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Wang Z, Chen Y, Tao Z, Yang M, Li D, Jiang L, Zhang W. Quantifying the Importance of Non-Suicidal Self-Injury Characteristics in Predicting Different Clinical Outcomes: Using Random Forest Model. J Youth Adolesc 2024; 53:1615-1629. [PMID: 38300442 DOI: 10.1007/s10964-023-01926-z] [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: 09/05/2023] [Accepted: 12/03/2023] [Indexed: 02/02/2024]
Abstract
Existing research on non-suicidal self-injury (NSSI) among adolescents has primarily concentrated on general risk factors, leaving a significant gap in understanding the specific NSSI characteristics that predict diverse psychopathological outcomes. This study aims to address this gap by using Random Forests to discern the significant predictors of different clinical outcomes. The study tracked 348 adolescents (64.7% girls; mean age = 13.31, SD = 0.91) over 6 months. Initially, 46 characteristics of NSSI were evaluated for their potential to predict the repetition of NSSI, as well as depression, anxiety, and suicidal risks at a follow-up (T2). The findings revealed distinct predictors for each psychopathology. Specifically, psychological pain was identified as a significant predictor for depression, anxiety, and suicidal risks, while the perceived effectiveness of NSSI was crucial in forecasting its repetition. These findings imply that it is feasible to identify high-risk individuals by assessing key NSSI characteristics, and also highlight the importance of considering diverse NSSI characteristics when working with self-injurers.
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Affiliation(s)
- Zhenhai Wang
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
| | - Yanrong Chen
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
| | - Zhiyuan Tao
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
| | - Maomei Yang
- Tangxia No.2 Junior High School, Dongguan, Guangdong, China
| | - Dongjie Li
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
| | - Liyun Jiang
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
| | - Wei Zhang
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China.
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2
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Kuburi S, Ewing L, Hamza CA, Goldstein AL. A Daily Diary Study of the Relation between Stress and Nonsuicidal Self-Injury and the Moderating Role of Emotion Dysregulation in Emerging Adulthood. J Youth Adolesc 2024; 53:1605-1614. [PMID: 38282067 DOI: 10.1007/s10964-024-01946-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 01/12/2024] [Indexed: 01/30/2024]
Abstract
Research on exposure to stressors and nonsuicidal self-injury (NSSI) in daily life has been lacking, particularly among emerging adults (aged 18-25 years). The aim of this study was to determine whether daily stressors predicted same-day and next-day NSSI thoughts and engagement, and whether emotion dysregulation moderated this relation. Participants included 160 emerging adults (83% female, Mage = 19.75, SD = 1.8, 44% White, 22% East Asian, 11% South Asian, and 23% other) who completed a baseline assessment and 14 days of daily diary entries which resulted in 1982 daily assessments (median compliance = 86%; IQR = 12-14). It was found that daily stressors significantly predicted same-day, but not next-day, NSSI thoughts and engagement and this relation was more pronounced for individuals with greater emotion dysregulation. The present study provides new insight into when individuals may be most at risk for NSSI, as well as which individuals may be most vulnerable.
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Affiliation(s)
- Sarah Kuburi
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, ON, Canada.
| | - Lexi Ewing
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, ON, Canada
| | - Chloe A Hamza
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, ON, Canada
| | - Abby L Goldstein
- Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, ON, Canada
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3
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Nagy LM, Muehlenkamp JJ. Negative self-perceptions and severity of NSSI: Testing the benefits and barriers model. J Clin Psychol 2024; 80:1365-1376. [PMID: 38401145 DOI: 10.1002/jclp.23667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 01/18/2024] [Accepted: 02/10/2024] [Indexed: 02/26/2024]
Abstract
Nonsuicidal self-injury (NSSI) is theorized to be caused by negative associations with the self, including low self-esteem, but the mechanisms explaining why low self-esteem is related to more severe NSSI are unclear. The current study aimed to address this limitation by evaluating a mediation model, proposing that low self-esteem would relate to more severe NSSI through increasing self-punishment motivations. Data came from 468 undergraduate students with a history of NSSI who completed an online survey measuring NSSI characteristics and functions, self-esteem, and self-punishment motivations for NSSI. Mediation was tested using a structural equation model using bootstrapped 95% percentile-corrected confidence intervals in which NSSI severity was modeled as a latent variable composed of NSSI frequency, recency, and versatility of methods. The total model was significant and the indirect effect of self-esteem on NSSI severity through self-punishment motives was significant. Self-esteem also retained significant direct effects on NSSI severity, indicating partial mediation. These results provide support for the benefits and barriers model of NSSI, suggesting that negative self-views increase risk for more severe NSSI through self-punishment motivations. Clinical interventions that emphasize self-compassion and focus on modifying self-punishment motivations may help reduce NSSI behavior.
