self-blame coping and poor self-concept clarity on NSSI such that neither risk factor was associated with NSSI when body regard was high. Poor self-concept clarity also retained a significant, although weakened, direct relationship with NSSI in the full model. CONCLUSIONS Positive body regard is protective and appears to mitigate the strength of the relationships between poor self-concept clarity and self-blame coping on past year NSSI. When body regard is low or average, poor self-concept clarity is associated with increased NSSI, partly through the effect of self-blame coping. Treatments that address body- and self-perceptions related to self-concept may enhance the effectiveness of interventions used to reduce NSSI behavior.
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Affiliation(s)
- Kaylee P Kruzan
- Center for Behavioral Intervention Technologies, 446 E. Ontario St., Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Jennifer J Muehlenkamp
- Department of Psychology, 105 Garfield Ave, University of Wisconsin Eau Claire, Eau Claire, WI 54701, USA.
| | - Laurence Claes
- KU Leuven, Faculty of Psychology and Educational Sciences, Tiensestraat 102, 3000 Leuven, Belgium; University of Antwerp, Faculty of Medicine and Health Sciences, Universiteitsplein 1, 2610 Wilrijk (Antwerp), Belgium
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19
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Interpersonal mechanisms for the maintenance of self-criticism: Expressive suppression, emotion expression, and self-concealment. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-020-00920-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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20
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Nam G, Moon H, Lee JH, Hur JW. Self-referential processing in individuals with nonsuicidal self-injury: An fMRI study. Neuroimage Clin 2022; 35:103058. [PMID: 35671558 PMCID: PMC9168135 DOI: 10.1016/j.nicl.2022.103058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 05/18/2022] [Accepted: 05/21/2022] [Indexed: 12/03/2022]
Abstract
Individuals with NSSI rated negative adjectives as more relevant. Altered self-referential processing in NSSI related to temporoparietal and subcortical areas. Brain activity in inferior parietal lobe related to ‘nonsuicidality’ in people with NSSI.
Nonsuicidal self-injury (NSSI) is associated with considerable deficits in managing negative self-directed internal experiences. The present study explores the neurophysiological correlates of self-referential processing in individuals with NSSI. A total of 26 individuals with NSSI (≥5 episodes of NSSI behavior in the past year, without suicide attempts) and 35 age-, sex-, education-, and intelligence quotient (IQ)-matched controls participated in this study. Participants underwent fMRI scanning as they performed a personal relevance rating task, which required them to evaluate the personal relevance of emotional words. As predicted, we found that individuals engaging in NSSI tended to rate negative adjectives as more relevant and positive adjectives as less relevant. An analysis of functional neuroimaging data showed that the NSSI group had increased activity relative to the control group in the inferior parietal lobe, inferior temporal gyrus, calcarine, insula, and thalamus in response to positive adjectives. The NSSI group also demonstrated greater activation in the calcarine and reduced activation in the inferior frontal gyrus in response to negative self-referential stimuli compared with the control group. In addition, increased right inferior parietal lobe activity during positive self-referential processing was correlated with reduced suicidal ideation in the NSSI group. Our study provides neural evidence for self-referential processing bias in individuals with NSSI and highlights the need for further research to clarify the pathophysiological features that are specific to NSSI.
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Affiliation(s)
- Gieun Nam
- Department of Psychology, Chung-Ang University, Seoul, Republic of Korea
| | - Hyeri Moon
- School of Psychology, Korea University, Seoul, Republic of Korea
| | - Jang-Han Lee
- Department of Psychology, Chung-Ang University, Seoul, Republic of Korea.
| | - Ji-Won Hur
- School of Psychology, Korea University, Seoul, Republic of Korea.
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21
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Carpenter RK, Alloway TP. Exploring working memory, self-criticism, and rumination as factors related to self-harm. Psychol Rep 2022:332941221074258. [PMID: 35084275 DOI: 10.1177/00332941221074258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The prevalence of self-harm and the relative emotional influences are well understood, but certain cognitive factors such as working memory, rumination, and self-criticism are not fully explored. The aim of the current study is to examine specific aspects of cognition to explore their influence on self-harming behaviors. Participants included 101 undergraduates from a British University. Factors were measured using the Centre for Epidemiological Studies Depression Scale, the Depressive Experiences Questionnaire, Ruminative Response Scale, and the Automated Working Memory Assessment. Findings indicated a greater incidence of self-harming behaviors among those who demonstrated higher depressive symptoms, but depression scores were not significantly related to self-harm. Additionally, a binary logistic regression indicated that self-criticism was associated with the presence of self-harming behavior, and a Classification and Regression Trees found that the single strongest predictor of self-harming behavior was a belief that love needs to be continually earned from others. Incorporating treatments that reduce self-criticism, such as improving self-compassion with Compassionate Mind Training, may address underlying mechanisms that trigger self-harm behavior. Keywords: rumination, depression, self-criticism, working memory, self-harm.
