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Brás M, Cunha A, Antunes J, Carmo C. The Positive and Negative Suicidal Ideation Inventory among Portuguese Adolescents: Factor Structure and Gender Invariance. Eur J Investig Health Psychol Educ 2024; 14:1002-1011. [PMID: 38667820 PMCID: PMC11048955 DOI: 10.3390/ejihpe14040065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2024] [Revised: 04/06/2024] [Accepted: 04/08/2024] [Indexed: 04/28/2024] Open
Abstract
Suicide worldwide is an issue that needs to be addressed, and adolescents are an at-risk group. Assessing suicidal ideation is central to tackling the issue of suicide. The Positive and Negative Suicidal Ideation inventory is a widely validated measure of suicidal ideation, and yet, very little is known about its invariance across various groups. The present study aimed to adapt and test the PANSI's structure in a Portuguese sample while testing its gender invariance. A total of 750 middle and high school students were recruited for the study, and data were collected on various suicide risk and protective factors, including the Portuguese-translated PANSI. Data were put through exploratory and confirmatory factor analysis. Kaiser's criterion and scree plot both extracted two factors (64.10% variance explained). Confirmatory factor analysis also supported the PANSI's structure (TLI = 0.943). The PANSI showed good reliability (α ≥ 0.83) and good construct and discriminative validity. The PANSI also exhibited scalar, but not strict, invariance. Overall, these results were similar to previous versions of this scale. The PANSI is a reliable measure of suicide risk among Portuguese adolescents. Future studies should further replicate these results in other cultures and expand on them by testing for invariance across other demographic variables.
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Affiliation(s)
- Marta Brás
- Faculty of Human and Social Sciences, University of Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (A.C.); (J.A.); (C.C.)
- Psychology Research Center, Rua de Santa Marta, 47-3°, 1169-023 Lisboa, Portugal
| | - Ana Cunha
- Faculty of Human and Social Sciences, University of Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (A.C.); (J.A.); (C.C.)
| | - João Antunes
- Faculty of Human and Social Sciences, University of Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (A.C.); (J.A.); (C.C.)
- Psychology Research Center, Rua de Santa Marta, 47-3°, 1169-023 Lisboa, Portugal
| | - Cláudia Carmo
- Faculty of Human and Social Sciences, University of Algarve, Campus de Gambelas, 8005-139 Faro, Portugal; (A.C.); (J.A.); (C.C.)
- Psychology Research Center, Rua de Santa Marta, 47-3°, 1169-023 Lisboa, Portugal
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Bertuccio P, Amerio A, Grande E, La Vecchia C, Costanza A, Aguglia A, Berardelli I, Serafini G, Amore M, Pompili M, Odone A. Global trends in youth suicide from 1990 to 2020: an analysis of data from the WHO mortality database. EClinicalMedicine 2024; 70:102506. [PMID: 38440131 PMCID: PMC10911948 DOI: 10.1016/j.eclinm.2024.102506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 02/06/2024] [Accepted: 02/15/2024] [Indexed: 03/06/2024] Open
Abstract
Background Suicide is a serious but preventable public health concern at the global level, showing relevant geographical differences. This study aims to monitor global temporal and geographical patterns in suicide mortality in pre-adolescents, adolescents, and young adults (i.e., aged 10-24 years), from 1990 to 2020 or the most recent available year. Methods Using the World Health Organisation mortality database, we conducted an analysis on a subset of 52 countries with valid and high-quality data. We computed age-standardised suicide rates (ASR) by sex, country, and calendar year, and performed a joinpoint regression analysis to identify significant changes in the temporal suicide trends over the studied period. Findings High variability in suicide rates and trends was observed, with a male-to-female ratio of two to five. Between 1990 and 2020, most European countries reported declining suicide trends, with some exceptions. In particular, alarming trends emerged in the United Kingdom, with annual rises of 2.5% (95% CI: 1.6-3.5) since 2005 among males and 8.5% (95% CI: 4.7-12.6) since 2012 among females. The most favorable trends and lowest suicide rates were in Southern Europe, with 3.1/100,000 persons in Italy (2020) and 3.5/100,000 persons in Spain (2021) among males, and 0.9/100,000 persons in Italy (2020) and 1.1/100,000 persons in Romania (2019) among females. Conversely, the highest rates were in Central-Eastern Europe, with 10.2/100,000 males in the Russian Federation (2019) and 10.0/100,000 males in Poland (2002). Higher suicide rates and significant increases were reported in not European areas. The highest ASR was 15.5/100,000 males in the United States of America, with an annual increase of 3.8% (95% CI: 3.1-4.5) among males in 2009-2020 and 6.7% (95% CI: 5.6-7.8) among females in 2007-2017, followed by a levelling off. Interpretation Temporal and geographical comparisons of suicide mortality should be interpreted with caution due to potential misclassification or under-reporting of suicide deaths in some countries. Funding None.
