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Cheng J, Zhao J, Song B, Han H, Liu N, Chen Y, Liu X, Dong Y, Bian W, Liu Z, Han S. Positive effects of parent-child group emotional regulation and resilience training on nonsuicidal self-injury behavior in adolescents: a quasi-experimental study. Front Psychiatry 2024; 15:1343792. [PMID: 38571996 PMCID: PMC10987729 DOI: 10.3389/fpsyt.2024.1343792] [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: 11/24/2023] [Accepted: 03/06/2024] [Indexed: 04/05/2024] Open
Abstract
Background Nonsuicidal self-injury (NSSI) among adolescents is a growing global concern. However, effective interventions for treating NSSI are limited. Method A 36-week quasi-experimental study design of parent-child group resilience training (intervention group) for adolescents aged 12-17 years was used and compared with treatment-as-usual (control group). The primary endpoint was the frequency of NSSI assessed with the Ottawa Self-Injury Inventory (OSI), and the secondary endpoints were the levels of depression, hope, resilience, and family adaptability and cohesion as assessed by the 24-item Hamilton depression rating scale (HAMD-24), Herth Hope Scale (HHS), Connor-Davidson Resilience Scale (CD-RISC), and Family Adaptability and Cohesion Evaluation Scale, second edition (FACES-II-CV), respectively. Result A total of 118 participants completed the trial. Both groups showed a significant reduction in NSSI frequency after 12, 24, and 36 weeks of intervention (p< 0.05), although the intervention group did not differ significantly from the control group. After 12, 24, and 36 weeks of intervention, the CD-RISC, HHS, HAMD-24, and FACES-II-CV scores in the intervention and control groups improved over baseline (p< 0.05). Furthermore, the intervention group had higher scores on the CD-RISC, HHS, and FACES-II-CV and lower scores on the HAMD-24 than the control group after 12, 24, and 36 weeks of intervention (p < 0.05). Conclusion Parent-child group emotional regulation and resilience training showed promise as treatment options for NSSI among adolescents, leading to increased hope, resilience, and improved family dynamics among NSSI teens. Moreover, NSSI frequency significantly decreased in the intervention group compared to baseline.
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Affiliation(s)
- Junxiang Cheng
- Department of Psychiatry, the First Hospital of Shanxi Medical University, Taiyuan, China
- School of Nursing, Shanxi Medical University, Taiyuan, China
| | - Juan Zhao
- Department of Psychiatry, the First Hospital of Shanxi Medical University, Taiyuan, China
| | - Baoli Song
- Department of Psychiatry, the First Hospital of Shanxi Medical University, Taiyuan, China
| | - Hong Han
- Department of Magnetic Resonance Imaging, Shanxi Bethune Hospital, Taiyuan, China
| | - Na Liu
- Department of Orthopedics, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Yangjie Chen
- Department of Psychiatry, the First Hospital of Shanxi Medical University, Taiyuan, China
| | - Xiaomei Liu
- Department of Psychiatry, the First Hospital of Shanxi Medical University, Taiyuan, China
| | - Yue Dong
- Department of Intensive Care Unit (ICU), the Affiliated Lianyungang Hospital of Xuzhou Medical University, Xuzhou, China
| | - Weina Bian
- Department of Nursing, Hanzhong Central Hospital, Hanzhong, China
| | - Zhifen Liu
- Department of Psychiatry, the First Hospital of Shanxi Medical University, Taiyuan, China
| | - Shifan Han
- Department of Psychiatry, the First Hospital of Shanxi Medical University, Taiyuan, China
- School of Nursing, Shanxi Medical University, Taiyuan, China
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Andersson H, Svensson E, Magnusson A, Holmqvist R, Zetterqvist M. Young adults looking back at their experiences of treatment and care for nonsuicidal self-injury during adolescence: a qualitative study. Child Adolesc Psychiatry Ment Health 2024; 18:16. [PMID: 38245758 PMCID: PMC10800066 DOI: 10.1186/s13034-024-00706-2] [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: 11/06/2023] [Accepted: 01/05/2024] [Indexed: 01/22/2024] Open
Abstract
BACKGROUND Nonsuicidal self-injury (NSSI) is associated with stigma, and negative attitudes among healthcare professionals toward NSSI have been reported. A person-centered approach that focuses on how individuals with lived experience of NSSI perceive the treatment and care they receive is invaluable in reducing barriers to help-seeking and improving treatment and mental healthcare services. The aim of the current qualitative study was to explore the perceptions of young adults when they look back upon their experiences of psychiatric treatment for NSSI during adolescence. METHODS Twenty-six individuals with lived experience of NSSI who were in contact with child and adolescent psychiatry during adolescence were interviewed. The interviews were analyzed using thematic analysis. RESULTS Three main themes were developed: Changed perceptions in retrospect, The importance of a collaborative conceptualization and Lasting impression of the relationship. Participants' perception of themselves as well as the treatment changed over time. The importance of a joint understanding of NSSI and an agreed-upon treatment focus was emphasized. The relationship to the mental health professionals, and experiences of how NSSI was communicated, were salient several years later. CONCLUSIONS Healthcare professionals need to communicate about NSSI in a respectful manner and include the perspective of the adolescent with lived experience of NSSI in a joint conceptualization of NSSI and treatment focus.
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Affiliation(s)
- H Andersson
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping university, Linköping, Sweden
| | - E Svensson
- Department of Behavioural Sciences and Learning, Linköping university, Linköping, Sweden
| | - A Magnusson
- Department of Behavioural Sciences and Learning, Linköping university, Linköping, Sweden
| | - R Holmqvist
- Department of Behavioural Sciences and Learning, Linköping university, Linköping, Sweden
| | - M Zetterqvist
- Center for Social and Affective Neuroscience, Department of Biomedical and Clinical Sciences, Linköping university, Linköping, Sweden.
- Department of Child and Adolescent Psychiatry, Region Östergötland, Linköping, Sweden.