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22
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Zinchuk M, Lavrishcheva A, Menshikova A, Voinova N, Artemieva M, Guekht A. Nonsuicidal self-injury in eating disorders. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:70-78. [DOI: 10.17116/jnevro202212209170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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23
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Bicaker E, Racine SE. Protection versus risk? The relative roles of compassionate and uncompassionate self-responding for eating disorder behaviors. Eat Behav 2022; 44:101592. [PMID: 34920209 DOI: 10.1016/j.eatbeh.2021.101592] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2021] [Revised: 11/14/2021] [Accepted: 11/30/2021] [Indexed: 12/14/2022]
Abstract
Research demonstrates the protective role of self-compassion for eating disorder symptoms. However, studies investigating self-compassion most often use the Self-Compassion Scale, which aggregates the distinct but related constructs of compassionate and uncompassionate self-responding. This study examined differential associations of compassionate and uncompassionate self-responding with positive and negative affect and with a range of eating disorder behaviors (i.e., binge eating, purging, dietary restriction, and excessive exercise). Participants were 547 undergraduate students (59% women, Mage = 20.49, SDage = 1.83) who completed measures of self-compassion, trait affect, and eating disorder behaviors. Compassionate and uncompassionate self-responding were moderately negatively correlated (rs = -0.41 and -0.33, among women and men, respectively). Compassionate self-responding was more strongly related to positive affect, and uncompassionate self-responding was more strongly related to negative affect. Among women, uncompassionate self-responding was related to all eating disorder behaviors controlling for compassionate self-responding, whereas compassionate self-responding was not uniquely related to any eating disorder behavior. Among men, a similar pattern emerged, except that only compassionate self-responding related uniquely to excessive exercise. Results are consistent with studies showing that the presence of uncompassionate self-responding might outweigh the absence of compassionate self-responding in explaining psychopathology. Findings highlight the potential importance of primarily targeting uncompassionate self-responding in eating disorder interventions.
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Affiliation(s)
- Ege Bicaker
- Department of Psychology, McGill University, Montreal, Canada
| | - Sarah E Racine
- Department of Psychology, McGill University, Montreal, Canada.
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24
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Ramsey WA, Berlin KS, Del Conte G, Lightsey OR, Schimmel-Bristow A, Marks LR, Strohmer DC. Targeting self-criticism in the treatment of nonsuicidal self-injury in dialectical behavior therapy for adolescents: a randomized clinical trial. Child Adolesc Ment Health 2021; 26:320-330. [PMID: 33608976 DOI: 10.1111/camh.12452] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/16/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND The Benefits and Barriers Model proposes both benefits and barriers associated with nonsuicidal self-injury (NSSI) and that a negative association with the self plays a key role in the initial selection of and acute motivation for NSSI. The current investigation builds upon previous findings by assessing the added benefit of targeting self-criticism in the treatment of NSSI. METHODS Sample included 40 participants (30 females; Mage = 14.92) enrolled in dialectical behavior therapy for adolescents within a partial hospitalization program. All study participants received dialectical behavior therapy for adolescents, and those randomized to the experimental condition received an additional brief cognitive intervention developed to decrease self-criticism. RESULTS There was no evidence of an indirect effect of targeting self-criticism upon NSSI at post-treatment via post-treatment self-criticism (b = -0.98, p = .543); however, there was evidence of a significant interaction between treatment condition and self-criticism at pretreatment in the prediction of NSSI at post-treatment (b = 0.33, p = .030). Analyses of simple slopes indicated the conditional direct effect of targeting self-criticism varied as a function of patient's level of self-criticism at the onset of treatment, such that individuals -1 SD below the mean (b = -5.76, p = .037) and at average pretreatment levels of self-criticism (b = -4.09, p = .042), but not + 1 SD above the mean (b = -2.42, p = .056), experienced fewer incidents of NSSI at post-treatment. CONCLUSIONS The results of this investigation support the added benefit of targeting self-criticism in the treatment of NSSI for adolescents.
