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Karmakar S, Duggal C. Trauma-Informed Approach to Qualitative Interviewing in Non-Suicidal Self-Injury Research. QUALITATIVE HEALTH RESEARCH 2024; 34:33-47. [PMID: 37924212 DOI: 10.1177/10497323231207746] [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: 11/06/2023]
Abstract
Non-suicidal self-injury (NSSI) is recognized as a public health concern owing to its chronic nature, association with suicide risk, and its growing prevalence rates across the globe. Including individuals living with NSSI in research is crucial as it offers opportunities to give primacy to participant voices and insights, further guiding therapeutic interventions. Research has established an association between history of traumatic events and adverse childhood experiences with subsequent risk of NSSI. When planning a qualitative research study with individuals with potential trauma history, researchers need to be aware of and sensitive to potential re-traumatization and distressing emotions that participants may experience during interviews, as well as complex trauma reactions that may affect individuals after study participation. The article emphasizes that researchers be cognizant of the multifaceted nature of trauma and how it can impact individuals and communities and be sensitive in their approach to interviewing vulnerable groups such as individuals with experiences of NSSI. The authors propose adopting a trauma-informed approach to ethically plan and conduct qualitative interviews exploring NSSI experiences. Trauma-informed recommendations for preparing and carrying out specific steps during different stages of NSSI interviews are detailed.
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Affiliation(s)
- Sushmita Karmakar
- School of Human Ecology, Tata Institute of Social Sciences, Mumbai, India
| | - Chetna Duggal
- School of Human Ecology, Tata Institute of Social Sciences, Mumbai, India
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Haregu T, Chen Q, Arafat SMY, Cherian A, Armstrong G. Prevalence, correlates and common methods of non-suicidal self-injury in South Asia: a systematic review. BMJ Open 2023; 13:e074776. [PMID: 37993150 PMCID: PMC10668266 DOI: 10.1136/bmjopen-2023-074776] [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: 04/18/2023] [Accepted: 10/27/2023] [Indexed: 11/24/2023] Open
Abstract
INTRODUCTION The dynamics of self-harm vary substantially around the world, yet it is severely under-researched outside of a small number of high-income 'Western' countries. South Asia is disproportionately impacted by suicide, yet we know less about non-suicidal self-injury (NSSI) in the region. OBJECTIVE To review and summarise evidence on the prevalence, correlates and common methods of NSSI in South Asia. METHODS We searched Medline, Embase and PsycINFO for the period 1 January 2000 to 31 August 2023, for peer-reviewed observational studies. A total of 11 studies from eight South Asian countries that reported prevalence and/or correlates of NSSI were included in this review. We assessed the quality of the studies using the Study Quality Assessment Tools for Observational Cohort and Cross-Sectional Studies. We used meta-regression to describe the sources of heterogeneity. Abstracted data were summarised using thematic synthesis. RESULTS For non-clinical populations, the 12-month prevalence of NSSI ranged from 3.2% to 44.8%, and the lifetime prevalence ranged from 21% to 33%. For clinical populations, the 12-month prevalence of NSSI ranged from 5% to 16.4%, while the lifetime prevalence ranged from 2% to 27%. Male sex, unemployment, financial stress, history of suicidal behaviour and depression were associated with a higher risk of NSSI. Better access to counselling services, higher self-esteem and self-knowledge were associated with a lower risk of NSSI. CONCLUSION The burden of NSSI in South Asia appears to be high in both clinical and non-clinical populations. Further research, especially with general population samples, is needed to build evidence on the epidemiology, context and meaning of NSSI in South Asia to inform the design of context-specific interventions. PROSPERO REGISTRATION NUMBER CRD42022342536.
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Affiliation(s)
- Tilahun Haregu
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - Quan Chen
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
| | - S M Yasir Arafat
- Department of Psychiatry, Enam Medical College and Hospital, Savar, Bangladesh
| | - Anish Cherian
- Department of Psychiatric Social Work, National Institute of Mental Health and Neuro Sciences, Bangalore, Karnataka, India
| | - Gregory Armstrong
- Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia
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Nyrenius J, Waern M, Eberhard J, Ghaziuddin M, Gillberg C, Billstedt E. Autism in adult psychiatric out-patients: self-reported suicidal ideation, suicide attempts and non-suicidal self-injury. BJPsych Open 2023; 9:e167. [PMID: 37674410 PMCID: PMC10594204 DOI: 10.1192/bjo.2023.553] [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: 02/14/2023] [Revised: 06/20/2023] [Accepted: 07/24/2023] [Indexed: 09/08/2023] Open
Abstract
BACKGROUND The prevalence of self-reported suicidal ideation, suicide attempts and non-suicidal self-injury (NSSI) remains unclear among adults with autism unrecognised in childhood who attend psychiatric services. AIMS We aimed to estimate the prevalence of suicidal ideation, suicide attempts and NSSI; identify factors associated with suicide attempts and NSSI; and describe NSSI in this group. METHOD Sixty-three new patients at an adult psychiatric out-patient clinic (57% women, mean age 32 years) who met full (n = 52) or subthreshold (two A criteria and minimum of two B criteria; n = 11) DSM-5 criteria for autism spectrum disorder were included in the study. Clinical assessments included overall diagnostic review, Paykel's questions on passive and active suicidality, evaluation of NSSI with the Functional Assessment of Self-Mutilation, and results of cognitive tests. One follow-up of medical records was made. RESULTS In this sample of psychiatric out-patients identified as first having autism in adulthood, almost a third (31%) of patients reported suicidal ideation during the past month, 86% had lifetime suicidal ideation and 25% reported at least one suicide attempt. Factors associated with suicide attempts included hazardous or harmful alcohol use and/or drug-related problems, and severity of depression. A total of 44% reported NSSI. Factors associated with NSSI were female sex, history of suicidal plans and antisocial personality disorder. Substance or alcohol use were often overlooked, especially in women. CONCLUSIONS Suicidal ideation, suicide attempts and NSSI were very common in adults with autism who were recently referred to an out-patient psychiatric service. Suicidal ideation and NSSI were more common than suicide attempts. Clinicians should always consider suicidal ideation and NSSI in adult psychiatric patients with autism.