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James KM, Balderrama-Durbin C, Israel E, Feurer C, Gibb BE. Self- and co-regulation of physiological activity during mother-daughter interactions: The role of adolescent non-suicidal self-injury. J Child Psychol Psychiatry 2024; 65:91-99. [PMID: 37469027 PMCID: PMC10796835 DOI: 10.1111/jcpp.13859] [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: 05/05/2023] [Indexed: 07/21/2023]
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) is a significant public health concern that is thought to increase risk for future self-injurious behaviors, including suicide attempts. Notably, NSSI is especially prevalent among adolescents, which underscores a critical need to identify modifiable risk factors that could be targeted to reduce future risk. The current study examined self- and co-regulation of physiological responses during mother-daughter interactions in adolescent girls with and without a history of NSSI. METHODS Participants were 60 girls aged 13-17 with (n = 27) and without (n = 33) a history of NSSI and their mothers. Adolescents and their mothers completed positive and negative interaction tasks during which physiological reactivity was assessed via respiratory sinus arrhythmia (RSA). RESULTS Using Actor-Partner Interdependence Modeling (APIM), we found that adolescents with an NSSI history demonstrated a higher RSA setpoint than adolescents without this history during the negative, but not positive, interaction task. In addition, there were differences in co-regulation during the negatively valenced interaction, such that mothers of daughters with NSSI were more reactive to fluctuations in their daughters' RSA than mothers of daughters without an NSSI history. CONCLUSIONS These findings highlight intra- and interpersonal aspects of physiological dysregulation associated with NSSI that could provide promising targets of intervention to reduce future risk in adolescent girls.
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Affiliation(s)
| | | | - Elana Israel
- Binghamton University (SUNY), Department of Psychology
| | - Cope Feurer
- University of Illinois Chicago, Department of Psychiatry
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4
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Qu D, Wen X, Liu B, Zhang X, He Y, Chen D, Duan X, Yu J, Liu D, Zhang X, Ou J, Zhou J, Cui Z, An J, Wang Y, Zhou X, Yuan T, Tang J, Yue W, Chen R. Non-suicidal self-injury in Chinese population: a scoping review of prevalence, method, risk factors and preventive interventions. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 37:100794. [PMID: 37693882 PMCID: PMC10485683 DOI: 10.1016/j.lanwpc.2023.100794] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/06/2023] [Accepted: 05/04/2023] [Indexed: 09/12/2023]
Abstract
Non-suicidal self-injury behavior (NSSI) is a serious public health concern that requires immediate attention. Despite the high prevalence of NSSI among the Chinese population, there is a significant gap in research on the comprehensive picture of this field. Therefore, a scoping review was conducted to investigate the prevalence, methods, risk factors, and preventive intervention programs related to NSSI in China. The review found that the estimated lifetime prevalence of NSSI among Chinese youth population is alarmingly high at 24.7% (N = 1,088,433). Common methods of NSSI include scratching, hitting, and biting. Additionally, the review synthesized 249 risk factors based on the biopsychosocial-ecological framework, highlighting the urgent need for intervention. However, only 12 empirical studies focus on NSSI prevention or intervention programs were included. These findings underscore the necessity for more clinical practices and larger studies to identify effective interventions and ultimately alleviate the burden of NSSI on the Chinese population. Funding This review was supported by Humanity and Social Science Youth foundation of Ministry of Education (22YJCZH018), Science and Technology Innovation 2030 (STI2030-Major Projects:2021ZD0200702), National Natural Science Foundation of China (81825009), and Shuimu Tsinghua Scholar. No funding agencies were involved in the data collection, data analysis, and writing of this paper.
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Affiliation(s)
- Diyang Qu
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Xue Wen
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Bowen Liu
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Xuan Zhang
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Yuhao He
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Dongyang Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Xueer Duan
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Jiaao Yu
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Dongyu Liu
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
| | - Xiaoqian Zhang
- Department of Psychiatry, Tsinghua University Yuquan Hospital, Beijing, China
| | - Jianjun Ou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Jiansong Zhou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China
| | - Zaixu Cui
- Chinese Institute for Brain Research, Beijing, 102206, China
| | - Jing An
- Beijing Huilongguan Hospital, Beijing, China
- Peking University Huilongguan Clinical Medical School, Beijing, China
- WHO Collaborating Center for Research and Training in Suicide Prevention, Beijing, China
| | - Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, China; School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, China
| | - Xinyu Zhou
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Tifei Yuan
- Brain Health Institute, National Center for Mental Disorders, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Jie Tang
- Department of Preventive, School of Public Health, Guangzhou Medical University, China
| | - Weihua Yue
- Chinese Institute for Brain Research, Beijing, 102206, China
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing 100191, China
- NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital), Beijing 100191, China
- PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, 100871, China
| | - Runsen Chen
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute for Healthy China, Tsinghua University, Beijing, China
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Kiekens G, Hasking P, Bruffaerts R, Alonso J, Auerbach RP, Bantjes J, Benjet C, Boyes M, Chiu WT, Claes L, Cuijpers P, Ebert DD, Mak A, Mortier P, O’Neill S, Sampson NA, Stein DJ, Vilagut G, Nock MK, Kessler RC. Non-suicidal self-injury among first-year college students and its association with mental disorders: results from the World Mental Health International College Student (WMH-ICS) initiative. Psychol Med 2023; 53:875-886. [PMID: 34140062 PMCID: PMC8683565 DOI: 10.1017/s0033291721002245] [Citation(s) in RCA: 43] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Although non-suicidal self-injury (NSSI) is an issue of major concern to colleges worldwide, we lack detailed information about the epidemiology of NSSI among college students. The objectives of this study were to present the first cross-national data on the prevalence of NSSI and NSSI disorder among first-year college students and its association with mental disorders. METHODS Data come from a survey of the entering class in 24 colleges across nine countries participating in the World Mental Health International College Student (WMH-ICS) initiative assessed in web-based self-report surveys (20 842 first-year students). Using retrospective age-of-onset reports, we investigated time-ordered associations between NSSI and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-IV) mood (major depressive and bipolar disorder), anxiety (generalized anxiety and panic disorder), and substance use disorders (alcohol and drug use disorder). RESULTS NSSI lifetime and 12-month prevalence were 17.7% and 8.4%. A positive screen of 12-month DSM-5 NSSI disorder was 2.3%. Of those with lifetime NSSI, 59.6% met the criteria for at least one mental disorder. Temporally primary lifetime mental disorders predicted subsequent onset of NSSI [median odds ratio (OR) 2.4], but these primary lifetime disorders did not consistently predict 12-month NSSI among respondents with lifetime NSSI. Conversely, even after controlling for pre-existing mental disorders, NSSI consistently predicted later onset of mental disorders (median OR 1.8) as well as 12-month persistence of mental disorders among students with a generalized anxiety disorder (OR 1.6) and bipolar disorder (OR 4.6). CONCLUSIONS NSSI is common among first-year college students and is a behavioral marker of various common mental disorders.