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Affiliation(s)
- William A Ramsey
- Department of Counseling Psychology, Education, and Research, The University of Memphis, Memphis, TN, USA
| | | | - Garry Del Conte
- Department of Psychology, The University of Memphis, Memphis, TN, USA.,Daybreak Treatment Center, Germantown, TN, USA
| | - Owen R Lightsey
- Department of Counseling Psychology, Education, and Research, The University of Memphis, Memphis, TN, USA
| | - Allison Schimmel-Bristow
- Department of Counseling Psychology, Education, and Research, The University of Memphis, Memphis, TN, USA
| | - Laura R Marks
- Department of Counseling Psychology, Education, and Research, The University of Memphis, Memphis, TN, USA
| | - Douglas C Strohmer
- Department of Counseling Psychology, Education, and Research, The University of Memphis, Memphis, TN, USA
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Dobias ML, Schleider JL, Jans L, Fox KR. An online, single-session intervention for adolescent self-injurious thoughts and behaviors: Results from a randomized trial. Behav Res Ther 2021; 147:103983. [PMID: 34688102 DOI: 10.1016/j.brat.2021.103983] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 07/28/2021] [Accepted: 10/03/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Across 50 years of research, existing interventions for self-injurious thoughts and behaviors (SITBs) in adolescents have remained largely ineffective and inaccessible. Single-session interventions, interventions designed to last one session, may be a low-cost and timely resource for adolescents engaging in SITBs who may not otherwise receive treatment. METHOD 565 adolescents (Mage = 14.95 years) endorsing recent engagement in non-suicidal self-injury (NSSI) were randomized to receive a 30-min, web-based, single-session intervention-"Project SAVE"-or an active, attention-matched control program. Proximal outcomes were measured at baseline and immediately post-intervention. Long-term outcomes were measured at baseline and 3-month follow-up. RESULTS Adolescents rated Project SAVE as acceptable; 80% of participants randomized to SAVE completed the intervention. Between-group effects were non-significant for pre-registered outcomes: post-intervention likelihood of future NSSI; 3-month frequencies of NSSI and suicidal ideation at follow-up. Relative to control-group participants, SAVE participants reported short-term improvements in two exploratory outcomes: self-hatred (d = -.35, p<.001) and desire to stop future NSSI (d = .25, p = .003). CONCLUSIONS Project SAVE is an acceptable resource for adolescents engaging in SITBs-with short-term effects on clinically-relevant outcomes. Future research may evaluate SAVE as an easy-to-access, short-term coping resource for youth engaging in SITBs. CLINICAL TRIALS. GOV IDENTIFIER NCT04498143.
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Affiliation(s)
- Mallory L Dobias
- Department of Psychology, Stony Brook University, Stony Brook, NY, 11794-2500, USA.
| | - Jessica L Schleider
- Department of Psychology, Stony Brook University, Stony Brook, NY, 11794-2500, USA
| | - Laura Jans
- Department of Psychology, University of Denver, Denver, CO, 80208, USA
| | - Kathryn R Fox
- Department of Psychology, University of Denver, Denver, CO, 80208, USA
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Farinha‐Fernandes A, Conceição N, Silva R. Categories of transdiagnostic processes: Qualitative data from psychotherapy practitioners. COUNSELLING & PSYCHOTHERAPY RESEARCH 2021. [DOI: 10.1002/capr.12348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- António Farinha‐Fernandes
- Research Center for Psychological Science (CICPSI) Faculdade de Psicologia Universidade de Lisboa Lisboa Portugal
| | - Nuno Conceição
- Research Center for Psychological Science (CICPSI) Faculdade de Psicologia Universidade de Lisboa Lisboa Portugal
- Applied Psychology Research Center Capabilities & Inclusion (APPsyCI) ISPA ‐ Instituto Universitário Lisboa Portugal
| | - Rita Silva
- Research Center for Psychological Science (CICPSI) Faculdade de Psicologia Universidade de Lisboa Lisboa Portugal
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Young HA, Davies J, Freegard G, Benton D. Nonsuicidal Self-Injury Is Associated With Attenuated Interoceptive Responses to Self-Critical Rumination. Behav Ther 2021; 52:1123-1136. [PMID: 34452667 DOI: 10.1016/j.beth.2021.02.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2020] [Revised: 02/17/2021] [Accepted: 02/22/2021] [Indexed: 10/22/2022]
Abstract
Nonsuicidal self-injury (NSSI) is a prevalent and dangerous behavior. Those with a history of NSSI often report high levels of self-critical rumination (SCR), a form of negatively valenced introspective self-referential processing. It is plausible that this overly analytical style of relating to the self might hinder the ability to process interoceptive signals, thereby increasing the capacity to engage in behaviors that cause bodily harm. Two studies investigated whether trait or state SCR influenced aspects of interoception in those with and without a history of NSSI. In Study 1 (N = 180), irrespective of NSSI history, trait SCR was associated with finding attending to the heartbeat unpleasant. However, no associations were observed for interoceptive confidence, or metacognitive insight into their interoceptive abilities (confidence-accuracy correspondence). Trait SCR was associated with having higher interoceptive accuracy, but only in those without a history of NSSI. In Study 2 (N = 98), irrespective of NSSI history, state self-criticism led to a more negative interoceptive valence, and reduced participants' metacognitive insight. In those without a history of NSSI, state self-criticism also increased interoceptive accuracy-an effect attenuated in those with NSSI. These findings suggest that those with NSSI are characterized by a blunted interoceptive response to negatively valenced self-focused attention.