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Affiliation(s)
- Laura M Nagy
- Department of Psychology, High Point University, High Point, North Carolina, USA
| | - Jennifer J Muehlenkamp
- Department of Psychology, University of Wisconsin-Eau Claire, Eau Claire, Wisconsin, USA
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Boyne H, Hamza CA. Pain tolerance as a 'barrier' to nonsuicidal self-injury: A longitudinal study. Psychiatry Res 2024; 336:115925. [PMID: 38678744 DOI: 10.1016/j.psychres.2024.115925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 03/26/2024] [Accepted: 04/22/2024] [Indexed: 05/01/2024]
Abstract
Theoretical perspectives underscore that low pain tolerance may be a relevant 'barrier' to non-suicidal self-injury (NSSI). However, there is limited longitudinal work on the link between pain tolerance and NSSI, which is needed to assess if pain tolerance precedes NSSI engagement, and/or if NSSI precedes altered pain tolerance. Further, assessing both NSSI frequency and versatility (or number of NSSI methods), in addition to engagement, can provide a more nuanced understanding of the influence of pain on NSSI severity. In the present study, 1125 undergraduate students at a large university (72 % female, Mage = 17.96) reported on their NSSI frequency, NSSI versatility, and perceived pain tolerance. Four individual regressions were run to examine the potential bidirectional nature of the association between NSSI frequency and pain tolerance, and NSSI versatility and pain tolerance. Pain tolerance predicted both NSSI frequency and versatility over time. Neither NSSI frequency nor versatility predicted pain tolerance. Results suggest that high pain tolerance may be a risk factor for severe NSSI engagement.
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Affiliation(s)
- Holly Boyne
- Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, 252 Bloor St W, Toronto, ON, M5S 1V6, Canada.
| | - Chloe A Hamza
- Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, 252 Bloor St W, Toronto, ON, M5S 1V6, Canada
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Shahnovsky O, Pirogovsky L, Toukhy N, Akhavan S, Grisaru Hergas D, Apter A, Haruvi-Catalan L, Benaroya-Milshtein N, Fennig S, Barzilay S. Psychosocial Correlates of Suicidal Ideation and Behavior in Adolescents and Preadolescent Children Discharged from an Emergency Department in Israel. Arch Suicide Res 2024:1-17. [PMID: 38813975 DOI: 10.1080/13811118.2024.2358090] [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: 05/31/2024]
Abstract
OBJECTIVES Adolescent suicidal behavior is highly prevalent in pediatric psychiatric emergency departments, and there is a growing occurrence of such behavior among preadolescent children. This study aims to examine the psychosocial factors associated with nonfatal suicidal behaviors in children (<12 years old) and adolescents (aged 12-18), to gain insight into unique and shared characteristics of suicidal behavior across these two age groups. METHOD This study investigates the psychosocial characteristics associated with suicidal ideation and behaviors in an emergency department sample of 183 children and adolescents aged 7-18 years in Israel. Participants completed a diagnostic interview, and self-report and parent-report questionnaires of psychosocial measures. Cross-sectional correlational and regression analyses were used to determine significant correlates of suicidal outcomes within the two age groups. RESULTS Among adolescents, females exhibited a higher prevalence of suicidal thoughts and behaviors, while in children, both boys and girls showed similar rates. Depression correlated with suicidal ideation for both adolescents and children. In children, anxiety and conduct symptoms were associated with suicidal behavior, whereas in adolescents, suicidal behavior was associated with depression and anxiety. CONCLUSIONS The present findings contribute to the growing understanding of factors associated with suicidal thoughts and behaviors among children in comparison to adolescents. These findings underscore the importance of targeting specific risk factors when developing assessment and intervention strategies tailored to the two age groups.