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Affiliation(s)
- Glenn Kiekens
- Center for Public Health Psychiatry, KU Leuven, Belgium
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Penelope Hasking
- School of Population Health, Curtin University, Perth, Australia
| | - Ronny Bruffaerts
- Center for Public Health Psychiatry, KU Leuven, Belgium
- Institute for Social Research, Population Studies Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Jordi Alonso
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER en Epidemiología y Salud Pública, Madrid, Spain
- Pompeu Fabra University, Barcelona, Spain
| | | | - Jason Bantjes
- Institute for Life Course Health Research, Department of Global Health, Faculty of Medicine and Health Sciences Stellenbosch University, South Africa
| | - Corina Benjet
- Department of Epidemiologic and Psychosocial Research, National Institute of Psychiatry Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Mark Boyes
- School of Population Health, Curtin University, Perth, Australia
| | - Wai Tat Chiu
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Antwerp, Belgium
| | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - David D. Ebert
- Department for Sport and Health Sciences, Chair for Psychology & Digital Mental Health Care, Technical University Munich, Germany
| | - Arthur Mak
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, Hong Kong SAR
| | - Philippe Mortier
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER en Epidemiología y Salud Pública, Madrid, Spain
| | - Siobhan O’Neill
- School of Biomedical Sciences, Ulster University, Derry-Londonderry, Northern Ireland
| | - Nancy A. Sampson
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Dan J. Stein
- Department of Psychiatry and Mental Health and South African Medical Council Research Unit on Risk and Resilience in Mental Disorders, University of Cape Town and Groote Schuur Hospital, Cape Town, South Africa
| | - Gemma Vilagut
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER en Epidemiología y Salud Pública, Madrid, Spain
| | - Matthew K. Nock
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Ronald C. Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
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6
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James KM, Balderrama-Durbin C, Kobezak HM, Recchia N, Foster CE, Gibb BE. Dynamics of Affective Reactivity during Mother-Daughter Interactions: The Impact of Adolescent Non-Suicidal Self-Injury. Res Child Adolesc Psychopathol 2023; 51:597-611. [PMID: 36607473 DOI: 10.1007/s10802-022-01011-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2022] [Indexed: 01/07/2023]
Abstract
Non-suicidal self-injury (NSSI) is an alarming public health concern that is particularly widespread among adolescents. The current study examined affective responses during mother-daughter interactions in adolescent girls with and without a history of NSSI. Participants were 60 girls aged 13-17 with (n = 27) and without (n = 33) a history of NSSI and their mothers. Adolescents and their mothers completed two interaction tasks: one positive and one negative. During these interactions, facial affect was assessed via electromyography (EMG). Results of Actor-Partner Interdependence Modeling (APIM) revealed several intra- and interpersonal disruptions in affect during both tasks among dyads in which the adolescent had an NSSI history. Findings suggest deficits in both self- and co-regulation of facial affect during mother-daughter interactions involving dyads in which the adolescents reports NSSI. Ultimately, if replicated and extended in longitudinal research, these disruptions may prove to be promising targets of intervention to reduce risk for future NSSI in adolescent girls.
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Affiliation(s)
- Kiera M James
- Department of Psychology, Binghamton University (SUNY), Binghamton, NY, 13902, USA. .,Department of Psychology, University of Pittsburgh, Pittsburgh, PA, 15260, USA.
| | | | - Holly M Kobezak
- Department of Psychology, Binghamton University (SUNY), Binghamton, NY, 13902, USA
| | - Nicolette Recchia
- Department of Psychology, Binghamton University (SUNY), Binghamton, NY, 13902, USA
| | - Claire E Foster
- Department of Psychology, Binghamton University (SUNY), Binghamton, NY, 13902, USA
| | - Brandon E Gibb
- Department of Psychology, Binghamton University (SUNY), Binghamton, NY, 13902, USA
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7
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Shahwan S, Zhang Y, Sambasivam R, Ong SH, Chong SA, Subramaniam M. A qualitative study of motivations for non-suicidal self-injury in a sample of psychiatric outpatients in Singapore. Singapore Med J 2022; 63:723-730. [PMID: 34628783 PMCID: PMC9875880 DOI: 10.11622/smedj.2021161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Introduction The popular notion that the need for attention drives non-suicidal self-injury (NSSI) serves to stigmatise rather than understand this warning sign of underlying psychological/psychiatric disorder. Despite the pervasiveness of NSSI in clinical and community settings, effective treatments for this behaviour are lacking. This qualitative research aims to understand the motivations of NSSI in adolescents/young adults in a mental health facility in Singapore. Methods Semi-structured interviews were conducted with 20 outpatients (6 males, 14 females) of the Institute of Mental Health aged 17-29 years who had reported NSSI as part of an earlier survey. The interviews were audio-recorded and transcribed verbatim. Thematic analysis was used to analyse the data. The main themes and sub-themes were identified and described. Results A preponderance of motivations served intrapersonal emotion-regulating purposes, which were categorised as to: (a) release bottled-up feelings; (b) self-punish; (c) turn aggression inwards; (d) sensitise oneself; and (e) attain a sense of control and mastery. By contrast, a small subset of motivations served the interpersonal motivation of signaling one's distress, especially when the capacity for verbal expression was limited or attempts to verbalise distress were futile. Conclusion Committing NSSI solely for attention-seeking is a myth that perpetuates the stigma and hinders those in need of psychological care from seeking appropriate treatment. NSSIs may be warning signs that indicate not only intrapersonal conflicts but external environments that are perceived unsafe to deal with these intrapersonal conflicts. An understanding of the underlying motives will facilitate better treatment of individuals presenting with NSSI.
