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Zhou X, Guo J, Wu H, Chen D, Wang C, You J. The Relationship between Ambivalence over Emotional Expression and Nonsuicidal Self-Injury Among Chinese Adolescents: A Longitudinal Moderated Mediation Model. Arch Suicide Res 2024; 28:90-106. [PMID: 36282550 DOI: 10.1080/13811118.2022.2134068] [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] [Indexed: 11/02/2022]
Abstract
BACKGROUND Nonsuicidal self-injury (NSSI) has become a significant mental health concern for adolescents. Previous empirical studies have shown that ambivalence over emotional expression is positively associated with negative emotions and behaviors. However, little is known about the relationship between ambivalence over emotional expression and NSSI among adolescents. Therefore, this study used a longitudinal design to examine the relationship between ambivalence over emotional expression and NSSI among Chinese adolescents, and also to explore the mediating and moderating mechanisms underlying this relationship. METHOD A total of 1,672 students (45.8% males; Mage = 16.12 years, SD = 1.56) in a middle school in Guangzhou were tracked. The investigation was conducted twice, with an interval of 6 months. RESULTS Ambivalence over emotional expression was positively correlated with NSSI. After controlling for gender and baseline NSSI, anxiety symptoms fully mediated the association between ambivalence over emotional expression and NSSI. In addition, the relationship between ambivalence over emotional expression and NSSI was moderated by NSSI refusal self-efficacy. CONCLUSIONS These findings imply that to decrease ambivalence over emotional expression, to reduce anxiety symptoms, and to promote NSSI refusal self-efficacy may be useful for interventions and preventions of NSSI.HIGHLIGHTSTested the relationship between ambivalence over emotional expression and NSSI in adolescents.Examined a moderated-mediation model over six months.Found the mediated effect of anxiety symptoms and moderated effect of NSSI refusal self-efficacy in the relationship between ambivalence over emotional expression and NSSI.
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Carranza AB, Wallis CRD, Jonnson MR, Klonsky ED, Walsh Z. Nonsuicidal Self-Injury and Intimate Partner Violence: Directionality of Violence and Motives for Self-Injury. JOURNAL OF INTERPERSONAL VIOLENCE 2022; 37:1688-1707. [PMID: 32437310 DOI: 10.1177/0886260520922372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Nonsuicidal self-injury (NSSI) is associated with intimate partner violence (IPV) perpetration and victimization. However, extant research has not distinguished between unidirectional and bidirectional IPV and has not examined relationships between IPV and functions of self-injury. This study of 1,018 university students revealed a significantly higher prevalence of NSSI among those who reported bidirectional IPV compared with nonviolent individuals. However, rates of NSSI in the unidirectional IPV groups are more similar to rates of NSSI in the bidirectional group than in nonviolent individuals. Individuals who engaged in bidirectional IPV were more likely to endorse interpersonal functions of self-injury than those who engaged in unidirectional IPV or no IPV. In contrast, intrapersonal functions of NSSI were not associated with IPV. Findings suggest that the association between IPV and NSSI may be best understood in the context of relationship conflict, rather than as a distinct correlate of either IPV victimization or IPV perpetration.