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Jiang Y, Ren Y, Liu T, You J. Rejection sensitivity and adolescent non-suicidal self-injury: Mediation through depressive symptoms and moderation by fear of self-compassion. Psychol Psychother 2021; 94 Suppl 2:481-496. [PMID: 32573911 DOI: 10.1111/papt.12293] [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: 12/13/2019] [Revised: 05/20/2020] [Indexed: 01/18/2023]
Abstract
OBJECTIVES Rejection sensitivity is a risk trait that contributes to the relationships between rejection experiences in various domains and non-suicidal self-injury (NSSI). However, research about the association between rejection sensitivity and NSSI has still been understudied. This study sought to examine the mediating role of depressive symptoms and the moderating role of fear of self-compassion in the association between rejection sensitivity and adolescent NSSI. DESIGN A cross-sectional correlational design was employed through which rejection sensitivity, depressive symptoms, fear of self-compassion, and NSSI experiences in the past year were measured. METHODS Seven-hundred twenty-eight Chinese secondary school students (51.1% females; mean age = 14.07, SD = 0.75) were included by convenient sampling. RESULTS Regression analyses revealed that depressive symptoms worked as a mediator in the association between rejection sensitivity and NSSI. It was also found that fear of self-compassion acted as a moderator, such that a higher level of fear of self-compassion strengthened the link between rejection sensitivity and depressive symptoms and the direct link between rejection sensitivity and NSSI. CONCLUSIONS These findings highlight the need to address adolescents' rejection sensitivity, depressive symptoms, and fear of self-compassion in preventing and intervening NSSI. PRACTITIONER POINTS Focusing on rejection sensitivity might help understand the relationships between intra- and interpersonal distress and NSSI. The findings of this study evidenced the risk effect of adolescents' rejection sensitivity on NSSI and the partial mediation of depressive symptoms in the link. Targeting adolescents' rejection sensitivity will be beneficial in developing NSSI-related prevention and intervention programs. This study also found that adolescents' fear of self-compassion magnified the associations between rejection sensitivity, depressive symptoms, and NSSI. It suggests that targeting adolescent's fear of self-compassion will also be beneficial.
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Affiliation(s)
- Yongqiang Jiang
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, School of Psychology, South China Normal University, Guangzhou, China.,The Faculty of Psychology, Beijing Normal University, China
| | - Yaxuan Ren
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, School of Psychology, South China Normal University, Guangzhou, China.,The Faculty of Psychology, Beijing Normal University, China
| | - Tian Liu
- The Fourth People's Hospital of Chengdu, 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, Ministry of Education, School of Psychology, South China Normal University, Guangzhou, China
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Nagy LM, Shanahan ML, Baer RA. An experimental investigation of the effects of self-criticism and self-compassion on implicit associations with non-suicidal self-injury. Behav Res Ther 2021; 139:103819. [PMID: 33640591 DOI: 10.1016/j.brat.2021.103819] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 01/19/2021] [Accepted: 01/30/2021] [Indexed: 11/22/2022]
Abstract
Non-suicidal self-injury (NSSI) is the intentional destruction of bodily tissue in the absence of suicidal motives. Individuals who self-injure often report doing so in order to punish the self or express self-hatred. Self-criticism, or thoughts marked by shame, self-consciousness, and inferiority, is associated with higher rates of NSSI while self-compassion, or the tendency to be sympathetic and caring with oneself, is negatively associated with NSSI. The aim of the present study was to determine whether experimentally-induced self-criticism would increase and self-compassion would decrease implicit identification with NSSI. Participants were randomly assigned to either a self-criticism induction, a self-compassion induction, or a neutral, control condition and completed a measure of strength of the automatic associations that a person holds between themselves and self-harming behaviors before and after the experimental induction. Study hypotheses were partially supported. Results showed that participants in the self-criticism induction experienced an increase in their implicit associations with NSSI while implicit associations in the self-compassion condition did not significantly change. These results highlight the importance of self-criticism in NSSI. Future research should examine increases in self-criticism as a potential precursor of NSSI in longitudinal samples.
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Affiliation(s)
- Laura M Nagy
- Department of Psychology, University of Kentucky, United States.
