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Li Y, Li YH, He Y, Chen SS, Chang JJ, Yuan MY, Cao LL, Wang SJ, Wang GF, Su PY. Psychological Resilience Mediates the Association Between Childhood Maltreatment and Self-Harm Phenotype in Chinese Early Adolescents. Child Psychiatry Hum Dev 2024; 55:1073-1082. [PMID: 36445604 DOI: 10.1007/s10578-022-01471-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/15/2022] [Indexed: 12/02/2022]
Abstract
Self-harm (SH) increases significantly in early adolescence with great variability, and childhood maltreatment (CM) contributes to this increase. Understanding the developmental pathway from CM to SH could provide clues for SH prevention. This study used latent class analysis (LCA) to detect the phenotype of SH and explored the role of psychological resilience in the pathway from the CM to SH phenotype among 5724 early adolescents (52.5% male). Three interpretable phenotypes of SH were identified: low SH (57.8%), medium SH (29.0%), and high SH (13.2%). Furthermore, CM was positively associated with the SH phenotype, psychological resilience mediated the association between CM and the SH phenotype (all ps < 0.001), and a larger mediating effect was observed in the medium SH (22.41%). Our findings offer new perspectives that improving psychological resilience can be used as an efficient intervention to reduce the risk of SH among early adolescents who have experienced CM.
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Affiliation(s)
- Yuan Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China
| | - Yong-Han Li
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China
| | - Yang He
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China
- Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China
| | - Shan-Shan Chen
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China
- Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China
| | - Jun-Jie Chang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China
- Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China
| | - Meng-Yuan Yuan
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China
- Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China
| | - Lei-Lei Cao
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China
- Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China
| | - Shao-Jie Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China
- Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China
| | - Geng-Fu Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China.
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, Hefei, China.
- NHC Key Laboratory of study on abnormal gametes and reproductive tract, No 81 Meishan Road, 230032, Hefei, Anhui, China.
- Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China.
| | - Pu-Yu Su
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China.
- Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, Hefei, China.
- NHC Key Laboratory of study on abnormal gametes and reproductive tract, No 81 Meishan Road, 230032, Hefei, Anhui, China.
- Anhui Medical University, No.81 Meishan Road, 230032, Hefei, Anhui, China.
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Tanaka R, Ando S, Kiyono T, Minami R, Endo K, Miyashita M, Yamasaki S, Kanata S, Fujikawa S, Hiraiwa-Hasegawa M, Nishida A, Kasai K. The longitudinal relationship between dissociative symptoms and self-harm in adolescents: a population-based cohort study. Eur Child Adolesc Psychiatry 2024; 33:561-568. [PMID: 36882639 PMCID: PMC10869437 DOI: 10.1007/s00787-023-02183-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 02/27/2023] [Indexed: 03/09/2023]
Abstract
Previous studies have reported that dissociative symptoms (DIS) are associated with self-harm (SH) in adolescents. However, most of these studies were cross-sectional, which limits the understanding of their theoretical relationship. We aimed to investigate the longitudinal relationship between DIS and SH in the general adolescent population. We used data from the Tokyo Teen Cohort study (N = 3007). DIS and SH were assessed at times 1 and 2 (T1 and T2) (12 years of age and 14 years of age, respectively). DIS were assessed using the parent-report Child Behavior Checklist (CBCL), and severe dissociative symptoms (SDIS) were defined as a score above the top 10th percentile. The experience of SH within 1 year was assessed by a self-report questionnaire. The longitudinal relationship between DIS and SH was examined using regression analyses. Using logistic regression analyses, we further investigated the risk for SH at T2 due to persistent SDIS and vice versa. DIS at T1 tended to predict SH at T2 (odds ratio (OR) 1.11, 95% CI 0.99 to 1.25, p = 0.08), while SH at T1 did not predict DIS at T2 (B = - 0.03, 95% CI - 0.26 to 0.20, p = 0.81). Compared with adolescents without SDIS, those with persistent SDIS had an increased risk of SH at T2 (OR 2.61, 95% CI 1.28 to 5.33, p = 0.01). DIS tended to predict future SH, but SH did not predict future DIS. DIS may be a target to prevent SH in adolescents. Intensive attention should be given to adolescents with SDIS due to their increased risk of SH.