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Affiliation(s)
| | | | | | | | - Zach Walsh
- University of British Columbia, Kelowna, Canada
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Alharbi R, Varese F, Husain N, Taylor PJ. Posttraumatic stress symptomology and non-suicidal self-injury: The role of intrusion and arousal symptoms. J Affect Disord 2020; 276:920-926. [PMID: 32739711 DOI: 10.1016/j.jad.2020.07.084] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 06/04/2020] [Accepted: 07/05/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Previous evidence has shown a strong relation between Posttraumatic Stress Disorder (PTSD) symptomology and Non-Suicidal Self-Injury (NSSI). The current study aimed to extend prior research by investigating the relationship between PTSD symptom clusters (arousal and intrusion) and NSSI, and putative moderators of this association within a large-scale adult sample in England. METHOD A subsample of participants with experiences of trauma in adulthood (n = 2,480) from the Adult Psychiatric Morbidity Survey 2007 (APMS 2007) was utilised to examine the relations among PTSD intrusion and arousal symptom clusters, childhood interpersonal trauma, perceived social support and lifetime NSSI. RESULTS Arousal symptoms were consistently associated with NSSI, even when adjusting for multiple covariates, and had a stronger relationship than intrusion symptoms. Childhood interpersonal trauma was independently and significantly associated with lifetime NSSI after adjusting for covariates. The moderating effects of childhood interpersonal trauma and perceived social support were not statistically significant. LIMITATIONS The study was cross-sectional and utilised self-report assessments to measure PTSD, NSSI, and childhood interpersonal trauma. CONCLUSION Findings support the role of PTSD arousal and childhood interpersonal trauma in relation to NSSI. The moderating role of childhood interpersonal trauma and perceived social support lacks supporting evidence. Findings highlight the need for NSSI screening as well as for specific interventions that target the complex needs of those who exhibit elevated PTSD arousal symptoms, especially those with a history of childhood interpersonal trauma.
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Affiliation(s)
- Reem Alharbi
- School of Health Sciences, Division of Psychology and Mental Health, The University of Manchester, Oxford Rd, Manchester, M13 9PL, England, United Kingdom.
| | - Filippo Varese
- School of Health Sciences, Division of Psychology and Mental Health, The University of Manchester, Oxford Rd, Manchester, M13 9PL, England, United Kingdom; Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, England, United Kingdom
| | - Nusrat Husain
- School of Health Sciences, Division of Psychology and Mental Health, The University of Manchester, Oxford Rd, Manchester, M13 9PL, England, United Kingdom; Lancashire & South Cumbria NHS Foundation Trust, Sceptre Point, Sceptre Way, Walton Summit, Preston, PR5 6AW, England, United Kingdom
| | - Peter James Taylor
- School of Health Sciences, Division of Psychology and Mental Health, The University of Manchester, Oxford Rd, Manchester, M13 9PL, England, United Kingdom
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Keefe KM, Hetzel-Riggin MD, Sunami N. The Mediating Roles of Hostility and Dissociation in the Relationship Between Sexual Assault and Suicidal Thinking in College Students. JOURNAL OF INTERPERSONAL VIOLENCE 2020; 35:1635-1653. [PMID: 29294684 DOI: 10.1177/0886260517698282] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Sexual assault and suicide are two serious public health concerns. Research has documented the relationship between sexual assault and suicidal thinking and attempts; however, limited research explores the more multifaceted relationships between posttraumatic stress reactions and suicidal ideation in college students through unsuccessful modulation of emotion. The authors hypothesized a mediation model where the relationship between sexual assault and suicidal ideation is mediated by dissociation and hostility. In total, 1,677 undergraduate students were administered modified versions of the Traumatic Life Events Questionnaire (TLEQ), Symptom Checklist-90-Revised (SCL-90-R), and Peritraumatic Dissociative Experiences Questionnaire (PDEQ). The results revealed both significant partial but equal mediators of hostility and dissociation. However, a portion of the direct effect between sexual assault and suicidal ideation remained unaccounted for by indirect effects. The current model supports previous work on dialectical behavior therapy that says either side of the dialectic between extreme expression and suppression of hostility increases the likelihood of suicidal thinking after sexual assault. With sexual assault survivors, practitioners should use strategies that emphasize both anger expression and healthy avoidance as a way to modulate emotion to potentially reduce suicidal thoughts. Future research should focus on different gender models, additional possible mediators such as alcohol use and guilt, and different forms of sexual assault. Limitations of the correlational, cross-sectional methodology are discussed.