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Affiliation(s)
- Johan Nyrenius
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden; Adult Psychiatric Clinic of Helsingborg, Region Skåne, Sweden; and Department of Clinical Sciences Lund/Helsingborg, Lund University, Sweden
| | - Margda Waern
- Sahlgrenska Suicide Studies, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Jonas Eberhard
- Adult Psychiatric Clinic of Helsingborg, Region Skåne, Sweden; and Department of Clinical Sciences Lund/Helsingborg, Lund University, Sweden
| | | | - Christopher Gillberg
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden; and Child Neuropsychiatric Clinic, Sahlgrenska University Hospital, Sweden
| | - Eva Billstedt
- Gillberg Neuropsychiatry Centre, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden; and Child Neuropsychiatric Clinic, Sahlgrenska University Hospital, Sweden
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Yeh YJ, Tsai W, Chen JH, Kimel S. Culture, Family Problems, Emotion Dysregulation and Nonsuicidal Self-injury: Differences among Taiwanese and Americans. CURRENT PSYCHOLOGY 2023. [DOI: 10.1007/s12144-023-04600-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
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Patra BN, Sen MS, Sagar R, Bhargava R. Deliberate self-harm in adolescents: A review of literature. Ind Psychiatry J 2023; 32:9-14. [PMID: 37274564 PMCID: PMC10236686 DOI: 10.4103/ipj.ipj_215_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 01/11/2022] [Accepted: 01/17/2022] [Indexed: 11/11/2022] Open
Abstract
Deliberate self-harm is a rising epidemic in the youth. This review examined the different self-harm behavior, approach to treatment, and the implication of such behaviors in the adolescent population in the academic literature. Using the PubMed database, we searched for specific terms related to different self-harm behaviors in Adolescents. The bibliography of the articles found relevant for the review was also screened. Each study's findings were taken with reference to our topic and findings were summarized. After reviewing the literature, we found that the prevalence of suicidal attempts was as high as 18% in the past year While the nonsuicidal attempts were as high as 31%. Risk factors associated with higher levels of suicide were bullying, loneliness and anxiety, tobacco and alcohol use, and weak family and social relationships. While the factors playing a protective role are being connected to school, having good social support, and attending school. There are very few studies focused on interventions related to suicide prevention in Adolescent and postvention programs. Out of the evidence available, the interventions are not focused on the target individuals and lack replicability. Self-harm is a major public health concern which needs to be understood holistically. The interventions aimed at preventing and managing self-harm behavior still need to be more targeted and precise. Other targets may include interventions suited to different phases of development, stopping the progression of the behavior to adulthood, including the varied population in such intervention, etc.
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Affiliation(s)
- Bichitra Nanda Patra
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Mahadev Singh Sen
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Rajesh Sagar
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
| | - Rachna Bhargava
- Department of Psychiatry, All India Institute of Medical Sciences, New Delhi, India
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Cherian AV, Menon V, Rathinam B, Aiman A, Shrinivasa Bhat U, Arahantabailu P, John S, Kumar S, Bhat A. Awareness and preferences about suicide crisis support service options among college students in India: A cross sectional study. Asian J Psychiatr 2022; 74:103172. [PMID: 35689875 DOI: 10.1016/j.ajp.2022.103172] [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: 04/06/2022] [Revised: 05/09/2022] [Accepted: 05/11/2022] [Indexed: 11/02/2022]
Abstract
BACKGROUND Our objective was to explore the awareness about suicide support services and preferred service options during a suicide crisis among college going young adults. METHODS Between September 2016 and February 2017, we invited students from colleges affiliated to three major universities in a coastal district of South India to participate in a cross-sectional survey. RESULTS A total of 1890 usable responses were obtained. Most participants (n = 1633, 86.4%) were unaware of any suicide crisis support options. Most commonly listed options were support from family members, peer groups, counselling and psychiatric consultation. These were also endorsed as most preferred support options. CONCLUSION There is a low level of awareness about suicide support services among young Indian adults. There is a need for coordinated efforts to raise awareness and promote uptake of suicide support services in this group.
