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Ahmad SI, Hinshaw SP. A Qualitative Analysis of Perspectives on Self-directed Violence in a Prospective Longitudinal Study of Young Women With and Without Childhood ADHD. J Atten Disord 2024:10870547231221729. [PMID: 38294171 DOI: 10.1177/10870547231221729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
OBJECTIVE Non-suicidal self-directed violence (NSSDV) is a significant and growing youth public health crisis. Girls with ADHD are at increased risk of engaging in NSSDV, yet qualitative studies with this population-to better understand manifestations, motivations, and developmental course-are lacking. METHOD We conducted semi-structured, qualitative interviews with a sub-sample of 57 young women (32 with childhood ADHD, 25 neurotypical comparisons; mean age of 27 years, part of a larger prospective longitudinal study) regarding histories and manifestations of NSSDV. RESULTS Inductive and deductive analysis revealed several key themes, including self-perceived reasons for engaging in NSSDV (affect regulation, attention seeking, self-punishment, asserting control), impulsivity, secretiveness, and in some cases motivations for desistance. CONCLUSION Findings underscore the importance of early education and screening, especially among high-risk clinical populations. Increased resources and supports for professionals, parents, and peers are indicated, along with countering the persistent stigma associated with ADHD and NSSDV.
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Affiliation(s)
| | - Stephen P Hinshaw
- University of California, San Francisco, USA
- University of California, Berkeley, USA
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2
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Diana F, Juárez-Mora OE, Boekel W, Hortensius R, Kret ME. How video calls affect mimicry and trust during interactions. Philos Trans R Soc Lond B Biol Sci 2023; 378:20210484. [PMID: 36871586 PMCID: PMC9985972 DOI: 10.1098/rstb.2021.0484] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 01/11/2023] [Indexed: 03/07/2023] Open
Abstract
Many social species, humans included, mimic emotional expressions, with important consequences for social bonding. Although humans increasingly interact via video calls, little is known about the effect of these online interactions on the mimicry of scratching and yawning, and their linkage with trust. The current study investigated whether mimicry and trust are affected by these new communication media. Using participant-confederate dyads (n = 27), we tested the mimicry of four behaviours across three different conditions: watching a pre-recorded video, online video call, and face-to-face. We measured mimicry of target behaviours frequently observed in emotional situations, yawn and scratch and control behaviours, lip-bite and face-touch. In addition, trust in the confederate was assessed via a trust game. Our study revealed that (i) mimicry and trust did not differ between face-to-face and video calls, but were significantly lower in the pre-recorded condition; and (ii) target behaviours were significantly more mimicked than the control behaviours. This negative relationship can possibly be explained by the negative connotation usually associated with the behaviours included in this study. Overall, this study showed that video calls might provide enough interaction cues for mimicry to occur in our student population and during interactions between strangers. This article is part of a discussion meeting issue 'Face2face: advancing the science of social interaction'.
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Affiliation(s)
- Fabiola Diana
- Comparative Psychology and Affective Neuroscience Laboratory, Department of Cognitive Psychology, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition (LIBC), Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands
| | - Oscar E. Juárez-Mora
- Laboratorio de Ecología de La Conducta, Instituto de Fisiología, Benemérita Universidad Autónoma de Puebla, Puebla, Puebla 72530, Mexico
| | - Wouter Boekel
- Comparative Psychology and Affective Neuroscience Laboratory, Department of Cognitive Psychology, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition (LIBC), Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands
| | - Ruud Hortensius
- Department of Psychology, Utrecht University, Utrecht, Heidelberglaan 1, 3584 CS Utrecht, The Netherlands
| | - Mariska E. Kret
- Comparative Psychology and Affective Neuroscience Laboratory, Department of Cognitive Psychology, Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands
- Leiden Institute for Brain and Cognition (LIBC), Leiden University, Wassenaarseweg 52, 2333 AK, Leiden, The Netherlands
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Dodd DR, Crosby RD, Cao L, Gordon KH, Wonderlich SA. Borderline personality disorder symptoms as mediational mechanisms linking childhood trauma and nonsuicidal self-injury among women with bulimia nervosa. Int J Eat Disord 2022; 55:372-381. [PMID: 34985154 PMCID: PMC8918001 DOI: 10.1002/eat.23669] [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] [Received: 08/02/2021] [Revised: 12/13/2021] [Accepted: 12/15/2021] [Indexed: 01/17/2023]
Abstract
OBJECTIVE Nonsuicidal self-injury (NSSI) frequently co-occurs with eating disorders, especially bulimia nervosa (BN). Theoretical models and empirical evidence show many overlapping risk factors for the onset and maintenance of NSSI and BN. However, among those with BN, it remains unclear what distinguishes those who do versus do not engage in NSSI. The primary objective of the present study was to identify factors predicting NSSI among women with BN. Specifically, we tested four domains of borderline personality disorder as mediators between childhood trauma and NSSI. METHOD Using structural equation modeling we tested a parallel mediation model to predict NSSI among women with BN (N = 130). Childhood trauma (measured by the Childhood Trauma Questionnaire at baseline) was the independent variable. The four parallel mediators (measured at baseline via the Diagnostic Interview for Borderlines, Revised) were lifetime negative affect, impulsive actions, atypical cognitions (e.g., odd thinking, unusual perceptual experiences, quasi-psychotic thinking), and interpersonal problems. The dependent variable was instances of NSSI during a subsequent two-week ecological momentary assessment protocol. RESULTS Childhood trauma was significantly associated with all four mediators (all p values < .01), but only atypical cognitions predicted NSSI (p = .03). The indirect path from childhood trauma to NSSI, through atypical cognitions was significant (path coefficient = .001, SE < .001, p = .01). DISCUSSION Among women with BN, childhood trauma was associated with atypical cognitions, which in turn predicted NSSI. Atypical cognitions may be a mechanism for NSSI in this population.
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Affiliation(s)
| | | | - Li Cao
- Sanford Center for Biobehavioral Research, Fargo, ND
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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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Cliffe C, Seyedsalehi A, Vardavoulia K, Bittar A, Velupillai S, Shetty H, Schmidt U, Dutta R. Using natural language processing to extract self-harm and suicidality data from a clinical sample of patients with eating disorders: a retrospective cohort study. BMJ Open 2021; 11:e053808. [PMID: 34972768 PMCID: PMC8720985 DOI: 10.1136/bmjopen-2021-053808] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVES The objective of this study was to determine risk factors for those diagnosed with eating disorders who report self-harm and suicidality. DESIGN AND SETTING This study was a retrospective cohort study within a secondary mental health service, South London and Maudsley National Health Service Trust. PARTICIPANTS All diagnosed with an F50 diagnosis of eating disorder from January 2009 to September 2019 were included. INTERVENTION AND MEASURES Electronic health records (EHRs) for these patients were extracted and two natural language processing tools were used to determine documentation of self-harm and suicidality in their clinical notes. These tools were validated manually for attribute agreement scores within this study. RESULTS The attribute agreements for precision of positive mentions of self-harm were 0.96 and for suicidality were 0.80; this demonstrates a 'near perfect' and 'strong' agreement and highlights the reliability of the tools in identifying the EHRs reporting self-harm or suicidality. There were 7434 patients with EHRs available and diagnosed with eating disorders included in the study from the dates January 2007 to September 2019. Of these, 4591 (61.8%) had a mention of self-harm within their records and 4764 (64.0%) had a mention of suicidality; 3899 (52.4%) had mentions of both. Patients reporting either self-harm or suicidality were more likely to have a diagnosis of anorexia nervosa (AN) (self-harm, AN OR=3.44, 95% CI 1.05 to 11.3, p=0.04; suicidality, AN OR=8.20, 95% CI 2.17 to 30.1; p=0.002). They were also more likely to have a diagnosis of borderline personality disorder (p≤0.001), bipolar disorder (p<0.001) or substance misuse disorder (p<0.001). CONCLUSION A high percentage of patients (>60%) diagnosed with eating disorders report either self-harm or suicidal thoughts. Relative to other eating disorders, those diagnosed with AN were more likely to report either self-harm or suicidal thoughts. Psychiatric comorbidity, in particular borderline personality disorder and substance misuse, was also associated with an increase risk in self-harm and suicidality. Therefore, risk assessment among patients diagnosed with eating disorders is crucial.