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Affiliation(s)
| | | | - Naoyuki Sunami
- Western Illinois University, Macomb, USA
- University of Delaware, Newark, USA
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Gardner MJ, Thomas HJ, Erskine HE. The association between five forms of child maltreatment and depressive and anxiety disorders: A systematic review and meta-analysis. CHILD ABUSE & NEGLECT 2019; 96:104082. [PMID: 31374447 DOI: 10.1016/j.chiabu.2019.104082] [Citation(s) in RCA: 180] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Revised: 07/10/2019] [Accepted: 07/12/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Child maltreatment is a global public health issue that encompasses physical abuse, sexual abuse, emotional abuse, neglect, and exposure to intimate partner violence (IPV). This systematic review and meta-analysis summarises the association between these five forms of child maltreatment and depressive and anxiety disorders. METHODS Published cohort and case-control studies were included if they reported associations between any form of child maltreatment (and/or a combination of), and depressive and anxiety disorders. A total of 604 studies were assessed for eligibility, 106 met inclusion criteria, and 96 were included in meta-analyses. The data were pooled in random effects meta-analyses, giving odds ratios (ORs) with corresponding 95% confidence intervals (CIs) for each form of child maltreatment. RESULTS All forms of child maltreatment were associated with depressive disorders (any child maltreatment [OR = 2.48, 2.14-2.87]; sexual abuse [OR = 2.11, 1.83-2.44]; physical abuse [OR = 1.78, 1.57-2.01]; emotional abuse [OR = 2.35, 1.74-3.18]; neglect [OR = 1.65, 1.35-2.02]; and exposure to IPV [OR = 1.68, 1.34-2.10]). Several forms of child maltreatment were significantly associated with anxiety disorders ('any child maltreatment' [OR = 1.68, 1.33-2.4]; sexual abuse [OR = 1.90, 1.6-2.25]; physical abuse [OR = 1.56, 1.39-1.76]; and neglect [OR = 1.34, 1.09-1.65]). Significant associations were also found between several forms of child maltreatment and post-traumatic stress disorder (PTSD). CONCLUSIONS There is a robust association between five forms of child maltreatment and the development of mental disorders. The Global Burden of Disease Study (GBD) includes only sexual abuse as a risk factor for depressive and anxiety disorders. These findings support the inclusion of additional forms of child maltreatment as risk factors in GBD.
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Affiliation(s)
- M J Gardner
- School of Public Health, The University of Queensland, Herston, Queensland, Australia; Queensland Centre for Mental Health Research, Wacol, Queensland, Australia.
| | - H J Thomas
- School of Public Health, The University of Queensland, Herston, Queensland, Australia; Queensland Centre for Mental Health Research, Wacol, Queensland, Australia; The University of Queensland Centre for Clinical Research, Herston, Queensland, Australia
| | - H E Erskine
- School of Public Health, The University of Queensland, Herston, Queensland, Australia; Queensland Centre for Mental Health Research, Wacol, Queensland, Australia; The University of Queensland Centre for Clinical Research, Herston, Queensland, Australia; Institute for Health Metrics and Evaluation, University of Washington, Seattle, WA, USA
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Coppersmith DDL, Nada-Raja S, Beautrais AL. Non-suicidal self-injury and suicide attempts in a New Zealand birth cohort. J Affect Disord 2017; 221:89-96. [PMID: 28641148 PMCID: PMC5569384 DOI: 10.1016/j.jad.2017.06.029] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 05/23/2017] [Accepted: 06/14/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) and suicide attempts are related, but distinct behaviors. The primary aim of the current study was to identify factors that distinguish those with different lifetime histories of self-injury. A secondary aim was to test whether lifetime history of self-injury at age 26 predicted current suicide ideation at age 32. METHODS Participants were 26 year olds from a large birth cohort with a lifetime history of no self-injury (n = 466), a lifetime history of NSSI (n = 191), or a lifetime history of NSSI and a suicide attempt (NSSI+SA; n = 52). They were compared on a history of psychiatric disorders, 12-month suicide ideation, lifetime history of childhood sexual abuse, and lifetime exposure to suicide. RESULTS An anxiety disorder, a substance dependence disorder, suicide ideation, and a history of childhood sexual abuse distinguished the NSSI+SA and NSSI only groups. Longitudinal results demonstrated that a history of NSSI predicted future suicide ideation after adjusting for other selected risk factors. LIMITATIONS The majority of analyses are cross-sectional which limits inferences about causality. The retrospective self-report for lifetime behavior could be subject to reporting biases. CONCLUSIONS Adults with a history of NSSI and adults with a history of NSSI and a suicide attempt are clinically distinct groups that are both at risk of future suicide ideation. Identifying and treating NSSI could be a key preventive factor in reducing subsequent suicide risk.
