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Tanaka R, Ando S, Kiyono T, Minami R, Endo K, Miyashita M, Yamasaki S, Kanata S, Fujikawa S, Hiraiwa-Hasegawa M, Nishida A, Kasai K. The longitudinal relationship between dissociative symptoms and self-harm in adolescents: a population-based cohort study. Eur Child Adolesc Psychiatry 2024; 33:561-568. [PMID: 36882639 PMCID: PMC10869437 DOI: 10.1007/s00787-023-02183-y] [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] [Received: 09/15/2022] [Accepted: 02/27/2023] [Indexed: 03/09/2023]
Abstract
Previous studies have reported that dissociative symptoms (DIS) are associated with self-harm (SH) in adolescents. However, most of these studies were cross-sectional, which limits the understanding of their theoretical relationship. We aimed to investigate the longitudinal relationship between DIS and SH in the general adolescent population. We used data from the Tokyo Teen Cohort study (N = 3007). DIS and SH were assessed at times 1 and 2 (T1 and T2) (12 years of age and 14 years of age, respectively). DIS were assessed using the parent-report Child Behavior Checklist (CBCL), and severe dissociative symptoms (SDIS) were defined as a score above the top 10th percentile. The experience of SH within 1 year was assessed by a self-report questionnaire. The longitudinal relationship between DIS and SH was examined using regression analyses. Using logistic regression analyses, we further investigated the risk for SH at T2 due to persistent SDIS and vice versa. DIS at T1 tended to predict SH at T2 (odds ratio (OR) 1.11, 95% CI 0.99 to 1.25, p = 0.08), while SH at T1 did not predict DIS at T2 (B = - 0.03, 95% CI - 0.26 to 0.20, p = 0.81). Compared with adolescents without SDIS, those with persistent SDIS had an increased risk of SH at T2 (OR 2.61, 95% CI 1.28 to 5.33, p = 0.01). DIS tended to predict future SH, but SH did not predict future DIS. DIS may be a target to prevent SH in adolescents. Intensive attention should be given to adolescents with SDIS due to their increased risk of SH.
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Affiliation(s)
- Riki Tanaka
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, Japan.
| | - Shuntaro Ando
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, Japan
| | - Tomoki Kiyono
- Department of Psychiatry, Teikyo University Mizonokuchi Hospital, Kanagawa, Japan
| | - Rin Minami
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, Japan
| | - Kaori Endo
- Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Mitsuhiro Miyashita
- Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Syudo Yamasaki
- Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Sho Kanata
- Department of Psychiatry, Teikyo University School of Medicine, Tokyo, Japan
| | - Shinya Fujikawa
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, Japan
| | - Mariko Hiraiwa-Hasegawa
- School of Advanced Science, SOKENDAI (Graduate University for Advanced Studies), Kanagawa, Japan
| | - Atsushi Nishida
- Research Center for Social Science and Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo, Japan
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Mann AJD, Tull MT, Gratz KL. Examining the Presence, Frequency, and Associated Characteristics of Nonsuicidal Self-Injury by Proxy: Initial Validation of the Nonsuicidal Self-Injury by Proxy Questionnaire (NSSIBPQ). Behav Modif 2024; 48:3-50. [PMID: 37599465 DOI: 10.1177/01454455231191710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
Nonsuicidal self-injury (NSSI) by proxy is the intentional destruction of one's own body tissue through the elicitation of another being's actions. Despite its clinical relevance, research on NSSI by proxy is limited and there are no available measures of this behavior. This research aimed to characterize NSSI by proxy among young adults and provide preliminary data on the validity of a new self-report measure, the NSSI by Proxy Questionnaire (NSSIBPQ). Two nationwide community samples of young adults (one general community sample and one with a history of traditional NSSI and suicidality) completed online studies. NSSI by proxy was reported by 18% of the general community sample and 45% of the self-injuring sample. Findings support the clinical relevance of NSSI by proxy and its potential to meet criteria for an NSSI disorder diagnosis. Results also provide preliminary support for the internal consistency and convergent, discriminant, and concurrent validity of the NSSIBPQ.
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Paladini G, Sciurpa E, Onorati R, Elhadidy HSMA, Giacomini G, Mamo C, Borraccino A. Gender and Age Influence on Emergency Department Visits for Non-Suicidal Self-Injuries in School Aged Children in Italy: An 11 Years Retrospective Cross-Sectional Study. Int J Public Health 2023; 68:1606370. [PMID: 38164389 PMCID: PMC10757917 DOI: 10.3389/ijph.2023.1606370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 11/30/2023] [Indexed: 01/03/2024] Open
Abstract
Objectives: Non-suicidal self-injury (NSSI) poses a threat in developmental ages, yet there is a scarcity of studies on NSSI trends, especially those in emergency departments (ED). Methods: The aim of this cross-sectional study is to describe trends in ED visits for NSSI among young people aged between 5 and 19 years in Italy from 2011 to 2021 in Piedmont. From the ministerial ED discharge information system, all occurring NSSIs were identified by medical report and/or ICD9CM code and reported as a population rate and a visit rate on all ED requests. Results: The general rate of ED visits remained stable, with around 210,000 (55% males) visits each year, along the whole period from 2011 to 2019, then halved during 2020 and 2021. The NSSI population and visits rates increased from 2013, peaking in 2019 at a rate of around 25 and 23 NSSI visits (girls) and 76 and 69 NSSI (boys) per 100,000 ED visits. In 2020 and 2021, the rate of NSSI visits increased, particularly in girls and among older adolescents. Conclusion: The gradual increase of NSSI over the last decade is a rising public health issue, which deserves wider attention to ensure early detection and prevention.
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Affiliation(s)
- Giovanni Paladini
- Department of Public Health Sciences and Pediatrics, University of Turin, Turin, Italy
| | - Elena Sciurpa
- Department of Public Health Sciences and Pediatrics, University of Turin, Turin, Italy
| | - Roberta Onorati
- Regional Public Health Observatory, Epidemiology Unit, Local Health Board TO3, Grugliasco, Italy
| | | | - Gianmarco Giacomini
- Department of Public Health Sciences and Pediatrics, University of Turin, Turin, Italy
| | - Carlo Mamo
- Regional Public Health Observatory, Epidemiology Unit, Local Health Board TO3, Grugliasco, Italy
| | - Alberto Borraccino
- Department of Public Health Sciences and Pediatrics, University of Turin, Turin, Italy
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Burke TA, Bettis AH, Walsh RFL, Levin RY, Lawrence HR, Sheehan AE, Turnamian MR, Liu RT. Nonsuicidal Self-Injury in Preadolescents. Pediatrics 2023; 152:e2023063918. [PMID: 37916265 PMCID: PMC10657775 DOI: 10.1542/peds.2023-063918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 11/03/2023] Open
Abstract
OBJECTIVES There is a dearth of literature on the prevalence and predictors of nonsuicidal self-injury (NSSI) history and onset among preadolescent youth. This gap in the literature is significant given evidence suggesting that NSSI is a robust predictor of negative mental health outcomes, and that early onset NSSI may be associated with a more severe course of self-injurious thoughts and behaviors. This study aimed to evaluate sociodemographic characteristics, psychiatric disorders, and suicidal ideation (SI) in relation to NSSI onset and history in preadolescents. METHODS Data were drawn from the Adolescent Brain and Cognitive Development (ABCD) study, which recruited a diverse sample of 11 875 youth aged 9 to 10 years. The primary outcome measures were lifetime history and recent onset of NSSI. Measures included sociodemographics and the K-SADS diagnostic interview assessing psychopathology and SI. RESULTS Female sex and identifying as Black were associated with lower odds of lifetime NSSI. Identifying as a sexual minority, having unmarried parents, and a low family income were associated with higher odds of lifetime NSSI. Although depression was most predictive of NSSI history and onset, a range of internalizing and externalizing disorders, greater comorbidity, and SI also were predictive. CONCLUSIONS Given that NSSI was associated with a range of mental health disorders and comorbidity, it may be best conceptualized as a transdiagnostic phenomenon. Findings highlight key sociodemographic and diagnostic factors that may help to direct screening efforts in preadolescents, particularly sexual minority status and depression.
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Affiliation(s)
- Taylor A. Burke
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | - Alexandra H. Bettis
- Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Rachel Y. Levin
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
| | | | - Ana E. Sheehan
- Department of Psychological and Brain Sciences, University of Delaware, Newark, Delaware
| | | | - Richard T. Liu
- Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts
- Harvard Medical School, Boston, Massachusetts
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Claréus B, Daukantaité D. Off track or on? Associations of positive and negative life events with the continuation versus cessation of repetitive adolescent nonsuicidal self-injury. J Clin Psychol 2023; 79:2459-2477. [PMID: 37178314 DOI: 10.1002/jclp.23533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 02/13/2023] [Accepted: 05/03/2023] [Indexed: 05/15/2023]
Abstract
OBJECTIVE This study examined how patterns of repetitive (≥5 instances) nonsuicidal self-injury (NSSI) associate with measures of resilience and life events retrospectively reported to have occurred within the last year, 1 to <5 years ago, and 5 to <10 years ago. METHOD Life events reported by 557 young adults (mean [SD] age 25.3 [0.68]; 59.2% women) were classified as positive, negative, or profoundly negative based on their relationship to participants' mental health and well-being. We subsequently examined how these categories, together with resilience, were cross-sectionally associated with reporting no NSSI, and the (full/partial) cessation/continuation of repetitive NSSI from adolescence to young adulthood. RESULTS Repetitive NSSI in adolescence was associated with (profoundly) negative life events. Relative to cessation, NSSI continuation was significantly associated with more kinds of negative life events (odds ratio [OR] = 1.79) and fewer kinds of positive life events 1 to <5 years ago (OR = 0.65) and tended to be associated with lower resilience (b = -0.63, p = 0.056). Neither life events nor resilience significantly differentiated individuals reporting full or partial cessation. CONCLUSION Resilience appears important for the cessation of repetitive NSSI, but contextual factors must still be considered. Assessing positive life events in future studies holds promise.
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Gómez-Peresmitré G, Platas-Acevedo RS, León-Hernández R, Guzmán-Saldaña R. Self-Injurious Behavior and Its Characteristics in a Sample of Mexican Adolescent Students. Healthcare (Basel) 2023; 11:1682. [PMID: 37372799 PMCID: PMC10298567 DOI: 10.3390/healthcare11121682] [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: 03/09/2023] [Revised: 05/29/2023] [Accepted: 05/30/2023] [Indexed: 06/29/2023] Open
Abstract
Adolescence is a difficult stage, a period of risk for developing disorders, including depression and self-injurious behavior. A non-random sample was drawn (n = 563) from first-year high school students (32.8%) 185 males and 378 females (67.14%) from public schools in Mexico. The age range was 15 and 19 years, with a mean age of 15.63 (SD = 0.78). According to the results, the sample was divided into n1 = 414 (73.3%) adolescents without self-injury (S.I.) and n2 = 149 (26.4%) S.I. adolescents. In addition, results were obtained on methods, motives, time, and frequency of S.I., and a model was generated in which depression and first sexual experience obtained the highest Odd Ratio and d values in their relationship with S.I. Finally, we contrasted the results with earlier reports and concluded that depression is an important variable in S.I. behavior. Early S.I. detection will prevent the aggravation of S.I. and suicide attempts.
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Affiliation(s)
- Gilda Gómez-Peresmitré
- Faculty of Psychology, The National Autonomous University of Mexico, Av. Universidad 3004 Col Copilco-Universidad, Alcaldía, Coyoacán, Mexico City C.P. 04510, Mexico
| | - Romana Silvia Platas-Acevedo
- Faculty of Psychology, The National Autonomous University of Mexico, Av. Universidad 3004 Col Copilco-Universidad, Alcaldía, Coyoacán, Mexico City C.P. 04510, Mexico
| | - Rodrigo León-Hernández
- National Council of Science and Technology, Avenida Insurgentes Sur 1582, Crédito Constructor, Ciudad de México C.P. 03940, Mexico
| | - Rebeca Guzmán-Saldaña
- Institute of Health Sciences, Autonomous University of the State of Hidalgo, Camino a Tilcuautla s/n Pueblo San Juan Tilcuautla, Hidalgo C.P. 42160, Mexico
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Predescu E, Sipos R. Self-Harm Behaviors, Suicide Attempts, and Suicidal Ideation in a Clinical Sample of Children and Adolescents with Psychiatric Disorders. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10040725. [PMID: 37189974 DOI: 10.3390/children10040725] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Revised: 04/11/2023] [Accepted: 04/12/2023] [Indexed: 05/17/2023]
Abstract
Suicidal ideation and self-harm behaviors have been found to be important risk factors for suicide. The aim of this study was to explore the rates of psychiatric disorders among different groups of patients with suicidal ideation, suicide attempts, and non-suicidal self-harm behaviors and to identify the associated socio-demographic and clinical variables. We conducted a cross-sectional study with emergency-admitted patients presenting with non-suicidal self-harm behaviors, suicide attempts, or suicidal ideation to the emergency room of the Child and Adolescent Psychiatry Clinic in Cluj-Napoca, Romania. Data were collected from the patients' charts using a questionnaire that contained socio-demographic and clinical variables. A total of 95 patients aged between 6 and 18 years were included in the study. Ingesting medication and cutting were the most frequently used methods to attempt suicide. Depression and mixed affective and conduct disorders were the diagnoses most commonly associated with suicidal behavior. Girls with depressive symptoms were more probable to have suicide attempts than boys, and girls with depressive symptoms and behavioral problems registered more self-harm behaviors. Further research should systematically examine the relationship between self-harm behaviors and suicide attempts and the profile of patients at risk of future suicide attempts.