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Affiliation(s)
- Anish V Cherian
- National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India.
| | - Vikas Menon
- Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, India
| | - Bharath Rathinam
- National Institute of Mental Health and Neuro Sciences (NIMHANS), Bengaluru, India
| | - Agnieta Aiman
- Department of Psychiatry, K S Hegde Medical Academy, Nitte Deemed to be University, Mangalore, India
| | - U Shrinivasa Bhat
- Department of Psychiatry, K S Hegde Medical Academy, Nitte Deemed to be University, Mangalore, India
| | | | - Soyuz John
- Department of Psychiatry, Kasturba Medical College, Manipal, India
| | - Shishir Kumar
- Department of Psychiatry, K S Hegde Medical Academy, Nitte Deemed to be University, Mangalore, India
| | - Aneesh Bhat
- Department of Psychiatry, Maharashtra Institute of Medical Education and Research (MIMER), India
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Gupta N, Chauhan N, Sharma P. Non-suicidal Self Injury: An Entity in Need of Validation? JOURNAL OF INDIAN ASSOCIATION FOR CHILD AND ADOLESCENT MENTAL HEALTH 2022. [DOI: 10.1177/09731342221136363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Affiliation(s)
- Nitin Gupta
- Editor, Consultant Psychiatrist, Gupta Mind Healing and Counselling Centre, Chandigarh, India
| | - Nidhi Chauhan
- Assistant Professor Department of Psychiatry Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Prerna Sharma
- Associate Professor, Clinical Psychology IHBAS, Delhi, India
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Sundar SP, Bhola P. Dimensional Personality Traits and Non-suicidal Self Injury Among Emerging Adults: The Mediating Role of Mentalization. PSYCHOLOGICAL STUDIES 2022. [DOI: 10.1007/s12646-022-00663-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Gandhi A, Luyckx K, Adhikari A, Parmar D, De Sousa A, Shah N, Maitra S, Claes L. Nonsuicidal self-injury and identity formation in Indian clinical and nonclinical samples: A comparative study. Int J Soc Psychiatry 2021; 67:219-226. [PMID: 32686554 DOI: 10.1177/0020764020943618] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Nonsuicidal self-injury (NSSI) is being increasingly identified as an important emerging mental health issue in the West. Yet, NSSI has not been adequately studied in clinical and nonclinical contexts in countries like India. AIM The aim of this study was to compare different features of NSSI between clinical and nonclinical samples in India. We also explored if the strength of the association between NSSI and disturbances in identity formation - a risk factor that can increase vulnerability to NSSI - was similar in the two samples mentioned above. METHOD For the clinical sample, data regarding NSSI and identity formation were collected from 100 psychiatric patients (47.0% females, mean age = 34.76 years, SD = 12.76, 17-70 years) from an outpatient/inpatient psychiatric department of a large tertiary hospital in Mumbai, India. Nonclinical data were collected from 120 young adults studying in a medical college in Mumbai, India (51.7% females, mean age = 19.7 years, SD = 2.16, 17-28 years). Information regarding NSSI and identity were collected using self-report questionnaires. RESULTS Lifetime prevalence of NSSI in the clinical and nonclinical samples was found to be around 17% and 21%, respectively. Although the prevalence of NSSI did not significantly differ between the two samples, some features of NSSI did differ between the two groups. Finally, multigroup Bayesian structural equation modeling indicated that irrespective of the type of the sample (i.e. clinical or nonclinical), consolidated and disturbed identity significantly (negative and positive, respectively) predicted lifetime NSSI. Additionally, the association between the aforementioned identity variables and NSSI did not significantly differ between the two samples. CONCLUSION The findings of these studies highlight the need for exploring issues related to identity formation in individuals who engage in NSSI irrespective of whether they suffer from a psychiatric disorder or not.