| | - Mackenzie L Shanahan
- Department of Psychology, Indiana University, Purdue University Indianapolis, United States
| | - Ruth A Baer
- Department of Psychology, University of Kentucky, United States
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Preliminary findings on processes of change and moderators for cognitive defusion and restructuring delivered through mobile apps. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2021. [DOI: 10.1016/j.jcbs.2021.02.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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31
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Norman H, Marzano L, Oskis A, Coulson M. The relationship between alexithymia and self-harm: The mediating role of mindfulness. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-021-01553-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Burke TA, Fox K, Kautz M, Siegel DM, Kleiman E, Alloy LB. Real-time monitoring of the associations between self-critical and self-punishment cognitions and nonsuicidal self-injury. Behav Res Ther 2021; 137:103775. [DOI: 10.1016/j.brat.2020.103775] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 10/23/2020] [Accepted: 11/13/2020] [Indexed: 11/16/2022]
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Evald TA, Møhl B. Before the damage is done: Early childhood hyperactivity difficulties in adolescents with deliberate self-harm - findings from the DALSC cohort. Scand J Child Adolesc Psychiatr Psychol 2021; 8:176-188. [PMID: 33598440 PMCID: PMC7879016 DOI: 10.21307/sjcapp-2020-018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Deliberate self-harm (DSH) is a growing issue among Danish adolescents, and a dramatic increase in the incidence of DSH has been observed since the turn of the millennium. The importance of early childhood factors on later development has been established, but research on the trajectories of DSH is still scarce, and longitudinal studies are much needed. METHOD Participants were 3,291 children and their mothers from The Danish Longitudinal Survey of Children (DALSC), a Danish population-based birth cohort from 1995. Logistic regression and mediation analyses were used to examine significant early childhood determinants of self-harming behavior in adolescence. RESULTS The study found that 17.9% of the children had a history with DSH at the age of 18 years. A significant relationship was found between the likelihood of DSH at the age of 18 years and hyperactivity difficulties assessed through the Strengths and Difficulties Questionnaire (SDQ) at 3 and 7 years of age. Using a mediation model, it is documented that difficulties in peer relationships at the age of 11 years is a partial mediator explaining 19% of the variation. LIMITATIONS i) a vague definition of self-harm in the questionnaires; ii) lack of sample representation as children of lower socio-economic groups have lower participation rates, and only Danish-ethnicity children have been sampled; iii) possibility of omitted variable bias. CONCLUSION The adolescents engaging in DSH are experiencing a more complex range of psychosocial problems than those who do not have experience with DSH. The main finding of the study is that hyperactivity as a risk factor for the development of DSH in adolescence can be identified as early as 3-7 years of age. This relationship between the very early occurring hyperactivity and later DSH, to the best of our knowledge, has not previously been described.
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Affiliation(s)
- Therese A. Evald
- The Finance Committee, City Council of Copenhagen, Copenhagen, Denmark
| | - Bo Møhl
- Faculty of Humanities, Aalborg University, Aalborg, Denmark
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34
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Lewis SP, Hasking PA. Self‐injury recovery: A person‐centered framework. J Clin Psychol 2020; 77:884-895. [DOI: 10.1002/jclp.23094] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 10/20/2020] [Accepted: 11/09/2020] [Indexed: 01/02/2023]
Affiliation(s)
- Stephen P. Lewis
- Department of Psychology University of Guelph Guelph Ontario Canada
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Suicidality in Chronic Illness: An Overview of Cognitive–Affective and Interpersonal Factors. J Clin Psychol Med Settings 2020; 28:137-148. [DOI: 10.1007/s10880-020-09749-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2020] [Indexed: 12/18/2022]
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Zelkowitz RL, Cole DA. Longitudinal relations of self-criticism with disordered eating behaviors and nonsuicidal self-injury. Int J Eat Disord 2020; 53:1097-1107. [PMID: 32406548 PMCID: PMC7641508 DOI: 10.1002/eat.23284] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 04/16/2020] [Accepted: 04/16/2020] [Indexed: 01/18/2023]
Abstract
OBJECTIVE Self-criticism has been proposed as a transdiagnostic predictor of disordered eating and nonsuicidal self-injury (NSSI). First, this study explored cross-sectional associations of multiple disordered eating behaviors, NSSI, and self-criticism. Second, it tested longitudinal relations of self-criticism with disordered eating and NSSI, adjusting for baseline levels of both behaviors. METHODS In Sub-study 1, undergraduates (N = 251, 79.5% female, Mage = 19.1 years) completed self-report measures of disordered eating, NSSI, and self-criticism at baseline and after 8 weeks. In Sub-study 2, community-based young adults with histories of disordered eating, NSSI, or both (N = 517, 88.8% female, Mage = 24.7 years) completed measures of disordered eating, NSSI, and self-criticism at baseline and after 4 weeks. All measures were completed online. RESULTS In Sub-study 1, both disordered eating and NSSI showed significant cross-sectional associations with self-criticism, and self-criticism was significantly related to binge eating, fasting, and NSSI at follow-up. In Sub-study 2, both behaviors again showed significant cross-sectional associations with self-criticism. Self-criticism showed significant longitudinal relations with fasting, purging, and excessive exercise. Longitudinal relations of self-criticism with NSSI varied across disordered eating behaviors. DISCUSSION NSSI showed cross-sectional associations with a range of disordered eating behaviors. Self-criticism reflects a common correlate of both disordered eating and NSSI. Evidence supported transdiagnostic longitudinal impact of self-criticism across multiple forms of disordered eating but provided more limited support for impacts on NSSI.