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Affiliation(s)
| | - Yunjue Zhang
- Research Division, Institute of Mental Health, Singapore
| | | | - Say How Ong
- Department of Developmental Psychiatry, Institute of Mental Health, Singapore
| | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore
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8
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Tschan T, Pfeiffer S, Gutzweiler R, In-Albon T. A comparison of expressed emotion between mothers and their adolescent daughters with and without a history of nonsuicidal self-injury. Child Adolesc Psychiatry Ment Health 2022; 16:64. [PMID: 35941688 PMCID: PMC9361609 DOI: 10.1186/s13034-022-00500-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/29/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Expressed Emotion refers to the extent to which close relatives express critical/hostile and/or emotionally overinvolved attitudes and feelings when speaking about a family member. High Expressed Emotion is a valuable predictor of clinical outcomes and is related to the presence of various mental disorders, including nonsuicidal self-injury (NSSI). Interpersonal factors have been shown to be relevant in initiating and in maintaining with NSSI, as interpersonal difficulties are often reported as triggers for emotional dysregulation. The parental role in the etiology and treatment of NSSI needs to be further investigated. This study assesses Expressed Emotion in adolescents who engage in NSSI and their mothers. METHOD We examined Expressed Emotion levels of mother-daughter dyads among adolescents who engage in NSSI, clinical controls (CCs), and nonclinical controls (NCs). The sample consisted of 70 female adolescents aged 12-20 years (M = 15.28 years, SD = 1.81; NSSI: n = 21, CC: n = 17, NC: n = 32) and 24 mothers aged 38-56 years (M = 46.47 years, SD = 4.61) using The Five-Minute Speech Sample (FMSS). RESULTS Adolescents who engage in NSSI exhibited significantly more covert criticism and critical tone toward their mothers than CCs (d = 0.65, d = 1.10) and NCs (d = 1.30, d = 1.10). CONCLUSION The findings highlight the importance of family-based interventions for the treatment of NSSI in order to enhance a positive relationship quality between parents and adolescents.
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Affiliation(s)
- Taru Tschan
- grid.5892.60000 0001 0087 7257Clinical Child and Adolescent Psychology, University of Koblenz-Landau, Landau, Ostbahnstraße 12, 76829 Landau, Germany
| | - Simone Pfeiffer
- grid.5892.60000 0001 0087 7257Clinical Child and Adolescent Psychology, University of Koblenz-Landau, Landau, Ostbahnstraße 12, 76829 Landau, Germany
| | - Raphael Gutzweiler
- grid.5892.60000 0001 0087 7257Clinical Child and Adolescent Psychology, University of Koblenz-Landau, Landau, Ostbahnstraße 12, 76829 Landau, Germany
| | - Tina In-Albon
- Clinical Child and Adolescent Psychology, University of Koblenz-Landau, Landau, Ostbahnstraße 12, 76829, Landau, Germany.
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9
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Attygalle UR. A family life cycle perspective on deliberate self-harm among adolescents: an initial qualitative study. ASIA PACIFIC JOURNAL OF COUNSELLING AND PSYCHOTHERAPY 2022. [DOI: 10.1080/21507686.2022.2098349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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10
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Liu CR, Wan LP, Liu BP, Jia CX, Liu X. Depressive symptoms mediate the association between maternal authoritarian parenting and non-suicidal self-injury among Chinese adolescents. J Affect Disord 2022; 305:213-219. [PMID: 35278486 DOI: 10.1016/j.jad.2022.03.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 03/03/2022] [Accepted: 03/07/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) is a significant public health concern. Authoritarian parenting is a common parenting style in China. Authoritarian parenting is associated with NSSI in adolescents. Little is known about the mechanism underlying this association. This study was to investigate the mediating effect of depressive symptoms on the association between maternal authoritarian parenting and NSSI among Chinese adolescents. METHODS A total of 7072 adolescents who participated in the 1-year follow-up of Shandong Adolescent Behavior & Health Cohort (SABHC) were included for the analysis. A self-administered questionnaire was used to assess authoritarian parenting, depressive symptoms, non-suicidal self-injury, and family demographics in November-December in 2015. One year later, a follow-up survey was carried out to assess participants' depressive symptoms and NSSI. RESULTS Of the sample, mean age was 14.58 (SD = 1.46) and 3536 (50%) were female at baseline. 19.4% adolescents reported having ever NSSI over the past 12 months at baseline, and 8.8% reported having ever NSSI at 1-year follow-up. The association of maternal authoritarian parenting with subsequent NSSI was at least partially mediated by depressive symptoms. Mediation analyses showed that effect size was 0.194 in the entire sample, 0.192 in females and 0.193 in males, respectively. LIMITATION All variables were measured based on self-report. CONCLUSIONS Maternal authoritarian parenting style is a significant predictor of NSSI and its association with NSSI is partially mediated by depressive symptoms among Chinese adolescents. It may be important to intervene poor parenting styles and depression to reduce the risk of NSSI in Chinese adolescents.
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Affiliation(s)
- Cai-Rui Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University and Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China
| | - Li-Peng Wan
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University and Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China
| | - Bao-Peng Liu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University and Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China
| | - Cun-Xian Jia
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University and Shandong University Center for Suicide Prevention Research, Jinan, Shandong, China.
| | - Xianchen Liu
- Center for Public Health Initiatives, University of Pennsylvania, Philadelphia, PA, USA
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11
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Moore J, Bauer R. Understanding Nonsuicidal Self-Injury. J Christ Nurs 2022; 39:98-103. [PMID: 35255028 DOI: 10.1097/cnj.0000000000000939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
ABSTRACT Nonsuicidal self-injury has existed since biblical times. It is increasing and gaining acceptance particularly among adolescents. Spiritual discontent or doubt is often a component. Therapeutic interventions include cognitive and behavior practices and developing strong, sustained relationships with patients to encourage healthy transformation.