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Affiliation(s)
- Amarendra Gandhi
- Leuven Biostatistics and Statistical Bioinformatics Centre, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium.,Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Koen Luyckx
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.,UNIBS, University of the Free State, Bloemfontein, South Africa
| | - Alka Adhikari
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, India
| | - Dhruv Parmar
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, India
| | - Avinash De Sousa
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, India
| | - Nilesh Shah
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, India
| | - Shubhada Maitra
- Centre for Health and Mental Health, Tata Institute of Social Sciences, Mumbai, India
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.,Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Antwerp, Belgium
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Costa RPDO, Peixoto ALRP, Lucas CCA, Falcão DN, Farias JTDS, Viana LFP, Pereira MADA, Sandes MLB, Lopes TB, Mousinho KC, Trindade-Filho EM. Profile of non-suicidal self-injury in adolescents: interface with impulsiveness and loneliness. J Pediatr (Rio J) 2021; 97:184-190. [PMID: 32151605 PMCID: PMC9432040 DOI: 10.1016/j.jped.2020.01.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 12/20/2019] [Accepted: 01/12/2020] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE Comprehend the profile and prevalence of non-suicidal self-injury (NSSI) in adolescents and its association with impulsiveness and loneliness. METHODS Cross-sectional study carried out in 2017 in Maceió-Alagoas, Northeast Brazil, in the households of 505 adolescents aged 12-17 years, using a sample stratified and randomized by gender and neighborhood. The following instruments were used: a sociodemographic questionnaire, Brazilian version of Functional Assessment of Self-Mutilation (FASM), the Brazilian Barratt Impulsiveness Scale (BIS-11), and the Brazilian Loneliness Scale (UCLA-BR). RESULTS A prevalence of 6.53% was found for non-suicidal self-injury disorder (DSM-5). Significant differences ( p ≤ 0.05) were observed regarding: the most frequently used forms of NSSI were the items "cut oneself" and "scratch oneself"; engaging in three or more different forms of self-injurious behavior (66.67%) and, reporting as reasons, "to relieve feelings of emptiness or indifference" and "to stop bad feelings/sensations." Significance was also related to the sociodemographic profile: 72.73% were females and 63.54% had family income below one minimum wage. Individuals with self-injurious behavior also had higher impulsiveness and loneliness scores (p ≤ 0.05). CONCLUSIONS The study identified a direct association between NSSI and impulsiveness and loneliness among adolescents, being more prevalent in females and in young individuals with socioeconomic vulnerability. The data provide support for improving public health policies, aimed at education, prevention, and treatment of adolescents with NSSI.
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Gandhi A, Luyckx K, Adhikari A, Parmar D, Desousa A, Shah N, Maitra S, Claes L. Non-suicidal self-injury and its association with identity formation in India and Belgium: A cross-cultural case-control study. Transcult Psychiatry 2021; 58:52-62. [PMID: 32873190 DOI: 10.1177/1363461520933759] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The aim of the present study was to compare different features of Non-Suicidal Self-Injury (NSSI) in India and Belgium. We also explored whether the strength of the association between NSSI and disturbances in identity formation-a risk factor that can increase vulnerability to NSSI-was similar in young adults from India and Belgium. Data regarding NSSI and identity formation were collected from 182 young adults in India (56% females, mean age = 21.5 years, SD = 3.70, range = 17-38 years). The Belgian data used for matching were derived from four existing datasets. Of the 182 Indian cases, 138 cases could be matched with the Belgian sample on age, gender, and lifetime prevalence of NSSI. Lifetime prevalence of NSSI in the Indian sample was found to be around 21.4%, with higher prevalence in females than in males. Comparison of features of NSSI in India and Belgium indicated that the age of onset of NSSI was higher in the Indian sample (around 17 years) than the Belgian sample (around 15 years). Additionally, self-bruising behavior was more commonly reported in India and scratching/cutting was more often reported in Belgium. Finally, the Belgian sample reported intra-personal functions of NSSI more often than the Indian sample. Moderation analysis indicated that the associations between NSSI and identity confusion/integration were stronger in the Belgian sample compared to the Indian sample. Higher self-knowledge was protective against NSSI in both the Indian and the Belgian sample.
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Affiliation(s)
- Amarendra Gandhi
- Leuven Biostatistics and Statistical Bioinformatics Centre (L-BioStat), Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Koen Luyckx
- Research Unit for School Psychology and Development in Context, KU Leuven, Leuven, Belgium UNIBS, University of the Free State, Bloemfontein, South Africa
| | - Alka Adhikari
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, India
| | - Dhruv Parmar
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, India
| | - Avinash Desousa
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, India
| | - Nilesh Shah
- Department of Psychiatry, Lokmanya Tilak Municipal Medical College, Mumbai, India
| | - Shubhada Maitra
- School of Social Work, Tata Institute of Social Sciences, Mumbai, India
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
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Kumar P, Patel V, Bhatt R, Raja H, Tiwari D, Vasavada D. Suicidal thoughts, suicidal attempts, and nonsuicidal self-injury among undergraduate health professionals. ARCHIVES OF MEDICINE AND HEALTH SCIENCES 2021. [DOI: 10.4103/amhs.amhs_321_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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La Guardia AC, Cramer RJ, Bryson CN, Emelianchik‐Key K. Analysis of Personality, Suicide, and Self‐Injury in Emerging Adulthood. JOURNAL OF COLLEGE COUNSELING 2020. [DOI: 10.1002/jocc.12149] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
| | - Robert J. Cramer
- School of Community and Environmental HealthOld Dominion University
- Now at Department of Public Health SciencesUniversity of North Carolina at Charlotte
| | - Claire N. Bryson
- Department of Psychology and PhilosophySam Houston State University
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Hasking PA, Lewis SP, Robinson K, Heath NL, Wilson MS. Conducting research on nonsuicidal self-injury in schools: Ethical considerations and recommendations. SCHOOL PSYCHOLOGY INTERNATIONAL 2019. [DOI: 10.1177/0143034319827056] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Research on nonsuicidal self-injury (NSSI) has grown significantly over the last 15 years, with much of this work focused on factors that initiate and maintain NSSI among school-aged youth. Although this work is important, it does raise several ethical concerns. In this article we outline key ethical issues underlying NSSI research in schools and offer recommendations for conducting ethically sound and productive research in this area. Ethical concerns addressed include: 1) recruitment of minors to research; 2) disclosure and confidentiality; 3) the risk of iatrogenic effects; 4) duty of care; 5) engaging schools in research; and 6) safety of the researchers. In each area, we offer recommendations to assist researchers, ethics committees, and schools in working together to conduct ethical NSSI research, further our understanding of NSSI, and address and respond to these behaviors in schools.