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Affiliation(s)
- Rachel L. Zelkowitz
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
- Women’s Health Sciences Division, National Center for PTSD, VA Boston Healthcare System
| | - David A. Cole
- Department of Psychology and Human Development, Vanderbilt University, Nashville, TN, USA
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Schleider JL, Dobias M, Sung J, Mumper E, Mullarkey MC. Acceptability and Utility of an Open-Access, Online Single-Session Intervention Platform for Adolescent Mental Health. JMIR Ment Health 2020; 7:e20513. [PMID: 32602846 PMCID: PMC7367540 DOI: 10.2196/20513] [Citation(s) in RCA: 55] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/07/2020] [Accepted: 06/14/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Many youths with mental health needs are unable to access care. Single-session interventions (SSIs) have helped reduce youth psychopathology across multiple trials, promising to broaden access to effective, low-intensity supports. Online, self-guided SSIs may be uniquely scalable, particularly if they are freely available for as-needed use. However, the acceptability of online SSI and their efficacy have remained unexamined outside of controlled trials, and their practical utility is poorly understood. OBJECTIVE We evaluated the perceived acceptability and proximal effects of Project YES (Youth Empowerment & Support), an open-access platform offering three online SSIs for youth internalizing distress. METHODS After selecting one of three SSIs to complete, participants (ages 11-17 years) reported pre- and post-SSI levels of clinically relevant outcomes that SSIs may target (eg, hopelessness, self-hate) and perceived SSI acceptability. User-pattern variables, demographics, and depressive symptoms were collected to characterize youths engaging with YES. RESULTS From September 2019 through March 2020, 694 youths accessed YES, 539 began, and 187 completed a 30-minute, self-guided SSI. SSI completers reported clinically elevated depressive symptoms, on average, and were diverse on several dimensions (53.75% non-white; 78.10% female; 43.23% sexual minorities). Regardless of SSI selection, completers reported pre- to post-program reductions in hopelessness (dav=0.53; dz=0.71), self-hate (dav=0.32; dz=0.61), perceived control (dav=0.60; dz=0.72) and agency (dav=0.39; dz=0.50). Youths rated all SSIs as acceptable (eg, enjoyable, likely to help peers). CONCLUSIONS Results support the perceived acceptability and utility of open-access, free-of-charge SSIs for youth experiencing internalizing distress. TRIAL REGISTRATION Open Science Framework; osf.io/e52p3.
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Affiliation(s)
| | - Mallory Dobias
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
| | - Jenna Sung
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
| | - Emma Mumper
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
| | - Michael C Mullarkey
- Department of Psychology, Stony Brook University, Stony Brook, NY, United States
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Kiekens G, Claes L. Non-Suicidal Self-Injury and Eating Disordered Behaviors: An Update on What We Do and Do Not Know. Curr Psychiatry Rep 2020; 22:68. [PMID: 33037934 PMCID: PMC7547297 DOI: 10.1007/s11920-020-01191-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/25/2020] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW The current report aims to summarize recent advances about the relationship between non-suicidal self-injury (NSSI) and eating disordered (ED) behaviors and highlights meaningful directions for future research. RECENT FINDINGS While there is solid evidence indicating a robust cross-sectional association between NSSI and ED behaviors, emerging evidence suggests that the temporal relationship between these behaviors may be bidirectional. Shared functions and risk factors may explain why these behaviors often co-develop. At the same time, little is still known about the psychosocial consequences of comorbid NSSI and ED engagement, and there is a lack of intervention studies that target these behaviors simultaneously. It is well-established that NSSI and ED behaviors frequently co-occur. The field should now turn to longitudinal designs to advance our understanding of the longer-term developmental and the shorter-term momentary relationship of these behaviors in daily life. Providing insight into these areas will help guide the deployment of evidence-based interventions that match the needs of clients who report comorbid NSSI and ED behaviors.
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Affiliation(s)
- Glenn Kiekens
- Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, box 3720, 3000, Leuven, Belgium. .,Department of Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium.
| | - Laurence Claes
- grid.5596.f0000 0001 0668 7884Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, box 3720, 3000 Leuven, Belgium ,grid.5284.b0000 0001 0790 3681Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Antwerp, Belgium
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Zhou S, Bian J, Zhao Y, Haynos AF, Rizvi R, Zhang R. Analysis of Twitter to Identify Topics Related to Eating Disorder Symptoms. IEEE INTERNATIONAL CONFERENCE ON HEALTHCARE INFORMATICS. IEEE INTERNATIONAL CONFERENCE ON HEALTHCARE INFORMATICS 2019; 2019. [PMID: 32030368 DOI: 10.1109/ichi.2019.8904863] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Eating disorders (EDs) are serious mental illnesses associated with physical and psychiatric problems, and premature death. Examining social media communication about ED symptoms may provide insight into how to prevent and treat these disorders. This study is to explore topics on Twitter related to EDs. We applied the Correlation Explanation (CorEx) topic model on 18,288 ED-related tweets and identified 20 topics, which were further grouped into 8 categories. The top two topic categories are body image and ED consequences. We manually evaluated the relevance of tweets to their assigned topics and average accuracy is 77.86%. Our findings are consistent with another study using content analysis, and we identified additional topics, such as ED consequences, pornography, and treatment and education from these tweets.