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Kiekens G, Hasking P, Nock MK, Kleiman E, Kirtley OJ, Houben M, Boyes M, Bruffaerts R, Myin-Germeys I, Claes L. A Comparison of Affective-Cognitive States in Daily Life Between Emerging Adults With and Without Past-Year Nonsuicidal Self-Injury. Behav Ther 2024; 55:469-484. [PMID: 38670662 DOI: 10.1016/j.beth.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 07/25/2023] [Accepted: 08/15/2023] [Indexed: 04/28/2024]
Abstract
Although the literature suggests trait-like differences in affective and cognitive vulnerabilities between individuals with and without a history of nonsuicidal self-injury (NSSI), little is known about how these dispositional differences are experienced in the natural environment. The present study compares the intensity, inertia, interaction, and variability of affective (negative and positive affect) and cognitive states (rumination, self-criticism) in the everyday lives of individuals who do and do not engage in NSSI. Using experience sampling methodology (ESM), 60 emerging adults (ages = 18-22 years) with and without past-year NSSI (equally distributed) completed eight questionnaires per day for 12 days (in total, 96 questionnaires per participant), resulting in 4,587 assessments (median compliance = 83.3%; IQR = 71.9-91.7). In a dynamic structural equation modeling framework, dynamic parameters (i.e., mean intensity, carryover effects, spillover effects, and within-person variability) were evaluated using multilevel vector autoregressive models. Emerging adults who engage in NSSI experience higher intensity and greater variability of negative affect, rumination, and self-criticism, whereas those who do not engage in NSSI experience higher intensity and lower variability of positive affect. In addition, past-year NSSI predicted stronger affective-cognitive interactions over time, with stronger spillover effects of negative and positive affect on subsequent rumination and self-criticism in individuals who engage in NSSI. Depressive symptoms and trait levels of emotion dysregulation and self-criticism partially negated these differences. Our findings provide evidence that emerging adults who self-injure experience more negative affective-cognitive states in daily life and point to the potential relevance of boosting positive emotions to buffer negative cognitions.
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Guo J, Wang C, You J. Patterns and Transitions of Nonsuicidal Self-Injury Outcome Expectancies and Their Associations with Nonsuicidal Self-Injury among Adolescents. J Youth Adolesc 2024; 53:895-909. [PMID: 37938484 DOI: 10.1007/s10964-023-01900-9] [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: 08/05/2023] [Accepted: 10/24/2023] [Indexed: 11/09/2023]
Abstract
Nonsuicidal self-injury (NSSI) outcome expectancies (i.e., the expectations that certain outcomes will follow NSSI) have been confirmed to predict NSSI engagement. However, it remains unclear whether adolescents hold different patterns of NSSI outcome expectancies and therefore vary in their risks of NSSI engagement. Moreover, little is known about whether patterns transition over time, influencing the development of NSSI. Additionally, possible gender differences in the patterns and their transitions need to be explored. This study aims to address these research gaps. A total of 679 adolescents (55.8% females; Mage = 15.19, SDage = 1.40) completed questionnaires and were surveyed semiannually for three times. Using latent profile analysis, regular latent transition analysis, and random intercept latent transition analysis, this study identified four patterns of NSSI outcome expectancies: High Affect Regulation and Moderate Negative Expectancies, Low Negative Expectancies, High Negative Expectancies, and High Communication and Negative Expectancies. The first two patterns showed high risks of NSSI, whereas the latter two patterns showed low risks of NSSI. Low Negative Expectancies was an unstable pattern. It had higher probabilities of transitioning to another high-risk pattern than transitioning to the low-risk patterns. The other three patterns had high stability. Gender had no significant effects on the four patterns or their transitions. The findings highlight the combined effects of NSSI outcome expectancies and underscore that NSSI outcome expectancies may change over time. Prevention and interventions targeting multiple factors corresponding to these expectancies should be developed.
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Affiliation(s)
- Jiaqi Guo
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, & School of Psychology, South China Normal University, Guangzhou, 510631, P. R. China
| | - Chuhan Wang
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, & School of Psychology, South China Normal University, Guangzhou, 510631, P. R. China
| | - Jianing You
- Center for Studies of Psychological Application, Guangdong Key Laboratory of Mental Health and Cognitive Science, Key Laboratory of Brain, Cognition and Education Sciences (South China Normal University), Ministry of Education, & School of Psychology, South China Normal University, Guangzhou, 510631, P. R. China.