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12
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Miscioscia M, Angelico C, Raffagnato A, Gatta M. Psychopathological and Interactive-Relational Characteristics in Non-Suicidal Self-Injury Adolescent Outpatients. J Clin Med 2022; 11:jcm11051218. [PMID: 35268309 PMCID: PMC8911069 DOI: 10.3390/jcm11051218] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 02/18/2022] [Accepted: 02/21/2022] [Indexed: 02/01/2023] Open
Abstract
Non-suicidal self-injury (NSSI) is described as behaviors that directly and intentionally inflict damage to body tissue without suicidal intent and for reasons not linked to cultural expectations or norms. Literature has confirmed several “specific risk factors” related to NSSI behaviors; emotional reactivity, internalizing problems, alexithymia traits, and maladaptive family functioning can predispose an individual to intrapersonal and interpersonal vulnerabilities related to difficulties in regulating one’s own cognitive-emotional experience. The present study aims to analyze and define the psychopathological and family interactive-relational characteristics of adolescents with NSSI through a case-control study. Thirty-one patients with NSSI and thirty-one patients without NSSI paired for sex, age, and psychiatric diagnosis (ICD-10) were recruited in Padua among two Child Neuropsychiatry Units before the COVID-19 pandemic. Results show a higher prevalence of internalizing problems, alexithymia trait related to “difficulty identifying feelings”, and lower quality of family functioning related to inclusion of partners, child involvement, and child self-regulation. These results carry significant implications for the clinical management and therapeutic care of non-suicidal self-injury patients and further confirm the need for an in-depth investigation of internalizing problems, alexithymia, and quality of family interactions.
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Affiliation(s)
- Marina Miscioscia
- Child and Adolescent Neuropsychiatric Unit, Department of Women’s and Children’s Health, University Hospital of Padua, 35128 Padova, Italy; (C.A.); (A.R.); (M.G.)
- Department of Developmental and Social Psychology, University of Padua, 35131 Padova, Italy
- Correspondence: ; Tel.: +39-(049)-821-1160
| | - Caterina Angelico
- Child and Adolescent Neuropsychiatric Unit, Department of Women’s and Children’s Health, University Hospital of Padua, 35128 Padova, Italy; (C.A.); (A.R.); (M.G.)
| | - Alessia Raffagnato
- Child and Adolescent Neuropsychiatric Unit, Department of Women’s and Children’s Health, University Hospital of Padua, 35128 Padova, Italy; (C.A.); (A.R.); (M.G.)
| | - Michela Gatta
- Child and Adolescent Neuropsychiatric Unit, Department of Women’s and Children’s Health, University Hospital of Padua, 35128 Padova, Italy; (C.A.); (A.R.); (M.G.)
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13
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Wang X, Huang X, Huang X, Zhao W. Parents' lived experience of adolescents' repeated non-suicidal self-injury in China: a qualitative study. BMC Psychiatry 2022; 22:70. [PMID: 35090423 PMCID: PMC8796418 DOI: 10.1186/s12888-022-03715-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 01/11/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The prevalence of non-suicidal self-injury (NSSI) is high among adolescents. Parents have significant impact on the development of NSSI. Many quantitative studies have demonstrated the relationship between parental factors such as parenting behaviors and adolescents' NSSI. However, few studies have explored parents' responses and adolescent-parent reciprocal interaction during repeated NSSI. This study aimed to explore parents' cognition, behaviors and adolescent-parent reciprocal interaction during repeated NSSI. METHODS This is a phenomenological study. By purposive sampling, 24 parents of adolescents with repeated NSSI were recruited from a child and adolescent psychiatric ward in a mental health center in Chengdu, China. Semi-structured interviews were conducted and audio-recorded. Audio-recordings were transcribed verbatim and analyzed using thematic analysis. FINDINGS Three themes were identified: parents' attribution, perceptions and coping behaviors of NSSI. Chronic stress of adolescents and triggers of NSSI were associated with parental expectations. Parents initially perceived NSSI as a manifestation of puberty, a way of making needs met or a coping strategy of negative emotions, and gradually realized that it was a condition requiring psychological assistance. Parents' coping behaviors of NSSI were divided into 4 stages, namely denial, dissuasion, reflection and adaptation, and working as a team. To be more specific, parents' coping strategies at dissuasion stage included criticizing and conciliating, while those at reflection and adaptation stage included neglecting, avoiding conflicts and increasing control. CONCLUSIONS These findings suggest that adjusting parents' expectation and negative perceptions of NSSI is beneficial to reduce adolescent-parent conflict and adolescents' inner conflict and prevent NSSI. Furthermore, it's necessary to publicize NSSI related knowledge to promote the early detection and treatment of NSSI.
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Affiliation(s)
- Xu Wang
- grid.13291.380000 0001 0807 1581Mental Health Center of West China Hospital, Sichuan University, No. 28 South Dianxin Street, Chengdu, 610041 China ,grid.13291.380000 0001 0807 1581West China School of Nursing, Sichuan University, Chengdu, China
| | - Xuehua Huang
- Mental Health Center of West China Hospital, Sichuan University, No. 28 South Dianxin Street, Chengdu, 610041, China.
| | - Xia Huang
- grid.13291.380000 0001 0807 1581Mental Health Center of West China Hospital, Sichuan University, No. 28 South Dianxin Street, Chengdu, 610041 China
| | - Wenting Zhao
- grid.13291.380000 0001 0807 1581West China School of Nursing, Sichuan University, Chengdu, China
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14
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Kiekens G, Robinson K, Tatnell R, Kirtley OJ. Opening the Black Box of Daily Life in Nonsuicidal Self-injury Research: With Great Opportunity Comes Great Responsibility. JMIR Ment Health 2021; 8:e30915. [PMID: 34807835 PMCID: PMC8663644 DOI: 10.2196/30915] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 08/18/2021] [Accepted: 08/23/2021] [Indexed: 01/03/2023] Open
Abstract
Although nonsuicidal self-injury (NSSI)-deliberate damaging of body tissue without suicidal intent-is a behavior that occurs in interaction with real-world contexts, studying NSSI in the natural environment has historically been impossible. Recent advances in real-time monitoring technologies have revolutionized our ability to do exactly that, providing myriad research and clinical practice opportunities. In this viewpoint paper, we review new research pathways to improve our ability to understand, predict, and prevent NSSI, and provide critical perspectives on the responsibilities inherent to conducting real-time monitoring studies on NSSI. Real-time monitoring brings unique opportunities to advance scientific understanding about (1) the dynamic course of NSSI, (2) the real-time predictors thereof and ability to detect acute risk, (3) the ecological validity of theoretical models, (4) the functional mechanisms and outcomes of NSSI, and (5) the promotion of person-centered care and novel technology-based interventions. By considering the opportunities of real-time monitoring research in the context of the accompanying responsibilities (eg, inclusive recruitment, sound and transparent research practices, participant safety and engagement, measurement reactivity, researcher well-being and training), we provide novel insights and resources to open the black box of daily life in the next decade(s) of NSSI research.