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Affiliation(s)
- Elena Predescu
- Department of Neuroscience, Psychiatry and Pediatric Psychiatry, "IuliuHatieganu" University of Medicine and Pharmacy, 400460 Cluj-Napoca, Romania
| | - Roxana Sipos
- Department of Neuroscience, Psychiatry and Pediatric Psychiatry, "IuliuHatieganu" University of Medicine and Pharmacy, 400460 Cluj-Napoca, Romania
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Valle A, Cavalli G, Miraglia L, Bracaglia EA, Fonagy P, Di Dio C, Marchetti A. The Risk-Taking and Self-Harm Inventory for Adolescents: Validation of the Italian Version (RTSHIA-I). Behav Sci (Basel) 2023; 13:bs13040321. [PMID: 37102835 PMCID: PMC10136143 DOI: 10.3390/bs13040321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 04/06/2023] [Accepted: 04/07/2023] [Indexed: 04/28/2023] Open
Abstract
The aim of the present paper is to establish the factorial validity and reliability of the Risk-Taking and Self-Harm Inventory for Adolescents (RTSHIA), proposed by Vrouva and colleagues in 2010, in an Italian sample. The RTSHIA measures both Risk-Taking and Self-Harm behavior in adolescents. We administered the scale to a total of 1292 Italian adolescents from 9th to 12th grade; to verify the validity of the scale, we also assessed emotion regulation and psychopathological traits. The exploratory factor analysis (EFA) (N = 638) and the confirmatory factor analysis (CFA) (N = 660) confirmed the original two-factor structure of the RTSHIA (Risk-Taking and Self-Harm). The only differences in the Italian version of the RTSHIA (RTSHIA-I) were that one item was moved from the original Risk-Taking factor to the Italian Self-Harm factor, and another item that was not included in the original RTSHIA is now part of the Risk-Taking factor in the Italian version. The reliability of the RTSHIA-I is also confirmed, and both factors correlate with emotion regulation and externalizing/internalizing traits. Our results suggest that the RTSHIA-I is a useful tool for assessing Risk-Taking and Self-Harm behaviors in Italian adolescents, and the correlational patterns indicate that these behaviors may be related to difficulties in mentalization skills.
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Affiliation(s)
- Annalisa Valle
- Research Unit on Theory of Mind, Department of Psychology, Università Cattolica del Sacro Cuore, 20123 Milano, Italy
| | - Giulia Cavalli
- Research Unit on Theory of Mind, Department of Psychology, Università Cattolica del Sacro Cuore, 20123 Milano, Italy
| | - Laura Miraglia
- Research Unit on Theory of Mind, Department of Psychology, Università Cattolica del Sacro Cuore, 20123 Milano, Italy
| | - Edoardo Alfredo Bracaglia
- Research Unit on Theory of Mind, Department of Psychology, Università Cattolica del Sacro Cuore, 20123 Milano, Italy
| | - Peter Fonagy
- Research Department of Clinical, Educational and Health Psychology, University College, UCL, London WC1E 6BT, UK
| | - Cinzia Di Dio
- Research Unit on Theory of Mind, Department of Psychology, Università Cattolica del Sacro Cuore, 20123 Milano, Italy
| | - Antonella Marchetti
- Research Unit on Theory of Mind, Department of Psychology, Università Cattolica del Sacro Cuore, 20123 Milano, Italy
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Yang J, Chen Y, Yao G, Wang Z, Fu X, Tian Y, Li Y. Key factors selection on adolescents with non-suicidal self-injury: A support vector machine based approach. Front Public Health 2022; 10:1049069. [PMID: 36438278 PMCID: PMC9687103 DOI: 10.3389/fpubh.2022.1049069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 10/24/2022] [Indexed: 11/12/2022] Open
Abstract
Comparing a family structure to a company, one can often think of parents as leaders and adolescents as employees. Stressful family environments and anxiety levels, depression levels, personality disorders, emotional regulation difficulties, and childhood trauma may all contribute to non-suicidal self-injury (NSSI) behaviors. We presented a support vector machine (SVM) based method for discovering the key factors among mazy candidates that affected NSSI in adolescents. Using SVM as the base learner, and the binary dragonfly algorithm was used to find the feature combination that minimized the objective function, which took into account both the prediction error and the number of selected variables. Unlike univariate model analysis, we used a multivariate model to explore the risk factors, which better revealed the interactions between factors. Our research showed that adolescent education level, anxiety and depression level, borderline and avoidant personality traits, as well as emotional abuse and physical neglect in childhood, were associated with mood disorders in adolescents. Furthermore, gender, adolescent education level, physical abuse in childhood, non-acceptance of emotional responses, as well as paranoid, borderline, and histrionic personality traits, were associated with an increased risk of NSSI. These findings can help us make better use of artificial intelligence technology to extract potential factors leading to NSSI in adolescents from massive data, and provide theoretical support for the prevention and intervention of NSSI in adolescents.
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Affiliation(s)
- Jiaxin Yang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China,Department of Emergency Medicine, The Second Xiangya Hospital, Central South University, Changsha, China,Department of Cardiovascular Surgery, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yinghao Chen
- Eastern Institute for Advanced Study, Yongriver Institute of Technology, Ningbo, China
| | - Gongyu Yao
- School of Mathematics and Statistics, Central South University, Changsha, China
| | - Zheng Wang
- School of Mathematics and Statistics, Central South University, Changsha, China
| | - Xi Fu
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yusheng Tian
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China,National Clinical Research Center for Mental Disorders, Department of Psychiatry and Hunan Medical Center for Mental Health, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Yamin Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China,*Correspondence: Yamin Li
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Psycho-Behavioral Profiles of Pediatric Inpatients with Past and Recent Onset of Nonsuicidal Self-Injury: A Cluster Analysis Approach. J Clin Med 2022; 11:jcm11154602. [PMID: 35956216 PMCID: PMC9369878 DOI: 10.3390/jcm11154602] [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: 06/29/2022] [Revised: 08/02/2022] [Accepted: 08/05/2022] [Indexed: 11/24/2022] Open
Abstract
Few studies have focused on the persistence of nonsuicidal self-injury (NSSI) over time in developmental age. This study aimed to define the psycho-behavioral profiles of young inpatients according to past or recent NSSI onset (i.e., NSSI for more or less than one year, respectively), and identify possible risk factors for maintaining NSSI over time. A total of 118 Italian NSSI inpatients aged 9–17 were involved. The Youth Self-Report (YSR) was administered. K-means cluster analyses were conducted using the YSR affective disorders, social competencies, and social problems scales as clustering variables. A binomial logistic regression was run to clarify which of these variables discriminate between the past and recent NSSI onset groups. Chi-square tests were performed to pinpoint the variables associated with long-standing NSSI. The final cluster solution displayed four psycho-behavioral profiles; a greater number of inpatients with recent NSSI onset was found in the clusters characterized by scarce social competencies. Affective disorders and social competencies were significant predictors, and higher scores on both scales were more likely in the past NSSI onset group. School problems and alcohol/substance use were related to long-standing NSSI. Therefore, a lack of social skills may be involved in recent NSSI onset, while affective disorders and other problem behaviors may dictate the continuation of NSSI over time.
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Munson KA, Janney CA, Goodwin K, Nagalla M. Cultural Representations of Borderline Personality Disorder. FRONTIERS IN SOCIOLOGY 2022; 7:832497. [PMID: 35399194 PMCID: PMC8990760 DOI: 10.3389/fsoc.2022.832497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Accepted: 01/28/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND/OBJECTIVE Borderline Personality Disorder (BPD) is characterized by unstable interpersonal relationships, impulsivity, and self-harm. There are many distinct stressors that predispose individuals to develop BPD or engage in self-harm behaviors. The objective of this systematic review was to compare methods of self-harm and psychological stressors in BPD across different cultures. METHODS A PubMed database search was conducted with the goal of capturing all articles (n = 22) that discussed methods of self-harm in BPD in any culture. Data extracted from the articles included methods of self-harm, psychological stressors, sample size, rurality, geographical location, and proportion of males to females. RESULTS Key differences were noted in the methods of self-harm. Eastern nations (n = 5) reported higher rates of self-poisoning (60%) than Western nations (11%). Western nations (n = 9) reported higher rates of skin-mutilating behavior (100%) than Eastern nations (80%). Two of the articles included participants from rural settings, one in the Sundarban region of India and the other in Mississippi. Notably, the Sundarban region reported the highest rate of poisoning (93%) whereas the Mississippi region reported high rates of skin mutilation. Differences were also noted in psychological stressors as the rates of interpersonal problems were higher in Western than in Eastern nations. CONCLUSIONS Additional research should be conducted into the presentation of BPD in different cultures. An improved understanding of the cultural presentations of BPD could improve diagnosis and treatment in various populations.
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Affiliation(s)
- Katherine A. Munson
- College of Human Medicine, Michigan State University, Grand Rapids, MI, United States
| | - Carol A. Janney
- College of Human Medicine, Michigan State University, Grand Rapids, MI, United States
- Pine Rest Christian Mental Health Services, Grand Rapids, MI, United States
| | - Kelsie Goodwin
- School of Osteopathic Medicine, A. T. Still University, Kirksville, MO, United States
| | - Madhavi Nagalla
- College of Human Medicine, Michigan State University, Grand Rapids, MI, United States
- Pine Rest Christian Mental Health Services, Grand Rapids, MI, United States
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Cumming C, Armstrong G, Borschmann R, Foulds JA, Newton-Howes G, McKetin R, Vallesi S, Preen D, Young J. Amphetamine-type stimulant use and self-harm: protocol for a systematic review of observational studies. BMJ Open 2022; 12:e057029. [PMID: 35074824 PMCID: PMC8788311 DOI: 10.1136/bmjopen-2021-057029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Amphetamine type stimulant (ATS) use and self-harm are both major public health concerns globally. Use of ATS is associated with a range of health and social problems, and has been increasing internationally in the last decade. Self-harm and ATS use share a number of underlying risk factors and occur at elevated rates in marginalised groups with high rates of exposure to trauma. The relationship between self-harm and ATS use is likely complex, and the causal pathway may run in either direction. A comprehensive review, synthesis and analysis of the evidence are warranted to investigate this relationship and inform policy and practice. METHODS AND ANALYSIS We will search the Medline, Embase, Cumulative Index to Nursing and Allied Health Literature, PsycINFO and Scopus databases for relevant observational studies published in peer-reviewed journals. The initial search was conducted on 5 February 2021, with a final search expected on 1 February 2022. All studies will be independently screened by two reviewers, first on title and abstract, and then on full-text to determine inclusion in the review. We place no restriction on the population that studies investigate, our exposure of interest is both prescription and illicit ATS use, comparators will be those not currently using ATS, and our primary outcome of interest is the prevalence of self-harm. Data will be extracted using a predesigned template, and pooled prevalence and pooled measures of effect for the association between ATS use and self-harm. If sufficient data are available, we will perform multiple meta-analyses to produce pooled measures of effect for each measure of ATS exposure, as well as different population sub-groups. The Methodological Standard for Epidemiological Research scale will be used to assess study quality, and Egger's test and I2 values will be used to assess publication bias and heterogeneity, respectively. ETHICS AND DISSEMINATION No ethical approval is required for this review. We will only synthesise information from published studies that were conducted with ethical approval, so no individual participant data will be used. We will disseminate our findings via publication in a peer-reviewed journal, national and international conference presentations, and presentations to stakeholders in the community. TRIAL REGISTRATION NUMBER This study has been registered with the International Prospective Register of Systematic Reviews (PROSPERO; CRD42021226562).