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Affiliation(s)
- Sicheng Zhou
- Institute for Health Informatics, University of Minnesota, Minneapolis, MN, USA
| | - Jiang Bian
- Department of Health Outcomes & Biomedical Informatics, University of Florida, Gainsville, FL, USA
| | - Yunpeng Zhao
- Department of Health Outcomes & Biomedical Informatics, University of Florida, Gainsville, FL, USA
| | - Ann F Haynos
- Department of Psychiatry, University of Minnesota, Minneapolis, MN, USA
| | - Rubina Rizvi
- Institute for Health Informatics and College of Pharmacy, University of Minnesota, Minneapolis, MN, USA
| | - Rui Zhang
- Institute for Health Informatics and College of Pharmacy, University of Minnesota, Minneapolis, MN, USA
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Fox KR, Wang SB, Boccagno C, Haynos AF, Kleiman E, Hooley JM. Comparing self-harming intentions underlying eating disordered behaviors and NSSI: Evidence that distinctions are less clear than assumed. Int J Eat Disord 2019; 52:564-575. [PMID: 30770581 PMCID: PMC6611160 DOI: 10.1002/eat.23041] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 01/27/2019] [Accepted: 01/27/2019] [Indexed: 01/16/2023]
Abstract
OBJECTIVE Eating disordered (ED) behaviors (i.e., binge eating, compensatory behaviors, restrictive eating) and nonsuicidal self-injury (NSSI; intentional and nonsuicidal self-harm) are highly comorbid and share several similarities, including consequent pain and physical damage. However, whereas NSSI is considered direct self-harm, ED behaviors are considered indirect self-harm. These distinctions stem from theoretical understanding that NSSI is enacted to cause physical harm in the moment, whereas ED behaviors are enacted for other reasons, with consequent physical harm occurring downstream of the behaviors. We sought to build on these theoretically informed classifications by assessing a range of self-harming intentions across NSSI and ED behaviors. METHOD Study recruitment was conducted via online forums. After screening for inclusion criteria, 151 adults reported on their intent to and knowledge of causing physical harm in the short- and long-term and suicide and death related cognitions and intentions when engaging in NSSI and specific ED behaviors. RESULTS Participants reported engaging in ED and NSSI behaviors with intent to hurt themselves physically in the moment and long-term, alongside thoughts of suicide, and with some hope and knowledge of dying sooner due to these behaviors. Distinctions across behaviors also emerged. Participants reported greater intent to cause physical harm in the moment via NSSI and in the long-run via restrictive eating. NSSI and restrictive eating were associated with stronger endorsement of most suicide and death-related intentions than binge eating or compensatory behaviors. CONCLUSIONS Findings shed light on classification of self-harming behaviors, casting doubt that firm boundaries differentiate direct and indirectly self-harming behaviors.
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Affiliation(s)
- Kathryn R. Fox
- Department of Psychology, Harvard University, Cambridge, Massachusetts
| | - Shirley B. Wang
- Department of Psychology, Harvard University, Cambridge, Massachusetts
| | - Chelsea Boccagno
- Department of Psychology, Harvard University, Cambridge, Massachusetts
| | - Ann F. Haynos
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota
| | - Evan Kleiman
- Department of Psychology, Harvard University, Cambridge, Massachusetts
| | - Jill M. Hooley
- Department of Psychology, Harvard University, Cambridge, Massachusetts
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Burke TA, Fox K, Zelkowitz RL, Smith DMY, Alloy LB, Hooley JM, Cole DA. Does nonsuicidal self-injury prospectively predict change in depression and self-criticism? COGNITIVE THERAPY AND RESEARCH 2019; 43:345-353. [PMID: 33162625 PMCID: PMC7643856 DOI: 10.1007/s10608-018-9984-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Few studies have investigated nonsuicidal self-injury (NSSI) as a predictor of outcomes other than suicidal self-injury, severely limiting our understanding of this behavior's full range of consequences. Three independent studies were used to examine the prospective association between NSSI and two outcomes: depressive symptoms and self-criticism. Data were collected from samples of (1) adults with past-month NSSI, (2) adults with lifetime NSSI, and (3) adults with past-year NSSI. Studies included one-month and six-month follow-up periods. Results were tested in an internal meta-analysis. Results suggested that NSSI did not prospectively predict changes in self-criticism. No changes in depressive symptoms were seen over shorter follow-up periods; however, NSSI predicted increases in depressive symptoms at six-month follow-up in one sample. The internal meta-analysis indicated a null relationship between NSSI and prospective internalizing symptoms. Future research should replicate these findings and examine a broader range of outcomes of NSSI to better understand its complex relationship to psychopathology.