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Affiliation(s)
- Charlotte Cliffe
- South London & Maudsley, NHS Foundation Trust, London, UK
- Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Aida Seyedsalehi
- Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Katerina Vardavoulia
- Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - André Bittar
- Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Sumithra Velupillai
- Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Hitesh Shetty
- Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Ulrike Schmidt
- South London & Maudsley, NHS Foundation Trust, London, UK
- Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Rina Dutta
- South London & Maudsley, NHS Foundation Trust, London, UK
- Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
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Krug I, Arroyo MD, Giles S, Dang AB, Kiropoulos L, De Paoli T, Buck K, Treasure J, Fuller-Tyszkiewicz M. A new integrative model for the co-occurrence of non-suicidal self-injury behaviours and eating disorder symptoms. J Eat Disord 2021; 9:153. [PMID: 34809723 PMCID: PMC8607624 DOI: 10.1186/s40337-021-00508-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Accepted: 11/07/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE The high co-occurrence of non-suicidal self-injury (NSSI) behaviours and eating disorder (ED) symptoms suggests these conditions share common aetiological processes. We assessed a new integrative model of shared factors for NSSI and ED symptoms, where affect dysregulation, impulsivity, self-esteem, and body dissatisfaction mediated the relationship between insecure attachment and maladaptive schemas and NSSI and ED symptoms. A further aim of the study was to assess whether the model behaved similarly across a clinical eating disorder (ED) and a community sample. METHOD 123 females with a lifetime ED diagnosis and 531 female individuals from the community completed an online survey, which included measures assessing the variables of interest. A cross-sectional single time point analysis was used. RESULTS Invariance testing indicated that the model was structurally non-invariant (different across groups). The proposed integrative model was a good fit for the ED group, but for the community sample only a revised model reached an acceptable fit. Both attachment and maladaptive schemas, included early in the model, were implicated in the pathways leading to ED and NSSI symptoms in the ED and community groups. In the community group, impulsivity, a mediator, was a shared predictor for NSSI and bulimic symptoms. No other mediating variables were shared by NSSI and ED symptoms in the two groups. Overall, the proposed model explained slightly more variance for the ED group relative to the community group in drive for thinness (R2 = .57 vs .51) and NSSI (R2 = .29 vs .24) but less variance in bulimic symptoms (R2 = .33 vs .39). CONCLUSION We conclude that the current model provides only limited support for explaining the comorbidity between NSSI and ED symptoms. It is vital to consider both common (e.g., attachment and maladaptive schemas) and specific factors (e.g., impulsivity) to better understand the pathways that lead to the co-occurrence of NSSI and ED symptoms. A new integrative model assessed whether emotion dysregulation, impulsivity, self-esteem, and body dissatisfaction were mediators in the relationship between insecure attachment and maladaptive beliefs about the world and the self and subsequent eating disorder and self-harm symptoms. A further aim was to assess whether the proposed model differed between a clinical eating disorder and a community sample. All participants were female and included 123 patients with a lifetime eating disorder and 531 individuals from the community. Participating individuals completed an online survey at one timepoint, which included measures assessing the variables of interest. The findings of the current study indicated that the proposed model was a good match for the clinical eating disorder sample, but for the community sample only a revised model yielded acceptable statistical fit. Both insecure attachment and maladaptive beliefs about the world and the self, included early in the model, were indirectly related to eating disorder and self-harm symptoms for both the eating disorder and the community groups. Impulsivity, a mediator, was the only shared predictor for self-harm, and bulimic symptoms in the community group. We conclude that the current model provides only limited support for explaining the comorbidity between self-harming behaviours and disordered eating symptoms.
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Affiliation(s)
- Isabel Krug
- Melbourne School of Psychological Sciences, University of Melbourne Psychology Clinic, Redmond Barry, Level 7, North Melbourne, VIC, 3051, Australia.
| | - Mercedes Delgado Arroyo
- Melbourne School of Psychological Sciences, University of Melbourne Psychology Clinic, Redmond Barry, Level 7, North Melbourne, VIC, 3051, Australia.,Department of Psychiatry, University Hospital Vall de' Hebron, Barcelona, Spain
| | - Sarah Giles
- Melbourne School of Psychological Sciences, University of Melbourne Psychology Clinic, Redmond Barry, Level 7, North Melbourne, VIC, 3051, Australia
| | - An Binh Dang
- Melbourne School of Psychological Sciences, University of Melbourne Psychology Clinic, Redmond Barry, Level 7, North Melbourne, VIC, 3051, Australia
| | - Litza Kiropoulos
- Melbourne School of Psychological Sciences, University of Melbourne Psychology Clinic, Redmond Barry, Level 7, North Melbourne, VIC, 3051, Australia
| | - Tara De Paoli
- Melbourne School of Psychological Sciences, University of Melbourne Psychology Clinic, Redmond Barry, Level 7, North Melbourne, VIC, 3051, Australia
| | - Kim Buck
- Melbourne School of Psychological Sciences, University of Melbourne Psychology Clinic, Redmond Barry, Level 7, North Melbourne, VIC, 3051, Australia
| | - Janet Treasure
- Department of Psychological Medicine, Institute of Psychiatry and Neuroscience, Section of Eating Disorders, King's College London, London, UK
| | - Matthew Fuller-Tyszkiewicz
- School of Psychology, Deakin University, Geelong, VIC, Australia.,Centre for Social and Early Emotional Development, Deakin University, Burwood, VIC, Australia
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Rodríguez-López Á, Rodríguez-Ortiz E, Romero-Gonzalez B. Non-suicidal self-injury in patients with eating disorders: nuclear aspects. COLOMBIA MEDICA (CALI, COLOMBIA) 2021; 52:e2044342. [PMID: 33911321 PMCID: PMC8054705 DOI: 10.25100/cm.v51i4.4342] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Background: Through the culture of thinness, increasingly promoted in our society as a beauty canon, it is not surprising that the number of people affected by eating disorders is increasing. Objective: This research aims to study the relationship between non-suicidal self-injuries and nuclear aspects of eating disorders specified along with this article. Methods: The sample consisted of 60 women diagnosed with anorexia and bulimia. Questionnaires assessing impulsivity, body satisfaction, alexithymia, body attitude and self-esteem were administered. Participants with non-suicidal self-harm were compared with those without it, and participants with anorexia with and without self-harm and participants with bulimia with and without self-harm were compared. Results: Differences were found in body dissatisfaction= 5.71; p ≤0.01), body attitudes= 4.80; p ≤0.02), self-esteem= 14.09; p ≤0.00) and impulsivity (t= 3.39; p ≤0.01) between participants with and without non-suicidal self-harm. Conclusions: These are key factors for the clinical area in the treatment of eating disorders to prevent the presence of self-harm, as it allows focusing the treatment target on those aspects such as dissatisfaction and impulsivity, which are key in the development of self-harm.
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Affiliation(s)
- Álvaro Rodríguez-López
- Universidad de Granada, Centro de Investigación Mente, Cerebro y Comportamiento, Granada, España Universidad de Granada Universidad de Granada Centro de Investigación Mente, Cerebro y Comportamiento Granada Spain
| | - Erika Rodríguez-Ortiz
- Policlínica Nuestra Señora de los Remedios, Morón de la Frontera, Sevilla, España Policlínica Nuestra Señora de los Remedios Morón de la FronteraSevilla España
| | - Borja Romero-Gonzalez
- Universidad de Valladolid, Facultad de Educación, Departamento de Psicología, Campus Duques de Soria. Valladolid, España. Universidad de Valladolid Universidad de Valladolid Facultad de Educación Departamento de Psicología Valladolid Spain
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8
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Gonçalves SF, Machado BC, Martins C, Brandão I, Roma torres A, Machado P. Dysregulated behaviours in bulimia nervosa—A case‐control study. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/cp.12013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Carla Martins
- School of Psychology, University of Minho, Braga, Portugal,
| | - Isabel Brandão
- Psychiatry Department, Hospital of S.João, Porto, Portugal,
| | | | - Paulo Machado
- School of Psychology, University of Minho, Braga, Portugal,
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Howard M, Gregertsen EC, Hindocha C, Serpell L. Impulsivity and compulsivity in anorexia and bulimia nervosa: A systematic review. Psychiatry Res 2020; 293:113354. [PMID: 32781364 DOI: 10.1016/j.psychres.2020.113354] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 07/27/2020] [Accepted: 08/01/2020] [Indexed: 01/14/2023]
Abstract
This study aimed to systematically appraise cross-sectional research that compared the cognitive performance of individuals in the acute phase of BN and/or AN to HCs on measures of impulsivity and compulsivity. The results of the systematic review showed support for the trans-diagnostic approach to eating disorders. There was no strong evidence to support the characterisation of AN as high in compulsivity (and low in impulsivity), nor to support the characterisation of BN as high in impulsivity (and low in compulsivity). There appeared to be mixed findings for both impulsivity and compulsivity across AN and BN. Results were highly variable due to the heterogeneous tasks used, and lack of replication across studies. There was no consensus amongst the included studies on the most appropriate task and/or outcome measures that should be used to study the constructs of impulsivity and compulsivity.
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Affiliation(s)
- Maxine Howard
- Department of Clinical, Educational, and Health Psychology, University College London, London, United Kingdom
| | - Eva C Gregertsen
- Department of Clinical, Educational, and Health Psychology, University College London, London, United Kingdom.
| | - Chandni Hindocha
- Department of Clinical, Educational, and Health Psychology, University College London, London, United Kingdom
| | - Lucy Serpell
- Department of Clinical, Educational, and Health Psychology, University College London, London, United Kingdom
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10
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Vieira AI, Moreira CS, Rodrigues TF, Brandão I, Timóteo S, Nunes P, Gonçalves S. Nonsuicidal self-injury, difficulties in emotion regulation, negative urgency, and childhood invalidation: A study with outpatients with eating disorders. J Clin Psychol 2020; 77:607-628. [PMID: 32762121 DOI: 10.1002/jclp.23038] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 06/09/2020] [Accepted: 07/20/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Among outpatients with eating disorders (ED), we compared participants without nonsuicidal self-injury (non-NSSI group), with NSSI over a year ago (past NSSI group) and with NSSI in the previous year (current NSSI group) regarding different variables, and examined whether difficulties in emotion regulation and negative urgency moderated the relationship between maternal/paternal invalidation and NSSI. METHOD The sample included 171 outpatients (94.2% female; Mage = 28.78, SDage = 11.19). RESULTS Fifty-four participants (31.6%) had NSSI in the previous year. This group showed higher eating pathology, difficulties in emotion regulation, negative urgency, and maternal/paternal invalidation than the non-NSSI group. Analyses revealed an adequate fit to the data for the model that included moderating effects of emotional awareness and negative urgency in the relationship between maternal/paternal invalidation and increased likelihood of NSSI in the previous year. CONCLUSIONS Interventions for NSSI and ED should include emotion regulation, impulse control, and validation strategies.