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Grover S, Sahoo S. Focus on youth mental health: The need of the hour. JOURNAL OF MENTAL HEALTH AND HUMAN BEHAVIOUR 2019. [DOI: 10.4103/jmhhb.jmhhb_65_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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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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Midkiff MF, Lindsey CR, Meadows EA. The role of coping self-efficacy in emotion regulation and frequency of NSSI in young adult college students. COGENT PSYCHOLOGY 2018. [DOI: 10.1080/23311908.2018.1520437] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Affiliation(s)
- Melanie F. Midkiff
- Department of Psychology, Northwestern State University of Louisiana, Natchitoches, LA, USA
- Department of Psychology, Central Michigan University, Mount Pleasant, MI, USA
| | - Cynthia R. Lindsey
- Department of Psychology, Northwestern State University of Louisiana, Natchitoches, LA, USA
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Affiliation(s)
- Om Prakash Singh
- Professor of Psychiatry, WBMES and Consultant Psychiatrists AMRI Hospitals, Kolkata, West Bengal, India
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What is in It for Them? Understanding the Impact of a 'Support, Appreciate, Listen Team' (SALT)-Based Suicide Prevention Peer Education Program on Peer Educators. SCHOOL MENTAL HEALTH 2018; 10:462-476. [PMID: 30464779 PMCID: PMC6223997 DOI: 10.1007/s12310-018-9264-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Youth suicide is a public health problem in India, and young people in school, particularly adolescents, experience heavy psychological burden. Prevention programs, involving peer educators (PEs), have proved useful strategies to address this problem, but their impact on the PEs is less understood, particularly in India. This qualitative study aims to explore the changes observed in PE students who were involved in a ‘mindfulness’ and ‘Support-Appreciate-Listen–Team’ (SALT)-based peer education program to address suicidal behavior in Indian school students. One hundred and fourteen students were trained as PEs in six high schools in Pune to identify and respond to the needs of students in distress. By listening to the narratives of the PEs, their parents, school authorities, and the associated NGO team, we reflect on perceived social, emotional, behavioral, and cognitive changes in PEs. The PEs demonstrated enhanced caring for those in distress both inside and outside school by improved listening skills, self-awareness, care, and empathy. Furthermore, the program had a positive impact on their broad emotional intelligence and PEs expressed increased ownership of life, taking action, and seeking support where needed. The study concludes that mindfulness and SALT-based peer education (PE) programs are valuable for the PEs. This could be used to motivate PEs to volunteer in such programs. Other results are discussed and further research areas are suggested.
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Taylor PJ, Jomar K, Dhingra K, Forrester R, Shahmalak U, Dickson JM. A meta-analysis of the prevalence of different functions of non-suicidal self-injury. J Affect Disord 2018; 227:759-769. [PMID: 29689691 DOI: 10.1016/j.jad.2017.11.073] [Citation(s) in RCA: 300] [Impact Index Per Article: 50.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2017] [Revised: 09/27/2017] [Accepted: 11/12/2017] [Indexed: 01/23/2023]
Abstract
BACKGROUND A broad variety of different functions can underlie acts of Non-suicidal self-injury (NSSI). Whilst research so far has identified many of the commonly reported functions, no reliable estimates of prevalence currently exist for these different NSSI functions. Understanding the prevalence of NSSI functions represents a key to better understanding the phenomenology of NSSI and addressing the differing needs of the NSSI population. We conducted a systematic review and meta-analysis of the prevalence of NSSI functions in community and clinical samples. METHOD A literature search of electronic databases PsycINFO, Medline, and Web of Science from date of inception to March 2017 was undertaken. A pre-specified framework for categorising different functions of NSSI was used to collate data from across studies. A random-effects meta-analysis of prevalence was then undertaken on these data. RESULTS Intrapersonal functions (66-81%), and especially those concerning emotion regulation were most commonly reported by individuals who engage in NSSI (63-78%). Interpersonal functions (e.g., expressing distress) were less common (33-56%). LIMITATIONS The review was limited to English-language articles. Reviewed articles were inconsistent in their measurement of NSSI. Inconsistency within pooled prevalence estimates was high when moderators were not accounted for. CONCLUSIONS Findings indicate that intrapersonal functions of NSSI are most common and are present for the majority of participants. This finding supports dominant emotion-regulation models of NSSI, and the use of interventions that work to improve emotion-regulation ability. However, interpersonal functions remain endorsed by a substantial portion of participants.