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8
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Wang H, Xu S, Wang S, Wang Y, Chen R. Using decision tree to predict non-suicidal self-injury among young adults: the role of depression, childhood maltreatment and recent bullying victimization. Eur J Psychotraumatol 2024; 15:2322390. [PMID: 38445506 PMCID: PMC10919298 DOI: 10.1080/20008066.2024.2322390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/13/2024] [Indexed: 03/07/2024] Open
Abstract
Importance: Non-suicidal self-injury (NSSI) is a significant mental health issue requiring a deeper understanding of its underlying causes, such as childhood maltreatment, adult bullying victimization, and depression. Previous studies have not adequately addressed the cumulative risks of these factors on NSSI among college students. This population-based study investigates these cumulative risk factors.Design, setting, and participants: The cross-sectional study included 63 university's college students with a mean age of 19.6 years (N = 95,833).Main outcomes and measures: Two Chi-Square Automatic Interaction Detection (CHAID) decision tree models were used to classify subgroups based on childhood maltreatment and adult bullying victimization experiences and to investigate their cumulative risks of NSSI. Recursive partitioning algorithms determined each predictor variable's relative importance.Results: The CHAID model accurately predicted NSSI behaviours with an overall accuracy rate of 77.8% for individuals with clinically relevant depressive symptoms and 97.2% for those without. Among depressed individuals, childhood emotional abuse was the strongest NSSI predictor (Chi-Square, 650.747; adjusted P < .001), followed by sexual and physical abuse. For non-depressed individuals, emotional abuse in childhood was the strongest NSSI predictor (Chi-Square, 2084.171; adjusted P < .001), with sexual and verbal bullying in the past year representing the most significant proximal risks.Conclusions and relevance: Emotional abuse during childhood profoundly impacts individuals, increasing the risk of NSSI in both depressed and non-depressed individuals. Clinically relevant depressive symptoms have a moderating effect on the relationship between childhood maltreatment, adult bullying victimization, and NSSI. Identifying these factors can inform targeted interventions to prevent NSSI development among young adults.
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Affiliation(s)
- Huagen Wang
- Vanke School of Public Health, Tsinghua University, Beijing, People’s Republic of China
- Institute for Healthy China, Tsinghua University, Beijing, People’s Republic of China
| | - Shicun Xu
- Northeast Asian Research Center, Jilin University, Changchun, People’s Republic of China
- Department of Population, Resources and Environment, Northeast Asian Studies College, Jilin University, Changchun, People’s Republic of China
| | - Shihui Wang
- Vanke School of Public Health, Tsinghua University, Beijing, People’s Republic of China
- Institute for Healthy China, Tsinghua University, Beijing, People’s Republic of China
| | - Yuanyuan Wang
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, People's Republic of China
- School of Psychology, Center for Studies of Psychological Application, and Guangdong Key Laboratory of Mental Health and Cognitive Science, South China Normal University, Guangzhou, People’s Republic of China
| | - Runsen Chen
- Vanke School of Public Health, Tsinghua University, Beijing, People’s Republic of China
- Institute for Healthy China, Tsinghua University, Beijing, People’s Republic of China
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9
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Millon EM, Alqueza KL, Kamath RA, Marsh R, Pagliaccio D, Blumberg HP, Stewart JG, Auerbach RP. Non-suicidal Self-injurious Thoughts and Behaviors Among Adolescent Inpatients. Child Psychiatry Hum Dev 2024; 55:48-59. [PMID: 35727385 PMCID: PMC9782727 DOI: 10.1007/s10578-022-01380-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/19/2022] [Indexed: 01/07/2023]
Abstract
Non-suicidal self-injury (NSSI) is a serious public health concern that typically onsets during early adolescence. Adolescents (N = 980, ages 12-19 years) admitted for acute, residential psychiatric treatment completed baseline clinical interviews assessing mental disorders and questionnaires measuring demographics, early life adversity, and symptom severity. Prevalence rates of NSSI for lifetime (thoughts: 78%; behaviors: 72%), past year (thoughts: 74%; behaviors: 65%), and past month (thoughts: 68%; behaviors: 51%) were high. Although effect sizes were modest, the presence of a lifetime depressive disorder, sexual abuse, and comorbidity (i.e., three or more current disorders) were significant correlates of experiencing NSSI thoughts and behaviors. Furthermore, lifetime depressive disorder, current anxiety disorder, and comorbidity were associated with a greater odds of persistent NSSI thoughts and/or behaviors. Longitudinal studies are needed to determine whether targeting these factors reduces the persistence of NSSI thoughts and behaviors.
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Affiliation(s)
- Emma M Millon
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA
| | - Kira L Alqueza
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA
| | - Rahil A Kamath
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA
| | - Rachel Marsh
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA
| | - David Pagliaccio
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA
| | - Hilary P Blumberg
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Jeremy G Stewart
- Department of Psychology and Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Randy P Auerbach
- Department of Psychiatry, Columbia University, New York, NY, USA.