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Affiliation(s)
- Riki Tanaka
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, Japan.
| | - Shuntaro Ando
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, Japan
| | - Tomoki Kiyono
- Department of Psychiatry, Teikyo University Mizonokuchi Hospital, Kanagawa, Japan
| | - Rin Minami
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, Japan
| | - Kaori Endo
- Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Mitsuhiro Miyashita
- Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Syudo Yamasaki
- Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Sho Kanata
- Department of Psychiatry, Teikyo University School of Medicine, Tokyo, Japan
| | - Shinya Fujikawa
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, Japan
| | - Mariko Hiraiwa-Hasegawa
- School of Advanced Science, SOKENDAI (Graduate University for Advanced Studies), Kanagawa, Japan
| | - Atsushi Nishida
- Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, Japan
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Cantrell A, Sworn K, Chambers D, Booth A, Taylor Buck E, Weich S. Factors within the clinical encounter that impact upon risk assessment within child and adolescent mental health services: a rapid realist synthesis. HEALTH AND SOCIAL CARE DELIVERY RESEARCH 2024; 12:1-107. [PMID: 38314750 DOI: 10.3310/vkty5822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2024]
Abstract
Background Risk assessment is a key process when a child or adolescent presents at risk for self-harm or suicide in a mental health crisis or emergency. Risk assessment by a healthcare professional should be included within a biopsychosocial assessment. However, the predictive value of risk-screening tools for self-harm and suicide in children and adolescents is consistently challenged. A review is needed to explore how best to undertake risk assessment and the appropriate role for tools/checklists within the assessment pathway. Aims To map research relating to risk assessment for child and adolescent mental health and to identify features that relate to a successful risk assessment. Objectives To review factors within the clinical encounter that impact upon risk assessments for self-harm and suicide in children and adolescents: i. to conduct a realist synthesis to understand mechanisms for risk assessment, why they occur and how they vary by context ii. to conduct a mapping review of primary studies/reviews to describe available tools of applicability to the UK. Data sources Databases, including MEDLINE, PsycINFO®, EMBASE, CINAHL, HMIC, Science and Social Sciences Citation Index and the Cochrane Library, were searched (September 2021). Searches were also conducted for reports from websites. Review methods A resource-constrained realist synthesis was conducted exploring factors that impact upon risk assessments for self-harm and suicide. This was accompanied by a mapping review of primary studies/reviews describing risk-assessment tools and approaches used in UK child and adolescent mental health. Following piloting, four reviewers screened retrieved records. Items were coded for the mapping and/or for inclusion in the realist synthesis. The review team examined the validity and limitations of risk-screening tools. In addition, the team identified structured approaches to risk assessment. Reporting of the realist synthesis followed RAMESES guidelines. Results From 4084 unique citations, 249 papers were reviewed and 41 studies (49 tools) were included in the mapping review. Eight reviews were identified following full-text screening. Fifty-seven papers were identified for the realist review. Findings highlight 14 explanations (programme theories) for a successful risk assessment for self-harm and suicide. Forty-nine individual assessment tools/approaches were identified. Few tools were developed in the UK, specifically for children and adolescents. These lacked formal independent evaluation. No risk-screening tool is suitable for risk prediction; optimal approaches incorporate a relationship of trust, involvement of the family, where appropriate, and a patient-centred holistic approach. The objective of risk assessment should be elicitation of information to direct a risk formulation and care plan. Limitations Many identified tools are well-established but lack scientific validity, particularly predictive validity, or clinical utility. Programme theories were generated rapidly from a survey of risk assessment. Conclusions No single checklist/approach meets the needs of risk assessment for self-harm and suicide. A whole-system approach is required, informed by structured clinical judgement. Useful components include a holistic assessment within a climate of trust, facilitated by family involvement. Study registration This study is registered as PROSPERO CRD42021276671. Funding This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR135079) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 1. See the NIHR Funding and Awards website for further award information.
