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Ren T, Wen Y, Ma L, Qiao D, Li G, Li H, Wang X, Liu Z. Psychosocial factors affect the occurrence of nonsuicidal self-injury in adolescents with major depressive disorder through chain mediation. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01858-0. [PMID: 38976048 DOI: 10.1007/s00406-024-01858-0] [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: 09/25/2023] [Accepted: 06/20/2024] [Indexed: 07/09/2024]
Abstract
In the adolescent group, about half of adolescents with major depressive disorder (MDD) have NSSI. Psychosocial factors are associated with the development of NSSI. Clarifying the relationship between psychosocial factors and NSSI in adolescents with MDD can help us achieve early prevent. Demographic data, Hamilton Depression Scale-24 (HAMA24), childhood trauma questionnaire, emotional intelligence scale and interpersonal reactivity index were collected from 187 adolescents with MDD. Use ANOVA, Chi-square test, Binary Logistic Regression, Pearson correlation analysis, Mediation effect analysis and the Structural Equation Model for data analysis. The results of ANOVA showed that there was significant difference between the two groups in HAMD24 total score, impulsiveness, emotional intelligence, and empathy (p < 0.05). In the regression analysis, women, depression degree, motor impulsiveness (MI), personal distress (PD) and appraisal of other's emotions empathy were the risk factors for MDD adolescents to produce NSSI behavior. Among the indicators that were significantly related to MDD and NSSI, MI and PD mediate the relationship between MDD and NSSI. The structural equation model showed that MDD, PD and MI had a direct impact on NSSI, but PD and MI had multiple intermediary effected in the relationship between MDD and NSSI. Emotional intelligence, emotional neglect and cognitive impulsiveness indirectly affected the occurrence of NSSI behavior. Impulsiveness, personal distress, emotional neglect, and emotional intelligence are important risk factors that affect NSSI behavior in adolescents with MDD, and they affect the occurrence of NSSI in adolescents with MDD through chain mediation.
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Affiliation(s)
- Tian Ren
- Department of Psychiatry, First Hospital of Shanxi Medical University, NO. 85 Jiefang South Road, Taiyuan, China
| | - Yujiao Wen
- Department of Psychiatry, First Hospital of Shanxi Medical University, NO. 85 Jiefang South Road, Taiyuan, China
| | - Lu Ma
- Department of Psychiatry, First Hospital of Shanxi Medical University, NO. 85 Jiefang South Road, Taiyuan, China
| | - Dan Qiao
- Department of Psychiatry, First Hospital of Shanxi Medical University, NO. 85 Jiefang South Road, Taiyuan, China
| | - Gaizhi Li
- Department of Psychiatry, First Hospital of Shanxi Medical University, NO. 85 Jiefang South Road, Taiyuan, China
| | - Hong Li
- Department of Psychiatry, First Hospital of Shanxi Medical University, NO. 85 Jiefang South Road, Taiyuan, China
| | - Xiao Wang
- Department of Psychiatry, First Hospital of Shanxi Medical University, NO. 85 Jiefang South Road, Taiyuan, China
| | - Zhifen Liu
- Department of Psychiatry, First Hospital of Shanxi Medical University, NO. 85 Jiefang South Road, Taiyuan, China.
- Shanxi Key Laboratory of Artificial Intelligence Assisted Diagnosis and Treatment for Mental Disorder, First Hospital of Shanxi Medical University, Taiyuan, China.
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Kaggwa MM, Chaimowitz GA, Erb B, Moulden H, Prat S, Davids A, Olagunju AT. Adverse childhood events and self-harming behaviours among individuals in Ontario forensic system: the mediating role of psychopathy. BMC Psychiatry 2024; 24:332. [PMID: 38693475 PMCID: PMC11064378 DOI: 10.1186/s12888-024-05771-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 04/17/2024] [Indexed: 05/03/2024] Open
Abstract
BACKGROUND Adverse childhood events (ACEs), psychopathy, and self-harming behaviours are prevalent among individuals in the forensic psychiatry system. While existing literature suggests that ACEs, self-harm, and psychopathy are interrelated, little is known about the interplay of psychopathic traits in this relationship. The present study aimed to determine the mediating role of psychopathy in the relationship between ACEs and self-harming behaviours in forensic patients. METHODS This was a retrospective study of patients under the Ontario Review Board (ORB) between 2014 and 2015. In the analysis, we included patients with complete data on ACEs, self-harming behaviours, and a Psychopathy Checklist-Revised (PCL-R) score - a measure of psychopathic traits and their severity conducted during the reporting period. Mediation analysis was based on the Baron and Kenny approach, and sensitivity analysis was performed based on the types of ACEs. RESULTS The sample population (n = 593) was made up of adults, with a mean age of 41.21 (± 12.35) years and were predominantly males (92.37%). While there was a partial mediating effect of psychopathy on the relationship between ACEs and incidents of self-harming behaviours in the past year, the mediation was complete in the relationship between ACEs and a lifetime history of self-harming behaviours. Following sensitivity analysis based on the types of ACE, the mediating effects were more attributed to specific ACEs, especially having experienced child abuse or having an incarcerated household member before 18 years. CONCLUSION Among forensic patients in Ontario, psychopathy mediates the relationship between experiencing ACEs and engaging in self-harming behaviours. Effective intervention to mitigate self-harming behaviours in this population should consider the potential role of psychopathy, especially among individuals who have experienced ACEs involving a history of child abuse and a family who was incarcerated.