- New York State Psychiatric Institute, 1051 Riverside Drive, Pardes 2407, New York, NY, 10032, USA.
- Division of Clinical Developmental Neuroscience, Sackler Institute, New York, NY, USA.
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10
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Qin Q, Yang G, Li Y, Wu W, Wang J, Chen Z, Kong X, Zhang W, Zou H. The relationship between major life events and non-suicidal self-injury among college students: the effect of rumination and body image. Front Public Health 2024; 11:1308186. [PMID: 38298255 PMCID: PMC10828039 DOI: 10.3389/fpubh.2023.1308186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 12/18/2023] [Indexed: 02/02/2024] Open
Abstract
Background Non-suicidal self-injury (NSSI) poses a growing risk to public health worldwide. While numerous studies have identified major life events as key risk factors for NSSI, the mechanisms by which emotional and cognitive problems mediate or moderate this relationship remain unclear. To enhance the understanding of this field, we will draw upon the cascade theory of self-injury and the benefits and barriers model, to examine the relationship between major life events and NSSI, as well as the effect of rumination and body image. Methods A sample of 2,717 college students (Mage = 19.81 years; SD = 1.09) participated in this study and anonymously completed the questionnaires. The moderated mediation model were conducted using Model 4 and Model 15 of the Process macro program in SPSS. Results The results showed that rumination mediated the positive relationship between major life events and NSSI. Furthermore, body image was found to moderate both the relationship between major life events and NSSI, as well as the relationship between rumination and NSSI. Conclusion The current findings suggest that rumination is an important mediator in the relationship between major life events and NSSI among college students. Teachers, parents, and researchers should recognize the important role of body image self-perceptions of college students and actively promote a healthy and accurate body image.
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Affiliation(s)
- Qian Qin
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
- School of Psychology, Shenzhen University, Shenzhen, China
| | - Guangni Yang
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
- Department of Psychology, Lingnan University, Hong Kong, China
| | - Yue Li
- College of Teacher Education, South China Normal University, Guangzhou, China
| | - Wanchun Wu
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
| | - Jianping Wang
- College of Teacher Education, South China Normal University, Guangzhou, China
- Journal of South China Normal University, South China Normal University, Guangzhou, China
| | - Ziyao Chen
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
| | - Xiaohua Kong
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
| | - Wei Zhang
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
| | - Hongyu Zou
- Center for Studies of Psychological Application, School of Psychology, South China Normal University, Guangzhou, China
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11
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Evseev VD, Bokhan NA, Mandel AI, Kadochnikova SV. [Prevalence and risk factors of non-suicidal self-injury behavior]. Zh Nevrol Psikhiatr Im S S Korsakova 2024; 124:13-19. [PMID: 38465806 DOI: 10.17116/jnevro202412402113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2024]
Abstract
The prevalence of non-suicidal self-injury (NSSI) behavior in adolescents has increased significantly in the early 21st century. The phenomenon of NSSI behavior has become one of the key health problems in the field of adolescent psychiatry and psychology over the past decade worldwide. However, the social characteristics and factors influencing NSSI are very different in different regions of the world. Studies of self-harming behavior indicate that the upward trend is almost equally relevant for developing and developed countries. To date, the methodological basis for the diagnosis of NSSI has not been sufficiently developed in the Russian Federation, there are only some studies of NSSI both from an empirical perspective and in the context of the search for risk factors, causes and functions, models of comorbidity with mental disorders.