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Affiliation(s)
- Ana I Vieira
- School of Psychology, Center for Research in Psychology (CIPsi), Psychotherapy and Psychopathology Unit, University of Minho, Braga, Portugal
| | - Célia S Moreira
- Mathematics Department, Center of Mathematics (CMUP), Faculty of Sciences, University of Porto, Porto, Portugal
| | - Tânia F Rodrigues
- School of Psychology, Center for Research in Psychology (CIPsi), Psychotherapy and Psychopathology Unit, University of Minho, Braga, Portugal
| | - Isabel Brandão
- Department of Psychiatry, Hospital Center of São João, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Sertório Timóteo
- Department of Psychiatry, Hospital Center of São João, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Patrícia Nunes
- Department of Psychiatry, Hospital Center of São João, Faculty of Medicine, University of Porto, Porto, Portugal
| | - Sónia Gonçalves
- School of Psychology, Center for Research in Psychology (CIPsi), Psychotherapy and Psychopathology Unit, University of Minho, Braga, Portugal
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11
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Childhood predictors and moderators of lifetime risk of self-harm in girls with and without attention-deficit/hyperactivity disorder. Dev Psychopathol 2020; 33:1351-1367. [DOI: 10.1017/s0954579420000553] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is associated with self-harm during adolescence and young adulthood, especially among females. Yet little is known about the developmental trajectories or childhood predictors/moderators of self-harm in women with and without childhood histories of ADHD. We characterized lifetime risk for nonsuicidal self-injury (NSSI), suicidal ideation (SI), and suicide attempts (SA), comparing female participants with (n = 140) and without (n = 88) childhood ADHD. We examined theory-informed childhood predictors and moderators of lifetime risk via baseline measures from childhood. First, regarding developmental patterns, most females with positive histories of lifetime self-harm engaged in such behaviors in adolescence yet desisted by adulthood. Females with positive histories of self-harm by late adolescence emanated largely from the ADHD-C group. Second, we found that predictors of NSSI were early externalizing symptoms, overall executive functioning, and father's negative parenting; predictors of SI were adverse childhood experiences and low self-esteem; and predictors of SA were early externalizing symptoms, adverse childhood experiences, and low self-esteem. Third, receiver operating characteristics analyses helped to ascertain interactive sets of predictors. Findings indicate that pathways to self-harm are multifaceted for females with ADHD. Understanding early childhood predictors and moderators of self-harm can inform both risk assessment and intervention strategies.
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12
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Rodríguez-López A, Rodríguez-Ortíz E, Romero-Gonzalez B. Non-suicidal self-injury in patients with eating disorders: nuclear aspects. Colomb Med (Cali) 2020. [DOI: 10.25100/cm.v52i1.4342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Background: Through the culture of thinness, increasingly promoted in our society as a beauty canon, it is not surprising that the number of people affected by eating disorders is increasing.
Objective: This research aims to study the relationship between non-suicidal self-injuries and nuclear aspects of eating disorders specified along with this article.
Methods: The sample consisted of 60 women diagnosed with anorexia and bulimia. Questionnaires assessing impulsivity, body satisfaction, alexithymia, body attitude and self-esteem were administered. Participants with non-suicidal self-harm were compared with those without, and participants with anorexia with and without self-harm and participants with bulimia with and without self-harm were compared.
Results: Differences were found in body dissatisfaction = 5,71; p ≤ ,01), body attitudes = 4,80; p ≤ ,02), self-esteem = 14,09; p ≤ .00) and impulsivity (t = 3,39; p ≤ ,01) between participants with and without non-suicidal self-harm.
Conclusions: These are key factors for the clinic in the treatment of eating disorders to prevent the presence of self-harm, as it allows focusing the treatment target on those aspects such as dissatisfaction and impulsivity, which are key in the development of self-harm.
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Affiliation(s)
- Alvaro Rodríguez-López
- Universidad de Granada, Centro de Investigación Mente, Cerebro y Comportamiento, Granada, España , Universidad de Granada, Universidad de Granada, Centro de Investigación Mente, Cerebro y Comportamiento, Granada, Spain
| | - Erika Rodríguez-Ortíz
- Policlínica Nuestra Señora de los Remedios, Morón de la Frontera, Sevilla, España , Policlínica Nuestra Señora de los Remedios, Morón de la FronteraSevilla, España
| | - Borja Romero-Gonzalez
- Universidad de Valladolid, Facultad de Educación, Departamento de Psicología, Campus Duques de Soria. Valladolid, España., Universidad de Valladolid, Universidad de Valladolid, Facultad de Educación, Departamento de Psicología, Valladolid, Spain
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Buelens T, Luyckx K, Verschueren M, Schoevaerts K, Dierckx E, Depestele L, Claes L. Temperament and Character Traits of Female Eating Disorder Patients with(out) Non-Suicidal Self-Injury. J Clin Med 2020; 9:jcm9041207. [PMID: 32331415 PMCID: PMC7230745 DOI: 10.3390/jcm9041207] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 04/19/2020] [Accepted: 04/21/2020] [Indexed: 11/26/2022] Open
Abstract
Eating disorder (ED) patients show alarmingly high prevalence rates of Non-Suicidal Self-Injury (NSSI). Adolescents seem to be particularly at risk, as EDs and NSSI both have their onset in mid-adolescence. It has been suggested that personality could be a transdiagnostic mechanism underlying both EDs and NSSI. However, little attention has been given to adolescent clinical samples compared to adult and/or community samples. Therefore, the current study investigated the role of personality in a sample of 189 female inpatients with an ED (M = 15.93, SD = 0.98). Our results confirmed the high prevalence of NSSI in EDs, specifically in patients with bingeing/purging behaviours (ED-BP). Temperamental differences were found between ED-BP and the restrictive ED subtype (ED-R). Namely, ED-BP patients showed more harm avoidance and less self-directedness compared to ED-R. Temperamental differences were found in NSSI as well, regardless of ED subtype: ED patients who had engaged in NSSI during their lifetime reported less self-directedness and more harm avoidance. Interestingly, only ED patients who recently engaged in NSSI showed less novelty seeking. These temperamental profiles should be recognised as key mechanisms in the treatment of adolescent ED patients with and without NSSI.
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Affiliation(s)
- Tinne Buelens
- Faculty of Psychology and Educational Sciences, KU Leuven, 3000 Leuven, Belgium; (K.L.); (M.V.); (L.D.); (L.C.)
- Correspondence: ; Tel.: +32-163-77-506
| | - Koen Luyckx
- Faculty of Psychology and Educational Sciences, KU Leuven, 3000 Leuven, Belgium; (K.L.); (M.V.); (L.D.); (L.C.)
- UNIBS, University of the Free State, 9300 Bloemfontein, South Africa
| | - Margaux Verschueren
- Faculty of Psychology and Educational Sciences, KU Leuven, 3000 Leuven, Belgium; (K.L.); (M.V.); (L.D.); (L.C.)
| | - Katrien Schoevaerts
- Psychiatric Hospital Alexianen Zorggroep Tienen, 3300 Tienen, Belgium; (K.S.); (E.D.)
| | - Eva Dierckx
- Psychiatric Hospital Alexianen Zorggroep Tienen, 3300 Tienen, Belgium; (K.S.); (E.D.)
- Department of Psychology and Educational Sciences, Vrije Universiteit Brussel, 1050 Elsene, Belgium
| | - Lies Depestele
- Faculty of Psychology and Educational Sciences, KU Leuven, 3000 Leuven, Belgium; (K.L.); (M.V.); (L.D.); (L.C.)
- Psychiatric Hospital Alexianen Zorggroep Tienen, 3300 Tienen, Belgium; (K.S.); (E.D.)
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, 3000 Leuven, Belgium; (K.L.); (M.V.); (L.D.); (L.C.)
- Faculty of Medicine and Health Sciences, Universiteit Antwerpen, 2610 Wilrijk, Belgium
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Claes L, Vandereycken W, Vertommen H. Family environment of eating disordered patients with and without self-injurious behaviors. Eur Psychiatry 2020; 19:494-8. [PMID: 15589709 DOI: 10.1016/j.eurpsy.2004.09.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2003] [Revised: 06/28/2004] [Accepted: 08/25/2004] [Indexed: 10/26/2022] Open
Abstract
AbstractObjective.– The family environment is known to be an important contributor to the course of psychiatric disorders. In this study, we examined the family context of eating disordered (ED) patients with and without self-injurious behaviors (SIB).Method.– A Dutch adaptation of the Family Environment Scale ‘Sci Eng 57(9-B):1997;5927’ was completed by 131 ED patients of whom 47% showed at least one form of SIB (e.g., cutting, burning, hair pulling, etc.).Results– Results showed a significant difference in family environment between patients with and without SIB. The family environment of self-injuring ED patients was less cohesive, expressive and socially oriented, and more conflictual and disorganized than the family environment of those without SIB. No significant differences in perceived family environment were found with respect to the number or form of SIB and the subtype of ED. Neither did we find a significant interaction effect between ED subtype and presence/absence of SIB.
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Affiliation(s)
- Laurence Claes
- Department of Psychology, Catholic University of Leuven, Tiensestraat 102, 3000 Leuven, Belgium.
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15
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Thompson-Memmer C, Glassman T, Diehr A. Drunkorexia: A new term and diagnostic criteria. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2019; 67:620-626. [PMID: 30285556 DOI: 10.1080/07448481.2018.1500470] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Revised: 06/11/2018] [Accepted: 07/10/2018] [Indexed: 06/08/2023]
Abstract
Individuals who restrict their caloric intake and/or exercise excessively to mitigate the calories from alcohol consumption may suffer from an eating disorder, substance abuse disorder, or both. While the term "drunkorexia" has been used in both academic articles and popular culture, issues persist with respect to diagnosing and treating this condition. Classifying the behavior as a subcategory of Other Specified Feeding and Eating Disorders (OSFED) would provide patients with an increased likelihood of receiving insurance coverage for this condition. A consistent definition of this behavior and a more medically accurate/appropriate term-such as "alcoholimia"-are both needed to advance treatment and prevention efforts.