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Affiliation(s)
| | - Shyamala Nada-Raja
- Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
| | - Annette L Beautrais
- School of Health Sciences, University of Canterbury, Christchurch, New Zealand
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Howard R, Karatzias T, Power K, Mahoney A. From Childhood Trauma to Self-Harm: An Investigation of Theoretical Pathways among Female Prisoners. Clin Psychol Psychother 2016; 24:942-951. [DOI: 10.1002/cpp.2058] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Revised: 10/13/2016] [Accepted: 10/17/2016] [Indexed: 11/06/2022]
Affiliation(s)
- Ruth Howard
- Edinburgh Napier University, School of Health and Social Care; Edinburgh UK
| | - Thanos Karatzias
- Edinburgh Napier University, School of Health and Social Care; Edinburgh UK
- NHS Lothian, Rivers Centre for Traumatic Stress; Edinburgh UK
| | - Kevin Power
- NHS Tayside, Psychological Therapies Service; Dundee UK
- Stirling University, School of Natural Sciences; Stirling UK
| | - Adam Mahoney
- HMP YOI Cornton Vale, Scottish Prison Service; Stirling UK
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Jackson J, Gouseti I. Threatened by Violence: Affective and Cognitive Reactions to Violent Victimization. JOURNAL OF INTERPERSONAL VIOLENCE 2016; 31:2987-3016. [PMID: 25972290 DOI: 10.1177/0886260515584336] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Stranger violence can have a variety of different physical, psychological, social, and economic effects on the victim. In this article, we address one possible impact, namely, a heightened sense of uncertainty, risk, and fear of violent crime. Drawing on recent advances in the psychology of risk, we make three contributions. First, we differentiate in our analysis between primary experience of violence (where the individual in question has been attacked by a stranger in the local streets) and secondary experience of violence (where the individual knows somebody who has been attacked in the local streets by a stranger). Second, we assess whether risk perception (beliefs about the likelihood, impact, and controllability of future victimization) mediates the empirical links between primary and secondary experience of violence and worry about violent crime. Finally, we examine whether victimization experience seems to have a greater impact on risk perception and worry among people with a high need for cognitive closure (who are averse to uncertainty and desire order and structure in their lives). Our findings indicate a number of potentially important mediating and moderating effects regarding the impact of stranger violence on fear of violent crime. We conclude with some implications for research and policy.
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Garisch JA, Wilson MS. Prevalence, correlates, and prospective predictors of non-suicidal self-injury among New Zealand adolescents: cross-sectional and longitudinal survey data. Child Adolesc Psychiatry Ment Health 2015; 9:28. [PMID: 26157484 PMCID: PMC4495816 DOI: 10.1186/s13034-015-0055-6] [Citation(s) in RCA: 106] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/25/2015] [Accepted: 06/09/2015] [Indexed: 11/16/2022] Open
Abstract
Non-suicidal self-injury (NSSI) is common among adolescents and linked to many maladaptive outcomes. This study aimed to assess the prevalence and correlates of NSSI among a community sample of New Zealand adolescents. A self-report questionnaire was administered to adolescents at time 1 (N = 1162, mean age = 16.35), and approximately five months later (time 2, N = 830, mean age = 16.49). Prevalence and bivariate correlations were assessed at both time points, and cross-lag correlations using matched data (N = 495, mean age = 16.23). Lifetime history of NSSI was 48.7 % (females 49.4 %, males 48 %). Consistent with previous international research, NSSI was associated with higher Alexithymia, depression, anxiety, bullying, impulsivity, substance abuse, abuse history and sexuality concerns and lower mindfulness, resilience and self-esteem. Cross-lag correlations suggested NSSI is directly (perhaps causally) related to psychological vulnerability in various domains (e.g., increased depression and lower self-esteem), while bullying may be more distal to NSSI, rather than a proximal predictor.