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Affiliation(s)
- Peter J Taylor
- Division of Psychology & Mental Health, University of Manchester, England M13 9PL, UK.
| | - Khowla Jomar
- Institute of Psychology, Health and Society, University of Liverpool, England L69 3GB, UK
| | - Katie Dhingra
- School of Social Sciences, Leeds Beckett University, England LS1 3HE, UK
| | - Rebecca Forrester
- Institute of Psychology, Health and Society, University of Liverpool, England L69 3GB, UK
| | - Ujala Shahmalak
- Institute of Psychology, Health and Society, University of Liverpool, England L69 3GB, UK
| | - Joanne M Dickson
- Institute of Psychology, Health and Society, University of Liverpool, England L69 3GB, UK; Department of Psychology, School of Arts and Humanities, Edith Cowan University, Australia.
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Bhola P, Manjula M, Rajappa V, Phillip M. Predictors of non-suicidal and suicidal self-injurious behaviours, among adolescents and young adults in urban India. Asian J Psychiatr 2017; 29:123-128. [PMID: 29061408 DOI: 10.1016/j.ajp.2017.04.024] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Revised: 04/19/2017] [Accepted: 04/28/2017] [Indexed: 11/27/2022]
Abstract
BACKGROUND The complex intersections between non-suicidal self-injurious (NSSI) behaviours; like cutting, burning or self-hitting, and suicide attempts, are an important domain of enquiry among vulnerable adolescents and young adults. A cross-sectional survey in urban schools and colleges assessed the rates of self-injurious behaviour among Indian adolescents and young adults. Predictors of NSSI and of self-injurious behaviours with associated suicidal intent, were also examined. PARTICIPANTS AND METHODS The sample comprised 1571 male and female students, from 19 private and government aided high schools, pre-university colleges and undergraduate colleges in an urban city in South India. Participants completed the Functional Assessment of Self-Mutilation which assesses the methods, characteristics and functions of self-injurious acts in the past 12 months. The measures of psychopathology included the Youth Self-Report and the Young-Adult Self-Report. RESULTS AND CONCLUSION The results indicated that rate of NSSI was 33.8%, with minor forms of self-injury reported more often (19.4%) than the moderate/severe forms (14.6%). A smaller proportion (6.8%) reported self-injurious acts with associated suicidal intent. Certain self-injury characteristics and levels of internalizing and externalizing problems differentiated self-injuring youth with and without suicidal intent. Logistic regression analyses identified predictors of any self-injurious behaviour and of self-injury associated with suicidal intent. The implications for assessment and intervention frameworks for self-injuring youth are discussed.
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Affiliation(s)
- Poornima Bhola
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bangalore, 560029, India.
| | - Munivenkatappa Manjula
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bangalore, 560029, India
| | - Vanitha Rajappa
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bangalore, 560029, India
| | - Mariamma Phillip
- Department of Biostatistics, National Institute of Mental Health and Neuro Sciences, Bangalore, 560 029, India
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Aggarwal S, Patton G, Reavley N, Sreenivasan SA, Berk M. Youth self-harm in low- and middle-income countries: Systematic review of the risk and protective factors. Int J Soc Psychiatry 2017; 63:359-375. [PMID: 28351292 DOI: 10.1177/0020764017700175] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND Self-harm (defined here as an act of intentionally causing harm to own self, irrespective of the type, motive or suicidal intent) is one of the strongest antecedents of suicide in youth. While there have been a number of studies of youth self-harm in low- and middle-income countries (LMICs), there is currently no systematic review of studies of prevalence rates and risk and protective factors. AIM To systematically review the evidence relating to the prevalence rates and forms of self-harm in youth in LMICs and its relationship to family economic status, family functioning, relationship with the peer group, social relationships and academic performance. METHODS Electronic searches of three databases, MEDLINE, PsycINFO and Scopus, were performed. In total, 27 school-, community- and hospital-based studies evaluating self-harm in LMICs with youth focus (with participants between 12 and 25 years) were included. RESULTS The self-harm was divided into suicidal and non-suicidal depending on the nature of self-harm. The 12-month prevalence rates of non-suicidal self-harm varied from 15.5% to 31.3%, and the range of suicidal behaviour rates was from 3.2% to 4.7%. Banging and hitting were the most common in the community-based studies, followed by cutting, scratching and wound picking. Self-poisoning with pesticides was most commonly reported in hospital-based studies. Risk factors for self-harm were family conflict, peer groups with members indulging in self-harm, truancy and school absenteeism. Protective factors were having an understanding family, having friends and higher school competence. Risk factors for suicidal thoughts and attempts were lack of close friends and history of suicide by a friend. CONCLUSION The 12-month prevalence rates of youth self-harm in LMICs are comparable to high-income countries (HICs). The profile of risk and protective factors suggests that family-based interventions could be useful in treatment and prevention. Future studies should aim for greater consistency in assessment methods and the constructs under evaluation.