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Affiliation(s)
- Craig Cumming
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Gregory Armstrong
- The University of Melbourne, Melbourne, Victoria, Australia
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, Carlton, Victoria, Australia
| | - Rohan Borschmann
- The University of Melbourne, Melbourne, Victoria, Australia
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, Carlton, Victoria, Australia
| | - James A Foulds
- Department of Psychological Medicine, University of Otago Christchurch, Christchurch, Canterbury, New Zealand
| | - Giles Newton-Howes
- Department of Psychological Medicine, University of Otago, Dunedin, New Zealand
| | - Rebecca McKetin
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Shannen Vallesi
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - David Preen
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
| | - Jesse Young
- School of Population and Global Health, The University of Western Australia, Perth, Western Australia, Australia
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Global Health, Carlton, Victoria, Australia
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13
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Zhang Y, Suo X, Zhang Y, Zhang S, Yang M, Qian L, Shang L, Zhang D, Xu F, Li W. The Relationship Between Negative Life Events and Nonsuicidal Self-Injury Among Chinese Adolescents: A Moderated-Mediation Model. Neuropsychiatr Dis Treat 2022; 18:2881-2890. [PMID: 36540672 PMCID: PMC9760044 DOI: 10.2147/ndt.s386179] [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: 08/13/2022] [Accepted: 11/25/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE This study aimed to investigate whether anxiety mediates the relationship between negative life events and nonsuicidal self-injury (NSSI) in adolescents and whether this mediating role is moderated through social support. METHODS The model consisted of an anonymous questionnaire survey of 506 Chinese adolescents (253 boys and 253 girls, mean age 15.11 years (SD = 1.83, range 11-18 years)). Self-designed questionnaires were used to collect demographic data. The frequency of NSSI, state anxiety, and social support degree of adolescents was assessed by the Adolescent Life Events Scale, the Chinese version of the Beck Anxiety Inventory, and the social support scale, respectively. RESULTS Negative life events were significantly and positively correlated with anxiety and the frequency of NSSI, and anxiety was significantly and positively correlated with the frequency of NSSI. The positive association between negative life events and the frequency of NSSI among adolescents was mediated by anxiety after controlling for demographic variables. Furthermore, this mediated relationship was moderated by social support. CONCLUSION Anxiety was a potential mechanism linking negative life events to NSSI in adolescents and low social support important risk factor for amplifying this indirect effect. Our findings provide an empirical basis for reducing NSSI in adolescents.
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Affiliation(s)
- Yang Zhang
- Department of Psychiatry, Shandong Daizhuang Hospital, Jining, People's Republic of China
| | - Xingbo Suo
- Department of Psychiatry, Jining Medical University, Jining, People's Republic of China
| | - Yuebing Zhang
- Department of Psychiatry, Shandong Daizhuang Hospital, Jining, People's Republic of China
| | - Shenshuai Zhang
- Department of Psychiatry, Jining Medical University, Jining, People's Republic of China
| | - Menglan Yang
- Department of Psychiatry, Jining Medical University, Jining, People's Republic of China
| | - Liju Qian
- Department of Psychiatry, Shandong Daizhuang Hospital, Jining, People's Republic of China
| | - Luning Shang
- Department of Psychiatry, Shandong Daizhuang Hospital, Jining, People's Republic of China
| | - Dong Zhang
- Department of Psychiatry, Shandong Daizhuang Hospital, Jining, People's Republic of China
| | - Fangfang Xu
- Department of Psychiatry, Jining Medical University, Jining, People's Republic of China
| | - Wu Li
- Department of Psychiatry, Shandong Daizhuang Hospital, Jining, People's Republic of China
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14
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Mancinelli E, Ruocco E, Napolitano S, Salcuni S. A network analysis on self-harming and problematic smartphone use - The role of self-control, internalizing and externalizing problems in a sample of self-harming adolescents. Compr Psychiatry 2022; 112:152285. [PMID: 34798535 DOI: 10.1016/j.comppsych.2021.152285] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 10/13/2021] [Accepted: 10/26/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Research has shown an increased risk for Non-suicidal self-injurious (NSSI) behavior as well as Problematic Smartphone Use (PSU) and particularly in adolescence, a developmental period defined by multi-level changes and still poor self-control capacities associating with risk-taking behaviors. OBJECTIVE The current study was aimed to assess the pattern of mutual relations characterizing NSSI considering self-control, internalizing and externalizing problems, and investigating how PSU fits within the network since NSSI and PSU are here conceptualized as attempts at emotion regulation. Age and gender differences were also assessed. METHOD Participants were Italian adolescents presenting NSSI behavior (N = 155; Mage = 14.68; SD = 1.647; Range = 11-18; 43.2%-females); the sample is based on community recruitment. A Network Analysis was performed to assess the organizational structure of NSSI; age and gender differences were assessed through multivariate rank tests further applying multiplicity control. RESULTS The emerged Network showed the centrality of low self-control and internalizing problems for NSSI. NSSI and PSU were associated through low self-control, and so were PSU and externalizing problems. Significant age differences were observed showing a decrease in NSSI as age increases (stat = -2.86; adj.p = .029). No gender differences have emerged. CONCLUSIONS The current findings provide support for the consideration and investigation of PSU as regards NSSI behavior in adolescence. Moreover, these findings point to the relevance of prevention practices during this peculiar developmental period, particularly sustaining self-control capacities and the use of more adaptive emotion regulation strategies, thereby limiting the accrue of at-risk behaviors.
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Affiliation(s)
- Elisa Mancinelli
- Department of Developmental Psychology and Socialization, University of Padua, Via Venezia 8, Padua, Italy; Digital Health Lab, Centre for Digital Health and Wellbeing, Fondazione Bruno Kessler, Trento, Via Sommarive 18, Povo, Italy.
| | | | - Stefania Napolitano
- The Net-ONLUS, Via degli Scrovegni 7, Padua, Italy; Complex Operating Unit - Childhood Adolescence Family and Consultants, Child Neuropsychiatry, ULSS6 Euganea, Via Enrico degli Scrovegni 14, Padua, Italy
| | - Silvia Salcuni
- Department of Developmental Psychology and Socialization, University of Padua, Via Venezia 8, Padua, Italy.
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15
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Zhou J, Zhang J, Huang Y, Zhao J, Xiao Y, Zhang S, Li Y, Zhao T, Ma J, Ou N, Wang S, Ou Q, Luo J. Associations between coping styles, gender, their interaction and non-suicidal self-injury among middle school students in rural west China: A multicentre cross-sectional study. Front Psychiatry 2022; 13:861917. [PMID: 36016979 PMCID: PMC9395723 DOI: 10.3389/fpsyt.2022.861917] [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: 01/25/2022] [Accepted: 07/13/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND To investigate the association between coping styles, gender, their interactions and non-suicidal self-injurious (NSSI) behaviors among middle school students in rural western China under COVID-19. METHODS A multicentre cross-sectional study method was used to conduct an online survey of 8,361 students from 23 middle schools in the northern Sichuan region by clustering sampling, using the General Information Questionnaire, the Ottawa Self-Injury Inventory, and the Coping Style Scale for Middle School Students. RESULTS The past year prevalence of NSSI among middle school students in rural west China was 5.7%. The differences in scores between those with and without NSSI on all dimensions of coping styles were statistically significant (p < 0.001). Multivariate logistic regression analysis revealed that vocational high school (OR = 1.67), girls (OR = 2.5), single parent with divorced parents (OR = 1.89), remarriage with divorced parents (OR = 1.81), and tolerance (OR = 1.17), venting emotions (OR = 1.15) and fantasy/denial (OR = 1.07) in coping styles may increase the risk of NSSI among middle school students, while problem solving (OR = 0.9) and seeking social support (OR = 0.9) among coping styles may reduce the risk of NSSI among middle school students. The interaction results show that gender has a moderating role in the process of endurance, avoidance, venting of emotions, and fantasy/denial influencing non-suicidal self-injury in middle school students. CONCLUSION There is an association between coping styles and self-injury among middle school students in rural areas in western China, with gender playing a moderating role. Active attention should be paid to students' coping styles and encouraging them to adopt positive coping styles as well as avoid negative coping styles, especially in the case of girls, which can help prevent self-injury.
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Affiliation(s)
- Jinhui Zhou
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Jiazhu Zhang
- Nanyang Centre for Public Administration, Nanyang Technological University, Singapore, Singapore
| | - Yilin Huang
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Jiayu Zhao
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Yun Xiao
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Shibei Zhang
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Yanfeng Li
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Ting Zhao
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Jinyu Ma
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Nanbing Ou
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Shuyi Wang
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Qing Ou
- School of Psychiatry, North Sichuan Medical College, Nanchong, China
| | - Jiaming Luo
- School of Psychiatry, North Sichuan Medical College, Nanchong, China.,Nanchong Psychosomatic Hospital, Nanchong, China
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16
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Reinhardt M, Horváth Z, Urbán R, Rice KG, Drubina B, Kökönyei G. Dissociative Tendencies Aggregate the Impact of Negative Life Events on Non-Suicidal Self-Injury among Male Juvenile Delinquents. Arch Suicide Res 2022; 26:226-244. [PMID: 32603215 DOI: 10.1080/13811118.2020.1784335] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Non-suicidal self-injury is a significant global public health problem during adolescence, nevertheless there is a lack of investigations among juvenile offenders. Our cross-sectional study aimed to investigate the relationship between negative life events and self-harm, including the effects of dissociation and experiential avoidance that accounted for this link in a sample of underaged male offenders (N = 226; Mage = 16.97, SD = 1.31; 23.5% performed self-harm in the past month). Structural equation modeling showed that dissociation can explain the effect of friendship- and romantic relationship-related negative life events on self-harm. Our findings pointed out that dissociative tendencies could reduce intense emotions stemming from negative life events associated with peer relationships, but consequences of such tendencies might be self-harm in a correctional context.
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17
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Marco JH, Gallego-Hernández de Tejada B, Guillén V, Baños RM, Pérez S. Meaning in Life Buffers the Association between Perceived Burdensomeness, Thwarted Belongingness, and Frequency of Non-Suicidal Self-Injuries in Spanish Adolescents. J Clin Med 2021; 10:jcm10214867. [PMID: 34768387 PMCID: PMC8584760 DOI: 10.3390/jcm10214867] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/05/2021] [Accepted: 10/18/2021] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Adolescence is a developmental stage when there is a high risk of engaging in non-suicidal self-injury (NSSI). There is recent interest in the study of thwarted belongingness and perceived burdensome as variables associated with the frequency of NSSI in adolescents. Meaning in life (MIL) might be negatively associated with thwarted belongingness and perceived burdensomeness. To date, no studies have analyzed the buffering role of MIL in the association between thwarted belongingness and perceived burdensomeness and the frequency of lifetime NSSI in Spanish adolescents. AIMS (a) To test whether thwarted belongingness and perceived burdensomeness are associated with frequency of lifetime NSSI; (b) to test whether MIL moderates the association between thwarted belongingness and frequency of lifetime NSSI; and (c) to test whether MIL moderates the association between perceived burdensomeness and frequency of lifetime NSSI. METHOD The sample consisted of N = 1531 participants (n = 736, 48.1%, were men, and n = 795, 51.9%, were women) between 12 and 18 years old from Spain. The participants filled out the Inventory of Statements about Self-Injury, Purpose-In-Life Test-Adolescent Version, and Interpersonal Needs Questionnaire. Moderation analyses were performed. RESULTS No statistically significant differences were found in the frequency of lifetime NSSI in the adolescents based on gender. Thwarted belongingness and perceived burdensomeness were positively associated with the frequency of lifetime NSSI in Spanish adolescents. MIL was a moderating variable between thwarted belongingness and the frequency of lifetime NSSI, and between perceived burdensomeness and the frequency of lifetime NSSI. CONCLUSIONS Thwarted belongingness and perceived burdensomeness might be positively associated with the frequency of lifetime NSSI, and MIL might be negatively associated with the frequency of lifetime NSSI. Thus, adding these variables to current descriptive theories of NSSI in adolescents would allow us to improve assessment and treatment protocols for adolescents with NSSI.
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Affiliation(s)
- Jose H. Marco
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Universitat de Valencia, 46010 Valencia, Spain; (V.G.); (R.M.B.); (S.P.)