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Affiliation(s)
- Glenn Kiekens
- Faculty of Psychology and Educational Sciences, Clinical Psychology, KU Leuven, Leuven, Belgium
- Department of Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Kealagh Robinson
- School of Psychology, Te Herenga Waka-Victoria University of Wellington, Wellington, New Zealand
| | - Ruth Tatnell
- Faculty of Health, School of Psychology, Deakin University, Melbourne, Australia
| | - Olivia J Kirtley
- Department of Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
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15
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Baetens I, Greene D, Van Hove L, Van Leeuwen K, Wiersema JR, Desoete A, Roelants M. Predictors and consequences of non-suicidal self-injury in relation to life, peer, and school factors. J Adolesc 2021; 90:100-108. [PMID: 34182197 DOI: 10.1016/j.adolescence.2021.06.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 06/11/2021] [Accepted: 06/13/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Numerous life, peer, and school-related factors have been found to be associated with non-suicidal self-injury (NSSI) among adolescents; however, most studies have not explored the possible reciprocal nature of these associations. The aim of the current study was to examine bidirectional and longitudinal associations between NSSI and several life, peer, and school-related factors (i.e., stressful life events, peer relationships, academic achievement, and attitudes towards school). METHOD Community-based adolescents completed questionnaires assessing the variables of interest at three time points; age 12 (T1; 55.09% girls), age 13 (T2; 56.95% girls), and ages 14-15 (T3; 57.41% girls). In total, 529 adolescents provided complete data across all three-time points. RESULTS Analyses showed a bidirectional association between NSSI and both attitudes towards school and stressful life events. Specifically, stressful life events at T2 predicted engagement in NSSI at T3, and NSSI at T2 predicted increased risk of stressful life events at T3. Similarly, having negative attitudes towards school predicted NSSI at T2, which, in turn, predicted negative attitudes towards school at T3. Further, academic achievement at T1 was negatively associated with NSSI at T2. Peer relationships were neither a predictor nor a consequence of NSSI. CONCLUSIONS Our results suggest that NSSI can be both a predictor and a consequence of various life, and school factors. Focus on these factors in prevention and intervention efforts for NSSI among adolescents may be warranted.
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Affiliation(s)
- I Baetens
- Brussels University Consultation Center, Department of Psychology, Faculty of Psychology & Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium.
| | - D Greene
- School of Psychology, Curtin University, Australia
| | - L Van Hove
- Brussels University Consultation Center, Department of Psychology, Faculty of Psychology & Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - K Van Leeuwen
- Faculty of Psychology and Educational Sciences, KU Leuven, Belgium
| | - J R Wiersema
- Faculty of Psychology and Educational Sciences, Ghent University, Belgium
| | - A Desoete
- Faculty of Psychology and Educational Sciences, Ghent University, Belgium
| | - M Roelants
- Department of Public Health and Primary Care, KU Leuven, Belgium
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16
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The Role of Psychological Factors in Non-suicidal Self-injury of Female Adolescents. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2021. [DOI: 10.5812/ijpbs.101562] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Non-suicidal self-injury (NSSI) is defined as inflicting damage to one’s own body. It begins in adolescence and tends to become chronic. Objectives: Considering the high prevalence and chronicity of NSSI among girls, the present study aimed to investigate the factors affecting the prevalence of NSSI in female adolescents from their perspective. Methods: The participants consisted of 604 female high-school students in Saveh, aged 14 - 17 years (14.29 ± 1.11), who were selected via random cluster sampling from November 2018 to January 2019. They answered six questionnaires, including the Inventory of Statements About Self-injury (ISAS), Ways of Coping questionnaire (WCQ), Child Abuse Self-report scale (CASRS), Family Emotional Involvement and Criticism scale (FEICS), Emotion Reactivity scale (ERS), and Aggression questionnaire (AQ). Data were analyzed using logistic regression analysis. Results: The predictor variables of child abuse, emotion reactivity, perceived parental criticism, family emotional involvement, and problem- and emotion-focused coping styles could successfully distinguish NSSI individuals from those without NSSI (P < 0.05). There were no significant differences between minor and moderate groups. Conclusions: Family emotional support is a protective factor, while criticism, child abuse, and emotion-focused coping style are risk factors for NSSI.
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17
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Gyori D, Farkas BF, Horvath LO, Komaromy D, Meszaros G, Szentivanyi D, Balazs J. The Association of Nonsuicidal Self-Injury with Quality of Life and Mental Disorders in Clinical Adolescents-A Network Approach. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:1840. [PMID: 33672808 PMCID: PMC7918829 DOI: 10.3390/ijerph18041840] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 02/08/2021] [Accepted: 02/10/2021] [Indexed: 11/17/2022]
Abstract
Although earlier research has highlighted that psychiatric disorders significantly impair patients' quality of life (QoL), few studies have examined the relationship between nonsuicidal self-injury (NSSI) and QoL. Our aim was to investigate whether QoL mediates the mental disorder-NSSI relationship, and to study the QoL ratings agreement of self and parents in a clinical population of adolescents. We involved 202 adolescents from Vadaskert Child Psychiatric Hospital and Outpatient Clinic, Budapest, aged 13-18 years. All participants completed the Deliberate Self-Harm Inventory, Inventar zur Erfassung der Lebensqualität bei Kindern und Jugendlichen, and the Mini International Neuropsychiatric Interview Kid. To map the interrelationship between the NSSI, mental disorders, and QoL dimensions, Mixed Graphical Models were estimated. Adolescents with a history of NSSI rated their QoL to be significantly lower than adolescents without NSSI. Self and parents' QoL ratings are closer in the NSSI sample than in the no-NSSI sample. Among all QoL dimensions, only family problems had a direct significant association with NSSI engagement. Our results highlight that, contrary to our hypothesis, the presence of mental disorders mediates the relationship between most QoL dimensions and the occurrence of NSSI. Our results draw attention to the potential causal effect of environmental factors (e.g., peer problems) on mental disorders that, in turn, result in NSSI. The present paper highlights the importance of network modelling in clinical research.