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Affiliation(s)
| | | | - Aaron Diehr
- Southern Illinois University , Carbondale , Illinois , USA
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16
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Abstract
Self-injurious behaviors (SIB) continue to afflict a significant segment of the clinical and general population, sometimes with fatal consequences. The development of SIB seems to share developmental pathways and mechanisms similar to attachment insecurity. To date, no reviews have explored their relationship. A search of publication databases PubMed and PsychInfo from 1969 through April 2018 was conducted and 17 papers met inclusion criteria. Of the 17 articles identified, 13 reported a positive relationship and 1 reported a negative relationship between attachment insecurity and SIB. Both attachment anxiety and avoidance seem to play a role in the risk for SIB, possibly through different mechanisms and likely with different impacts on the choice for either self-harm or suicide attempts.
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17
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Different Clinical Presentations in Eating Disorder Patients with Non-Suicidal Self-Injury Based on the Co-Occurrence of Borderline Personality Disorder. Psychol Belg 2018; 58:243-255. [PMID: 30479820 PMCID: PMC6194535 DOI: 10.5334/pb.420] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Non-suicidal self-injury (NSSI) and borderline personality disorder (BPD) features are common in patients with eating disorders (ED), yet little is known regarding the clinical presentation of ED patients who present with NSSI with and without BPD. The current study compared self-injurious, female ED inpatients with (n = 98; NSSI+BPD) and without BPD (n = 45; NSSI-only) on different self-reported clinical features. Results suggest that ED patients with NSSI+BPD differ from those with NSSI-only with regard to frequency of suicidal ideation, alcohol, drug or medication abuse, internalizing/externalizing psychopathology, interpersonal problems, and coping strategies, with the NSSI+BPD group demonstrating more impairment in each of these domains. Despite these differences in clinical presentation, however, groups did not differ in NSSI features. In sum, while self-injurious ED patients may present with similar NSSI behavior regardless of BPD diagnosis, those with NSS+BPD represent a group with much higher clinical complexity and greater treatment needs.
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18
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Brausch AM, Perkins NM. Nonsuicidal self-injury and disordered eating: Differences in acquired capability and suicide attempt severity. Psychiatry Res 2018; 266:72-78. [PMID: 29857291 DOI: 10.1016/j.psychres.2018.05.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2017] [Revised: 05/07/2018] [Accepted: 05/08/2018] [Indexed: 12/13/2022]
Abstract
Nonsuicidal self-injury (NSSI) and eating disorders are both strongly related to suicide behaviors, and both can be conceptualized as painful and provocative events that associate with acquired capability for suicide. Individuals who self-injure report greater acquired capability than those who do not engage in these behaviors, but results are mixed in eating disorder samples. Given that NSSI and disordered eating (DE) commonly co-occur, it is important to examine how acquired capability for suicide and suicide attempt severity may differ between individuals who engage in either, both, or neither of these behaviors. It was expected that individuals with both NSSI and DE would report the greatest acquired capability, assessed by fearlessness about death and fear about suicide, and suicide attempt severity, compared to NSSI only, DE only, and controls. In a sample of 1179 undergraduates, results indicated no differences on fearlessness about death, but the NSSI + DE group reported the lowest scores on fear of suicide and greatest suicide attempt severity compared to the other groups. Differences between fearlessness about death and fear about suicide are discussed, as well as the possible additive effect of engaging in both direct (NSSI) and indirect (DE) self-harm on fear about suicide and suicide risk.
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Affiliation(s)
- Amy M Brausch
- Department of Psychological Sciences, Western Kentucky University, 1906 College Heights Blvd, Bowling Green, KY 42101, United States.
| | - Natalie M Perkins
- Department of Psychological Sciences, Western Kentucky University, 1906 College Heights Blvd, Bowling Green, KY 42101, United States
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19
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Abstract
Patients who repeatedly injure themselves present particular management problems for general psychiatric teams. This article, the first of a series of four, examines the characteristics of those that present to adult mental health services, and the possible underlying background and trigger factors that lead to these anxiety-raising events. Suggestions are made on preventive and assessment procedures, staff reactions and management strategies aimed at helping patients deal with the overwhelming feelings that underlie self-injury.
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20
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Gandhi A, Luyckx K, Baetens I, Kiekens G, Sleuwaegen E, Berens A, Maitra S, Claes L. Age of onset of non-suicidal self-injury in Dutch-speaking adolescents and emerging adults: An event history analysis of pooled data. Compr Psychiatry 2018; 80:170-178. [PMID: 29121554 DOI: 10.1016/j.comppsych.2017.10.007] [Citation(s) in RCA: 99] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2017] [Revised: 09/24/2017] [Accepted: 10/14/2017] [Indexed: 10/18/2022] Open
Abstract
OBJECTIVE Non-Suicidal Self-Injury (NSSI) has emerged as an important mental-health concern. However, epidemiological features like age of onset of NSSI have remained understudied. Therefore, the current study investigated the distribution of age of onset of NSSI in pooled sample of Dutch-speaking adolescents and emerging adults using event history analysis. METHOD Eleven datasets measuring age at first NSSI in community and clinical participants collected by researchers in the Dutch-speaking part of Belgium were pooled together. The final dataset consisted of 1973 community males, 1901 community females, and 505 clinical females. Discrete-time event history analysis was used to model the effect of gender and psychiatric disorders on the age of onset of NSSI. RESULTS Twenty-one percent of adolescents from the community samples engaged in at least one episode of NSSI by the age of 25years. Irrespective of the type of sample (community or psychiatric disorder), the probability of age of onset peaked around the age of 14-15years. A second peak was observed around the age of 20 and 24years in the community and psychiatric samples respectively. CONCLUSIONS Psychosocial interventions for prevention of NSSI should not only target adolescence through school mental health programs but also target emerging adults at the university level.
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Affiliation(s)
- Amarendra Gandhi
- Faculty of Psychology and Educational Sciences, KU Leuven, Belgium.
| | - Koen Luyckx
- Faculty of Psychology and Educational Sciences, KU Leuven, Belgium
| | - Imke Baetens
- Faculty of Psychology and Educational Sciences, KU Leuven, Belgium; Department of Clinical and Life Span Psychology, Vrije Universiteit Brussels, Belgium
| | - Glenn Kiekens
- Research Group Psychiatry, Department of Neurosciences, KU Leuven, Belgium
| | - Ellen Sleuwaegen
- University Department of Psychiatry, Campus Psychiatric Hospital Duffel, Belgium; Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Belgium
| | - Ann Berens
- University Department of Psychiatry, Campus Psychiatric Hospital Duffel, Belgium
| | - Shubhada Maitra
- Centre for Health and Mental Health, Tata Institute of Social Sciences, India
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, Belgium; Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Belgium
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21
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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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Experiential avoidance versus decentering abilities: the role of different emotional processes on disordered eating. Eat Weight Disord 2017; 22:467-474. [PMID: 27209046 DOI: 10.1007/s40519-016-0291-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 05/03/2016] [Indexed: 10/21/2022] Open
Abstract
In modern western societies, the female body is a predominantly used dimension in self and social evaluations. In fact, the perceived discrepancy between one's current and ideal body image may act as a pathogenic phenomenon on women's well-being. Furthermore, significant differences in the tendency to engage in disordered eating attitudes and behaviours have been verified between women sharing similar characteristics and perceptions about body's weight and shape, which suggests that different emotion regulation processes may be involved in this association. This study thus aims to clarify the mediational effect of two different emotional regulation processes, experiential avoidance and decentering, on the association of weight and body shape-related variables and shame with disordered eating, in a sample of 760 women. The tested path model explained 44 % of disordered eating attitudes and behaviours, and showed an excellent model fit. Results demonstrated that body mass index had a direct effect, albeit weak, on disordered eating behaviours, and that body-image discrepancy and shame presented indirect effects through the mechanisms of experiential avoidance and decentering. Results also revealed that experiential avoidance and decentering showed significant mediator effects on the relationship of weight and body shape and shame with disordered eating behaviours. These findings suggested that while experiential avoidance exacerbates the impact of weight and body shape and shame on disordered eating attitudes and behaviours, decentering seems to attenuate this association. Our findings appear to offer significant clinical and research implications, highlighting the importance of targeting maladaptive emotion processes and of the development of decentering abilities.