- CIBER Fisiopatología Obesidad y Nutrición (CB06/03), Instituto de Salud Carlos III, 28029 Madrid, Spain
- Correspondence: ; Tel.: +34-963-983-431
| | - Blanca Gallego-Hernández de Tejada
- Departamento de Personalidad, Evaluación e Intervención Terapéutica, Facultad de Psicología, Universidad Católica de Valencia, San Vicente Mártir, 46100 Burjassot, Spain;
| | - Verónica Guillén
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Universitat de Valencia, 46010 Valencia, Spain; (V.G.); (R.M.B.); (S.P.)
- CIBER Fisiopatología Obesidad y Nutrición (CB06/03), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Rosa M. Baños
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Universitat de Valencia, 46010 Valencia, Spain; (V.G.); (R.M.B.); (S.P.)
- CIBER Fisiopatología Obesidad y Nutrición (CB06/03), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Sandra Pérez
- Departamento de Personalidad, Evaluación y Tratamiento Psicológico, Facultad de Psicología, Universitat de Valencia, 46010 Valencia, Spain; (V.G.); (R.M.B.); (S.P.)
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Mancinelli E, Sharka O, Lai T, Sgaravatti E, Salcuni S. Self-injury and Smartphone Addiction: Age and gender differences in a community sample of adolescents presenting self-injurious behavior. Health Psychol Open 2021; 8:20551029211038811. [PMID: 34659789 PMCID: PMC8512283 DOI: 10.1177/20551029211038811] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study aimed to identify the variables (i.e., internalizing, and externalizing problems, self-control, emotion dysregulation, and alexithymia) relevant for Smartphone Addiction and non-suicidal self-injury (NSSI), conceptualized as emotion-regulation strategies, also assessing age and gender differences. Based on power analysis, N = 78 Italian adolescents (11-19 years; Mage = 14.24; SD = 1.56; 73.1% females) were considered. Step-wise multivariate linear regressions evidence a mutual association between NSSI and Smartphone Addiction, particularly relevant in pre-adolescence. Low self-control is significantly associated with the Smartphone Addiction, while emotion dysregulation and alexithymia with NSSI. This study supports NSSI and Smartphone Addiction conceptualization as emotion-regulation strategies and the importance of prevention interventions.
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Affiliation(s)
- Elisa Mancinelli
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
| | - Ona Sharka
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
| | | | - Eleonora Sgaravatti
- The Net-ONLUS, Padua, Italy.,Complex Psychology Unit - Infancy, Adolescence and Family, USSL3, Via Piazzetta Unità d'Italia, Padua, Italy
| | - Silvia Salcuni
- Department of Developmental Psychology and Socialization, University of Padua, Padua, Italy
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19
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Drubina B, Kökönyei G, Reinhardt M. Associations between non-suicidal self-injury and negative romantic relationship life events in male justice-involved adolescents. BMC Psychiatry 2021; 21:401. [PMID: 34388998 PMCID: PMC8361803 DOI: 10.1186/s12888-021-03408-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 07/19/2021] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND In the current study we investigated impulsivity and negative life events in relation to non-suicidal self-injury (NSSI) in correctional settings. METHODS A total of 141 male justice-involved juveniles participated in our cross-sectional study, aged between 14 and 21 years old (M = 17.75; SD = 1.38). Data collection took place in correctional institutions in Hungary. A binary logistic regression was conducted to investigate possible associations between NSSI, impulsivity and negative life events. RESULTS Lifetime prevalence of NSSI was 53.9% (N = 76). In a binary logistic regression model, only negative romantic relationship events were significantly associated with the risk of current NSSI (OR = 1.29; 95% CI = [1.06-1.56]). Other types of negative life events (family-related, friendship-related), impulsivity, age and conviction status did not have a significant role in the model. CONCLUSIONS The results suggest that juvenile offenders should receive additional support to manage stress that is associated with negative life events, especially problems in romantic relationships. It is essential to help young inmates to find an adaptive way of reducing stress caused by negative relationship life events.
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Affiliation(s)
- Boglárka Drubina
- Doctoral School of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary. .,Department of Clinical Psychology and Addiction, Institute of Psychology, Faculty of Education and Psychology, ELTE Eötvös Loránd University, 46 Izabella Street, Budapest, H-1064, Hungary. .,Child Protection Centre of Budapest and Local Child Protection Professional Services, Expert Committee, Budapest, Hungary.
| | - Gyöngyi Kökönyei
- grid.5591.80000 0001 2294 6276Department of Clinical Psychology and Addiction, Institute of Psychology, Faculty of Education and Psychology, ELTE Eötvös Loránd University, 46 Izabella Street, Budapest, H-1064 Hungary ,grid.11804.3c0000 0001 0942 9821SE-NAP2 Genetic Brain Imaging Migraine Research Group, Hungarian Academy of Sciences, Semmelweis University, Budapest, Hungary ,grid.11804.3c0000 0001 0942 9821Department of Pharmacodynamics, Faculty of Pharmacy, Semmelweis University, Budapest, Hungary
| | - Melinda Reinhardt
- Department of Clinical Psychology and Addiction, Institute of Psychology, Faculty of Education and Psychology, ELTE Eötvös Loránd University, 46 Izabella Street, Budapest, H-1064, Hungary. .,XIV District Medical Center, Child and Adolescent Psychiatry, Budapest, Hungary.
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20
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Uncovering the Mystery of Non-Suicidal Self-Injury Among Selected Filipino Adolescents: A Grounded Theory Approach. PSYCHOLOGICAL STUDIES 2021. [DOI: 10.1007/s12646-021-00619-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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21
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Testing for Sex Differences in the Nomological Network of the Triarchic Model of Psychopathy in Incarcerated Individuals. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2021. [DOI: 10.1007/s10862-021-09897-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
AbstractThe triarchic model of psychopathy conceptualizes variants of this clinical condition as expressions of three distinct biobehavioral dispositions, termed boldness, meanness, and disinhibition. As a trait-oriented model, the triarchic model situates psychopathy within a broader nomological network of personality and psychopathology, and has proven useful for characterizing how psychopathy relates to variables in these domains as well as to biological and behavioral variables. The current study was the first to examine sex differences in the external correlates of psychopathic traits as described by the triarchic model in a prison sample. Results were generally consistent with hypotheses: The triarchic traits related to measures of personality and psychopathology in patterns that were largely consistent across sex, but with some notable differences between males and females, in the correlates of disinhibition in particular. These included stronger associations for disinhibition with substance use problems, self-harm, and staff ratings of prison misbehavior among females compared to males. Findings from this study support the value of the triarchic model for understanding similarities and differences in the nomological network of psychopathy in incarcerated males and females.
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22
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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: 3] [Impact Index Per Article: 1.0] [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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Leone C, Galosi S, Mollica C, Fortunato M, Possidente C, Milone V, Misuraca S, Berillo L, Truini A, Cruccu G, Ferrara M, Terrinoni A. Dissecting pain processing in adolescents with Non-Suicidal Self Injury: Could suicide risk lurk among the electrodes? Eur J Pain 2021; 25:1815-1828. [PMID: 33982830 PMCID: PMC8453562 DOI: 10.1002/ejp.1793] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 02/01/2021] [Accepted: 05/02/2021] [Indexed: 12/13/2022]
Abstract
Background Although non‐suicidal self‐injury (NSSI) disorder is highly prevalent in adolescents, its relationship with pain system function and suicidality is still controversial. The present study was designed to assess the function of the nociceptive afferent pathways and the endogenous pain modulation in adolescent patients with NSSI and to longitudinally register any suicide attempt, describe its frequency and find a possible association between suicide, neurophysiological measures and psychological measures. Methods We enrolled 30 adolescents suffering from NSSI and 20 age‐ and gender‐matched healthy controls. Patients underwent a comprehensive psychological evaluation. Each participant underwent thermal pain thresholds of the quantitative sensory testing, laser‐evoked potential recording to study the ascending nociceptive pathway and the conditioned pain modulation testing to test the endogenous pain modulation. Results We found that patients with NSSI had a reduced amplitude of the N2 component of laser‐evoked potentials and an abnormal conditioned pain modulation. The amplitude of the N2 was associated with suicidal risk. Conclusions The deficit of the endogenous pain modulation likely depends on a saturation due to continuous pain solicitation. The strong association of a reduced amplitude of the N2 component with suicide suggests that it may serve as a possible biomarker in self‐harming adolescents. Significance The present study identifies the N2 component of laser‐evoked potentials as a possible neurophysiological biomarker of suicidal risk in patients with non‐suicidal self‐injury, therefore, raising the possibility for a non‐invasive test to identify subjects at higher risk of suicide among self‐harming patients.
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Affiliation(s)
- Caterina Leone
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - Serena Galosi
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - Cristina Mollica
- Department of Methods and Models for Economics, Territory and Finance, Sapienza University, Rome, Italy
| | - Mattia Fortunato
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | | | - Valeria Milone
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - Sofia Misuraca
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - Luana Berillo
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - Andrea Truini
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - Giorgio Cruccu
- Department of Human Neuroscience, Sapienza University, Rome, Italy
| | - Mauro Ferrara
- Department of Human Neuroscience, Sapienza University, Rome, Italy
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Levels of Personality Functioning Questionnaire (LoPF-Q) 12–18 Turkish Version: Reliability, Validity, Factor Structure and Relationship with Comorbid Psychopathology in a Turkish Adolescent Sample. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2021. [DOI: 10.1007/s10862-021-09867-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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Guénolé F, Spiers S, Gicquel L, Delvenne V, Robin M, Corcos M, Pham-Scottez A, Speranza M. Interpersonal Relatedness and Non-suicidal Self-Injurious Behaviors in Female Adolescents With Borderline Personality Disorder. Front Psychiatry 2021; 12:731629. [PMID: 34867523 PMCID: PMC8634159 DOI: 10.3389/fpsyt.2021.731629] [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: 06/27/2021] [Accepted: 10/26/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Psychopathological models of adolescent borderline personality disorder (BPD) suggest that non-suicidal self-injuring (NSSI)-a particularly frequent symptom in girls-may constitute a way of coping with distress resulting from interpersonal concerns they typically experience as a developmental psychopathological feature. Objectives: Our objective was to investigate the relationship in BPD female adolescents between NSSI and the Sidney Blatt two-polarities model of personality development, which focuses on the psychological processes of interpersonal relatedness and self-definition. Methods: The study was conducted within the European Research Network on Borderline Personality Disorder in Adolescence, using the Depressive Experience Questionnaire (DEQ). Results: BPD patients (n = 59; mean age = 16.6 ± 1.3) scored significantly higher than healthy controls on the two DEQ sub-factors assessing the more immature forms of Interpersonal Relatedness (Neediness) and Self-definition (Self-criticism) and significantly lower on the more mature form of Self-definition (Efficacy). BPD adolescents with NSSI showed significantly higher scores on both mature and immature forms of Interpersonal Relatedness (Neediness and Connectedness) compared to BPD adolescents without NSSI. A logistic regression analysis showed that the subfactor Neediness of the DEQ was the only significant predictor of the presence of NSSI among BPD adolescents. Conclusions: The preliminary results of this study suggests that NSSI in adolescents with BPD is developmentally linked to high developmental concerns in the domain of interpersonal relatedness, which may be taken into consideration in clinical practice. More studies are necessary to better understand the relationships between NSSI and developmental psychopathology in borderline adolescents.