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Affiliation(s)
- Jessica Anne Garisch
- School of Psychology, Victoria University of Wellington, P.O. Box 600 Kelburn Parade, Wellington, New Zealand
| | - Marc Stewart Wilson
- School of Psychology, Victoria University of Wellington, P.O. Box 600 Kelburn Parade, Wellington, New Zealand
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10
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The association between nonsuicidal self-injury and the emotional disorders: A meta-analytic review. Clin Psychol Rev 2015; 37:72-88. [DOI: 10.1016/j.cpr.2015.02.006] [Citation(s) in RCA: 119] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 02/16/2015] [Accepted: 02/17/2015] [Indexed: 12/27/2022]
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11
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Smith NB, Kouros CD, Meuret AE. The role of trauma symptoms in nonsuicidal self-injury. TRAUMA, VIOLENCE & ABUSE 2014; 15:41-56. [PMID: 23878145 DOI: 10.1177/1524838013496332] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Reports of traumatic events by individuals who engage in nonsuicidal self-injury (NSSI) are common; yet, evidence for the relation between traumatic events and NSSI is inconclusive. This review explores the thesis that trauma symptoms, rather than the experience of a traumatic event per se, underlie this relation, specifically suggesting that trauma symptoms might serve as a mediator. The literature indicates that self-injury plays an important functional role in coping with trauma symptoms such that self-injury can provide an escape from intrusive thoughts and aversive emotional states, as well as end dissociation and periods of numbness through the generation of feelings. Additionally, trauma symptoms have been shown to mediate the relation between the occurrence of traumatic events and NSSI. Taken together, trauma symptoms may play an important role in the development and maintenance of NSSI. The review concludes with treatment implications and future directions for research.
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Affiliation(s)
- Noelle B Smith
- Department of Psychology, Southern Methodist University, Dallas, TX, USA
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Jaquier V, Hellmuth JC, Sullivan TP. Posttraumatic stress and depression symptoms as correlates of deliberate self-harm among community women experiencing intimate partnerviolence. Psychiatry Res 2013; 206:37-42. [PMID: 23040795 PMCID: PMC3594077 DOI: 10.1016/j.psychres.2012.09.020] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Revised: 09/07/2012] [Accepted: 09/14/2012] [Indexed: 11/28/2022]
Abstract
Deliberate self-harm (DSH) among women in the general population is correlated separately with posttraumatic stress, depression, and abuse during childhood and adulthood. The prevalence of these DSH correlates is particularly high among women exposed to intimate partner violence (IPV), yet few studies have examined DSH among this high-risk population and none have examined these correlates simultaneously. Two hundred and twelve IPV-victimized women in the community participated in a 2-h retrospective interview. One-third reported current or past DSH. Discriminant analysis was used to examine which posttraumatic stress and depression symptoms and types of current IPV and childhood abuse were uniquely associated with current DSH. Findings show that women who currently use DSH reported greater severity of posttraumatic stress numbing symptoms and more severe sexual IPV compared to women who used DSH only in the past. Examining factors that are associated with women's current DSH in this population is critical so that a focus on DSH can be integrated into the treatment plans of women who are receiving mental health care, but also so that women who are not receiving such care can be referred to adequate mental health services.
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Affiliation(s)
| | | | - Tami P. Sullivan
- Corresponding author: Yale University, School of Medicine, Department of Psychiatry, The Consultation Center, 389 Whitney Avenue, New Haven, CT 06511. Phone 203 789 7645; Fax 203 562 6355;
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