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Affiliation(s)
- Anna Cantrell
- Health Economics & Decision Science (HEDS) School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
| | - Katie Sworn
- Health Economics & Decision Science (HEDS) School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
| | - Duncan Chambers
- School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
| | - Andrew Booth
- Health Economics & Decision Science (HEDS) School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
| | | | - Scott Weich
- School of Health and Related Research (ScHARR), Regent Court, Sheffield, UK
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Hamal M, Kekkonen V, Kraav SL, Kivimäki P, Rissanen ML, Hintikka J, Tolmunen T. Depression and dissociation mediate the association between bullying victimization and self-cutting. Nord J Psychiatry 2023; 77:676-685. [PMID: 37314765 DOI: 10.1080/08039488.2023.2222698] [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: 12/25/2022] [Revised: 05/03/2023] [Accepted: 05/16/2023] [Indexed: 06/15/2023]
Abstract
BACKGROUND Bullying victimization is experienced by more than 10% of children and adolescents worldwide and has been associated with numerous negative mental health consequences, such as depression and dissociation. AIMS We investigated the association between bullying victimization and self-cutting in a Finnish adolescent population and whether depression and dissociation act as mediators in this association. METHODS We used cross-sectional questionnaire data from Finnish students (age 13-18; N = 3345; boys n = 1454; girls n = 1891). Logistic regression and mediation analyses were performed. RESULTS Bullying victimized adolescents were younger, more likely to be afraid to go to school, had fewer friends, felt lonelier, and had a poorer relationship with family members, as well as higher level of depressive and dissociative symptoms compared to non-bullied adolescents. According to logistic regression analysis, the association between bullying and self-cutting remained significant despite all other adjustments besides those for depressive symptoms. In serial mediation analysis, depressive and dissociative symptoms mediated the effect of bullying victimization on self-cutting, regardless of their order in the model. CONCLUSIONS Self-cutting is more common among bullying victimized adolescents than their peers. The association is mediated by depressive and dissociative symptoms. More studies are needed to clarify the exact mechanisms via which depressive and dissociative symptoms interact with the association between bullying and self-harm.
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Affiliation(s)
- Manisha Hamal
- Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Department of Adolescent Psychiatry, Kuopio University Hospital, Kuopio, Finland
| | - Virve Kekkonen
- Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Department of Adolescent Psychiatry, Kuopio University Hospital, Kuopio, Finland
| | - Siiri-Liisi Kraav
- Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Faculty of Social Sciences and Business Studies, University of Eastern Finland, Kuopio, Finland
| | - Petri Kivimäki
- Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Department of Adolescent Psychiatry, Kuopio University Hospital, Kuopio, Finland
| | - Marja-Liisa Rissanen
- Department of Social Services and Health Care, South-Eastern University of Applied Sciences, Mikkeli, Finland
- Faculty of Social Sciences, Health Sciences, University of Tampere, Tampere, Finland
| | - Jukka Hintikka
- Faculty of Medicine and Health Technology, University of Tampere, Tampere, Finland
| | - Tommi Tolmunen
- Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
- Department of Adolescent Psychiatry, Kuopio University Hospital, Kuopio, Finland
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Schmitz M, Back SN, Seitz KI, Harbrecht NK, Streckert L, Schulz A, Herpertz SC, Bertsch K. The impact of traumatic childhood experiences on interoception: disregarding one's own body. Borderline Personal Disord Emot Dysregul 2023; 10:5. [PMID: 36788573 PMCID: PMC9930318 DOI: 10.1186/s40479-023-00212-5] [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: 09/22/2022] [Accepted: 02/01/2023] [Indexed: 02/16/2023] Open
Abstract
BACKGROUND Deficient interoception, the processing and perception of internal bodily signals, has been discussed as a mechanism underlying various mental disorders. First results indicate a mediating role of interoception in the interplay of traumatic childhood experiences and adult mental disorders. Traumatic childhood experiences may hinder the adequate processing, integration, and trust in bodily signals that are important in order to understand and regulate own needs and emotions, thereby increasing the vulnerability for mental disorders. However, an overarching study investigating alterations in different interoceptive measures and trauma-related disorders as well as their mediating role between early trauma and emotion dysregulation is still missing. METHODS One hundred thirty-six individuals with varying levels of traumatic childhood experiences who either had a current diagnosis of major depression, posttraumatic stress disorder, or somatic symptom disorder, or no mental disorder, took part in a multidimensional assessment of interoceptive processes, including interoceptive accuracy, sensibility, and awareness. Kruskal-Wallis tests were used to compare groups regarding interoceptive processes and associations with traumatic childhood experiences and emotion dysregulation were analyzed with Spearman correlations. Furthermore, mediation analyses were computed to examine and compare interoceptive processes as potential mediators between traumatic childhood experiences and emotion dysregulation. RESULTS Only body dissociation, a measure for interoceptive sensibility, was significantly reduced in individuals with a current mental disorder. Body dissociation was also the only interoceptive measure significantly associated with traumatic childhood experiences and emotion dysregulation and the only significant mediator in the relationship between traumatic childhood experiences and emotion dysregulation across groups. CONCLUSION Results suggest body dissociation, but not other interoceptive measures, as an important feature linking traumatic childhood experiences to current emotion dysregulation, an important transdiagnostic feature. As body dissociation refers to a habitual non-attendance or disregard of interoceptive signals, integrative therapeutic interventions could help affected individuals to overcome difficulties in emotion perception and regulation. TRIAL REGISTRATION The general study design was preregistered; see the German Clinical Trials Register (DRKS-ID: DRKS00015182). This study's analysis plan was not preregistered.