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Affiliation(s)
- Fabian Guénolé
- Centre Hospitalier Universitaire de Caen, Service de Psychiatrie de l'Enfant et de l'Adolescent, Caen, France
| | - Solène Spiers
- Centre Hospitalier Universitaire de Caen, Service de Psychiatrie de l'Enfant et de l'Adolescent, Caen, France
| | - Ludovic Gicquel
- Centre Hospitalier Universitaire de Poitiers, Service de Psychiatrie de l'Enfant et de l'Adolescent, Poitiers, France
| | - Veronique Delvenne
- Service de Pédopsychiatrie, Hôpital Universitaire des Enfants Reine Fabiola, Brussels, Belgium
| | - Marion Robin
- Institut Mutualiste Montsouris, Service de Psychiatrie de l'Adolescent et de l'Adulte Jeune, Paris, France.,Université Paris-Saclay, UVSQ, INSERM, Centre for Research in Epidemiology and Population Health (CESP), Team "DevPsy," Villejuif, France
| | - Maurice Corcos
- Institut Mutualiste Montsouris, Service de Psychiatrie de l'Adolescent et de l'Adulte Jeune, Paris, France
| | | | - Mario Speranza
- Université Paris-Saclay, UVSQ, INSERM, Centre for Research in Epidemiology and Population Health (CESP), Team "DevPsy," Villejuif, France.,Centre Hospitalier de Versailles, Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Le Chesnay, France
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Huang Q, Xiao M, Ai M, Chen J, Wang W, Hu L, Cao J, Wang M, Kuang L. Disruption of Neural Activity and Functional Connectivity in Adolescents With Major Depressive Disorder Who Engage in Non-suicidal Self-Injury: A Resting-State fMRI Study. Front Psychiatry 2021; 12:571532. [PMID: 34140897 PMCID: PMC8203805 DOI: 10.3389/fpsyt.2021.571532] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 03/31/2021] [Indexed: 11/29/2022] Open
Abstract
Background: Non-suicidal self-injury (NSSI), which commonly occurs during adolescence, often co-occurs with major depressive disorder (MDD). However, the underlying neurobiological mechanisms in adolescents with MDD who engage in NSSI remain unclear. The current study examined the aberrant local neural activity in certain areas of the visual regions and the default mode network (DMN) and the resting-state functional connectivity (rs-FC) in changed brain regions in adolescents with MDD who engage in NSSI and adolescents with MDD only. Methods: A total of 67 adolescents with MDD were divided into two groups based on their NSSI behavior: the NSSI group (n = 31) and an age-, gender-, and education-matched MDD group (n = 36). The Hamilton Depression Rating Scale (HAMD) was used to assess the severity of MDD. Amplitude of low-frequency fluctuation (ALFF) analysis was used to detect alterations in local neural activity. Brain regions with aberrant neural activity were considered regions of interest (ROI). ALFF-based rs-FC analysis was used to further explore the underlying changes in connectivity between ROI and other areas in the NSSI group. Correlation analyses were performed to examine the relationship between neural changes and clinical characteristics. Results: There was no significant difference in HAMD scores between the two groups. ALFF analysis revealed that, compared to adolescents with MDD only, adolescents with MDD who engaged in NSSI displayed significantly enhanced neural activity in the right fusiform gyrus (FFG. R) and the right median cingulate and paracingulate gyri (DCG. R). Significantly reduced rs-FC of the FFG. R-bilateral medial orbital of the superior frontal gyrus (ORBsupmed. L/R)/bilateral medial superior frontal gyrus (SFGmed. L/R), FFG. R-bilateral posterior cingulate gyrus (PCG. L/R), DCG. R-left pallidum (PAL. L), DCG. R-right superior temporal gyrus (STG. R), and DCG. R-right postcentral gyrus (PoCG. R)/right inferior parietal lobule (IPL. R) was found in adolescents with MDD who were engaged in NSSI. Additionally, no significant correlations were observed between ALFF or rs-FC values and the HAMD scores between the two groups. Limitations: Owing to the cross-sectional design, the alterations in ALFF and rs-FC values in the FFG. R and DCG. R could not demonstrate that it was a state or feature in adolescents with MDD who engaged in NSSI. Additionally, the sample size was relatively small. Conclusions: This study highlights changes in regional brain activity and remote connectivity in the FFG. R and DCG. R in adolescents with MDD who engage in NSSI. This could provide a new perspective for further studies on the neurobiological mechanism of NSSI behavior in adolescents with MDD.
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Affiliation(s)
- Qian Huang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Muni Xiao
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ming Ai
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jianmei Chen
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Wo Wang
- Mental Health Center, University-Town Hospital of Chongqing Medical University, Chongqing, China
| | - Lan Hu
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Jun Cao
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Mengyao Wang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Li Kuang
- Department of Psychiatry, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
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Mousavi Asl E, Dabaghi P, Taghva A. Screening borderline personality disorder: The psychometric properties of the Persian version of the McLean screening instrument for borderline personality disorder. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2020; 25:97. [PMID: 33273942 PMCID: PMC7698379 DOI: 10.4103/jrms.jrms_949_19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/18/2020] [Revised: 02/22/2020] [Accepted: 06/16/2020] [Indexed: 11/10/2022]
Abstract
Background: Screening for personality disorders through reliable instruments is of high importance for clinical and preventive purposes. Examining the psychometric properties of measures in societies with diverse cultures can improve their external validity. This research is specifically aimed to studying psychometric properties of the McLean Screening Instrument for Borderline Personality Disorder (MSI-BPD) in a sample of Iranian men serving military service. Materials and Methods: The Persian version of the MSI-BPD was prepared through forwarding translation, reconciliation, and back-translation. A sample of 254 soldiers was selected through the convenience sampling method in Tehran and completed a set of questionnaires, including the MSI-BPD, The Deliberate Self-harm Inventory (DSHI), Borderline Personality Scale (STB), Cognitive Flexibility Inventory (CFI), and Self-Compassion Scale (SCS) Short-Form. The construct validity of the MSI-BPD was assessed using confirmatory factor analysis and divergent and convergent validity. Internal Consistency and test-retest reliability (2 weeks'interval) were used to evaluate the reliability. Data analysis was conducted using LISREL (version 8.8) and SSPS (version 22) software. Results: MSI-BPD and its subscales were found to be valid and reliable measures, with good internal consistency and good test-retest reliability among soldiers. In terms of convergent validity, MSI-BPD and subscales showed a significant positive correlation with self-report measures of DSHI and STB. MSI-BPD and subscales showed negative correlation with SCS Short-Form and CFI, thus demonstrated a good divergent validity. The results of this study also provide support for both one-factor and two-factor models of the MSI-BPD. Conclusion: The MSI-BPD showed good validity and reliability, making it a useful measure to Screening borderline personality disorder in the Iranian population. Screening offers a means of identifying persons for more detailed evaluation for early intervention and for research. The MSI-BPD is an efficient instrument suitable for screening purposes among soldiers.
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Affiliation(s)
- Esmaeil Mousavi Asl
- Department of Clinical Psychology, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Iran
| | - Parviz Dabaghi
- Department of Clinical Psychology, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Iran
| | - Arsia Taghva
- Department of Psychiatry, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Iran
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Rossi R, Ridolfi ME. Borderline personality disorder in young people: state of the art and future plans in Italy. Curr Opin Psychol 2020; 37:61-65. [PMID: 32877857 DOI: 10.1016/j.copsyc.2020.08.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 08/10/2020] [Accepted: 08/11/2020] [Indexed: 11/30/2022]
Abstract
Treatment of Borderline Personality Disorder (BPD) in Italy has a relatively recent history. In the last few years, based on the increasing number of BPD patients admitted in Italian Mental Health Services (MHS), several regions have introduced treatment for BPD among their clinical priorities. A general 'call for action' has been launched within the psychiatric community. The aim of the current review is to describe the state of the art of research and clinical programs for personality disorders in young people. The Italian clinical context will be described with a focus on the transition discontinuity of care between adult and child/adolescent services. Prevention and early intervention programs available in Italy will be reviewed and a new agenda will be discussed.
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Affiliation(s)
- Roberta Rossi
- Unit of Psychiatry, IRCCS Istituto Centro San Giovanni di Dio - FBF, Brescia, Italy.
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Lockwood J, Townsend E, Daley D, Sayal K. Impulsivity as a predictor of self-harm onset and maintenance in young adolescents: a longitudinal prospective study. J Affect Disord 2020; 274:583-592. [PMID: 32663991 DOI: 10.1016/j.jad.2020.05.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2019] [Revised: 03/30/2020] [Accepted: 05/10/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND Rates of self-harm in young adolescents are increasing and self-harm typically emerges at this developmental stage. Greater specificity of impulsivity as a multifaceted construct is enabling investigation of links between individual impulsivity facets and self-harm outcomes. However, studies have yet to adequately explore these associations in young adolescents, and prospective relationships between multidimensional impulsivity and self-harm in younger adolescents remain untested. This study investigates unidimensional facets of impulsivity as risk-factors for the emergence and maintenance of self-harm, specifically within young community-based adolescents. METHODS A school-based sample of 594 adolescents (aged 13-15 years) provided data at two time points, 12 weeks apart. Logistic regression analyses determined associations between impulsivity-related facets (as delineated by the UPPS-P scale) and self-harm outcomes over time. RESULTS Overall, 23.6% of young people reported lifetime self-harm. A higher tendency towards Sensation Seeking was associated with self-harm onset over the study-period (OR 1.19, 95% CI 1.017-1.401). Deficits in Premeditation predicted maintained (versus remitted) self-harm behaviour during this time (OR 1.16, 95% CI 1.013-1.328). Negative Urgency was a significant cross-sectional correlate, but did not offer prospective predictive utility. LIMITATIONS The study relied on self-report. Interpretations are cautious given low incidence of self-harm outcomes over the course of the study. CONCLUSIONS Separate pathways to impulsive behaviour describe the psychological context in which self-harm starts and develops in young people. Findings support differential treatment targets and developmentally-focused early intervention. The predictive utility of impulsivity was inconsistent between cross-sectional and longitudinal analyses, underlining the role for temporality in the establishment of risk of self-harm.
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Affiliation(s)
- Joanna Lockwood
- Division of Psychiatry & Applied Psychology, School of Medicine, University of Nottingham, UK & Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan, Institute of Mental Health, University of Nottingham, UK; Self-Harm Research Group, School of Psychology, University of Nottingham, UK; Centre for Mood Disorders, Institute of Mental Health, University of Nottingham, UK; NIHR MindTech MedTech Co-operative, Institute of Mental Health, University of Nottingham, UK.
| | - Ellen Townsend
- Self-Harm Research Group, School of Psychology, University of Nottingham, UK; Centre for Mood Disorders, Institute of Mental Health, University of Nottingham, UK
| | - David Daley
- Division of Psychiatry & Applied Psychology, School of Medicine, University of Nottingham, UK & Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan, Institute of Mental Health, University of Nottingham, UK; NIHR MindTech MedTech Co-operative, Institute of Mental Health, University of Nottingham, UK
| | - Kapil Sayal
- Division of Psychiatry & Applied Psychology, School of Medicine, University of Nottingham, UK & Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan, Institute of Mental Health, University of Nottingham, UK; Centre for Mood Disorders, Institute of Mental Health, University of Nottingham, UK
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30
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Pallini S, Terrinoni A, Iannello S, Cerutti R, Ferrara M, Fantini F, Laghi F. Attachment-Related Representations and Suicidal Ideations in Nonsuicidal Self-Injury Adolescents with and without Suicide Attempts: A Pilot Study. Suicide Life Threat Behav 2020; 50:909-920. [PMID: 32175618 DOI: 10.1111/sltb.12633] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 01/15/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Consistent with the debate surrounding the association between nonsuicidal self-injury (NSSI), suicidal intent, and suicidal behavior, and between NSSI and dysregulation processes, we attempted to analyze suicide intent and emotion dysregulation in NSSI adolescents, in the framework of the attachment representations and exploring these clues of emotion dysregulation characteristics of insecure attachment. Furthermore, we intended to focus on these attachment-related segregated systems regarding death and suicidal ideations, to explore how differently they would characterize self-injuring adolescents with and without suicide attempts. METHODS Thirty-four NSSI inpatient adolescents, 17 with suicide attempts, 17 without suicide attempts, and 17 healthy controls (age 11-17) were assessed using Adult Attachment Projective, which allows for the classification of attachment status and related emotion dysregulation and segregated systems. RESULTS The majority of the NSSI group with and without suicide attempts showed unresolved (disorganized) attachment-related representations and clues of damaged reflective functions, whereas only the NSSI with suicide attempts showed clues of impaired interpersonal relationships. The two clinical groups used words expressing suicidal intent, whereas the healthy group did not. CONCLUSIONS Therapists are encouraged not to underestimate suicidal ideation in NSSI regardless of whether or not they have already attempted suicide.
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Affiliation(s)
- Susanna Pallini
- Department of Education, University of Rome Tre, Roma, Italy
| | - Arianna Terrinoni
- Department of Pediatrics and Child and Adolescent Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Sara Iannello
- Department of Developmental and Social Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Rita Cerutti
- Department of Dynamic and Clinical Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Mauro Ferrara
- Department of Pediatrics and Child and Adolescent Neurology and Psychiatry, Sapienza University of Rome, Rome, Italy
| | - Fiorella Fantini
- Department of Dynamic and Clinical Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Fiorenzo Laghi
- Department of Developmental and Social Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
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Gargiulo A. Narratives of Self-Harm at School: Identifying Trajectories of Intervention in Educational Contexts. EUROPES JOURNAL OF PSYCHOLOGY 2020; 16:95-111. [PMID: 33680172 PMCID: PMC7913034 DOI: 10.5964/ejop.v16i1.1883] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 06/24/2019] [Indexed: 11/25/2022]
Abstract
Recent studies have shown that self-harming behaviour is increasingly widespread among adolescents, in particular at school. However, educational institutions perceive themselves unable to cope with the phenomenon, searching for protocols and guidelines to improve its management. Considering schools as useful contexts for intercepting the young malaise, this study aims at exploring the main meanings of self-harming behaviours made within the educational cultural contexts starting from the student’s narrations, in order to understand the possible trajectories of practice. In two high schools we have collected 96 narratives of self-harm written by adolescents (mean age 14; 74% females), who have been engaged in non-suicidal self-injury once in their life. The analysis of the narratives, produced with the help of a software for the automatic qualitative analysis of texts, has allowed to identify four prevalent themes organized into three sense vectors. The findings highlighted significant gender differences in the representation of the experience of self-harm between males and females, as well as the importance of meaningful relationships developed in familiar and educational contexts, which may allow the help seeking process. The emerging of culturally-shared meanings among adolescents within the investigated contexts may allow to think about possible protocols of preventive and clinical practices in schools.