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Affiliation(s)
- Mark Mohan Kaggwa
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada.
- Forensic Psychiatry Program, St. Joseph's Healthcare, Hamilton, ON, Canada.
- Department of Psychiatry, Mbarara University of Science and Technology, Mbarara, Uganda.
| | - Gary A Chaimowitz
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Forensic Psychiatry Program, St. Joseph's Healthcare, Hamilton, ON, Canada
| | - Bailea Erb
- Forensic Psychiatry Program, St. Joseph's Healthcare, Hamilton, ON, Canada
| | - Heather Moulden
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Forensic Psychiatry Program, St. Joseph's Healthcare, Hamilton, ON, Canada
| | - Sebastien Prat
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Forensic Psychiatry Program, St. Joseph's Healthcare, Hamilton, ON, Canada
| | - Arianna Davids
- Forensic Psychiatry Program, St. Joseph's Healthcare, Hamilton, ON, Canada
| | - Andrew T Olagunju
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
- Forensic Psychiatry Program, St. Joseph's Healthcare, Hamilton, ON, Canada
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, 5000, Australia
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Kaggwa MM, Chaimowitz GA, Erb B, Prat S, Davids A, Moulden H, Robbins A, Bradford J, Mamak M, Olagunju AT. Self-harming behaviors and forensic system-related factors: an analysis of the Ontario review board database. BMC Psychiatry 2023; 23:913. [PMID: 38057757 PMCID: PMC10698976 DOI: 10.1186/s12888-023-05394-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 11/21/2023] [Indexed: 12/08/2023] Open
Abstract
BACKGROUND In Canada, ensuring public safety, and the safety and well-being of accused individuals under the jurisdiction of the provincial review board are very important. While previous studies have reported a significant risk of self-harming behaviors (non-suicidal self-injury and suicide attempt) in forensic psychiatric settings, no large population study has assessed any relationship between forensic system-related factors and self-harming behaviors. A better understanding of these factors can help clinicians implement protective measures to mitigate self-harming behaviors or actions. METHODS Using the Ontario Review Board (ORB) database covering 2014-2015 period (n = 1211, mean age = 42.5 ± 13.37 years, males = 86.1%), we analyzed the prevalence and factors associated with self-harming behaviors, emphasizing the characterization of the forensic system-related factors (ORB status, legal status, type of offense, previous criminal history, and victim relationship). The relationships between the forensic system-related factors and self-harming behaviors were explored using five separate logistic regression models, controlling for clinical and sociodemographic characteristics. RESULTS Approximately 4% of the individuals in the forensic system over the study period engaged in self-harming behaviors Among the studied patients, individuals determined to be unfit to stand trial and inpatients were significantly more likely to have self-harming behaviors. There was no significant relationship between the type of offence, victim relationship, and previous criminal history with self-harming behavior. CONCLUSION Forensic psychiatry inpatients should have close observation, screening, monitoring, and individual tailored management strategies for self-harming behaviors. The findings of this study indicate that forensic system-related factors, especially those that pertain to the status of individuals in the forensic system (i.e., unfit to stand trial and being an inpatient) are more responsible for self-harming behaviors among forensic patients in Ontario.
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Affiliation(s)
- Mark Mohan Kaggwa
- Forensic Psychiatry Program, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada.
- Department of Psychiatry and Behavioral Sciences, McMaster University, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada.