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Affiliation(s)
- Shilpa Aggarwal
- 1 IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia
| | - George Patton
- 2 Department of Pediatrics, Royal Children's Hospital, Parkville, VIC, Australia.,3 Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia
| | - Nicola Reavley
- 3 Melbourne School of Population and Global Health, University of Melbourne, Carlton, VIC, Australia
| | | | - Michael Berk
- 1 IMPACT Strategic Research Centre, School of Medicine, Deakin University, Geelong, VIC, Australia.,4 Orygen: The National Centre of Excellence in Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
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Wu D, Rockett IRH, Yang T, Feng X, Jiang S, Yu L. Deliberate self-harm among Chinese medical students: A population-based study. J Affect Disord 2016; 202:137-44. [PMID: 27262635 DOI: 10.1016/j.jad.2016.05.030] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Accepted: 05/22/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND The phenomenon of deliberate self-harm (DSH) among college students has received increased attention in recent decades. Adopting a psychosocial perspective, this study aims to describe self-reported DSH among Chinese medical college students, assess respective associations between uncertainty stress and social capital with DSH, and explore the mechanism linking these three phenomena. METHODS A cross-sectional survey employing multi-stage, sampling was conducted. 4446 undergraduate students were recruited from 22 participating Chinese medical universities. Perceived stress from uncertainty and social capital were assessed among the students. The Chi-square test and multiple logistic regression models assessed correlates of DSH. Relationship among social capital, uncertainty stress, and DSH were examined by means of Structural Equation Modeling. RESULTS The prevalence of DSH in the past 12 months among Chinese students was 9.6%. The most common types of physical DSH reported were scratching, cutting, and pinching. Age (χ(2)=26.63, p<0.01), gender (χ(2)=30.24, p<0.01), major field (χ(2)=28.13, p<0.01), and annual household income (χ(2)=11.10, p<0.05) were statistically associated with DSH. Uncertainty stress is a unique correlate of DSH, and shows a stronger association than do three certainty stressors. Social capital is also a strong correlate of DSH, especially cognitive social capital. Moreover, social capital may be indirectly associated with DSH through impacting uncertainty stress. LIMITATIONS This study was a cross-sectional and thus could not evaluate causal relationships. CONCLUSION We recommend that a DSH intervention study should target uncertainty stress management and social capital accumulation. This study provides scientific evidence and theoretical foundation for future DSH interventions, with a view to enhancing the mental health of medical college students.
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Affiliation(s)
- Dan Wu
- Department of Psychology, School of Humanities and Management, Guangdong Medical University, Dongguan, Guangdong 523808, China
| | - Ian R H Rockett
- Injury Control Research Center and Department of Epidemiology, School of Public Health,West Virginia University, Morgantown, WV 26506, USA
| | - Tingzhong Yang
- Department of Social Medicine/Center for Tobacco Control Research, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, China.
| | - Xueying Feng
- Department of Social Medicine/Center for Tobacco Control Research, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Shuhan Jiang
- Department of Social Medicine/Center for Tobacco Control Research, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Lingwei Yu
- Department of Social Medicine/Center for Tobacco Control Research, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, China
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Gandhi A, Luyckx K, Maitra S, Claes L. Non-suicidal self-injury and other self-directed violent behaviors in India: A review of definitions and research. Asian J Psychiatr 2016; 22:196-201. [PMID: 26482720 DOI: 10.1016/j.ajp.2015.09.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 09/21/2015] [Accepted: 09/28/2015] [Indexed: 10/22/2022]
Abstract
The interpersonal theory of suicide suggests that most forms of self-directed violent behaviors lie on a continuum, with each behavior successively increasing the capability of committing suicide. There is increasing evidence to suggest that the continuum may begin with Non-Suicidal Self-Injury (NSSI). This theory can be important in developing interventions for suicide prevention. However, in India, consistent usage of definitions of various forms of self-directed violent behaviors is lacking. In the present study, we reviewed definitions of various forms of self-directed violent behaviors that have been investigated in India. Further, we compared the usage of these definitions with the usage by WHO. Additionally, we reviewed NSSI research in India. Thirty-eight publications were identified by a comprehensive electronic search undertaken in Indian psychiatry, psychology, and mental health-related databases. Inconsistent definitions of eight self-directed violent behaviors were observed in Indian literature. Agreement on consistent definitions of various forms of self-directed behaviors is essential. Based on the findings of the current review, it can be suggested that culturally relevant large-scale research on NSSI in India is required to confirm the limited evidence that suggests high prevalence of NSSI in India.