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Affiliation(s)
- Anna Gargiulo
- Department of Humanities, University of Naples Federico II, Naples, Italy
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Brislin SJ, Cernohorsky P, Patrick CJ, Drislane LE, Caruso M, Giulini P, Sica C. Comparing the Triarchic and Five-Factor Trait Models: Relations With Psychopathy and Other Clinical Criteria in an Incarcerated Offender Sample. J Pers Disord 2019; 33:792-817. [PMID: 30650033 DOI: 10.1521/pedi_2019_33_378] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This study compared how normative personality dimensions of the Five-Factor Model (FFM) and neurobehavioral traits of the triarchic model relate to psychopathic tendencies and clinical outcomes in an incarcerated sample of 277 Italian male offenders. Associations between triarchic model traits, measured using the TriPM and the FFM dimensions, measured using the NEO-FFI, were consistent with prior studies. Scores on the TriPM, particularly the Disinhibition scale, were associated with substance abuse and self-harm behavior over and above the presence of psychopathy, and beyond the personality dimensions indexed by the NEO-FFI. By contrast, the Neuroticism and Extraversion scales showed incremental validity, over and above psychopathy and TriPM scores, in predicting depressive tendencies. Lastly, both NEO-FFI and TriPM scales contributed to prediction of staff ratings of behavior in prison and prognosis for release, above and beyond psychopathy. These findings highlight potential advantages of the FFM and triarchic trait models for predicting clinical outcomes.
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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:ijerph16224581. [PMID: 31752375 PMCID: PMC6888476 DOI: 10.3390/ijerph16224581] [Citation(s) in RCA: 190] [Impact Index Per Article: 38.0] [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;
- Correspondence:
| | - 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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Laghi F, Cerutti R, Terrinoni A, Lonigro A, Pongetti A, Ferrara M, Fantini F. Evaluation of the “Reading the Mind in the Eyes Test” with Non-Suicidal Self-Injury (NSSI) adolescents: A pilot study. CURRENT PSYCHOLOGY 2019. [DOI: 10.1007/s12144-019-00505-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Ewing L, Hamza CA, Willoughby T. Stressful Experiences, Emotion Dysregulation, and Nonsuicidal Self-Injury among University Students. J Youth Adolesc 2019; 48:1379-1389. [PMID: 31025157 DOI: 10.1007/s10964-019-01025-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Accepted: 04/10/2019] [Indexed: 11/29/2022]
Abstract
Developmental theory on nonsuicidal self-injury (NSSI; e.g., self-cutting without lethal intent) underscores that stressful life experiences may lead to heightened risk for NSSI, potentially by undermining individuals' emotion coping capacities. Given that the transition to university is often accompanied by new stressors for emerging adults, it is possible that stressors experienced during the university years may lead to heightened susceptibility for NSSI during this developmental period. Cross-sectional research supports a positive association between stressful experiences and NSSI among students; however, longitudinal research is needed to examine the direction of effects and explore potential mediating factors (i.e., emotion dysregulation). In the present study, university students (N = 1132; 70.5% female; mage = 19.11) reported on their stressful experiences in university, difficulties in emotion regulation, and NSSI each year for three consecutive years. Path analysis revealed a bidirectional association between stressful experiences and NSSI. Increased stressful experiences predicted increased risk for NSSI through emotion dysregulation, and NSSI predicted increased stressful experiences through emotion dysregulation. Overall, these findings provide new insight into the processes through which NSSI may be initiated and maintained, as well as elucidate the impacts of NSSI on emotion regulation and stressful life experiences in university.
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Affiliation(s)
- Lexi Ewing
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, 252 Bloor Street West, Toronto, ON, M5S 1V6, Canada.
| | - Chloe A Hamza
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, 252 Bloor Street West, Toronto, ON, M5S 1V6, Canada
| | - Teena Willoughby
- Department of Psychology, Brock University, 1812 Sir Isaac Brock Way, St. Catharines, ON, L2S 3A1, Canada
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Černis E, Chan C, Cooper M. What is the relationship between dissociation and self-harming behaviour in adolescents? Clin Psychol Psychother 2019; 26:328-338. [PMID: 30690804 DOI: 10.1002/cpp.2354] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Revised: 11/29/2018] [Accepted: 12/03/2018] [Indexed: 01/13/2023]
Abstract
Deliberate self-harm in adolescents is an increasing clinical problem, but there is a limited understanding of the mechanisms causing or maintaining this behaviour. One proposed mechanism is that of dissociation. However, the role this mechanism may play is unclear: although some suggest that adolescents engage in self-harm to end the aversive experience of dissociation, others propose that self-harm is used to purposefully trigger a dissociative state to avoid emotional pain. This systematic review is the first to evaluate the available evidence regarding the relationship between dissociation and deliberate self-harm in adolescents (aged 18 or younger). Nineteen relevant studies were identified. These studies were limited by cross-sectional design and poor methods of measurement, but some important conclusions could be drawn. The majority of studies found a positive correlation between the severity of dissociation and the severity and frequency of deliberate self-harm in adolescents, and a small number of results suggest that dissociation mediates the relationship between childhood trauma and adolescent self-harm.
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Affiliation(s)
- Emma Černis
- Oxford Institute of Clinical Psychology Training, The Isis Education Centre, Oxford, UK
| | - Carmen Chan
- Horizon, Oxford Health NHS Foundation Trust, Witney, UK
| | - Myra Cooper
- Oxford Institute of Clinical Psychology Training, The Isis Education Centre, Oxford, UK
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Ghinea D, Koenig J, Parzer P, Brunner R, Carli V, Hoven CW, Sarchiapone M, Wasserman D, Resch F, Kaess M. Longitudinal development of risk-taking and self-injurious behavior in association with late adolescent borderline personality disorder symptoms. Psychiatry Res 2019; 273:127-133. [PMID: 30641342 DOI: 10.1016/j.psychres.2019.01.010] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 01/02/2019] [Accepted: 01/02/2019] [Indexed: 12/31/2022]
Abstract
Self-injurious behavior and risk-taking behaviors are associated with adolescent borderline personality disorder (BPD). Developmental trajectories of self-injurious and risk-taking behavior in predicting BPD have not been fully understood. The aim of the present study was to examine self-injurious and risk-taking behavior development and their prospective influence on BPD symptoms in adolescence. Data (n = 506; 62.06 % females, 14.53 years) from the German Saving and Empowering Young Lives in Europe cohort were analyzed. Self-injurious and risk-taking behaviors were assessed at baseline and one-year follow-up. BPD symptoms were assessed at two-year follow-up. In fully adjusted stepwise binominal regression analyses, recent onset, termination and maintenance of risky alcohol use and self-injurious behavior remained as significant predictors of BPD. Highest ORs were found for alcohol termination and maintenance of self-injurious behavior. Other facets of risk-taking behavior were not associated with increased ORs of BPD symptoms at two-year follow-up. These findings highlight the importance of self-injurious behavior and specific facets of risk-taking behavior in the development of adolescent BPD. Clinicians should focus on efforts in preventing adolescents from risk-taking and self-injurious behavior, since engaging in young age and therefore in potentially longer periods of these behaviors is associated with the highest risk of BPD.
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Affiliation(s)
- Denisa Ghinea
- Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany; Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Julian Koenig
- Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Peter Parzer
- Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Romuald Brunner
- Section for Disorders of Personality Development, Clinic of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University Hospital Heidelberg, Heidelberg, Germany; Clinic and Policlinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Regensburg District Hospital, Regensburg, Germany
| | - Vladimir Carli
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden
| | - Christina W Hoven
- Division of Child and Adolescent Psychiatry, New York State Psychiatric Institute, Columbia University, New York, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, USA
| | - Marco Sarchiapone
- Department of Medical and Health Sciences, University of Molise, Campobasso, Italy
| | - Danuta Wasserman
- National Centre for Suicide Research and Prevention of Mental Ill-Health (NASP), Karolinska Institute, Stockholm, Sweden
| | - Franz Resch
- Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany
| | - Michael Kaess
- Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Center for Psychosocial Medicine, University of Heidelberg, Heidelberg, Germany; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.
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Stead VE, Boylan K, Schmidt LA. Longitudinal associations between non-suicidal self-injury and borderline personality disorder in adolescents: a literature review. Borderline Personal Disord Emot Dysregul 2019; 6:3. [PMID: 30783532 PMCID: PMC6375156 DOI: 10.1186/s40479-019-0100-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 02/01/2019] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Borderline personality disorder (BPD) in adolescent samples is similar to BPD in adults concerning clinical characteristics. A notable difference is that adolescents with BPD - and adolescents in general - are more likely than adults to present with acute symptoms such as non-suicidal self-injury (NSSI) and suicidal behaviours. BPD is the only disorder in the Diagnostic and Statistical Manual- 5th Edition that includes a criterion of NSSI. Additionally, NSSI is purported to be a developmental precursor of BPD under the biosocial developmental model. Though much cross-sectional data have illustrated the robust association of adolescent NSSI and BPD, no review to date has summarized the longitudinal associations between these phenomena. The aim of this literature review was to summarize what is known about the longitudinal associations between adolescent NSSI and BPD symptoms. Information on the developmental course of NSSI in relation to BPD would be helpful to clinicians, as the rate of NSSI is high in adolescent populations, and research indicates early, possibly BPD-specific interventions are imperative. METHODS A literature search was conducted using Embase, MEDLINE, and PsycINFO databases and cited reference searches. Criteria included studies of adolescents (age ≤ 18 at baseline) from either epidemiological or clinical samples, incorporating a longitudinal design, with predictors and outcomes of interest, including both NSSI and BPD diagnosis/symptoms/traits. RESULTS Six independent samples were identified that matched our search criteria.The articles were grouped and reported on separately by population type (epidemiological vs. clinical), and directionality of relations. We identified two epidemiological and four clinical samples. Five samples examined the longitudinal associations of NSSI preceding BPD, three samples measured BPD in adolescence (baseline age ≤ 18), and two of those samples measured BPD at baseline. Both epidemiological studies revealed significant longitudinal associations between NSSI and later BPD/BPD symptoms; however, they differed notably in their methodologies hindering data synthesis across studies. In the clinical studies, findings of the association or predictive relations were not consistent. This is potentially due to differing methodologies, or differences in treatment effectiveness and responsiveness across the samples. CONCLUSIONS This review highlights the paucity of data that are available examining the longitudinal association between NSSI and BPD within adolescent samples. Thus, it is not possible to reliably comment on how NSSI and BPD are related over time. Future studies will benefit from the measurement of BPD symptoms in very early adolescence, and concurrent measurement of NSSI as well as other forms of suicidal behaviours across adolescence.