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Affiliation(s)
- Marius Schmitz
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany. .,Department of Psychology, Ludwig-Maximilians-University Munich, Munich, Germany. .,Institute of Psychology, University of Heidelberg, Heidelberg, Germany.
| | - Sarah N Back
- Department of Psychology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Katja I Seitz
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.,Institute of Psychology, University of Heidelberg, Heidelberg, Germany
| | - Nele K Harbrecht
- Department of Psychology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Lena Streckert
- Department of Psychology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - André Schulz
- Department of Behavioural and Cognitive Sciences, Clinical Psychophysiology Laboratory, University of Luxembourg, Esch-Sur-Alzette, Luxembourg
| | - Sabine C Herpertz
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Katja Bertsch
- Department of General Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany.,Department of Psychology, Ludwig-Maximilians-University Munich, Munich, Germany
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Cheng Q, Zhao G, Chen J, Deng Y, Xie L, Wang L. Gender differences in the prevalence and impact factors of adolescent dissociative symptoms during the coronavirus disease 2019 pandemic. Sci Rep 2022; 12:20193. [PMID: 36418430 PMCID: PMC9684521 DOI: 10.1038/s41598-022-24750-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 11/21/2022] [Indexed: 11/25/2022] Open
Abstract
The purpose of this study was to explore the differences between the prevalence and impact factors of adolescent dissociative symptoms (ADSs) by using sex-stratification during the coronavirus disease 2019 (COVID-19) pandemic. A school-based, two-center cross-sectional study was conducted in Hangzhou City, China, between January 1, 2021 and April 30, 2022. The sample included 1,916 adolescents aged 13-18 years that were randomly selected using a multiphase, stratified, cluster sampling technique. A two-stage assessment procedure was used to find out the ADSs. We used a multivariate logistic regression analysis to assess the impact factors of ADSs during the COVID-19 pandemic. The adolescent dissociative scores (t = 4.88, P < 0.001) and positive ADSs rate (Chi-square = 15.76, P < 0.001) in males were higher than in females. Gender-stratified, stepwise multiple logistic regression analysis revealed that the conflict relationship of teacher-student [adjusted odds ratio (AOR) 1.06, 95% confidence interval (CI) 1.01-1.10], family expressiveness (AOR 0.87, 95% CI 0.78-0.98), family conflict (AOR 1.15, 95% CI 1.05-1.27), family organization (AOR 0.88, 95% CI 0.78-0.99), and family cohesion (AOR 0.87, 95% CI 0.77-0.99) were linked to ADSs only in males, while individual psychological states of somatic complaint (AOR 1.04, 95% CI 1.00-1.08) and paranoid ideation (AOR 1.09, 95% CI 1.01-1.19) were associated with female ADSs only. The ADSs seemed to be prevalent in Hangzhou City, studied during the COVID-19 pandemic. Gender differences in the prevalence and impact factors of dissociative symptoms seem to be significant among adolescents. Thus, gender-specific intervention programs against ADSs should be considered as reducing this risk.
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Affiliation(s)
- Qinglin Cheng
- grid.410735.40000 0004 1757 9725Division of Infectious Diseases, Hangzhou Center for Disease Control and Prevention, 568 Mingshi Road, Hangzhou, 310021 China ,grid.410595.c0000 0001 2230 9154School of Public Health, Hangzhou Normal University, Hangzhou, 310021 China
| | - Gang Zhao
- grid.410735.40000 0004 1757 9725Division of Infectious Diseases, Hangzhou Center for Disease Control and Prevention, 568 Mingshi Road, Hangzhou, 310021 China
| | - Junfang Chen
- grid.410735.40000 0004 1757 9725Division of Infectious Diseases, Hangzhou Center for Disease Control and Prevention, 568 Mingshi Road, Hangzhou, 310021 China
| | - Yuanyuan Deng
- grid.410595.c0000 0001 2230 9154School of Public Health, Hangzhou Normal University, Hangzhou, 310021 China
| | - Li Xie
- grid.410735.40000 0004 1757 9725Division of Infectious Diseases, Hangzhou Center for Disease Control and Prevention, 568 Mingshi Road, Hangzhou, 310021 China
| | - Le Wang
- grid.410735.40000 0004 1757 9725Division of Infectious Diseases, Hangzhou Center for Disease Control and Prevention, 568 Mingshi Road, Hangzhou, 310021 China
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Santo MADS, Bedin LM, Dell’Aglio DD. Self-injurious behavior and factors related to suicidal intent among adolescents: a documentary study. PSICO-USF 2022. [DOI: 10.1590/1413-82712022270212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract It is a type of quantitative documentary research of descriptive and exploratory content in which studied the profile of adolescents with self-injurious behavior and the variables of risk and protection regarding the suicidal intent, reported in a Children and Youth Psychosocial Care Center (CAPS IJ) from a metropolitan region in the south of Brazil. Data from 139 assisted adolescents, admitted for self-injury, reported that self-injuries occurred predominantly at home (M=14,36 years; SD=1,63), with multiple episodes, using sharp objects with suicidal intent. The hierarchical binary logistic regression results point out that experiencing abuse in the present -using non-sharps objects- having severe injuries and practicing them in different places are risk variables. Whereas the existence of community and school social support networks are protective factors. There is a necessity of investment in the studies that explore the etiology of self-injuries and that provide support for cases of prevention, detection, and treatment.