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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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24
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Owens EB, Zalecki C, Gillette P, Hinshaw SP. Girls with childhood ADHD as adults: Cross-domain outcomes by diagnostic persistence. J Consult Clin Psychol 2017; 85:723-736. [PMID: 28414486 DOI: 10.1037/ccp0000217] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To ascertain adult outcomes in 10 domains reflecting symptomatology (internalizing, externalizing, self-injury, substance use), attainment (education, employment), and impairment (health, social, driving, overall) as a function of both childhood diagnosis of attention-deficit/hyperactivity disorder (ADHD) and persistence of ADHD symptoms across time. METHOD We prospectively followed 140 grade-school-aged girls with rigorously diagnosed childhood ADHD and 88 age- and ethnicity-matched comparison girls for 16 years. Outcome measures were obtained via self- and parent-report questionnaires, interviews, and objective tests. RESULTS Childhood ADHD, whether it remitted or persisted, was a pernicious risk factor for a limited number of poor outcomes, including low educational attainment, unplanned pregnancy, body mass index (BMI), and clinician-rated impairment. Childhood ADHD that persisted over time, whether completely or partially, was associated with a number of additional detrimental outcomes in the externalizing, internalizing, self-injury, occupational, social, and overall impairment domains. Finally, in this all-female sample, ADHD was not associated with objective measures of employment, substance use, or driving outcomes. CONCLUSIONS We discuss the considerable impairments accruing from both childhood-limited and adult-persisting ADHD, with major implications for the health and well-being of females with this neurodevelopmental disorder. (PsycINFO Database Record
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Affiliation(s)
| | | | - Peter Gillette
- Institute of Human Development, University of California, Berkeley
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25
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Balazs J, Kereszteny A. Attention-deficit/hyperactivity disorder and suicide: A systematic review. World J Psychiatry 2017; 7:44-59. [PMID: 28401048 PMCID: PMC5371172 DOI: 10.5498/wjp.v7.i1.44] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 01/02/2017] [Accepted: 01/18/2017] [Indexed: 02/05/2023] Open
Abstract
AIM To investigate suicidality and attention-deficit/hyperactivity disorder (ADHD), this paper aims to systematically review the literature as an extension of previous reviews.
METHODS We searched five databases (Ovid MEDLINE, Psychinfo, PubMed, Scopus, Web of Science) with two categories of search terms: (1) suicide; suicidal; suicide behavior; suicide attempt; suicidal thought; and (2) ADHD.
RESULTS The search resulted 26 articles. There is a positive association between ADHD and suicidality in both sexes and in all age groups. Comorbid disorders mediate between suicidality and ADHD.
CONCLUSION Recognizing ADHD, comorbid conditions and suicidality is important in prevention.
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Turner BJ, Yiu A, Claes L, Muehlenkamp JJ, Chapman AL. Occurrence and co-occurrence of nonsuicidal self-injury and disordered eating in a daily diary study: Which behavior, when? Psychiatry Res 2016; 246:39-47. [PMID: 27657802 DOI: 10.1016/j.psychres.2016.09.012] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 06/18/2016] [Accepted: 09/10/2016] [Indexed: 10/21/2022]
Abstract
Although research has explored between-person traits that may account for the co-occurrence of non-suicidal self-injury (NSSI) and disordered eating (DE), little is known about within-person processes that predict when each behavior occurs. This study describes the socioemotional contexts of NSSI and DE behaviors during a two-week daily diary period. Young adults (aged 18-35) who reported ≥1 episode of NSSI and ≥1 episode of DE (binge eating, purging, or fasting) during the diary period were included (N=25). NSSI and DE co-occurred approximately one third of the time. Participants were more likely to act on NSSI thoughts following arguments and feelings of rejection. They were more likely to act on binge eating/purging thoughts after eating or watching television, and when they felt self-hatred. They were more likely to act on fasting thoughts after discussing upsetting memories, and when they were in a public setting. NSSI days were marked by more intense negative mood in the evenings relative to fasting days, and greater fatigue in the morning relative to binge eating/purging days. This study underscores the utility of using experience-sampling methods to develop and test within-person models to advance our understanding of co-occurring behaviors.
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Affiliation(s)
- Brianna J Turner
- Department of Psychology, University of Victoria, Victoria, BC, Canada; Department of Psychology, Harvard University, Cambridge, MA, USA.
| | - Angelina Yiu
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium; Department of Psychiatry, Antwerp University, Antwerp, Belgium
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Meza JI, Owens EB, Hinshaw SP. Response Inhibition, Peer Preference and Victimization, and Self-Harm: Longitudinal Associations in Young Adult Women with and without ADHD. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2016; 44:323-34. [PMID: 25985979 DOI: 10.1007/s10802-015-0036-5] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Self-harm (suicidal ideation and attempts; non-suicidal self-injuries behavior) peaks in adolescence and early-adulthood, with rates higher for women than men. Young women with childhood psychiatric diagnoses appear to be at particular risk, yet more remains to be learned about the key predictors or mediators of self-harm outcomes. Our aims were to examine, with respect to self-harm-related outcomes in early adulthood, the predictive validity of childhood response inhibition, a cardinal trait of attention-deficit hyperactivity disorder (ADHD), as well as the potential mediating effects of social preference and peer victimization, ascertained in early adolescence. Participants were an ethnically and socioeconomically diverse sample of 228 girls with and without ADHD, an enriched sample for deficits in response inhibition. Childhood response inhibition (RI) predicted young-adult suicide ideation (SI), suicide attempts (SA), and non-suicidal self-injury (NSSI), over and above full-scale IQ, mother's education, household income, and age. Importantly, teacher-rated social preference in adolescence was a partial mediator of the RI-SI/SA linkages; self-reported peer victimization in adolescence emerged as a significant partial mediator of the RI-NSSI linkage. We discuss implications for conceptual models of self-harm and for needed clinical services designed to detect and reduce self-harm.
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Affiliation(s)
- Jocelyn I Meza
- University of California, 2205 Tolman Hall, Berkley, CA, 94720-1650, USA.
| | - Elizabeth B Owens
- University of California, 2205 Tolman Hall, Berkley, CA, 94720-1650, USA
| | - Stephen P Hinshaw
- University of California, 2205 Tolman Hall, Berkley, CA, 94720-1650, USA
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28
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Verschueren M, Luyckx K, Kaufman EA, Vansteenkiste M, Moons P, Sleuwaegen E, Berens A, Schoevaerts K, Claes L. Identity Processes and Statuses in Patients with and without Eating Disorders. EUROPEAN EATING DISORDERS REVIEW 2016; 25:26-35. [PMID: 27790863 DOI: 10.1002/erv.2487] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2016] [Revised: 09/29/2016] [Accepted: 10/04/2016] [Indexed: 11/07/2022]
Abstract
Problems with identity formation are associated with a range of psychiatric disorders. Yet, the mechanisms underlying such problems and how they are refined into specific diagnostic presentations require further investigation. The present study investigated identity processes among 123 women with eating disorders (ED) and age-matched community controls via a newly developed identity model. Several clinical outcome variables were assessed. Patients with ED scored lower on committing to and identifying with identity-related choices and scored higher on maladaptive or ruminative exploration, identity diffusion and identity disorder. They also experienced less identity achievement as compared with controls. The identity disorder status was associated with the highest scores on anxiety, depression, borderline personality disorder symptoms, and non-suicidal self-injury and the lowest scores on need satisfaction. Results indicate that patients with ED experience more identity problems than community controls and those captured by an identity disorder status experience the most problematic psychosocial functioning. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
| | - Koen Luyckx
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Erin A Kaufman
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Maarten Vansteenkiste
- Department of Developmental, Social, and Personality Psychology, Ghent University, Ghent, Belgium
| | - Philip Moons
- Department of Public Health and Primary Care, Academic Center for Nursing and Midwifery, KU Leuven, Leuven, Belgium
- Institute of Health and Care Sciences, University of Gothenburg, Sweden
| | - Ellen Sleuwaegen
- Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Antwerp, Belgium
- Psychiatrisch Ziekenhuis Duffel, Antwerp, Belgium
| | - Ann Berens
- Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Antwerp, Belgium
- Psychiatrisch Ziekenhuis Duffel, Antwerp, Belgium
| | | | - Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Antwerp, Belgium
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Vieira AI, Ramalho S, Brandão I, Saraiva J, Gonçalves S. Adversity, emotion regulation, and non-suicidal self-injury in eating disorders. Eat Disord 2016; 24:440-52. [PMID: 27348732 DOI: 10.1080/10640266.2016.1198205] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The comorbidity between non-suicidal self-injury and eating disorder behaviors suggests that psychosocial factors may play a role in both types of behaviors. This study aimed to assess the presence of non-suicidal self-injury in 66 eating disorder patients and to analyze the associations among adversity, emotion regulation, non-suicidal self-injury, and disordered eating behavior. A total of 24 participants (36.4%) reported non-suicidal self-injury. Patients endorsing self-injury had a higher severity of disordered eating behavior. More difficulties in emotion regulation and a greater number of methods of non-suicidal self-injury were associated with a higher severity of eating pathology. Clinicians should consider these relationships in the assessment and treatment of eating disorders.
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Affiliation(s)
- Ana Isabel Vieira
- a Center for Research in Psychology (CIPsi), School of Psychology , University of Minho , Braga , Portugal
| | - Sofia Ramalho
- a Center for Research in Psychology (CIPsi), School of Psychology , University of Minho , Braga , Portugal
| | - Isabel Brandão
- b Faculty of Medicine, Hospital of S. João , University of Porto , Porto , Portugal
| | - Joana Saraiva
- c Child and Adolescent Psychiatry Department , Hospital Centre of Porto , Porto , Portugal
| | - Sónia Gonçalves
- a Center for Research in Psychology (CIPsi), School of Psychology , University of Minho , Braga , Portugal
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Prevalence and Correlates of Self-Harm in the German General Population. PLoS One 2016; 11:e0157928. [PMID: 27362348 PMCID: PMC4928828 DOI: 10.1371/journal.pone.0157928] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 06/07/2016] [Indexed: 11/23/2022] Open
Abstract
The study aimed at evaluating the psychometric properties of the German version of the Self- Harm Inventory (SHI) and examining the lifetime prevalence and correlates of self-harm in a representative German population sample (N = 2,507; age mean = 48.79, SD = 18.11; range 14 to 94 years; 55.5% women) using the SHI. All participants answered the German SHI, the short form of the Barratt Impulsiveness Scale (BIS-15), the ultra-brief Patient Health Questionnaire for Depression and Anxiety (PHQ-4), and provided sociodemographic information. The one-factorial structure of the SHI was replicated using a confirmatory factor analysis. Internal consistency coefficients were sufficient and in line with previous studies. Almost half of the sample (49%) acknowledged at least one self-harming behavior over the life-span, most frequently indirect forms of self-harm. The rate of participants who engaged in at least one SHI behavior was higher among men than women (51.6% vs. 46.9%, respectively, χ2= 5.38, p = 0.020). Higher SHI scores were related to younger age, male gender, living alone, more symptoms of anxiety and depression (PHQ-4), higher impulsivity scores (BIS-15), and suffering from obesity grade 2. Women engaged more often in discreet forms of self-harm than men, e.g., preventing wounds from healing, exercising an injury, starving, and abusing laxatives. In terms of other indirect self-harming behaviors, men admitted more often driving recklessly, being promiscuous and losing a job on purpose, while women reported more frequently engaging in emotionally abusive relationships. With respect to direct self-harm, women were more likely to endorse suicide attempts and cutting, while men admitted more often head-banging. The findings suggest that self-harm constitutes a common problem. Future longitudinal studies are required to examine the natural course, sociodemographic and psychopathological risk factors, as well as possible time-trends of self-harming behaviors in more depth.