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Affiliation(s)
- Dora Gyori
- Doctoral School of Psychology, Eotvos Lorand University, 1075 Budapest, Hungary; (L.O.H.); (D.S.)
- Institute of Psychology, Eotvos Lorand University, 1075 Budapest, Hungary; (D.K.); (J.B.)
| | - Bernadett Frida Farkas
- Mental Health Sciences Doctoral School, Semmelweis University, 1083 Budapest, Hungary; (B.F.F.); (G.M.)
| | - Lili Olga Horvath
- Doctoral School of Psychology, Eotvos Lorand University, 1075 Budapest, Hungary; (L.O.H.); (D.S.)
- Institute of Psychology, Eotvos Lorand University, 1075 Budapest, Hungary; (D.K.); (J.B.)
| | - Daniel Komaromy
- Institute of Psychology, Eotvos Lorand University, 1075 Budapest, Hungary; (D.K.); (J.B.)
- Faculty of Social and Behavioural Sciences, University of Amsterdam, 1018 WV Amsterdam, The Netherlands
- Department of Behavioural and Movement Sciences, Vrije Universiteit, 1081 HV Amsterdam, The Netherlands
| | - Gergely Meszaros
- Mental Health Sciences Doctoral School, Semmelweis University, 1083 Budapest, Hungary; (B.F.F.); (G.M.)
- Faculty of Medicine, Department of Psychiatry and Psychotherapy, Semmelweis University, 1083 Budapest, Hungary
| | - Dora Szentivanyi
- Doctoral School of Psychology, Eotvos Lorand University, 1075 Budapest, Hungary; (L.O.H.); (D.S.)
- Institute of Psychology, Eotvos Lorand University, 1075 Budapest, Hungary; (D.K.); (J.B.)
- Pedagogical Assistance Services, 1067 Budapest, Hungary
| | - Judit Balazs
- Institute of Psychology, Eotvos Lorand University, 1075 Budapest, Hungary; (D.K.); (J.B.)
- Department of Psychology, Bjørknes University College, 0456 Oslo, Norway
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18
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Gyori D, Balazs J. Nonsuicidal Self-Injury and Perfectionism: A Systematic Review. Front Psychiatry 2021; 12:691147. [PMID: 34305684 PMCID: PMC8293614 DOI: 10.3389/fpsyt.2021.691147] [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: 04/05/2021] [Accepted: 06/07/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Nonsuicidal self-injury (NSSI) and perfectionism mean a huge concern related to mental health and psychopathology. Recently, there has been a growing interest in research on the exploration of the association of perfectionism and NSSI, but till today there is no systematic review has been prepared in this topic. Aims: Therefore, we performed a systematic literature review of published studies that investigated the association between NSSI and perfectionism. Methods: The systematic search was made on PubMed, OVID Medline, PsychInfo, Scopus, and Web of Science. The search terms were ("nonsuicidal self-injury" OR "nonsuicidal self-injury" OR NSSI OR "self-injury" OR "self-injurious behavior" OR SIB OR "self-harm" OR "deliberate self-harm" OR DSH) AND (perfectionism). The inclusion criteria were as follows: written in English; reported empirical data; used validated self-report measures; investigated the association of nonsuicidal self-injury and perfectionism. There were no restrictions on participants regarding age, gender, race or ethnicity. Exclusion criteria: not written in English; was a review/meta-analysis; measured suicide behavior; measured self-injury irrespective of motivation or suicidal intent; was not about the association between nonsuicidal self-injury and perfectionism. Results: After the screening process, 15 studies were included in our systematic review. The majority of studies (12) were published in the last 10 years. Nine (60%) recruited participants from community samples, four (26.7%) from clinical populations, and two (13.3%) both from community and clinical participants. Fourteen (93.3%) of the studies were cross-sectional studies, and one study contained a longitudinal investigation. The majority of studies included only or mainly female participants (62.3-87.2%) and two studies contained a balanced male-female ratio population. Fourteen (93.3%) studies from the 15 studies found a significant positive association between NSSI and perfectionism. Limitations: The heterogeneity of used instruments makes it difficult to compare the results of involved studies. Only two studies investigated populations with balanced gender ratios. Only two studies examined both clinical and community populations. Clinical investigations enrolled mainly eating-disordered (ED) patients. Conclusions: The results of the current systematic review highlight the role of perfectionism in NSSI engagement. This systematic review may help the development of effective prevention initiatives and treatment strategies.
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Affiliation(s)
- Dora Gyori
- Doctoral School of Psychology, Eotvos Lorand University, Budapest, Hungary.,Institute of Psychology, Eotvos Lorand University, Budapest, Hungary
| | - Judit Balazs
- Institute of Psychology, Eotvos Lorand University, Budapest, Hungary.,Department of Psychology, Bjørknes University College, Oslo, Norway
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19
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Stewart SL, Toohey A, Poss JW. iCCareD: The Development of an Algorithm to Identify Factors Associated With Distress Among Caregivers of Children and Youth Referred for Mental Health Services. Front Psychiatry 2021; 12:737966. [PMID: 34867533 PMCID: PMC8637612 DOI: 10.3389/fpsyt.2021.737966] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Accepted: 10/22/2021] [Indexed: 11/13/2022] Open
Abstract
Caregiver well-being plays an important role in children's development and a number of factors have been found to impact distress levels among caregivers of children and youth referred for mental health services. Further, caregiver distress impacts youth psychopathology, its acuity as well as related mental health interventions. The purpose of this study was to develop and validate an algorithm for identifying caregivers who are at greatest risk of experiencing caregiver distress. This algorithm was derived from, and will be embedded in, existing comprehensive interRAI child and youth instruments. Ontario data based on the interRAI Child and Youth Mental Health assessment instruments (ChYMH and ChYMH-DD) were analyzed to identify predictors of distress among caregivers of children and youth ages 4-18 years. Starting with proactive aggression, the algorithm uses 40 assessment items to assign one of 30 nodes that are grouped into five levels of risk. The interRAI ChYMH Caregiver Distress (iCCareD) algorithm was validated using longitudinal data from mental health agencies across Ontario and was found to be a good predictor among this sample with a c-statistic of 0.71 for predicting new or ongoing caregiver distress and 65% for both sensitivity and specificity using algorithm values of 3 or greater. This algorithm provides an evidence-based decision-support tool embedded within a comprehensive assessment tool that may be used by clinicians to inform their selection of supports and services for families.
