Clinical Correlates of Deliberate Self-Harm Among Migrant Trauma-Affected Subgroups

Influence of stress on self-injury among Chinese left-behind adolescents is not cast in stone: Synergistic roles of family protective factors

BACKGROUND

Left-behind adolescents are vulnerable to stressful life events and often engage in nonsuicidal self-injury (NSSI), which is a growing public concern in China. However, little is known about the synergistic protective effect of family resources on the relationship between stressful life events and NSSI in these adolescents.

OBJECTIVE

Based on theories of family socialization and resilience, the aim of this study was to examine the synergistic protective role of maternal knowledge and mother-child cohesion in buffering the effect of stressful life events on NSSI in father-absent left-behind adolescents.

METHODS

This study used two-wave longitudinal data. The analytical sample included 673 adolescents (Mage = 13.47 ± 1.11 years, 48 % male) who were enlisted from 4 junior high schools in rural China. Respondents completed questionnaires on stressful life events, parental knowledge, parent-child cohesion, and NSSI at two-time points.

RESULTS

The effects of stressful life events on NSSI were significant in father-absent left-behind adolescents. Additionally, maternal knowledge moderated the associations between stressful life events and NSSI in father-absent left-behind adolescents. Moreover, maternal knowledge and mother-child cohesion were found to play synergistic protective roles in the relationship between stressful life events and NSSI. In father-absent left-behind adolescents, only high maternal knowledge and high-quality mother-child cohesion could eliminate the negative effect of stressful life events on NSSI.

CONCLUSION

The findings underscore the synergistic protective roles of maternal knowledge and mother-child cohesion in buffering the negative effect of stressful life events on NSSI in father-absent left-behind adolescents. Both maternal knowledge and mother-child cohesion should be considered in interventions aimed at reducing NSSI in these adolescents.

Chronicity of self-harming behaviors among adolescent teenage girls living in refugee settlements in Northern Uganda

BACKGROUND

Self-harming ideations demand targeted research due to their persistent nature, especially among female adolescents within refugee populations who face unique challenges that can exacerbate self-harming tendencies. This study aimed to assess the factors associated with self-harming ideations chronicity among female teenagers living in refugee settlement in Northern Uganda.

METHOD

This cross-sectional study used a pretested questionnaire to assess self-harming ideations and other demographic characteristics. Ordinal logistic regression was used to determine factors associated with chronicity of self-harm ideations.

RESULTS

Of 385 participants, the prevalence of self-harming ideations was 4.2% (n = 16) for acute, 8% (n = 31) for subacute, and 3.1% (n = 12) for chronic. The likelihood of having more chronic self-harming ideations increased with having ever been pregnant (adjusted odds ratio [aOR] = 3.78, 95% Confidence Interval [CI] = 1.57-9.08). However, having a spouse as the family head reduced the likelihood of having more chronic self-harming ideations (aOR = 0.19, 95% CI = 0.04-0.95).

CONCLUSIONS

The persistence of self-harming thoughts among female teenagers in Northern Ugandan refugee settlements varies. Pregnancy history is associated with a higher chance of prolonged self-harming thoughts while having a spouse as the family's head is linked with a lower likelihood. Examining different demographic and familial elements when addressing the mental well-being of female teenage refugees is vital. It stresses the necessity for customized interventions and support networks targeting the reduction of self-harm behaviors among this vulnerable group.

Effects of BPD tendencies and subjective well-being on NSSI in adolescents with PTSD

Background

Severe posttraumatic stress disorder (PTSD) may lead to non-suicidal self-injury (NSSI), and borderline personality disorder (BPD) tendencies may play a role in this process. Secondary vocational students experience more social, familial and other pressures and are more vulnerable to psychological problems. Thus, we explored the effect of BPD tendencies and subjective well-being (SWB) on NSSI in secondary vocational students with PTSD.

Methods

A total of 2,160 Chinese secondary vocational students in Wuhan participated in our cross-sectional investigation. The Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), criteria for PTSD, NSSI Questionnaire, Personality Diagnostic Questionnaire-4+, subjective well-being scale, and family adaptation, partnership, growth, affection, and resolve (APGAR) Index were used. We conducted a binary logistic regression model and linear regression analysis.

Results

Sex (odds ratio [OR] = 0.354, 95% confidence interval [CI] = 0.171-0.733), BPD tendencies (OR = 1.192, 95% CI = 1.066-1.333) and SWB (OR = 0.652, 95% CI = 0.516-0.824) were independent factors that predicted NSSI in secondary vocational students with PTSD. Spearman's correlation analysis showed that BPD tendencies were positively correlated with NSSI frequency (r = 0.282, P < 0.01). SWB was negatively correlated with NSSI frequency (r = -0.301, P < 0.01). The linear regression showed that BPD tendencies (β = 0.137, P < 0.05 and β = -0.230, P < 0.001) were significantly correlated with NSSI frequency. Spearman's correlation analysis showed that family functioning was positively correlated with SWB (r = 0.486, P < 0.01) and negatively correlated with BPD tendencies (r = -0.296, P < 0.01).

Conclusion

In adolescents, PTSD in response to stressful events could lead to NSSI, and BPD tendencies promote the intensity of NSSI, while SWB diminishes its intensity. Improvement in family functioning may actively guide the development of mental health and improve SWB; such steps may constitute interventions to prevent or treat NSSI.

Torture Survivors and Asylum: Legal, Medical, and Psychological Perspectives

Torture occurs worldwide. Survivors seeking asylum are detained and must complete a complicated legal process to prove a "well-founded fear of persecution" if returned to their home countries. Forensic evaluations guided by the United Nations Istanbul Protocol increase asylum grant rates. Medical evaluation emphasizes skin examination, which can provide strong evidence of torture. Female genital mutilation and cutting, a basis for asylum, is classified according to the World Health Organization. Many resettled refugees and foreign-born immigrants at urban health care facilities have been tortured, but few report it to physicians due to factors affecting both survivors and physicians. Specific torture methods can cause characteristic long-term sequelae. Painful somatic disorders of mind-body interaction and psychological disorders are common. Practices derived from cultural factors and traumatized individuals' feedback enhance management of survivors. Individual and group psychotherapy provide modest proven benefit, but assessment is limited. Physicians and psychotherapists should coordinate care.