- Mbarara University of Science and Technology, Mbarara, Uganda.
| | - Gary Andrew Chaimowitz
- Forensic Psychiatry Program, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada
- Department of Psychiatry and Behavioral Sciences, McMaster University, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada
| | - Bailea Erb
- Forensic Psychiatry Program, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada
| | - Sébastien Prat
- Forensic Psychiatry Program, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada
- Department of Psychiatry and Behavioral Sciences, McMaster University, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada
| | - Arianna Davids
- Forensic Psychiatry Program, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada
| | - Heather Moulden
- Forensic Psychiatry Program, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada
- Department of Psychiatry and Behavioral Sciences, McMaster University, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada
| | - Amara Robbins
- Forensic Psychiatry Program, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada
| | - John Bradford
- Forensic Psychiatry Program, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada
- Department of Psychiatry and Behavioral Sciences, McMaster University, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada
- Division of Forensic Psychiatry, University of Ottawa, Ottawa, ON, Canada
| | - Mini Mamak
- Forensic Psychiatry Program, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada
- Department of Psychiatry and Behavioral Sciences, McMaster University, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada
| | - Andrew Toyin Olagunju
- Forensic Psychiatry Program, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada
- Department of Psychiatry and Behavioral Sciences, McMaster University, St Joseph's Healthcare Hamilton, 100 West 5th, Hamilton, ON, L89 3K7, Canada
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, 5000, Australia
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Thomas D, Bonnaire C. Non-Suicidal Self-Injury and Emotional Dysregulation in Male and Female Young Adults: A Qualitative Study. Soa Chongsonyon Chongsin Uihak 2023; 34:159-168. [PMID: 37426830 PMCID: PMC10326353 DOI: 10.5765/jkacap.230033] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 06/09/2023] [Accepted: 06/21/2023] [Indexed: 07/11/2023] Open
Abstract
Objectives Non-suicidal self-injury (NSSI) has been theoretically, clinically, and empirically associated with emotional dysregulation. NSSI is a means of regulating emotional states, particularly negative emotions. However, empirical studies on this topic are scarce and the literature lacks qualitative research on individuals' perceptions and comprehension of the function of self-injury. Thus, this qualitative study aimed to provide novel insights into the relationship between NSSI and emotional dysregulation in young adults. Methods Twelve participants (mean age=22.7 years, 9 females and 3 males) from different support groups and a healthcare center participated in semi-structured interviews on NSSI-related emotional processes. Three aspects were investigated: reasons for NSSI, function of NSSI, and emotions. Each interview was voice recorded and typically lasted between 20 and 40 minutes. All responses were analyzed using thematic analysis. Results Four major themes were identified. The results showed that NSSI had both intrapersonal and interpersonal functions, within which emotional regulation played a significant role. NSSI was also used to regulate positive emotions. The results also showed a sequence of emotions among the participants, going from feeling overwhelmed to feeling relatively calm but guilty. Conclusion NSSI has several functions for the same individual. Thus, it would be interesting to provide integrative therapy, such as emotion-focused therapy, which focus on improving intrapersonal and interpersonal emotion regulation skills and strategies.
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Affiliation(s)
| | - Celine Bonnaire
- Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, Boulogne Billancourt, France
- Centre de Soins d'Accompagnement et de Prévention en Addictologie Pierre Nicole, Paris, France
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Thomas D, Bonnaire C. Relationship Between Non-Suicidal Self-Injury and Emotion Dysregulation Among Male and Female Young Adults. Psychol Rep 2023:332941231183336. [PMID: 37300551 DOI: 10.1177/00332941231183336] [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: 06/12/2023]
Abstract
Over recent years, non-suicidal self-injury (NSSI) has been associated with emotion dysregulation. However, only a few quantitative studies have empirically investigated differences in emotion dysregulation among people who self-harm, while none have explored gender differences in this regard. Thus, this research study aimed to further examine the association between NSSI and emotion regulation deficits and strategies in young adults. A total of 201 participants (mean age = 21.82 years) were recruited from different support groups dedicated to NSSI and from health care centres and were divided into two groups: a control group (CG, n = 100, mean age = 21.92 years, comprised of 30% males) and an NSSI group (NSSIG, n = 101, mean age = 21.72 years, comprised of 16% males). All participants completed the Deliberate Self-Harm Inventory, the Difficulties in Emotion Regulation Scale, and the Emotion Regulation Questionnaire. The results showed that compared to the CG participants, those from the NSSIG had increased emotion regulation deficits, higher expressive suppression scores, and lower cognitive re-evaluation scores. Within the NSSIG, females had higher impulse control difficulties and limited access to emotion regulation strategies, while males had higher expressive suppression scores. Factors associated with NSSI also differed by gender. These results indicate the necessity to take gender into account when planning treatment, since treatment protocols must be adapted to the specific emotion regulation difficulties concerned.
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Affiliation(s)
| | - Céline Bonnaire
- Laboratoire de Psychopathologie et Processus de Santé, Université Paris Cité, Boulogne Billancourt, France
- Centre de Soins d'Accompagnement et de Prévention en Addictologie Pierre Nicole, Paris, France
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