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Affiliation(s)
| | - Ashley Toohey
- Faculty of Education, Western University, London, ON, Canada
| | - Jeffrey W Poss
- Faculty of Applied Health Sciences, University of Waterloo, Waterloo, ON, Canada
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20
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Edinger A, Fischer-Waldschmidt G, Parzer P, Brunner R, Resch F, Kaess M. The Impact of Adverse Childhood Experiences on Therapy Outcome in Adolescents Engaging in Nonsuicidal Self-Injury. Front Psychiatry 2020; 11:505661. [PMID: 33329074 PMCID: PMC7672012 DOI: 10.3389/fpsyt.2020.505661] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2019] [Accepted: 09/16/2020] [Indexed: 11/13/2022] Open
Abstract
Objective: Nonsuicidal self-injury (NSSI) is a prevalent and clinically significant behavior. There is a substantial association between adverse childhood experiences (ACEs) and NSSI. However, there are no studies investigating the impact of ACEs on NSSI treatment (psychotherapy) outcome. The aim of this secondary analysis of a randomized controlled trial (RCT) on psychotherapy of NSSI was to investigate the relationship between ACEs and treatment outcome in adolescents engaging in NSSI. Method: A sample of 74 adolescent outpatients engaging in repetitive NSSI (incidents on ≥ 5 days within the last 6 months) was recruited for a RCT. ACEs were assessed by the Childhood Experience of Care and Abuse (CECA) interview before treatment onset. Based on the CECA, participants were divided in two groups: with a history of ACEs (n = 30) and without a history of ACEs (n = 44). Frequencies of NSSI, depression, and suicide attempts as well as quality of life were measured at three points in time: before treatment onset (baseline; T0), 4 (T1), and 10 months (T2) after treatment onset. Results: Both participants with and without ACEs were able to reduce the frequency of NSSI significantly [χ2 (1) = 26.72; p < 0.001]. Surprisingly, participants with ACEs reached a significantly greater reduction in NSSI frequency within the past 6 months compared to participants without ACEs [χ2 (1) = 5.08; p = 0.024]. There were also substantial and similar improvements regarding depressive symptoms, suicide attempts and quality of life in both groups. Conclusion: ACEs seem to positively predict treatment response in psychotherapy for adolescent NSSI. This is contrary to prior research suggesting ACE as an unfavorable prognostic factor in the treatment of mental disorders. Clinical Trial Registration: Short term therapy in adolescents with self-destructive and risk-taking behaviors; http://www.drks.de; DRKS00003605.
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Affiliation(s)
- Alexandra Edinger
- Section for Translational Psychobiology in Child and Adolescent Psychiatry, Clinic of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
- Clinic of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Gloria Fischer-Waldschmidt
- Section for Translational Psychobiology in Child and Adolescent Psychiatry, Clinic of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
- Clinic of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Peter Parzer
- Clinic of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Romuald Brunner
- Clinic and Policlinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Regensburg District Hospital, Regensburg, Germany
| | - Franz Resch
- Clinic of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
| | - Michael Kaess
- Section for Translational Psychobiology in Child and Adolescent Psychiatry, Clinic of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
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21
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Kiekens G, Claes L. Non-Suicidal Self-Injury and Eating Disordered Behaviors: An Update on What We Do and Do Not Know. Curr Psychiatry Rep 2020; 22:68. [PMID: 33037934 PMCID: PMC7547297 DOI: 10.1007/s11920-020-01191-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/25/2020] [Indexed: 12/21/2022]
Abstract
PURPOSE OF REVIEW The current report aims to summarize recent advances about the relationship between non-suicidal self-injury (NSSI) and eating disordered (ED) behaviors and highlights meaningful directions for future research. RECENT FINDINGS While there is solid evidence indicating a robust cross-sectional association between NSSI and ED behaviors, emerging evidence suggests that the temporal relationship between these behaviors may be bidirectional. Shared functions and risk factors may explain why these behaviors often co-develop. At the same time, little is still known about the psychosocial consequences of comorbid NSSI and ED engagement, and there is a lack of intervention studies that target these behaviors simultaneously. It is well-established that NSSI and ED behaviors frequently co-occur. The field should now turn to longitudinal designs to advance our understanding of the longer-term developmental and the shorter-term momentary relationship of these behaviors in daily life. Providing insight into these areas will help guide the deployment of evidence-based interventions that match the needs of clients who report comorbid NSSI and ED behaviors.
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Affiliation(s)
- Glenn Kiekens
- Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, box 3720, 3000, Leuven, Belgium. .,Department of Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium.
| | - Laurence Claes
- grid.5596.f0000 0001 0668 7884Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, box 3720, 3000 Leuven, Belgium ,grid.5284.b0000 0001 0790 3681Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Antwerp, Belgium
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22
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Brown RC, Witt A. Social factors associated with non-suicidal self-injury (NSSI). Child Adolesc Psychiatry Ment Health 2019; 13:23. [PMID: 31210782 PMCID: PMC6563365 DOI: 10.1186/s13034-019-0284-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 06/04/2019] [Indexed: 11/29/2022] Open
Affiliation(s)
- Rebecca C. Brown
- grid.410712.1Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Steinhoevelstr. 5, 89075 Ulm, Germany
| | - Andreas Witt
- grid.410712.1Department of Child and Adolescent Psychiatry and Psychotherapy, University Hospital Ulm, Steinhoevelstr. 5, 89075 Ulm, Germany
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