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Affiliation(s)
- Victoria E Stead
- 1Department of Psychology, Neuroscience & Behaviour, McMaster University, 1280 King St West, Hamilton, ON L8S 4K1 Canada
| | - Khrista Boylan
- 2Department of Psychiatry and Behavioural Neurosciences, McMaster University, St. Joseph's Healthcare Hamilton, 100 West 5th, Administration - B3, Hamilton, L8N 3K7 ON Canada.,3McMaster Children's Hospital, 1200 Main St. West Hamilton, Hamilton, ON L9N 3Z5 Canada
| | - Louis A Schmidt
- 1Department of Psychology, Neuroscience & Behaviour, McMaster University, 1280 King St West, Hamilton, ON L8S 4K1 Canada
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The Strengths and Difficulties Questionnaire -Dysregulation Profile, Non-Suicidal Self-Injury Behaviors and the Mediating Role of Stressful Life Events. SPANISH JOURNAL OF PSYCHOLOGY 2018; 21:E22. [PMID: 29897027 DOI: 10.1017/sjp.2018.23] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Non-suicidal self-injury (NSSI) behaviors are self-injurious behaviors inflicted without intending death. Literature has shown the relationship between stressful life events (SLE) and NSSI behaviors. The Strengths and Difficulties Questionnaire-Dysregulation Profile (SDQ-DP) is defined as an index of self-regulatory problems, related to higher risk for suicidal ideation and attempts in adolescents. In this study the relationship between SDQ-DP and NSSI behaviors, mediated by SLE in a clinical sample of children and adolescents is analyzed. A cross-sectional study was conducted on 239 subjects (aged from 11 to 17) to test the mediation model. SDQ-DP significantly correlates with NSSI behaviors (Wald = 6.5477, p = .0105); SDQ-DP significantly correlates with SLE (T = 5.7229, p < .001); SLE significantly correlates NSSI behaviors, and the relation remains significant whilst controlling for SDQ-DP (Wald = 4.1715, p = .041); the relation between SDQ-DP and NSSI behaviors stops being significant whilst controlling for the potential mediator (SLE) (Wald = 2.9951, p = .0835). Study of indirect effect supports the mediation model (.0585 CI [.0016, .1266]). Findings are compatible with the complete mediation scenario. These results point out the importance of self-regulatory problems in coping strategies with regards to SLE and the development of NSSI behaviors.
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Xavier A, Cunha M, Pinto-Gouveia J. Validation of the Risk-Taking and Self-Harm Inventory for Adolescents in a Portuguese Community Sample. MEASUREMENT AND EVALUATION IN COUNSELING AND DEVELOPMENT 2018. [DOI: 10.1080/07481756.2018.1435189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Affiliation(s)
- Ana Xavier
- University of Coimbra, Coimbra, Portugal
| | - Marina Cunha
- University of Coimbra, Coimbra, Portugal
- Instituto Superior Miguel Torga, Coimbra, Portugal
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Cerutti R, Zuffianò A, Spensieri V. The Role of Difficulty in Identifying and Describing Feelings in Non-Suicidal Self-Injury Behavior (NSSI): Associations With Perceived Attachment Quality, Stressful Life Events, and Suicidal Ideation. Front Psychol 2018; 9:318. [PMID: 29593617 PMCID: PMC5859383 DOI: 10.3389/fpsyg.2018.00318] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Accepted: 02/26/2018] [Indexed: 11/16/2022] Open
Abstract
Objective: Core alexithymic features, such as the difficulty in identifying and describing feelings, are associated with poor attachment styles and emotional trauma, which influence the capacity to regulate affect. Additionally, emotional regulation has been found to be the most commonly identified function associated with non-suicidal self-injury behavior (NSSI) in adolescents as they attempt to modulate strong emotions. However, few studies have examined the link between difficulty in identifying and describing feelings (core components of alexithymia), NSSI behaviors, quality of attachment, life stressors and suicidal ideation in healthy early adolescents. Consequently, this study aims to investigate these constructs and the relationship among them in a large non-clinical sample of adolescents. Methods: Seven hundred and nine middle school students (50.4% males), aged 10–15 years (M = 12.6; SD = 1.06) were involved in this study. In order to investigate the variables considered in the study, the following measures were administered: the Deliberate Self-Harm Inventory exploring non-suicidal self-injurious behaviors; the Alexithymia Questionnaire for Children examining difficulty in identifying and describing feelings; the Inventory of Parent and Peer Attachment assessing the quality of parental and peer attachment; the Life Stressor Checklist-Revised outlining stressful/traumatic events and the Children’s Depression Inventory evaluating suicidal ideation. Results: We found significantly positive relationships among difficulty in identifying and describing feelings, NSSI behaviors, stressful events, and suicidal ideation. Data indicated a significant negative association of difficulty in identifying and describing feelings with quality of attachment to parents and peers. Further findings highlighted that difficulty in identifying and describing feelings significantly mediated the effect of quality of attachment (parent and peer) on NSSI and suicidal ideation. Conclusion: The ability to identify and describing feelings is important to managing emotional expression and understanding the feelings of others, both crucial in attaining successful interpersonal relationships. Our data revealed that, while controlling for stressful life events, low levels of attachment may increase adolescents’ difficulty in identifying and describing their own feelings, which in turn may increase the risk of both NSSI and suicidal ideation.
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Affiliation(s)
- Rita Cerutti
- Department of Dynamic and Clinic Psychology, Sapienza University of Rome, Rome, Italy
| | - Antonio Zuffianò
- Department of Psychology, Liverpool Hope University, Liverpool, United Kingdom
| | - Valentina Spensieri
- Department of Dynamic and Clinic Psychology, Sapienza University of Rome, Rome, Italy
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Masi G, Milone A, Montesanto AR, Valente E, Pisano S. Non suicidal self-injury in referred adolescents with mood disorders and its association with cyclothymic-hypersensitive temperament. J Affect Disord 2018; 227:477-482. [PMID: 29156361 DOI: 10.1016/j.jad.2017.11.049] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Revised: 09/24/2017] [Accepted: 11/11/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Non suicidal self-injuries (NSSIs) are deliberate self-harm behaviors without suicidal intent, usually starting in adolescence, with increasing rates of occurrence both in epidemiological and clinical samples. Several studies associated cyclothymic-hypersensitive temperament (CHT) with self-harm behaviors and suicidal risk. Aim of this study is to explore the association between NSSIs and CHT in a clinical sample of adolescents. We hypothesized that CHT may differentiate NSSI from non-NSSI adolescents with mood disorders, when other psychopathological features are controlled for. METHODS A consecutive sample of 89 adolescents with mood disorders were assessed for presence and phenomenology of NSSIs, CHT, demographics, comorbid categorical psychiatric diagnoses, dimensional psychopathology, impairment and previous suicide attempts. RESULTS NSSIs were reported in 52% of the sample, with higher rates in females and in bipolar disorder. Regression analyses showed that CHT, but not age, gender, bipolar vs depression diagnosis, functional impairment, was associated with NSSIs. DISCUSSION CHT may be in close association with NSSIs in adolescents with mood disorders. An assessment of CHT in adolescents referred for mood disorder may help to detect specific psychological features of NSSIs, which may improve diagnostic and treatment strategies. LIMITATIONS Given the cross-sectional design, a developmental relation between CHT and NSSIs cannot be determined. The small sample size and the selection bias of severely impaired patients limit the generalization of the results. More sophisticated measures of CHT may consent to explore other dimensions of the cyclothymic construct (i.e., emotional intensity, emotional reactivity, emotional stability, positive vs. negative emotions, interpersonal sensitivity, impulsivity).
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Affiliation(s)
- Gabriele Masi
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy
| | - Annarita Milone
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy
| | - Anna Rita Montesanto
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy
| | - Elena Valente
- IRCCS Stella Maris, Scientific Institute of Child Neurology and Psychiatry, Calambrone, Pisa, Italy
| | - Simone Pisano
- Clinic of Child and Adolescent Neuropsychiatry, Department of Medicine and Surgery, University of Salerno, Baronissi, Salerno, Italy.
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Han A, Wang G, Xu G, Su P. A self-harm series and its relationship with childhood adversity among adolescents in mainland China: a cross-sectional study. BMC Psychiatry 2018; 18:28. [PMID: 29390995 PMCID: PMC5796511 DOI: 10.1186/s12888-018-1607-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Accepted: 01/16/2018] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Self-harm (SH) is an emerging problem among Chinese adolescents. The present study aimed to measure the prevalence of SH behaviours and to explore the relationship between childhood adversity and different SH subtypes among Chinese adolescents. METHODS A total of 5726 middle school students were randomly selected in three cities of Anhui province, China, using a stratified cluster sampling method. SH was categorized into five subtypes (highly lethal self-harm, less lethal self-harm with visible tissue damage, self-harm without visible tissue damage, self-harmful behaviours with latency damage and psychological self-harm). Multivariate logistic regression was used to explore the relationships between childhood adversity and different subtypes of adolescent SH. RESULTS The prevalence rates of highly lethal self-harm, less lethal self-harm with visible tissue damage, self-harm without visible tissue damage, self-harmful behaviours with latency damage and psychological self-harm were 6.1, 20.4, 32.0, 20.0 and 23.0%, respectively. Childhood sexual abuse and physical peer victimization were associated with each SH subtype with adjusted odds ratios (AORs) ranging from 1.23 to 1.76. Highly lethal self-harm was associated with childhood physical peer victimization, sexual abuse, emotional abuse, and emotional neglect. The less lethal SH subtypes (i.e., less lethal self-harm with visible tissue damage, self-harm without visible tissue damage, self-harmful behaviours with latency damage and psychological self-harm) were associated with childhood peer victimization, family life stress event scores and childhood sexual abuse. CONCLUSIONS A high prevalence of SH exists among Chinese adolescents. The association of childhood adversity with SH merits serious attention in both future research and preventive interventions.
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Affiliation(s)
- Azhu Han
- 0000 0000 9490 772Xgrid.186775.aDepartment of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, Hefei, Anhui 230032 China
| | - Gengfu Wang
- 0000 0000 9792 1228grid.265021.2Department of Maternal, Child and Adolescent Health, School of Public Health, Tianjin Medical University, No. 22 Qixiangtai Road, Tianjin, 300070 China
| | - Geng Xu
- 0000 0000 9490 772Xgrid.186775.aDepartment of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, Hefei, Anhui 230032 China
| | - Puyu Su
- Department of Maternal, Child and Adolescent Health, School of Public Health, Anhui Medical University, No.81 Meishan Road, Hefei, Anhui, 230032, China. .,Anhui Provincial Key Laboratory of Population Health and Aristogenics, Hefei, Anhui, China.
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Childhood maltreatment and non-suicidal self-injury: a systematic review and meta-analysis. Lancet Psychiatry 2018; 5:51-64. [PMID: 29196062 PMCID: PMC5743605 DOI: 10.1016/s2215-0366(17)30469-8] [Citation(s) in RCA: 151] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Revised: 10/16/2017] [Accepted: 10/16/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND Non-suicidal self-injury is being increasingly recognised as a prominent public health concern. Identification of early and modifiable risk factors is necessary to advance the screening and intervention efforts, particularly early detection of at-risk individuals. We aimed to examine childhood maltreatment, including its specific subtypes, in relation to non-suicidal self-injury. METHODS We did a comprehensive meta-analysis of childhood maltreatment (overall, sexual abuse, physical abuse and neglect, and emotional abuse and neglect) in association with non-suicidal self-injury. We also provided a qualitative review of mediators and moderators of this association. We identified relevant articles published from inception to Sept 25, 2017, through a systematic search of Embase, MEDLINE, and PsycINFO. We extracted continuous and categorical data and assessed for potential moderators using ten study characteristics. We generated random-effects models for analysis and evaluated for publication bias. FINDINGS We identified 71 publications that met eligibility criteria. Overall childhood maltreatment was associated with non-suicidal self-injury (odds ratio 3·42, 95% CI 2·74-4·26), and effect sizes for maltreatment subtypes ranged from 1·84 (1·45-2·34) for childhood emotional neglect to 3·03 (2·56-3·54) for childhood emotional abuse. Publication bias was not evident, except in the case of childhood emotional neglect. Across multiple maltreatment subtypes, we found stronger associations with non-suicidal self-injury in non-clinical samples. INTERPRETATION With the exception of childhood emotional neglect, childhood maltreatment and its subtypes are associated with non-suicidal self-injury. Screening of childhood maltreatment history in non-suicidal self-injury risk assessments might hold particular value in community settings, and increased attention to childhood emotional abuse is warranted. FUNDING National Institute of Mental Health.