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Affiliation(s)
- Paola Bertuccio
- School of Public Health, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
| | - Andrea Amerio
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Enrico Grande
- Integrated System for Health, Social Assistance and Welfare, National Institute of Statistics, Rome, Italy
| | - Carlo La Vecchia
- Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy
| | - Alessandra Costanza
- Department of Psychiatry, Faculty of Medicine, Geneva University (UNIGE), Geneva, Switzerland
- Department of Psychiatry, Adult Psychiatry Service (SPA), University Hospitals of Geneva (HUG), Geneva, Switzerland
- Department of Psychiatry, Faculty of Biomedical Sciences, University of Italian Switzerland, Lugano, Switzerland
| | - Andrea Aguglia
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Isabella Berardelli
- Department of Neuroscience, Mental Health and Sensory Organs, Sant’Andrea Hospital Sapienza University, Rome, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Mario Amore
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Maurizio Pompili
- Department of Neuroscience, Mental Health and Sensory Organs, Sant’Andrea Hospital Sapienza University, Rome, Italy
- International Consortium for Mood & Psychotic Disorder Research, Mailman Research Center, McLean Hospital, Belmont, MA, United States of America
| | - Anna Odone
- School of Public Health, Department of Public Health, Experimental and Forensic Medicine, University of Pavia, Pavia, Italy
- Medical Direction, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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Dai Y, Jiang T, Gaer W, Poon KT. Workplace Objectification Leads to Self-Harm: The Mediating Effect of Depressive Moods. PERSONALITY AND SOCIAL PSYCHOLOGY BULLETIN 2023:1461672231213898. [PMID: 38047443 DOI: 10.1177/01461672231213898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2023]
Abstract
In the current research, we aimed to extend the literature on workplace objectification and contribute to employees' well-being by exploring whether and how workplace objectification increases self-harm as well as the coping strategy that may weaken the effect. Employing archive data analytic, correlational, longitudinal, and experimental designs, we found that workplace objectification was associated with, or led to, self-harm, irrespective of whether such actions provided an escape from work. This effect could not be simply ascribed to the negative nature of workplace objectification. We further found that depressive moods mediated this effect. The detrimental effect of workplace objectification on self-harm was lessened when employees perceived higher alternatives in life. Theoretical and managerial implications were discussed.
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Affiliation(s)
- Yuwan Dai
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Tonglin Jiang
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Wangchu Gaer
- School of Psychological and Cognitive Sciences and Beijing Key Laboratory of Behavior and Mental Health, Peking University, Beijing, China
| | - Kai-Tak Poon
- Department of Psychology and Centre for Psychosocial Health, The Educational University of Hong Kong, Hong Kong, China
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Cunha AM, Carmo C, Bras M. Psychological Risk and Protective Factors for Suicidal Ideation: A Study in an Adolescent Sample in an Insular Context. Soa Chongsonyon Chongsin Uihak 2023; 34:250-257. [PMID: 37841492 PMCID: PMC10568188 DOI: 10.5765/jkacap.230031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 06/10/2023] [Accepted: 08/18/2023] [Indexed: 10/17/2023] Open
Abstract
Objectives Adolescents are at risk of suicide. As suicide is a multifactorial process, risk and protective factors are relevant constructs for suicide prediction. This study explored the effects of risk and protective factors on suicidal ideation in adolescents on the island of São Miguel (Azores). Methods A sample of 750 adolescents (male: n=358; 47.7%; mean age=14.67 years; standard deviation=1.85 years) from the island of São Miguel (Azores) completed several measures related to suicidal ideation and associated factors. Using a cross-sectional design, this study conducted descriptive, correlational, predictive, mediation, and moderation analyses. Results Adolescents generally displayed high levels of risk and protective factors; an indicative proportion exhibited significant suicidal ideation with females presenting the greatest vulnerability. Furthermore, the results highlight that depression is the best predictor of suicidal ideation, however, the association between these variables is mediated. Conclusion The data corroborate that the suicidal reality of adolescents in the Autonomous Region of the Azores is worrisome. Having substantiated the complexity of the suicidal context in young people in the present research, the need to continue studying risk/protective factors in this area is supported.
