Adolescents' attitudes toward non-suicidal self-injury (NSSI) and their perspectives of barriers to seeking professional treatment for NSSI

Children's experiences of living with their mental ill-health - a scoping review

PURPOSE

This study aims to identify and summarize existing qualitative empirical research on children's experiences of living with their mental ill-health.

METHODS

A scoping review with a systematic search of the databases PubMed, CINAHL, and PsychINFO was conducted. The search generated 9,864 studies, which were screened by title, abstract, and full text.

RESULTS

Forty articles were included comprising 826 children aged 8-19 years. The key findings were described in four themes: Identifying oneself with mental ill-health, Managing suffering and daily challenges, Seeking supportive and caring relationships and Navigating a complex school environment. Being identified with mental ill-health brought challenges for children's everyday struggles. Their own coping strategies as well as supportive relationships with friends and adults were important. However, the balance between support and stress was complex.

CONCLUSIONS

Children have a desire to manage and comprehend their complex everyday lives of living with mental ill-health and wish for supported yet independent decision-making. Attitudes of friends, adults and professionals are important in providing understanding and non-judgemental support, valuable for children's well-being. Open conversations about mental health and providing accessible, child-centred interventions based on the needs expressed by children are necessary. This study contributes to the literature by emphasizing the central role of children's voices in matters of mental ill-health.

Prevalence and correlates of non-suicidal self-injury among patients with bipolar disorder: A multicenter study across China

BACKGROUND

Non-suicidal self-injury (NSSI) is increasingly prevalent among patients with bipolar disorder (BD), raising concerns in psychology and mental health. Investigating the incidence and factors associated with NSSI is crucial for developing prevention and intervention strategies.

METHODS

NSSI behaviors were identified using the Ottawa Self-injury Inventory. The Clinically Useful Depression Outcome Scale supplemented with questions for the DSM-5 specifier of mixed features (CUDOS-M) and the Mini International Neuropsychiatric Interview (Hypo-)Manic Episode with Mixed Features-DSM-5 Module (MINI-M) were used to evaluate clinical symptoms. Non-parametric tests, chi-square tests, point-biserial correlation and logistic regression analyses were employed for the purposes of data analysis.

RESULTS

The enrolled sample comprised 1044 patients with BD from 20 research centers across China. Out of 1044 individuals, 446 exhibited NSSI behaviors, with 101 of them being adolescents, leading to a prevalence of 78.3 % among adolescent patients. The most common methods for females and males were "cutting" (41.2 %) and "hitting" (34.7 %), respectively. By binary logistic regression analysis, young age, female, bipolar type II disorder, with suicidal ideation and mixed states, depressive symptoms and without family history of mental disorder were correlates of NSSI in patients with BD (P < 0.05).

LIMITATIONS

As a cross-sectional study, causality between NSSI behaviors and associated factors cannot be established. Reporting and recall biases may occur due to self-rating scales and retrospective reports.

CONCLUSION

Our study indicates a concerning prevalence of NSSI, particularly among young patients with BD in China. Future research should focus on understanding NSSI behaviors in this population and developing effective interventions.

Non-suicidal self-injury trajectories among adolescents during the COVID-19 pandemic: The role of parenting dimensions and stress reactions

BACKGROUND

The literature on the trajectories of NSSI behavior during the pandemic is scarce and mainly short-term. Furthermore, studies have not explored the buffering mechanisms that may have altered risk trajectories during this vulnerable period. This study aims to analyze the univariate change of NSSI during adolescence and to examine the alteration of the univariate growth due to the time-varying effect of COVID-19-related stress, parenting dimensions (i.e., positive and negative parenting), and their interaction.

METHODS

Participants included 830 Italian adolescents (44.2 % females; Mage = 14.52; SD = 0.80), who participated in at least one time point of data collection, from a three-wave longitudinal study (T1: from December 2019 to January 2020; T2: December 2020; T3: December 2021).

RESULTS

The Latent Growth Curve Analyses show a linear increase in NSSI over time. In regards to time-varying, at T1, the results highlight that higher levels of negative parenting are associated with higher levels of NSSI at the same time point. Instead, at T2, results show that pandemic stress is associated with higher levels of NSSI at T2. Regarding the interaction effect, positive parenting significantly buffered the effect of COVID-19 stress on NSSI at both T2 and T3.

LIMITATIONS

Only some dimensions of parenting style (i.e., positive and negative parenting) are included.

CONCLUSIONS

This study attempts to deepen the trajectory of NSSI behavior during the two years of the pandemic and examine the changes caused by the time-varying effects, thus providing suggestions for designing programs to prevent engagement in NSSI.

How do professionals and non-professionals respond to non-suicidal self-injury? Lived experiences of psychiatric outpatients in Singapore

BACKGROUND

For young people who engage in non-suicidal self-injury (NSSI), receiving negative responses to their NSSI can pose a barrier to future help-seeking. This qualitative study aimed to explore helpful and unhelpful ways in which professionals and non-professionals respond to NSSI, from the perspectives of individuals with lived experiences of NSSI.

METHODS

Semi-structured interviews were conducted with 20 outpatients (6 males, 14 females) aged 17 to 29 years from a tertiary psychiatric hospital in Singapore, who had reported engaging in NSSI behavior in an earlier study. The interviews were audio recorded and transcribed verbatim. Thematic analysis was used to identify themes and subthemes in the data.

RESULTS

Professionals' responses were organized into three main themes: 'prescribing solutions without understanding needs', 'disapproval or judgment', and 'helpful responses'. Non-professionals' responses were organized into four main themes: 'emotionally charged responses', 'avoidance and inaction', 'poor understanding of reasons for NSSI', and 'providing tangible support and acknowledging NSSI'. Participants also described how unhelpful responses negatively impacted their willingness to seek help.

CONCLUSIONS

Our findings provide a better understanding of responses to NSSI that are considered helpful and unhelpful, and can be used to improve existing guidelines on responding to NSSI.

Challenges for psychiatric nurses working with non-suicidal self-injury adolescents: a qualitative study

BACKGROUND

Psychiatric nurses play a crucial role in treating and supporting adolescents with non-suicidal self-injury (NSSI) in China. However, few studies have explored their experiences and challenges.

OBJECTIVES

The aim of this qualitative study was to describe the challenges experienced by psychiatric nurses when working with adolescents having NSSI behaviors.

METHODS

This was a descriptive qualitative study using phenomenological approach. 18 psychiatric nurses from psychiatric wards were recruited from a tertiary hospital from Changsha, Hunan province, China. In-depth interview was performed for each participant collecting information about their feelings and experiences taking care of NSSI adolescents. ATLAS.ti 8 was used to enter data and perform thematic analysis following the six-phased process described by Braun and Clarke.

RESULTS

Two main themes and five sub-themes were summarized in this study. Nurses experienced both (1) Internal challenges (Lacking knowledge and skills to deal with NSSI adolescents and Feeling hard and stressful working with NSSI adolescents) and (2) External barriers (Unrealistic high expectations from family and schools, Uncooperative parents and Little help from communities and schools).

CONCLUSIONS

Psychiatric nurses had to face with their own negative feelings, insufficient knowledge and skills, alongside with pressures and little help from family, schools and communities when working with NSSI adolescents. Targeted training programs of treating NSSI adolescents and their supporting systems be performed in nurses, furthermore, family, schools and societies should also be raised.