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Pauwels E, Dierckx E, Schoevaerts K, Claes L. Early Maladaptive Schemas in Eating Disordered Patients With or Without Non-Suicidal Self-Injury. EUROPEAN EATING DISORDERS REVIEW 2016; 24:399-405. [PMID: 27349211 DOI: 10.1002/erv.2460] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2015] [Revised: 05/09/2016] [Accepted: 05/18/2016] [Indexed: 11/09/2022]
Abstract
This study investigates early maladaptive schemas (EMSs) in function of eating disorder (ED) subtypes (restrictive/bulimic) and the presence/absence of non-suicidal self-injury (NSSI). Female inpatients (N = 491) completed the Young Schema Questionnaire and the Self-Injury Questionnaire. The influence of ED subtype and the presence/absence of NSSI and their interaction on the EMS were investigated by means of a MANCOVA. The results showed main effects of ED subtype and the presence of NSSI on EMS. Patients with bulimia scored significantly higher on insufficient self-control and emotional deprivation, which are more related to cluster B compared with restrictive patients, whereas restrictive patients scored significantly higher on social undesirability, failure to achieve, subjugation and unrelenting standards compared with patients with bulimia that are more related to cluster C. Patients with ED with NSSI reported significantly higher EMS levels compared with patients without NSSI, suggesting that they could be of particular interest to benefit from schema therapy. Copyright © 2016 John Wiley & Sons, Ltd and Eating Disorders Association.
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Affiliation(s)
- Els Pauwels
- Department of Psychology, University of Leuven, Leuven, Belgium.,Psychiatric Hospital Alexianen Tienen, Tienen, Belgium.,Department of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | - Eva Dierckx
- Psychiatric Hospital Alexianen Tienen, Tienen, Belgium.,Department of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
| | | | - Laurence Claes
- Department of Psychology, University of Leuven, Leuven, Belgium.,Faculty of Medicine and Health Sciences, University of Antwerp, Campus Drie Eiken, Wilrijk, Belgium
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Nederkoorn C, Vancleef L, Wilkenhöner A, Claes L, Havermans RC. Self-inflicted pain out of boredom. Psychiatry Res 2016; 237:127-32. [PMID: 26847946 DOI: 10.1016/j.psychres.2016.01.063] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2015] [Revised: 12/07/2015] [Accepted: 01/27/2016] [Indexed: 11/26/2022]
Abstract
Previous research has shown that in response to a monotonous, boring lab situation, non-clinical participants voluntarily self-administer electric shocks. The shocks probably served to disrupt the tedious monotony: they were the only available external source of stimulation. Alternatively, the shocks might have functioned to regulate the negative emotional experience caused by the induction of boredom, consistent with theories on the function of non-suicidal self-injury (NSSI). According to this latter explanation, induction of other negative emotions would also increase the administration of shocks. To test this explanation, 69 participants watched a monotonous, sad or neutral film fragment, during which they could self-administer electric shocks. Participants in the boredom condition self-administered more shocks and with higher intensity, compared to both the neutral and sadness condition. Sadness had no effect on the self-administration of shocks. The effect of boredom was more pronounced in participants with a history of NSSI: they administered more shocks in the first 15min. The results indicate that the shocks function to disrupt monotony and not to regulate negative emotional experience in general. Moreover, boredom appears an important impetus for NSSI.
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Affiliation(s)
- Chantal Nederkoorn
- Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands.
| | - Linda Vancleef
- Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
| | - Alexandra Wilkenhöner
- Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
| | - Laurence Claes
- Department of Clinical Psychology, KU Leuven, Leuven, Belgium
| | - Remco C Havermans
- Department of Clinical Psychological Science, Maastricht University, Maastricht, The Netherlands
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Guendelman MD, Owens EB, Galán C, Gard A, Hinshaw SP. Early-adult correlates of maltreatment in girls with attention-deficit/hyperactivity disorder: Increased risk for internalizing symptoms and suicidality. Dev Psychopathol 2016; 28:1-14. [PMID: 25723055 PMCID: PMC4826281 DOI: 10.1017/s0954579414001485] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
We examined whether maltreatment experienced in childhood and/or adolescence prospectively predicts young adult functioning in a diverse and well-characterized sample of females with childhood-diagnosed attention-deficit/hyperactivity disorder (N = 140). Participants were part of a longitudinal study and carefully evaluated in childhood, adolescence, and young adulthood (M age = 9.6, 14.3, and 19.7 years, respectively), with high retention rates across time. A thorough review of multisource data reliably established maltreatment status for each participant (M κ = 0.78). Thirty-two (22.9%) participants experienced at least one maltreatment type (physical abuse, sexual abuse, or neglect). Criterion variables included a broad array of young adult measures of functioning gleaned from multiple-source, multiple-informant instruments. With stringent statistical control of demographic, prenatal, and family status characteristics as well as baseline levels of the criterion variable in question, maltreated participants were significantly more impaired than nonmaltreated participants with respect to self-harm (suicide attempts), internalizing symptomatology (anxiety and depression), eating disorder symptomatology, and well-being (lower overall self-worth). Effect sizes were medium. Comprising the first longitudinal evidence linking maltreatment with key young adult life impairments among a carefully diagnosed and followed sample of females with attention-deficit/hyperactivity disorder, these findings underscore the clinical importance of trauma experiences within this population.
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Brausch AM, Boone SD. Frequency of Nonsuicidal Self-Injury in Adolescents: Differences in Suicide Attempts, Substance Use, and Disordered Eating. Suicide Life Threat Behav 2015; 45:612-622. [PMID: 25682929 DOI: 10.1111/sltb.12155] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2014] [Accepted: 11/19/2014] [Indexed: 11/28/2022]
Abstract
The relationship between frequency of nonsuicidal selfinjury (NSSI) and suicide attempts, substance use, and disordered eating was assessed in a community sample of 4,839 adolescents, 922 of whom reported NSSI in the past year. It was expected that the engagement in risk behaviors would significantly increase as NSSI frequency increased. Participants completed the Youth Risk Behavior Survey (Centers for Disease Control and Prevention, 2009) and were subdivided into five NSSI frequency groups: none, 1 time, 2-3 times, 4-5 times, and 6 or more times. A one-way MANOVA found significant mean differences for all variables across NSSI frequency groups. The no NSSI group was significantly lower than all other groups on all variables. For suicide attempts, all frequency groups were significantly different from each other, with attempt frequency increasing with each increase in NSSI frequency. The six or more group reported significantly more substance use and disordered eating than all other groups. Overall, adolescents with more frequent NSSI represent a group at risk for concurrent unhealthy behaviors and suicide attempts.