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Cipriano A, Cella S, Cotrufo P. Nonsuicidal Self-injury: A Systematic Review. Front Psychol 2017; 8:1946. [PMID: 29167651 PMCID: PMC5682335 DOI: 10.3389/fpsyg.2017.01946] [Citation(s) in RCA: 219] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Accepted: 10/23/2017] [Indexed: 01/22/2023] Open
Abstract
Objective: Nonsuicidal self-injury (NSSI) refers to the intentional self-inflicted destruction of body tissue without suicidal intention and for purposes not socially sanctioned. Our paper presents an up-to-date overview on nonsuicidal, self-injurious behaviors. Method: In accordance with PRISMA guidelines, a systematic literature search was conducted across two databases, PubMed and PsycARTICLES, regarding the main features of NSSI with a focus on epidemiological and etiologic data, diagnostic criteria, and functions. All English articles, published between 1998 and 2016, were considered, and screened against a priori inclusion/exclusion criteria. The search terms include: self-harm, self-injury, NSSI, epidemiology, comorbidity, gender, functions and DSM. We also examined the references of the retrieved articles. Results: NSSI is most common among adolescents and young adults, and the age of onset is reported to occur between 12 and 14 years. Comorbidity with borderline personality disorder (BPD) and eating disorders is often reported. DSM-5 includes NSSI as a condition requiring further study. This review gives an overview of the prevalence rates (7.5–46.5% adolescents, 38.9% university students, 4–23% adults) and main causes that appear to stem from childhood trauma, comorbidity with many other disorders and several functions of NSSI, and the potential independence of a NSSI disorder. Conclusion: Over the years, interest in NSSI grew to such an extent that an ongoing debate was instigated on whether NSSI should be considered as a diagnosis in its own right and given its own category. This paper provides an up-to-date overview on self-injury, what is known about it and what remains to be done. Clearly, our understanding of the main issues of NSSI has increased in last two decades. However, future researches is needed to examine the developmental trajectories, cultural backgrounds and shed light on the risk factors and functions as well as clarify its role as an independent diagnostic entity.
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Affiliation(s)
- Annarosa Cipriano
- Observatory on Eating Disorders, Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Stefania Cella
- Observatory on Eating Disorders, Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
| | - Paolo Cotrufo
- Observatory on Eating Disorders, Department of Psychology, University of Campania "Luigi Vanvitelli", Caserta, Italy
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Schreiner MW, Klimes-Dougan B, Mueller BA, Eberly LE, Reigstad KM, Carstedt PA, Thomas KM, Hunt RH, Lim KO, Cullen KR. Multi-modal neuroimaging of adolescents with non-suicidal self-injury: Amygdala functional connectivity. J Affect Disord 2017; 221. [PMID: 28628767 PMCID: PMC5555154 DOI: 10.1016/j.jad.2017.06.004] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) is a significant mental health problem among adolescents. Research is needed to clarify the neurobiology of NSSI and identify candidate neurobiological targets for interventions. Based on prior research implicating heightened negative affect and amygdala hyperactivity in NSSI, we pursued a systems approach to characterize amygdala functional connectivity networks during rest (resting-state functional connectivity [RSFC)]) and a task (task functional connectivity [TFC]) in adolescents with NSSI. METHOD We examined amygdala networks in female adolescents with NSSI and healthy controls (n = 45) using resting-state fMRI and a negative emotion face-matching fMRI task designed to activate the amygdala. Connectivity analyses included amygdala RSFC, amygdala TFC, and psychophysiological interactions (PPI) between amygdala connectivity and task conditions. RESULTS Compared to healthy controls, adolescents with NSSI showed atypical amygdala-frontal connectivity during rest and task; greater amygdala RSFC in supplementary motor area (SMA) and dorsal anterior cingulate; and differential amygdala-occipital connectivity between rest and task. After correcting for depression symptoms, amygdala-SMA RSFC abnormalities, among others, remained significant. LIMITATIONS This study's limitations include its cross-sectional design and its absence of a psychiatric control group. CONCLUSIONS Using a multi-modal approach, we identified widespread amygdala circuitry anomalies in adolescents with NSSI. While deficits in amygdala-frontal connectivity (driven by depression symptoms) replicates prior work in depression, hyperconnectivity between amygdala and SMA (independent of depression symptoms) has not been previously reported. This circuit may represent an important mechanism underlying the link between negative affect and habitual behaviors. These abnormalities may represent intervention targets for adolescents with NSSI.
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Affiliation(s)
| | | | - Bryon A. Mueller
- Department of Psychiatry, University of Minnesota Medical School
| | - Lynn E. Eberly
- Division of Biostatistics, University of Minnesota School of Public Health
| | | | | | - Kathleen M. Thomas
- Institute of Child Development, University of Minnesota College of Education and Human Development
| | - Ruskin H. Hunt
- Institute of Child Development, University of Minnesota College of Education and Human Development
| | - Kelvin O. Lim
- Department of Psychiatry, University of Minnesota Medical School
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Vega D, Torrubia R, Soto À, Ribas J, Soler J, Pascual JC, Rodríguez-Fornells A, Marco-Pallarés J. Exploring the relationship between non suicidal self-injury and borderline personality traits in young adults. Psychiatry Res 2017; 256:403-411. [PMID: 28692921 DOI: 10.1016/j.psychres.2017.07.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2016] [Revised: 04/30/2017] [Accepted: 07/03/2017] [Indexed: 11/28/2022]
Abstract
Non-suicidal self-injury (NSSI) is highly prevalent during late adolescence and young adulthood. There is some evidence of a link between NSSI and Borderline Personality Disorder (BPD), but little is known about the association between BPD traits and the various functions that maintain NSSI. The main purpose of this study was to explore the association between borderline personality traits and NSSI functions in a sample of college students. We also compared NSSI functions in college students who engaged in NSSI to those in an age-matched sample of BPD patients. This study included a total of 238 college students and 36 BPD patients. Participants were asked to complete a number of clinical measures. In the non-clinical sample, BPD features were more pronounced in the presence of NSSI, and we observed a differential relationship between NSSI functions and psychopathological BPD-traits. The NSSI clinical variables most strongly associated with BPD were frequency, variety of methods and severity, but not age of onset. Our results provide new information on the relationship between BPD and NSSI in young adults, and could be used to improve the early detection of vulnerable BPD-individuals and in planning NSSI treatment.
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Affiliation(s)
- Daniel Vega
- Servei de Psiquiatria i Salut Mental, Hospital d'Igualada (Consorci Sanitari de l'Anoia) Igualada, Barcelona, Spain; Unitat de Psicologia Mèdica, Departament de Psiquiatria i Medicina Legal & Institut de Neurociències, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain; Cognition and Brain Plasticity Group [Bellvitge Biomedical Research Institute-IDIBELL], L'Hospitalet de Llobregat, Barcelona, Spain.
| | - Rafael Torrubia
- Unitat de Psicologia Mèdica, Departament de Psiquiatria i Medicina Legal & Institut de Neurociències, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain
| | - Àngel Soto
- Servei de Psiquiatria i Salut Mental, Hospital d'Igualada (Consorci Sanitari de l'Anoia) Igualada, Barcelona, Spain
| | - Joan Ribas
- Servei de Psiquiatria i Salut Mental, Hospital d'Igualada (Consorci Sanitari de l'Anoia) Igualada, Barcelona, Spain
| | - Joaquim Soler
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau & Institut d'Investigació Biomèdica - Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Juan Carlos Pascual
- Department of Psychiatry, Hospital de la Santa Creu i Sant Pau & Institut d'Investigació Biomèdica - Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Antoni Rodríguez-Fornells
- Cognition and Brain Plasticity Group [Bellvitge Biomedical Research Institute-IDIBELL], L'Hospitalet de Llobregat, Barcelona, Spain; Dept. of Basic Psychology, Campus Bellvitge, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain; Catalan Institution for Research and Advanced Studies, ICREA, Barcelona, Spain
| | - Josep Marco-Pallarés
- Cognition and Brain Plasticity Group [Bellvitge Biomedical Research Institute-IDIBELL], L'Hospitalet de Llobregat, Barcelona, Spain; Dept. of Basic Psychology, Campus Bellvitge, University of Barcelona, L'Hospitalet de Llobregat, Barcelona, Spain
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Benjet C, González-Herrera I, Castro-Silva E, Méndez E, Borges G, Casanova L, Medina-Mora ME. Non-suicidal self-injury in Mexican young adults: Prevalence, associations with suicidal behavior and psychiatric disorders, and DSM-5 proposed diagnostic criteria. J Affect Disord 2017; 215:1-8. [PMID: 28288307 DOI: 10.1016/j.jad.2017.03.025] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 02/23/2017] [Accepted: 03/08/2017] [Indexed: 01/26/2023]
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) may lead to scarring, infection, accidental death and psychological distress. Little is known about NSSI in the general population of young adults in developing countries like Mexico. The current study examined the prevalence of any NSSI and each type of NSSI, the prevalence of meeting DSM-5 proposed criteria, and finally the association of NSSI with socio-demographic variables, suicidal behavior and psychiatric disorders. METHODS This study was conducted in a community sample of 1071 young adults between 19 and 26 years of age residents of Mexico City. RESULTS The lifetime prevalence of NSSI was 18.56% with females having 87% greater odds. The 12-month prevalence was 3.19%. Only 0.22% of the total sample and 6.96% of those that self-injured in the past 12 months met full criteria proposed by DSM-5, in part due to the lack of reported impairment; 39.99% of those that self-injured reported impairment. Suicidal behavior commonly co-occurred with NSSI. All lifetime anxiety, mood, disruptive behavior and substance use disorders were associated with greater risk for lifetime NSSI whereas only 12-month depression and substance use disorder was associated with greater risk of 12-month NSSI. LIMITATIONS The cross-sectional nature of the study precludes conclusions of causality and directionality and the study excluded institutionalized and homeless young adults. CONCLUSIONS NSSI is a concerning problem in young adults from Mexico City due to the important associations with all types of psychiatric disorders and suicidal behavior. Because many who self-injure do not perceive impairment, they are unlikely to seek treatment.
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Affiliation(s)
- Corina Benjet
- National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico.
| | | | | | - Enrique Méndez
- National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico
| | - Guilherme Borges
- National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico
| | - Leticia Casanova
- National Institute of Psychiatry Ramón de la Fuente, Mexico City, Mexico
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Meszaros G, Horvath LO, Balazs J. Self-injury and externalizing pathology: a systematic literature review. BMC Psychiatry 2017; 17:160. [PMID: 28468644 PMCID: PMC5415783 DOI: 10.1186/s12888-017-1326-y] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 04/24/2017] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND During the last decade there is a growing scientific interest in nonsuicidal self-injury (NSSI). The aim of the current paper was to review systematically the literature with a special focus on the associations between self-injurious behaviours and externalizing psychopathology. An additional aim was to review terminology and measurements of self-injurious behaviour and the connection between self-injurious behaviours and suicide in the included publications. METHODS A systematic literature search was conducted on 31st December 2016 in five databases (PubMed, OVID Medline, OVID PsycINFO, Scopus, Web of Science) with two categories of search terms (1. nonsuicidal self-injury, non-suicidal self-injury, NSSI, self-injurious behaviour, SIB, deliberate self-harm, DSH, self-injury; 2. externalizing disorder, attention deficit hyperactivity disorder, ADHD, conduct disorder, CD, oppositional defiant disorder, OD, ODD). RESULTS Finally 35 papers were included. Eleven different terms were found for describing self-injurious behaviours and 20 methods for measuring it. NSSI has the clearest definition. All the examined externalizing psychopathologies had strong associations with self-injurious behaviours according to: higher prevalence rates in externalizing groups than in control groups, higher externalizing scores on the externalizing scales of questionnaires, higher symptom severity in self-injurious groups. Eight studies investigated the relationship between suicide and self-injurious behaviours and found high overlap between the two phenomena and similar risk factors. CONCLUSIONS Based on the current findings the association between externalizing psychopathology and self-injurious behaviours has been proven by the scientific literature. Similarly to other reviews on self-injurious behaviours the confusion in terminology and methodology was noticed. NSSI is suggested for use as a distinct term. Further studies should investigate the role of comorbid conditions in NSSI, especially when internalizing and externalizing pathologies are both presented.
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Affiliation(s)
- Gergely Meszaros
- Semmelweis University, Mental Health Sciences School Of Ph.D., Üllői út 26, Budapest, 1085, Hungary. .,Vadaskert Child Psychiatry Hospital and Outpatient Clinic, Lipótmezei út 1-5, Budapest, 1021, Hungary.
| | - Lili Olga Horvath
- 0000 0001 2294 6276grid.5591.8Doctoral School of Psychology, Eötvös Loránd University, Izabella utca 46, Budapest, Hungary ,0000 0001 2294 6276grid.5591.8Institute of Psychology, Eötvös Loránd University, Izabella utca 46, Budapest, Hungary
| | - Judit Balazs
- Vadaskert Child Psychiatry Hospital and Outpatient Clinic, Lipótmezei út 1-5, Budapest, 1021 Hungary ,0000 0001 2294 6276grid.5591.8Institute of Psychology, Eötvös Loránd University, Izabella utca 46, Budapest, Hungary
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Castro Silva E, Benjet C, Juárez García F, Jurado Cárdenas S, Lucio Gómez-Maqueo ME, Valencia Cruz A. Adaptación y propiedades psicométricas del Inventory of Statements About Self-injury en estudiantes mexicanos. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.aipprr.2016.08.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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