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Longo P, Panero M, Amodeo L, Demarchi M, Abbate-Daga G, Marzola E. Psychoform and somatoform dissociation in anorexia nervosa: A systematic review. Clin Psychol Psychother 2020; 28:295-312. [PMID: 32918777 DOI: 10.1002/cpp.2517] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 09/09/2020] [Accepted: 09/10/2020] [Indexed: 02/06/2023]
Abstract
Dissociation is a debilitating condition often present as comorbidity in patients with eating disorders, but to date only sparse findings are available on this topic. Additionally, very little data exist on the classification of dissociation, namely, psychoform and somatoform, in anorexia nervosa (AN). This review aimed to provide an updated view on the literature about dissociation in AN, with a focus on AN subtypes (i.e., restricter and binge-purging) as well as dissociation type (i.e., psychoform and somatoform), when available. We screened 304 studies, and after title and abstract selection and full-text reading, 29 of them were included in this review. Most of the studies investigated psychoform dissociation, whereas just four publications considered somatoform dissociation. Dissociation resulted to be present in AN more than in healthy controls and in individuals with other psychiatric disorders, and it was related mostly to the binge-purging subtype of AN. Moreover, dissociation was linked to traumatic events, self-harm and negative treatment outcomes, especially in patients affected by the binge-purging subtype of AN. However, results on these matters are scarce and partially discordant. The methodological assessment we performed revealed an overall fair quality of the included studies, although several flaws emerged as well. The present review reported on one hand the relevance of dissociation in AN, but on the other hand the need to stimulate the scientific debate on (a) a deeper investigation of somatoform dissociation in AN and (b) the relationship between dissociation and both clinical severity and treatment response/resistance in AN.
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Affiliation(s)
- Paola Longo
- Eating Disorders Center, Department of Neuroscience, University of Turin, Turin, Italy
| | - Matteo Panero
- Eating Disorders Center, Department of Neuroscience, University of Turin, Turin, Italy
| | - Laura Amodeo
- Eating Disorders Center, Department of Neuroscience, University of Turin, Turin, Italy
| | - Matilde Demarchi
- Eating Disorders Center, Department of Neuroscience, University of Turin, Turin, Italy
| | - Giovanni Abbate-Daga
- Eating Disorders Center, Department of Neuroscience, University of Turin, Turin, Italy
| | - Enrica Marzola
- Eating Disorders Center, Department of Neuroscience, University of Turin, Turin, Italy
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Janů A, Malinakova K, Kosarkova A, Tavel P. Associations of childhood trauma experiences with religious and spiritual struggles. J Health Psychol 2020; 27:292-304. [PMID: 32830557 DOI: 10.1177/1359105320950793] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Childhood trauma is associated with many interpersonal and psychosocial problems in adulthood. The aim of this study was to explore the associations with a spiritual area of personality, namely religious and spiritual struggles (R/S struggles). A nationally representative sample of 1,000 Czech respondents aged 15 years and older participated in the survey. All types of CT were associated with an increased level of all six types of R/S struggles, with the highest values for demonic struggles. Thus, the findings of this study might be important for clinical practice and pastoral care as well as a further research.
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Affiliation(s)
- Anna Janů
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czech Republic
| | - Klara Malinakova
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czech Republic
| | - Alice Kosarkova
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czech Republic
| | - Peter Tavel
- Olomouc University Social Health Institute, Palacky University Olomouc, Olomouc, Czech Republic
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