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Affiliation(s)
- Amy M Brausch
- Psychological Sciences, Western Kentucky University, Bowling Green, KY, USA
| | - Shannon D Boone
- Psychology, Western Kentucky University, Bowling Green, KY, USA
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Islam MA, Steiger H, Jimenez-Murcia S, Israel M, Granero R, Agüera Z, Castro R, Sánchez I, Riesco N, Menchón JM, Fernández-Aranda F. Non-suicidal Self-injury in Different Eating Disorder Types: Relevance of Personality Traits and Gender. EUROPEAN EATING DISORDERS REVIEW 2015; 23:553-60. [DOI: 10.1002/erv.2374] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Revised: 05/12/2015] [Accepted: 05/13/2015] [Indexed: 11/06/2022]
Affiliation(s)
- Mohammed A. Islam
- Department of Psychiatry; University Hospital of Bellvitge-IDIBELL; Barcelona Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBEROBN); Instituto Salud Carlos III; Barcelona Spain
| | - Howard Steiger
- Douglas University Institute in Mental Health & Psychiatry Department; McGill University; Montreal Canada
| | - Susana Jimenez-Murcia
- Department of Psychiatry; University Hospital of Bellvitge-IDIBELL; Barcelona Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBEROBN); Instituto Salud Carlos III; Barcelona Spain
- Clinical Sciences Department, School of Medicine; University of Barcelona; Spain
| | - Mimi Israel
- Douglas University Institute in Mental Health & Psychiatry Department; McGill University; Montreal Canada
| | - Roser Granero
- Ciber Fisiopatologia Obesidad y Nutrición (CIBEROBN); Instituto Salud Carlos III; Barcelona Spain
- Departament de Psicobiologia i Metodologia; Universitat Autònoma de Barcelona; Spain
| | - Zaida Agüera
- Department of Psychiatry; University Hospital of Bellvitge-IDIBELL; Barcelona Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBEROBN); Instituto Salud Carlos III; Barcelona Spain
| | - Rita Castro
- Department of Psychiatry; University Hospital of Bellvitge-IDIBELL; Barcelona Spain
| | - Isabel Sánchez
- Department of Psychiatry; University Hospital of Bellvitge-IDIBELL; Barcelona Spain
| | - Nadine Riesco
- Department of Psychiatry; University Hospital of Bellvitge-IDIBELL; Barcelona Spain
| | - José M. Menchón
- Department of Psychiatry; University Hospital of Bellvitge-IDIBELL; Barcelona Spain
- Clinical Sciences Department, School of Medicine; University of Barcelona; Spain
- Ciber Salud Mental (CIBERSAM); Instituto Salud Carlos III; Barcelona Spain
| | - Fernando Fernández-Aranda
- Department of Psychiatry; University Hospital of Bellvitge-IDIBELL; Barcelona Spain
- Ciber Fisiopatologia Obesidad y Nutrición (CIBEROBN); Instituto Salud Carlos III; Barcelona Spain
- Clinical Sciences Department, School of Medicine; University of Barcelona; Spain
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Gordon CT, Hinshaw SP. Parenting Stress as a Mediator Between Childhood ADHD and Early Adult Female Outcomes. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY 2015; 46:588-599. [PMID: 26042524 DOI: 10.1080/15374416.2015.1041595] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
The purpose of this study is to examine the mediating role of parenting stress (both parental distress and stress due to dysfunctional interactions in the mother-daughter relationship [PSDI]) in the link between childhood attention-deficit/hyperactivity disorder (ADHD) status and several important young adult outcomes. The diverse sample comprised 140 girls with ADHD and 88 age- and ethnicity-matched comparisons, evaluated at ages 6-12 years and followed prospectively for five years (M age = 14.2) and 10 years (M age = 19.6). The PSDI experienced by a mother during her daughter's adolescence mediated the link between her daughter's childhood ADHD status and adult externalizing and internalizing symptoms. PSDI also mediated the link between ADHD status and young adult nonsuicidal self-injury and had an indirect effect in the relation between childhood ADHD and young adult depressive symptoms. The mediating role of PSDI with respect to internalizing symptoms and depressive symptoms remained in place even when covarying adolescent internalizing/depressive symptoms. Parenting stress, particularly related to maternal perceptions of dysfunctional interactions with adolescent daughters, serves as a key mediator in the association between childhood ADHD status and important domains of young adult functioning. Minimizing parenting stress and dysfunctional mother-daughter interactions during adolescence might reduce the risk of adverse adult outcomes for girls with ADHD.
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Olatunji BO, Cox R, Ebesutani C, Wall D. Self-harm history predicts resistance to inpatient treatment of body shape aversion in women with eating disorders: The role of negative affect. J Psychiatr Res 2015; 65:37-46. [PMID: 25868550 DOI: 10.1016/j.jpsychires.2015.03.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2015] [Revised: 03/17/2015] [Accepted: 03/19/2015] [Indexed: 11/24/2022]
Abstract
Although self-harm has been observed among patients with eating disorders, the effects of such tendencies on treatment outcomes are unclear. The current study employed structural equation modeling to (a) evaluate the relationship between self-harm and changes in body dissatisfaction and drive for thinness in a large sample of patients (n = 2061) who underwent inpatient treatment, and (b) to examine whether the relationship between self-harm and changes in body dissatisfaction and drive for thinness during inpatient treatment remains significant when controlling for change in negative affect during treatment. Results revealed that patients with a history of self-harm reported significantly less reduction in body dissatisfaction and drive for thinness following treatment. Patients experiencing less change in negative affect also reported significantly less reduction in body dissatisfaction and drive for thinness after discharge from treatment. However, the association between history of self-harm and reduction in body dissatisfaction and drive for thinness after treatment became non-significant when controlling for change in negative affect. This pattern of findings was also replicated among patients with a primary diagnosis of anorexia nervosa (n = 845), bulimia nervosa (n = 565), and eating disorder not otherwise specified (n = 651). The implications of these findings for delineating the specific role of self-harm in the nature and treatment of eating disorders are discussed.
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Affiliation(s)
| | | | | | - David Wall
- Remuda Ranch Programs for Eating Disorders, USA
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Claes L, Islam MA, Fagundo AB, Jimenez-Murcia S, Granero R, Agüera Z, Rossi E, Menchón JM, Fernández-Aranda F. The Relationship between Non-Suicidal Self-Injury and the UPPS-P Impulsivity Facets in Eating Disorders and Healthy Controls. PLoS One 2015; 10:e0126083. [PMID: 25993565 PMCID: PMC4439129 DOI: 10.1371/journal.pone.0126083] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 03/30/2015] [Indexed: 11/18/2022] Open
Abstract
In the present study, we investigated the association between Non-Suicidal Self-Injury (NSSI) and the UPPS-P impulsivity facets in eating disorder patients and healthy controls. The prevalence of NSSI in eating disorder (ED) patients ranged from 17% in restrictive anorexia nervosa (AN-R) patients to 43% in patients with bulimia nervosa (BN). In healthy controls (HC), the prevalence of NSSI was 19%. Eating disorder patients from the binge eating/purging type showed significantly more NSSI compared to restrictive ED and HC participants. Binge-eating/purging ED patients also scored significantly higher on Negative/Positive Urgency, Lack of Premeditation and Lack of Perseverance compared to HC and restrictive ED patients. Comparable findings were found between ED patients and HC with and without NSSI; ED patients and HC with NSSI scored significantly higher in four of the five UPPS-P dimensions compared to participants without NSSI; Sensation Seeking was the exception. Finally, the presence of NSSI in HC/ED patients was particularly predicted by low levels of Perseverance. Therefore, the treatment of ED patients with NSSI certainly needs to focus on the training of effortful control.
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Affiliation(s)
- Laurence Claes
- Faculty of Psychology and Educational Sciences, University of Leuven, Leuven, Belgium
| | - Mohammed A. Islam
- CIBER Fisiología de la Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
| | - Ana B. Fagundo
- CIBER Fisiología de la Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Susana Jimenez-Murcia
- CIBER Fisiología de la Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Roser Granero
- CIBER Fisiología de la Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
- Departament de Psicobiologia i Metodologia, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Zaida Agüera
- CIBER Fisiología de la Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - Elisa Rossi
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
| | - José M. Menchón
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
- CIBER Salud Mental (CIBERSAM), Instituto Salud Carlos III, Barcelona, Spain
| | - Fernando Fernández-Aranda
- CIBER Fisiología de la Obesidad y Nutrición (CIBERobn), Instituto Salud Carlos III, Barcelona, Spain
- Department of Psychiatry, University Hospital of Bellvitge-IDIBELL, Barcelona, Spain
- Department of Clinical Sciences, School of Medicine, University of Barcelona, Barcelona, Spain
- * E-mail:
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Venta A, Sharp C. Attachment organization in suicide prevention research: preliminary findings and future directions in a sample of inpatient adolescents. CRISIS 2015; 35:60-6. [PMID: 24197486 DOI: 10.1027/0227-5910/a000231] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Identifying risk factors for suicide-related thoughts and behaviors (SRTB) is essential among adolescents in whom SRTB remain a leading cause of death. Although many risk factors have already been identified, influential theories now suggest that the domain of interpersonal relationships may play a critical role in the emergence of SRTB. Because attachment has long been seen as the foundation of interpersonal functioning, we suggest that attachment insecurity warrants attention as a risk factor for SRTB. AIMS This study sought to explore relations between attachment organization and suicidal ideation, suicide attempts, and self-harm in an inpatient adolescent sample, controlling for demographic and psychopathological covariates. METHOD We recruited 194 adolescents from an inpatient unit and assigned them to one of four attachment groups (secure, preoccupied, dismissing, or disorganized attachment). Interview and self-report measures were used to create four variables reflecting the presence or absence of suicidal ideation in the last year, single lifetime suicide attempt, multiple lifetime suicide attempts, and lifetime self-harm. RESULTS Chi-square and regression analyses did not reveal significant relations between attachment organization and SRTB, although findings did confirm previously established relations between psychopathology and SRTB, such that internalizing disorder was associated with increased self-harm, suicide ideation, and suicide attempt and externalizing disorder was associated with increased self-harm. CONCLUSION The severity of this sample and methodological differences from previous studies may explain the nonsignificant findings. Nonsignificant findings may indicate that the relation between attachment organization and SRTB is moderated by other factors that should be explored in future research.
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Affiliation(s)
- Amanda Venta
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Carla Sharp
- Department of Psychology, University of Houston, Houston, TX, USA
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Klomek AB, Lev-Wiesel R, Shellac E, Hadas A, Berger U, Horwitz M, Fennig S. The relationship between self-injurious behavior and self-disclosure in adolescents with eating disorders. Eat Weight Disord 2015; 20:43-8. [PMID: 25112791 DOI: 10.1007/s40519-014-0145-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2014] [Accepted: 07/21/2014] [Indexed: 11/26/2022] Open
Abstract
PURPOSE The aim of the current study is to examine the association between self disclosure and self-injurious behaviors among adolescent patients diagnosed with an eating disorder. METHODS Sixty three female patients who fulfilled the DSM-IV diagnostic criteria of eating disorders were included (i.e. anorexia, bulimia, binge eating disorder and eating disorders not otherwise specified). Participants' age ranged from 11.5 to 20 years (M = 15.42, SD = 1.82). Participants completed self- report questionnaires about eating disorders, self-disclosure, self-injurious behaviors (FASM) and depression (BDI-II) RESULTS: 82.5% of the sample endorsed severe self-injurious behaviors. A moderate negative relationship was found between general disclosure to parents and self-injurious behaviors indicating that patients who generally self-disclose to their parents (on different topics, apart from suicidal ideation) engage less frequently in self-injurious behaviors. In addition, the more patients self-disclose their suicidal ideation to others, the more they tend to self-injure. CONCLUSION Self-disclosure to parents on any topic may buffer against self-injurious behaviors and therefore it is important to work with adolescents suffering from eating disorders on effective self disclosure. In addition, self-disclosure about suicidal ideation to others by adolescents suffering from eating disorders should always be taken seriously, since it may be related to self-injurious behaviors.