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Affiliation(s)
- Ana Margarida Cunha
- Department of Psychology and Educational Sciences, Universidade do Algarve, Faro, Portugal
| | - Claudia Carmo
- Department of Psychology and Educational Sciences, Universidade do Algarve, Faro, Portugal
- Psychology Research Centre (CIP-UAL), Universidade Autónoma de Lisboa, Lisbon, Portugal
| | - Marta Bras
- Department of Psychology and Educational Sciences, Universidade do Algarve, Faro, Portugal
- Psychology Research Centre (CIP-UAL), Universidade Autónoma de Lisboa, Lisbon, Portugal
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Van Meter AR, Knowles EA, Mintz EH. Systematic Review and Meta-analysis: International Prevalence of Suicidal Ideation and Attempt in Youth. J Am Acad Child Adolesc Psychiatry 2023; 62:973-986. [PMID: 36563876 DOI: 10.1016/j.jaac.2022.07.867] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 07/22/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Globally, rates of youth suicide vary considerably. Suicidal thoughts and behaviors (STB) are consistently associated with risk of death by suicide. However, international trends in STB have not yet been compared. To address this gap, an international meta-analysis of epidemiological and school-based studies that report on STB in youth was conducted. METHOD Systematic searches were conducted in PubMed and PsycINFO through April 2022. Eligible studies included prevalence of active suicidal ideation (SI) or suicide attempts (SA) in community youth younger than age 22. All studies were coded by 2 authors. Mixed models accounting for shared methods and including hypothesized moderators were conducted using the metafor package in R. RESULTS There were 371 effect sizes for SI, 94 for SI with a plan, and 316 for SA, representing 149 regions. Year of data collection ranged from 1981 to 2021. Participants were 6 to 21 years old. The prevalence of SI ranged across regions from 14.3% to 22.6%; the prevalence of SA ranged from 4.6% to 15.8%. Year was not associated with increasing STB prevalence except for studies from the United States, which showed increasing rates of SI and SA since 2007. CONCLUSION This is the most comprehensive meta-analysis of STB in youth, providing valuable data about how risk factors most commonly associated with suicide vary internationally and over time. International rates of STB among youth are not improving and may be getting worse in the United States, despite efforts to reduce suicide risk. Most studies did not report rates of SI or SA separately for LGBTQIA+ (lesbian, gay, bisexual, transgender, queer, intersex, asexual, and others) youth and youth of color. A better understanding of proximal risk at the individual level will be important to informing future prevention efforts, especially for high-risk groups.
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Affiliation(s)
- Anna R Van Meter
- New York University Grossman School of Medicine, New York; Zucker Hillside Hospital, Queens, New York; Feinstein Institutes for Medical Research, Manhasset, New York; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York.
| | - Ellen A Knowles
- Feinstein Institutes for Medical Research, Manhasset, New York; Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New York
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Farkas BF, Takacs ZK, Kollárovics N, Balázs J. The prevalence of self-injury in adolescence: a systematic review and meta-analysis. Eur Child Adolesc Psychiatry 2023:10.1007/s00787-023-02264-y. [PMID: 37486387 DOI: 10.1007/s00787-023-02264-y] [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: 11/20/2022] [Accepted: 07/18/2023] [Indexed: 07/25/2023]
Abstract
In the past 10 years, there has been a growing interest in self-injurious behavior (SIB) among adolescents. The lifetime prevalence of SIB is between 16 and 22% in community sample with females more likely to engage in SIB. There are conflicting results about the global distribution of the prevalence of SIB and whether the SIB has increased in the 21st century. Our aim in the current study was to conduct a systematic search of and meta-analysis on the prevalence of SIB in adolescents over the past 5 years' worth of published papers and to examine gender, continental, and year differences. We conducted a systematic search in June 2020 of six databases (PubMed, Scopus, Web of Science, OVID Medline, PsycINFO, EBSCO) with three main search terms: "self-injurious behavior," "prevalence," and "adolescence." Article inclusion criteria were (a) written in English; (b) published between January 1, 2015, and June 18, 2020; and (c) focused on a community sample. Titles and abstracts of the articles were screened first. Then, the relevant full texts were read, and those that met the inclusion criteria were collected. We used Comprehensive Meta-Analysis software was used to conduct the analyses. After the screening process 97, articles were included in the meta-analysis. The age of the samples ranged from 11.00 to 18.53 years. The overall average prevalence of nonsuicidal self-injury in the studies was 16%. There was a significant gender difference: females reported a higher prevalence than males (19.4% and 12.9%, respectively). A significantly higher prevalence was found among Asian articles than those from other continents (19.5% and 14.7%, respectively). The prevalence of SIB did not change significantly between 2013 and 2018. The current research draws attention to the high prevalence of SIB among adolescents, especially among females and those living in Asia. It is important to address this behavior, both in terms of prevention and intervention.