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Affiliation(s)
- Taylor A. Burke
- Department of Psychology, Temple University, Philadelphia,
PA, USA
| | - Kathryn Fox
- Department of Psychology, Harvard University, Cambridge,
MA, USA
| | - Rachel L. Zelkowitz
- Department of Psychology and Human Development, Vanderbilt
University, Nashville, TN, USA
| | | | - Lauren B. Alloy
- Department of Psychology, Temple University, Philadelphia,
PA, USA
| | - Jill M. Hooley
- Department of Psychology, Harvard University, Cambridge,
MA, USA
| | - David A. Cole
- Department of Psychology and Human Development, Vanderbilt
University, Nashville, TN, USA
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Muehlenkamp JJ, Suzuki T, Brausch AM, Peyerl N. Behavioral functions underlying NSSI and eating disorder behaviors. J Clin Psychol 2019; 75:1219-1232. [PMID: 30672588 DOI: 10.1002/jclp.22745] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 11/13/2018] [Accepted: 12/27/2019] [Indexed: 11/11/2022]
Affiliation(s)
| | - Takakuni Suzuki
- Department of Psychiatry and Human BehaviorUniversity of Mississippi Medical CenterJackson Mississippi
- Department of Psychological SciencesPurdue University Indiana
| | - Amy M. Brausch
- Department of Psychological ScienceWestern Kentucky UniversityBowling Green Kentucky
| | - Naomi Peyerl
- Department of PsychologyUniversity of North DakotaGrand Forks North Dakota
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Victor SE, Hipwell AE, Stepp SD, Scott LN. Parent and peer relationships as longitudinal predictors of adolescent non-suicidal self-injury onset. Child Adolesc Psychiatry Ment Health 2019; 13:1. [PMID: 30622642 PMCID: PMC6317237 DOI: 10.1186/s13034-018-0261-0] [Citation(s) in RCA: 82] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 12/22/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescence is characterized by developmental changes in social relationships, which may contribute to, or protect against, psychopathology and risky behaviors. Non-suicidal self-injury (NSSI) is one type of risky behavior that typically begins during adolescence and is associated with problems in relationships with family members and peers. Prior research on social factors in adolescent NSSI has been limited, however, by a narrow focus on specific interpersonal domains, cross-sectional methods, retrospective self-report of childhood experiences, and a failure to predict NSSI onset among as-yet-unaffected youth. METHODS We investigated these relationships in 2127 urban-living adolescent girls with no NSSI history at age 13, who were participating in a longitudinal cohort study (Pittsburgh Girls Study). We used discrete-time survival analyses to examine the contribution of time-varying interpersonal risk factors, assessed yearly at ages 13-16, to NSSI onset assessed in the following year (ages 14-17), controlling for relevant covariates, such as depression and race. We considered both behavioral indicators (parental discipline, positive parenting, parental monitoring, peer victimization), and cognitive/affective indicators (quality of attachment to parent, perceptions of peers, and perceptions of one's own social competence and worth in relation to peers) of interpersonal difficulties. RESULTS Parental harsh punishment, low parental monitoring, and poor quality of attachment to parent predicted increased odds of subsequent adolescent NSSI onset, whereas positive parenting behaviors reduced the odds of next year NSSI onset. Youth who reported more frequent peer victimization, poorer social self-worth and self-competence, and more negative perceptions of peers were also at increased risk of NSSI onset in the following year. When tested simultaneously, no single parenting variable showed a unique association with later NSSI onset; in contrast, peer victimization and poor social self-worth each predicted increased odds of later NSSI onset in an omnibus model of peer and parent relationship characteristics. CONCLUSIONS In this urban sample of adolescent girls, both peer and parent factors predicted new onset NSSI, although only peer factors were associated with subsequent NSSI in combined multivariate models. Results further suggest that both behavioral and cognitive/affective indicators of interpersonal problems predict NSSI onset. These findings highlight the relevance of family and peer relationships to NSSI onset, with implications for prevention of NSSI onset among at-risk youth.
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Affiliation(s)
- Sarah E. Victor
- 0000 0004 1936 9000grid.21925.3dDepartment of Psychiatry, University of Pittsburgh, Sterling Plaza Suite 408, Pittsburgh, PA 15213 USA
| | - Alison E. Hipwell
- 0000 0004 1936 9000grid.21925.3dDepartment of Psychiatry, University of Pittsburgh, Sterling Plaza Suite 408, Pittsburgh, PA 15213 USA
| | - Stephanie D. Stepp
- 0000 0004 1936 9000grid.21925.3dDepartment of Psychiatry, University of Pittsburgh, Sterling Plaza Suite 408, Pittsburgh, PA 15213 USA
| | - Lori N. Scott
- 0000 0004 1936 9000grid.21925.3dDepartment of Psychiatry, University of Pittsburgh, Sterling Plaza Suite 408, Pittsburgh, PA 15213 USA
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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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