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Affiliation(s)
- Anat Brunstein Klomek
- Psychological Medicine, Schneider Children's Medical Center of Israel, Petach Tikva, Israel,
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Claes L, Luyckx K, Bijttebier P, Turner B, Ghandi A, Smets J, Norre J, Van Assche L, Verheyen E, Goris Y, Hoksbergen I, Schoevaerts K. Non-Suicidal Self-Injury in Patients with Eating Disorder: Associations with Identity Formation Above and Beyond Anxiety and Depression. EUROPEAN EATING DISORDERS REVIEW 2014; 23:119-25. [DOI: 10.1002/erv.2341] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2014] [Revised: 11/22/2014] [Accepted: 11/25/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Laurence Claes
- Faculty of Psychology and Educational Sciences; KU Leuven; Leuven Belgium
| | - Koen Luyckx
- Faculty of Psychology and Educational Sciences; KU Leuven; Leuven Belgium
| | | | - Brianna Turner
- Department of Psychiatry and Behavioral Sciences; University of Washington Medical Center; Seattle WA USA
| | - Amarendra Ghandi
- Faculty of Psychology and Educational Sciences; KU Leuven; Leuven Belgium
- TATA Institute for Social Sciences; Mumbai India
| | - Jos Smets
- Kliniek Broeders Alexianen Tienen; Tienen Belgium
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42
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Prevalence and Correlates of Eating Disorder Symptoms in a Community Sample with Non-Suicidal Self-Injury. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2014. [DOI: 10.1007/s10862-014-9470-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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43
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A Longitudinal Moderated Mediation Model of Nonsuicidal Self-injury among Adolescents. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2014; 43:381-90. [DOI: 10.1007/s10802-014-9901-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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44
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Allely CS. The association of ADHD symptoms to self-harm behaviours: a systematic PRISMA review. BMC Psychiatry 2014; 14:133. [PMID: 24884622 PMCID: PMC4020381 DOI: 10.1186/1471-244x-14-133] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2013] [Accepted: 04/03/2014] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Self-harm is a major public health issue in young people worldwide and there are many challenges to its management and prevention. Numerous studies have indicated that ADHD is associated with completed suicides and other suicidal behaviours (i.e., suicidal attempt and ideation). However, significantly less is known about the association between ADHD and self-harm. METHOD This is the first review of the association between ADHD and self-harm. A systematic PRISMA review was conducted. Two internet-based bibliographic databases (Medline and CINAHL) were searched to access studies which examined to any degree the association between, specifically, ADHD and self-harm. RESULTS Only 15 studies were identified which investigated the association between ADHD and self-harm and found evidence to support that ADHD is a potential risk factor for self-harm. CONCLUSION This association raises the need for more awareness of self-harm in individuals with symptoms of ADHD.
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Affiliation(s)
- Clare S Allely
- Institute of Health and Wellbeing, University of Glasgow, RHSC Yorkhill, Glasgow 8SJ G3, Scotland.
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45
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Swanson EN, Owens EB, Hinshaw SP. Pathways to self-harmful behaviors in young women with and without ADHD: a longitudinal examination of mediating factors. J Child Psychol Psychiatry 2014; 55:505-15. [PMID: 25436256 PMCID: PMC4251707 DOI: 10.1111/jcpp.12193] [Citation(s) in RCA: 63] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
BACKGROUND Rates of suicide attempts and nonsuicidal self-injury [(NSSI); e.g., cutting, burning] peak in adolescence and early adulthood; females and individuals with psychiatric symptoms and diagnoses appear to beat particular risk. Hinshaw et al. [Journal of Consulting and Clinical Psychology, (2012), 80, 1041] reported that young women with histories of childhood ADHD diagnoses reported higher rates of suicide attempts and NSSI than nondiagnosed, comparison women. METHODS Via analyses of an ongoing longitudinal investigation, our aims are to examine, with respect to both aspects of self-harmful behavior, (a) ADHD subtype differences and effects of diagnostic persistence (vs. transient and nondiagnosed classifications) and (b) potential mediating effects of impulsivity and comorbid psychopathology, ascertained during adolescence. RESULTS Young adult women with a childhood diagnosis of ADHD-Combined type were at highest risk for suicide attempts as well as the most varied and severe forms of NSSI compared with those with ADHD-Inattentive type and those in the comparison group; participants with a persistent ADHD diagnosis were at higher risk than those with a transient diagnosis or those never meeting criteria for ADHD. Mediator analyses revealed that, during adolescence, an objective measure of impulsivity plus comorbid externalizing symptoms were simultaneous, partial mediators of the childhood ADHD-young adult NSSI linkage.Adolescent internalizing symptoms emerged as a partial mediator of the childhood ADHD-young adult suicide attempt linkage. CONCLUSIONs: ADHD in females, especially when featuring childhood impulsivity and especially with persistent symptomatology, carries high risk for self-harm. Psychiatric comorbidity and response inhibition are important mediators of this clinically important longitudinal association. We discuss limitations and implications for prevention and intervention.
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46
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Non-suicidal self-injury (functions) in eating disorders: Associations with reactive and regulative temperament. PERSONALITY AND INDIVIDUAL DIFFERENCES 2014. [DOI: 10.1016/j.paid.2013.09.022] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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47
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Kanakam N, Treasure J. A review of cognitive neuropsychiatry in the taxonomy of eating disorders: state, trait, or genetic? Cogn Neuropsychiatry 2013; 18:83-114. [PMID: 22994309 DOI: 10.1080/13546805.2012.682362] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
A greater understanding of neuropsychological traits in eating disorders may help to construct a more biologically based taxonomy. The aim of this paper is to review the current evidence base of neuropsychological traits in people with eating disorders. Evidence of difficulties in set shifting, weak central coherence, emotional processing difficulties, and altered reward sensitivity is presented for people both in the acute and recovered phase of the illness. These traits are also seen in first degree relatives. At present there is limited research linking these neuropsychological traits with genetic and neuroanatomical measures. In addition to improving the taxonomy of eating disorders, neuropsychological traits may be of value in producing targeted treatments.
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Affiliation(s)
- Natalie Kanakam
- Section of Eating Disorders, Psychological Medicine, Institute of Psychiatry, King's College London, London, UK.
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48
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The Relationship between the UPPS-P Impulsivity Dimensions and Nonsuicidal Self-Injury Characteristics in Male and Female High-School Students. PSYCHIATRY JOURNAL 2013; 2013:654847. [PMID: 24236284 PMCID: PMC3820090 DOI: 10.1155/2013/654847] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/16/2012] [Accepted: 01/09/2013] [Indexed: 11/17/2022]
Abstract
The present study investigated the association between nonsuicidal self-injury characteristics, functions, and the UPPS-P impulsivity-related traits in high-school students using self-report questionnaires. More than 17% of the 613 students engaged in at least one type of NSSI behavior. Compared to male students, female students engaged more often in cutting and less in head banging. All NSSI behaviors were significantly related to Negative and Positive Urgency, that is, the tendency to act impulsive in the presence of negative/positive affect. Interactions between different UPPS-P impulsivity dimensions did not increase the percentage of explained variance in the different NSSI behaviors. Furthermore, severe cutting was negatively related to Lack of Premeditation. Different NSSI functions showed differential relationships with the five UPPS-P impulsivity dimensions.
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49
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Iannaccone M, Cella S, Manzi SA, Visconti L, Manzi F, Cotrufo P. My body and me: self-injurious behaviors and body modifications in eating disorders--preliminary results. Eat Disord 2013; 21:130-9. [PMID: 23421696 DOI: 10.1080/10640266.2013.761087] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
We investigated self-injurious behaviors and body modification practices in eating disorder patients, considering different ED diagnoses and illness severities. Of the total sample, 50.9% showed at least one form of self-injury and 50.9% reported at least one tattoo, piercing, or both. Patients reporting only body modifications showed more positive feelings toward their bodies, higher levels of self-esteem, less impulsivity, depression, and anxiety, and lower levels of social dysfunction than those reporting only self-injury or both self-injury and body modifications. Self-injury was influenced by both diagnosis and severity of disorders.
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Affiliation(s)
- Mara Iannaccone
- Observatory on Eating Disorders, Department of Psychology, Second University of Naples, Caserta, Italy.
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50
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Vansteelandt K, Claes L, Muehlenkamp J, De Cuyper K, Lemmens J, Probst M, Vanderlinden J, Pieters G. Variability in Affective Activation Predicts Non-suicidal Self-injury in Eating Disorders. EUROPEAN EATING DISORDERS REVIEW 2012; 21:143-7. [DOI: 10.1002/erv.2220] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | | | - Jennifer Muehlenkamp
- Department of Psychology; University of Wisconsin-Eau Claire; Eau Claire; WI 54702-4004; USA
| | | | - Jos Lemmens
- University Psychiatric Center KU Leuven-Campus Kortenberg; Belgium
| | | | | | - Guido Pieters
- University Psychiatric Center KU Leuven-Campus Kortenberg; Belgium
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