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Affiliation(s)
| | - Zsofia K Takacs
- Faculty of Education and Psychology, Institute of Education, Eötvös Loránd University, Budapest, Hungary
- School of Health in Social Sciences, University of Edinburgh, Edinburgh, UK
| | - Nóra Kollárovics
- Mental Health Sciences Doctoral School, Semmelweis University, Budapest, Hungary
| | - Judit Balázs
- Department of Developmental and Clinical Child Psychology, Faculty of Education and Psychology, Institute of Psychology, Eötvös Loránd University, Budapest, Hungary
- Oslo New University College, Oslo, Norway
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Carvalho CB, Teixeira M, Costa R, Cordeiro F, Cabral JM. The Enhancing Role of Emotion Regulation in the Links between Early Positive Memories and Self-harm and Suicidal Ideation in Adolescence. J Youth Adolesc 2023:10.1007/s10964-023-01777-8. [PMID: 37178280 DOI: 10.1007/s10964-023-01777-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 04/17/2023] [Indexed: 05/15/2023]
Abstract
Adolescence is a critical developmental period associated with an increased variety of interrelated risks and vulnerabilities. Previous studies have found associations between early memories of warmth and safeness, as well as emotion regulation, and self-harm and suicidal ideation in adolescence. Additionally, these early emotional memories have been found to be positively linked with some indicators of emotion regulation during this period. The present cross-sectional study extends prior research by exploring the moderating role of emotion regulation in the relationships between early memories of warmth and safeness, as well as each of the following risk-related outcomes in adolescence, in younger (i.e., 13-15) and older (i.e., 16-19) adolescents: suicidal ideation and self-harm and its associated functions (i.e., automatic and social reinforcement. Three self-report measures of these early emotional memories, emotion regulation, and risk-related outcomes, and a sample of 7918 Portuguese adolescents (53.3% females), with ages ranging from 13 to 19 (Mage = 15.5), were used. In both age groups, at high levels of emotion regulation, early memories of warmth and safeness had a greater (negative) effect on suicidal ideation and the automatic reinforcement function of self-harm, compared to at average and low levels of emotion regulation. These findings highlight the enhancing role of emotion regulation on the associations between early memories of warmth and safeness and some risk-related outcomes in adolescents, both younger and older, which reveals the relevance of targeting emotion regulation when preventing or tackling these outcomes, regardless of adolescents' levels of early memories of warmth and safeness.
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Affiliation(s)
- Célia Barreto Carvalho
- Faculty of Social and Human Sciences, University of the Azores, Ponta Delgada, Portugal.
- Cognitive and Behavioural Centre for Research and Intervention, Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal.
| | - Marco Teixeira
- Family Therapy and Systemic Intervention Center, Coimbra, Portugal
| | - Rodrigo Costa
- Gaspar Frutuoso Foundation, University of the Azores, Ponta Delgada, Portugal
| | - Filipa Cordeiro
- Gaspar Frutuoso Foundation, University of the Azores, Ponta Delgada, Portugal
| | - Joana Moura Cabral
- Faculty of Social and Human Sciences, University of the Azores, Ponta Delgada, Portugal
- Cognitive and Behavioural Centre for Research and Intervention, Faculty of Psychology and Education Sciences, University of Coimbra, Coimbra, Portugal
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Psychosocial Factors and Sociodemographic Characteristics Associated with Suicidality Risk in Chilean Adolescents. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9081185. [PMID: 36010075 PMCID: PMC9406739 DOI: 10.3390/children9081185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Revised: 07/24/2022] [Accepted: 07/26/2022] [Indexed: 11/17/2022]
Abstract
Background: Suicidality in adolescents is a growing concern and is currently a public health issue in Chile and the world. Objective: To determine the association between the risk of suicidality with self-harm, sociodemographic parameters (that is, gender and type of school), psychosocial variables, and social and family support in Chilean adolescents. Methods: In a cross-sectional study, 829 (377, 45.5% girls) children/adolescents between 10 and 19 years of age participated. Suicidality, self-esteem, health-related quality of life (HRQoL), and social support perception were evaluated by standard, validated questionnaires. The presence of self-harm, dating violence, and family dysfunction was also evaluated through a self-report survey. Results: Suicidality risk was related to low self-esteem (OR = 9.73; 95%; CI = 6.62−14.28; p < 0.001), low HRQoL (OR = 5.0; 95%; CI = 3.51−7.13; p < 0.001), low social support (OR; 3.38, 95%; CI; 2.48−4.6; p < 0.001), and self-harm (OR = 8.03; 95%; CI = 5.69−11.33; p < 0.001). In family terms, suicidality risk was associated with exposure to physical (OR = 2.47, 95%CI; 1.69−3.6; p < 0.001) and psychological (OR = 1.78, 95; 1.33−2.39; p < 0.001) aggression between parents, and with considering their family dysfunctional (OR = 2.41 95%; CI = 1.69−3.41; p < 0.001). Finally, suicidality was associated with feeling mistreated by a boyfriend/girlfriend (OR = 2.18; 95% CI = 1.19−3.98; p = 0.011). Conclusion: Suicidality was associated with self-harm, low social, psychological and family well-being, and/or feeling mistreated by a boyfriend/girlfriend.