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Affiliation(s)
- Amarendra Gandhi
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium.
| | - Koen Luyckx
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Shubhada Maitra
- Centre for Health and Mental Health, Tata Institute of Social Sciences, Mumbai, India
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium; Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Antwerpen, Belgium
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Abstract
For too long, medical/psychiatric and psychological studies, with focus on emotional sensitivity, personality traits, and correlation with psychopathology, have dominated research on self-injuring acts. The phenomenon thus has been defined as a predominantly medical issue. However, a large body of community prevalence studies show self-injuring acts to be a common phenomenon in society, and most of those who self-injure are unknown in psychiatric or other clinical settings. This article describes and analyzes the medicalization of self-injuring acts and argues a need to move research on self-injuring acts out of the medical paradigm. There is a need to explicitly explore the impact of social, cultural, structural, and gendered factors surrounding and influencing self-injuring acts. A non-medical approach, beyond the limits of the medical perspective, would feed research forward and create a more nuanced view on this widespread social phenomenon.
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Kharsati N, Bhola P. Self-injurious behavior, emotion regulation, and attachment styles among college students in India. Ind Psychiatry J 2016; 25:23-28. [PMID: 28163404 PMCID: PMC5248415 DOI: 10.4103/0972-6748.196049] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
CONTEXT Intentional self-directed acts of injury are the most common among adolescents and young adults. Developmental psychopathology theories that conceptualize pathways to self-injurious behaviors (SIBs) implicate insecure attachment representations and inadequate self-regulatory skills to cope with emotional distress. AIMS The study aimed to examine relationships between SIBs, attachment, and emotion regulation among college students. MATERIALS AND METHODS A total of 470 participants from undergraduate and postgraduate colleges completed the functional assessment of self-mutilation questionnaire, attachment style questionnaire, and the difficulties in emotion regulation scale. RESULTS Results indicated that 31.2% of the participants reported SIB in the past year, with the mean age of onset being 15.9 years. Moderate/severe forms of self-injury (e.g. cutting, burning) were reported by 19.8% of the sample. Self-injuring youth reported higher levels of anxious attachment, preoccupation with relationships and need for approval in relationships, and difficulties in all domains of emotion regulation. Logistic regression analysis identified preoccupation with relationships and impulse control difficulties as predictors of SIB. CONCLUSIONS The findings have implications for comprehensive interventions for self-injuring youth.
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Affiliation(s)
| | - Poornima Bhola
- Department of Clinical Psychology, National Institute of Mental Health and Neuro Sciences, Bengaluru - 560 029, Karnataka, India
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27
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Gholamrezaei M, De Stefano J, Heath NL. Nonsuicidal self-injury across cultures and ethnic and racial minorities: A review. INTERNATIONAL JOURNAL OF PSYCHOLOGY 2015; 52:316-326. [PMID: 26644040 DOI: 10.1002/ijop.12230] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Accepted: 10/01/2015] [Indexed: 11/08/2022]
Abstract
The field of nonsuicidal self-injury (NSSI) is dominated by research conducted with Caucasian-majority samples in Western countries such as United States, Canada, Australia and European countries. This article critically reviewed the empirical research on NSSI in non-Western countries and among ethnic/racial minority individuals who live in the West to give voice to and understand the patterns of NSSI among individuals who do not fall within the dominant Caucasian majority. The study found both similarities and differences between Western and non-Western data in terms of characteristics and functions of NSSI. Differences in gender patterns in regards to prevalence of NSSI and methods used as well as presence of a more relational functionality of NSSI rather than emotion regulation functionality were two points of divergence in the findings of these studies. In addition, the findings seem to indicate that the role of ethnicity/race is mediated by important factors such as socioeconomic status (SES) and gender. Existing gaps in the literature and suggestions for further research are discussed.
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Affiliation(s)
- Maryam Gholamrezaei
- Department of Educational and Counselling Psychology, McGill University, Montreal, Canada
| | - Jack De Stefano
- Department of Educational and Counselling Psychology, McGill University, Montreal, Canada
| | - Nancy L Heath
- Department of Educational and Counselling Psychology, McGill University, Montreal, Canada
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Reinholz M, Poetschke J, Schwaiger H, Epple A, Ruzicka T, Gauglitz GG. The dermatology life quality index as a means to assess life quality in patients with different scar types. J Eur Acad Dermatol Venereol 2015; 29:2112-9. [DOI: 10.1111/jdv.13135] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Accepted: 03/12/2015] [Indexed: 11/29/2022]
Affiliation(s)
- M. Reinholz
- Department of Dermatology and Allergy; Ludwig-Maximilian University; Munich Germany
| | - J. Poetschke
- Department of Dermatology and Allergy; Ludwig-Maximilian University; Munich Germany
| | - H. Schwaiger
- Department of Dermatology and Allergy; Ludwig-Maximilian University; Munich Germany
| | - A. Epple
- Department of Dermatology and Allergy; Ruprecht-Karls University; Heidelberg Germany
| | - T. Ruzicka
- Department of Dermatology and Allergy; Ludwig-Maximilian University; Munich Germany
| | - G. G. Gauglitz
- Department of Dermatology and Allergy; Ludwig-Maximilian University; Munich Germany
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