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Gouveia-Pereira M, Duarte E, Gomes HS, da Silva CT, Santos N. Exploring the suicidal continuum: Deliberate self-harm diversity and severity as predictors of suicidal ideation and suicide attempts. Psychiatry Res 2022; 309:114400. [PMID: 35078007 DOI: 10.1016/j.psychres.2022.114400] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 01/08/2022] [Accepted: 01/14/2022] [Indexed: 11/17/2022]
Abstract
Deliberate self-harm (DSH) in adolescence is a predictor of suicidal thoughts and behaviors (STBs). However, there is still a lack of research systematizing the association between DSH and STBs. Therefore, our main goal was to analyze if DSH diversity and severity predicted suicidal ideation and suicide attempts. Our sample comprised 237 Portuguese adolescents and young adults with a history of DSH, from community (80.2%, n = 190) and clinical (19.8%, n = 47) settings, aged between 14 and 23 years (M = 17.31, SD=1.36). Results showed that DSH diversity and severity were significant predictors of suicidal ideation and suicide attempts. These results were further discussed, underlining the impact that DSH has for suicide risk and highlighting the need to address further variables to understand these suicidality trajectories.
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Affiliation(s)
- Maria Gouveia-Pereira
- Applied Psychology Research Center Capabilities & Inclusion (APPsyCI), ISPA - Instituto Universitário, Lisbon, Portugal.
| | - Eva Duarte
- Applied Psychology Research Center Capabilities & Inclusion (APPsyCI), ISPA - Instituto Universitário, Lisbon, Portugal.
| | - Hugo S Gomes
- Psychology Research Centre (CIPsi/UM), School of Psychology, University of Minho, Braga, Portugal
| | | | - Nazaré Santos
- Núcleo de Estudos de Suicídio (NES), Serviço de Psiquiatria e Saúde Mental do Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, EPE., Lisbon, Portugal
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Wong SL, Chung MC. The subjective experience of non-suicidal self-injury among female Chinese university students. Nord J Psychiatry 2022; 76:18-28. [PMID: 34061715 DOI: 10.1080/08039488.2021.1929461] [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] [Indexed: 10/21/2022]
Abstract
OBJECTIVE The purpose of this study was to explore the subjective experience of non-suicidal self-injury (NSSI) among female Chinese university students in Hong Kong. DESIGN Interpretative phenomenological analysis was used. METHODS Seven female students participated in the study, two engaged in biting and scratching, and three in cutting. RESULTS The majority of them indicated negative attitudes towards NSSI and saw no particular meaning attached to it. However, they all persisted with their behaviours, which suggested that they were unable to stop. Students found themselves in a paradoxical situation whereby although they saw no real benefit of NSSI, they still engaged in it to cope with distress. Feelings characterised by this distress were about entrapment and issues with academia, intimacy, loneliness, insecurity, negative self-worth, regulating distressing emotions, increasing positive physical sensations, healing oneself, and feeling alive. CONCLUSIONS The experience of hurting themselves persistently for these female students symbolised their struggle with academic or relationship difficulties, self-acceptance, emotional regulation and survival without self-injury.
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Affiliation(s)
- Siu Ling Wong
- Student Affairs Office, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Man Cheung Chung
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin, Hong Kong
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Wen Y, Zhang X, Xu Y, Qiao D, Guo S, Sun N, Yang C, Han M, Liu Z. Cognitive Impairment in Adolescent Major Depressive Disorder With Nonsuicidal Self-Injury: Evidence Based on Multi-indicator ERPs. Front Hum Neurosci 2021; 15:637407. [PMID: 33716699 PMCID: PMC7943920 DOI: 10.3389/fnhum.2021.637407] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 02/02/2021] [Indexed: 11/13/2022] Open
Abstract
The lifetime prevalence of major depressive disorder (MDD) in adolescents is reported to be as high as 20%; thus, MDD constitutes a significant social and public health burden. MDD is often associated with nonsuicidal self-injury (NSSI) behavior, but the contributing factors including cognitive function have not been investigated in detail. To this end, the present study evaluated cognitive impairment and psychosocial factors in associated with MDD with NSSI behavior. Eighteen and 21 drug-naïve patients with first-episode MDD with or without NSSI (NSSI+/- group) and 24 healthy control subjects (HC) were enrolled in the study. The Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Adolescent Self-injury Questionnaire, Beck Scale for Suicide Ideation-Chinese Version (BSI-CV), Shame Scale for Middle School Students, Sensation Seeking Scale (SSS) and Childhood Trauma Questionnaire (CTQ) were used to assess depression-related behaviors, and event-related potentials (ERPs) were recorded as a measure of cognitive function. The latency of the N1, N2, P3a, P3b, and P50 components of ERPs at the Cz electrode point; P50 amplitude and P50 inhibition (S1/S2) showed significant differences between the 3 groups. CTQ scores also differed across three groups, and the NSSI- and NSSI+ groups showed significant differences in scores on the Shame Scale for Middle School Students. Thus, cognitive function was impaired in adolescents with MDD with NSSI behavior, which was mainly manifested as memory decline, attention and executive function deficits, and low anti-interference ability. We also found that childhood abuse, lack of social support, and a sense of shame contributed to NSSI behavior. These findings provide insight into the risk factors for MDD with NSSI behavior, which can help mental health workers more effectively diagnose and treat these patients.
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Affiliation(s)
- Yujiao Wen
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Xuemin Zhang
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Yifan Xu
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Dan Qiao
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Shanshan Guo
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Ning Sun
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Chunxia Yang
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Min Han
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, China
| | - Zhifen Liu
- Department of Psychiatry, The First Hospital of Shanxi Medical University, Taiyuan, China
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Ati NAL, Paraswati MD, Windarwati HD. What are the risk factors and protective factors of suicidal behavior in adolescents? A systematic review. JOURNAL OF CHILD AND ADOLESCENT PSYCHIATRIC NURSING 2020; 34:7-18. [DOI: 10.1111/jcap.12295] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 06/22/2020] [Accepted: 09/02/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Niken A. L. Ati
- School of Nursing, Faculty of Medicine Brawijaya University Malang Indonesia
| | - Mareta D. Paraswati
- School of Nursing, Faculty of Medicine Brawijaya University Malang Indonesia
| | - Heni D. Windarwati
- School of Nursing, Faculty of Medicine Brawijaya University Malang Indonesia
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Duarte TA, Paulino S, Almeida C, Gomes HS, Santos N, Gouveia-Pereira M. Self-harm as a predisposition for suicide attempts: A study of adolescents' deliberate self-harm, suicidal ideation, and suicide attempts. Psychiatry Res 2020; 287:112553. [PMID: 31526562 DOI: 10.1016/j.psychres.2019.112553] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Revised: 09/02/2019] [Accepted: 09/02/2019] [Indexed: 01/09/2023]
Abstract
The aim of this study was to analyze the predictive risk factors for self-harm in adolescents with and without suicidal ideation. 600 adolescents answered a questionnaire about self-harm and suicidal behaviors. A logistic regression analysis was conducted. Over half of the individuals with deliberate self-harm (DSH) presented significant suicide risk. There was a direct association between DSH and suicide attempts, with almost the totality of the adolescents with suicide attempts also reporting DSH. According to the prediction model, suicidal ideation and diversity of DSH behaviors are significant predictors of suicide attempts, with an augmentation in the diversity of DSH behaviors and suicidal ideation predicting suicide attempts. Depression and anxiety appeared also as significant predictors of suicide attempts in adolescent self-harmers. Considering that the majority of the sample was not from a clinical setting, an alarming finding was that one third of the total sample was at suicide risk. These results place DSH as a key variable for early intervention.
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Affiliation(s)
- Tiago A Duarte
- Núcleo de Estudos de Suicídio (N.E.S.), Serviço de Psiquiatria e Saúde Mental do Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, E.P.E., Av. Prof. Egas Moniz, Lisbon 1649-035, Portugal; Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal.
| | - Sofia Paulino
- Núcleo de Estudos de Suicídio (N.E.S.), Serviço de Psiquiatria e Saúde Mental do Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, E.P.E., Av. Prof. Egas Moniz, Lisbon 1649-035, Portugal; Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Carolina Almeida
- Núcleo de Estudos de Suicídio (N.E.S.), Serviço de Psiquiatria e Saúde Mental do Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, E.P.E., Av. Prof. Egas Moniz, Lisbon 1649-035, Portugal; Centro Hospitalar Lisboa Ocidental, E.P.E., Lisbon, Portugal
| | - Hugo S Gomes
- Research Centre on Psychology (CIPsi), School of Psychology, University of Minho, Braga, Portugal
| | - Nazaré Santos
- Núcleo de Estudos de Suicídio (N.E.S.), Serviço de Psiquiatria e Saúde Mental do Hospital de Santa Maria, Centro Hospitalar Universitário Lisboa Norte, E.P.E., Av. Prof. Egas Moniz, Lisbon 1649-035, Portugal; Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
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Duarte E, Gouveia-Pereira M, Gomes HS, Sampaio D. How Do Families Represent the Functions of Deliberate Self-Harm? A Comparison between the Social Representations from Adolescents and Their Parents. Arch Suicide Res 2020; 24:173-189. [PMID: 30537902 DOI: 10.1080/13811118.2018.1545713] [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: 01/28/2023]
Abstract
Research has recognized the importance of understanding the social representations about the functions of deliberate self-harm, particularly in the context of clinical intervention. In addition, parents can play a relevant role in the rehabilitation of adolescents with these behaviors. However, there are few studies that focused on the description and comparison of the social representations about these functions, particularly in families. This article aimed to analyze the social representations about the functions of deliberate self-harm from adolescents and their parents. We developed two sets of analyses: first we compared the social representations from adolescents without a history of deliberate self-harm and their parents, and secondly we compared the social representations about the functions of deliberate self-harm from adolescents with a history of these behaviors and their parents' social representations. Results revealed significant differences between both groups of families, implying that the groups of participants represent the functions of deliberate self-harm differently. Overall, parents emphasized interpersonal functions and devalued intrapersonal functions. These differences were heightened in the families of adolescents with deliberate self-harm. The present article provides important insights regarding the social representations about the functions of deliberate self-harm and the differences between parents' social representations and their children experiences and social representations.
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Duarte E, Gouveia-Pereira M, Gomes HS. Development and Factorial Validation of the Inventory of Deliberate Self-Harm Behaviours for Portuguese Adolescents. Psychiatr Q 2019; 90:761-776. [PMID: 31385122 DOI: 10.1007/s11126-019-09660-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Deliberate self-harm (DSH) is a public health problem that mainly affects adolescents and young adults. Evidence suggests that multiple methods are used with a self-aggressive intent. The present article focuses on the development and factorial validation of the Inventory of Deliberate Self-harm Behaviours for Portuguese adolescents. This instrument assesses the lifetime frequency of 13 DSH methods, with and without suicidal intent. Study 1 consisted of an exploratory factor analysis with a sample of 131 adolescents with a reported history of DSH. Results revealed a three-factor structure with acceptable internal consistency: High Severity DSH, Mild Severity DSH, and Substance Use DSH. After item reduction, this structure was tested in Study 2 through a confirmatory factor analysis with an independent sample of 109 adolescents also with a history of DSH. Results showed an acceptable model fit. This instrument presents a solid structure and acceptable psychometric properties, allowing its use in further research.
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Affiliation(s)
- Eva Duarte
- CIE-ISPA, ISPA - Instituto Universitário, Rua Jardim do Tabaco 34, 1149-041, Lisbon, Portugal.
| | - Maria Gouveia-Pereira
- CIE-ISPA, ISPA - Instituto Universitário, Rua Jardim do Tabaco 34, 1149-041, Lisbon, Portugal
| | - Hugo S Gomes
- CIPsi - Psychology Research Center, Victims, Offenders and Justice System Research Unit, School of Psychology, University of Minho, Campus de Gualtar, 4710-057, Braga, Portugal
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Lim KS, Wong CH, McIntyre RS, Wang J, Zhang Z, Tran BX, Tan W, Ho CS, Ho RC. Global Lifetime and 12-Month Prevalence of Suicidal Behavior, Deliberate Self-Harm and Non-Suicidal Self-Injury in Children and Adolescents between 1989 and 2018: A Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:E4581. [PMID: 31752375 PMCID: PMC6888476 DOI: 10.3390/ijerph16224581] [Citation(s) in RCA: 229] [Impact Index Per Article: 45.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Revised: 11/03/2019] [Accepted: 11/07/2019] [Indexed: 12/13/2022]
Abstract
OBJECTIVE This meta-analysis aimed to estimate the global lifetime and 12-month prevalence of suicidal behavior, deliberate self-harm and non-suicidal self-injury in children and adolescents. METHODS A systematic search for relevant articles published between 1989 to 2018 was performed in multiple electronic databases. The aggregate 12-month and lifetime prevalence of suicidal behavior, deliberate self-harm, and non-suicidal self-injury were calculated based on the random-effects model. Subgroup analyses were performed to compare the prevalence according to school attendance and geographical regions. Results: A total of 686,672 children and adolescents were included. The aggregate lifetime and 12-month prevalence of suicide attempts was 6% (95% CI: 4.7-7.7%) and 4.5% (95% CI: 3.4-5.9%) respectively. The aggregate lifetime and 12-month prevalence of suicidal plan was 9.9% (95% CI: 5.5-17%) and 7.5% (95% CI: 4.5-12.1%) respectively. The aggregate lifetime and 12-month prevalence of suicidal ideation was 18% (95% CI: 14.2-22.7%) and 14.2% (95% CI: 11.6-17.3%) respectively. The aggregate lifetime and 12-month prevalence of non-suicidal self-injury was 22.1% (95% CI: 16.9-28.4%) and 19.5% (95% CI: 13.3-27.6%) respectively. The aggregate lifetime and 12-month prevalence of deliberate self-harm was 13.7% (95% CI: 11.0-17.0%) and 14.2% (95% CI: 10.1-19.5%) respectively. Subgroup analyses showed that full-time school attendance, non-Western countries, low and middle-income countries, and geographical locations might contribute to the higher aggregate prevalence of suicidal behaviors, deliberate self-harm, and non-suicidal self-injury. Conclusions: This meta-analysis found that non-suicidal self-injury, suicidal ideation, and deliberate self-harm were the three most common suicidal and self-harm behaviors in children and adolescents.
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Affiliation(s)
- Kim-San Lim
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore; (K.-S.L.); (R.C.H.)
| | - Celine H. Wong
- Division of Child and Adolescent Psychiatry, Department of Psychological Medicine, National University Health System, Singapore 119228, Singapore;
| | - Roger S. McIntyre
- Mood Disorders Psychopharmacology Unit, University Health Network, University of Toronto, Toronto, ON M5T 1R8, Canada;
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - Jiayun Wang
- Institute of Cognitive Neuroscience, Huaibei Normal University, Huaibei 235000, China;
| | - Zhisong Zhang
- Institute of Cognitive Neuroscience, Huaibei Normal University, Huaibei 235000, China;
| | - Bach X. Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi 100000, Vietnam;
- Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD 21205, USA
- Vietnam Young Physicians’ Association, Hanoi 100000, Vietnam
| | - Wanqiu Tan
- The China-Singapore (Chongqing) Demonstration Initiative on Strategic Connectivity Think Tank, Chongqing 400043, China;
| | - Cyrus S. Ho
- Department of Psychological Medicine, National University Health System, Singapore 119228, Singapore;
| | - Roger C. Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore; (K.-S.L.); (R.C.H.)
- Institute of Cognitive Neuroscience, Huaibei Normal University, Huaibei 235000, China;
- Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore 119228, Singapore
- Center of Excellence in Behavioral Medicine, Nguyen Tat Thanh University, Ho Chi Minh City 70000, Vietnam
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Social representations about the functions of deliberate self-harm: Adolescents and parents. J Adolesc 2019; 73:113-121. [PMID: 31102879 DOI: 10.1016/j.adolescence.2019.05.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Revised: 04/30/2019] [Accepted: 05/02/2019] [Indexed: 11/21/2022]
Abstract
INTRODUCTION The understanding of the social representations about the functions of deliberate self-harm can be an important factor for the comprehension of this phenomenon. Nonetheless, only a few studies focused on this topic and specifically on the social representations from adolescents with and without a history of deliberate self-harm and their parents. METHODS This article presents two studies that analysed these representations. Study 1 compared the social representations from 411 Portuguese adolescents (219 females and 192 males, aged 12-19 years), from which 109 reported having a history of deliberate self-harm. Study 2 focused on the comparison of the social representations from 471 parents (265 mothers and 206 fathers, aged 33-62 years) of Portuguese adolescents. Of the parents in Study 2, 120 had children with a history of deliberate self-harm. RESULTS In Study 1, adolescents without a history of deliberate self-harm perceived most interpersonal functions as more relevant than adolescents with a history of these behaviours, while adolescents with a history of deliberate self-harm emphasized one intrapersonal function. In Study 2, no differences were found between parents of adolescents with and without a history of deliberate self-harm. However, results revealed differences between the representations of mothers and fathers in several intrapersonal functions. CONCLUSIONS This research provides important insight regarding the social representations about the functions of deliberate self-harm from adolescents with and without a reported history of these behaviours and their parents. The impact for clinical intervention and prevention programs is discussed.
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