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Affiliation(s)
- V D Evseev
- Mental Health Research Institute - Tomsk National Research Medical Center Russian Academy of Sciences, Tomsk, Russia
| | - N A Bokhan
- Mental Health Research Institute - Tomsk National Research Medical Center Russian Academy of Sciences, Tomsk, Russia
- Siberian State Medical University, Tomsk, Russia
| | - A I Mandel
- Mental Health Research Institute - Tomsk National Research Medical Center Russian Academy of Sciences, Tomsk, Russia
| | - S V Kadochnikova
- Siberian State Medical University, Tomsk, Russia
- Tomsk Clinical Psychiatric Hospital, Tomsk, Russia
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12
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Mann AJD, Tull MT, Gratz KL. Examining the Presence, Frequency, and Associated Characteristics of Nonsuicidal Self-Injury by Proxy: Initial Validation of the Nonsuicidal Self-Injury by Proxy Questionnaire (NSSIBPQ). Behav Modif 2024; 48:3-50. [PMID: 37599465 DOI: 10.1177/01454455231191710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
Nonsuicidal self-injury (NSSI) by proxy is the intentional destruction of one's own body tissue through the elicitation of another being's actions. Despite its clinical relevance, research on NSSI by proxy is limited and there are no available measures of this behavior. This research aimed to characterize NSSI by proxy among young adults and provide preliminary data on the validity of a new self-report measure, the NSSI by Proxy Questionnaire (NSSIBPQ). Two nationwide community samples of young adults (one general community sample and one with a history of traditional NSSI and suicidality) completed online studies. NSSI by proxy was reported by 18% of the general community sample and 45% of the self-injuring sample. Findings support the clinical relevance of NSSI by proxy and its potential to meet criteria for an NSSI disorder diagnosis. Results also provide preliminary support for the internal consistency and convergent, discriminant, and concurrent validity of the NSSIBPQ.
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13
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Klonoff-Cohen HS, Cohen A, Gobin RL, Polavarapu M, Allen R, Reddy S, Vuyyuru C. Suicide Ideation and Self-Harm Behaviors in First-Year Dormitory Students at a Public Midwestern University: A Pilot Study. CHRONIC STRESS (THOUSAND OAKS, CALIF.) 2024; 8:24705470241259939. [PMID: 38846597 PMCID: PMC11155327 DOI: 10.1177/24705470241259939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 05/22/2024] [Indexed: 06/09/2024]
Abstract
Purpose: Currently, 1 in 5 college students struggle with suicidal ideation while 7% to 44% engage in nonsuicidal self-injury. Illinois has one of the highest teenage and college student suicide rates in the United States. This pilot study assessed suicide ideation and self-harm behaviors at a public Illinois university. This is the first study to use 5 standardized psychological instruments to investigate these 2 crises in freshmen college students who are all required to reside in dormitories. The main hypothesis was to determine if the independent effects of freshmen students' depression, Five-Factor Model, and Reasons for Living affected the dependent variables, self-harm behaviors and suicide ideation. Methods: Forty first-year college dormitory students completed the Beck Depression Inventory-II, Scale of Suicidal Ideation, Five-Factor Model, Inventory of Statements About Self-Injury, and Reasons for Living Scale in person. Results: Participants were 18 to 19 years old, predominantly female (65%), and non-White (62%). Forty percent reported self-harm behaviors and 19% reported suicidal ideation. The top reasons for contemplated suicide attempts included the inability to solve problems (33%) and attention/revenge (28%). Students experienced high levels of anxiety (55%), self-consciousness (43%), and depression (18%). Depression was associated with suicide ideation (β = 0.05, P = .006), while neuroticism and openness were associated with self-harm behaviors (aOR = 3.36, P = .02, aOR = 0.48, P = .047, respectively). Ninety-five percent reported "responsibility to family" as a Reason for Living. Conclusions: Preliminary evidence necessitates an examination of self-harm and suicide ideation among all freshmen, investigating both risk and protective factors. In the future, a prevention intervention should be implemented campus-wide (and eventually nationwide) for all first-year dormitory students to enhance their mental well-being.
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Affiliation(s)
| | - Auroraleigh Cohen
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Robyn L. Gobin
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | | | - Ryan Allen
- Midwestern University Chicago College of Osteopathic Medicine, Downers Grove, IL, USA
| | - Swetha Reddy
- Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Champaign, IL, USA
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Dierickx S, Claes L, Buelens T, Smits D, Kiekens G. DSM-5 non-suicidal self-injury disorder in a community sample: comparing NSSI engagement, recency and severity among emerging adults. Front Psychiatry 2023; 14:1251514. [PMID: 38144473 PMCID: PMC10748385 DOI: 10.3389/fpsyt.2023.1251514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 11/20/2023] [Indexed: 12/26/2023] Open
Abstract
Up to one in five emerging adults engage in non-suicidal self-injury (NSSI). Providing a better understanding of factors that differentiate between who engages in lifetime NSSI and who is more likely to engage in recent and clinically severe NSSI can provide meaningful information for prevention and intervention of NSSI. The present study (n = 669) considered NSSI lifetime engagement (no prior history of NSSI vs. lifetime NSSI), recency [past NSSI (>12 months ago) vs. recent (≤12-month) NSSI], and clinical severity among those with recent NSSI (subthreshold vs. DSM-5 NSSI disorder). The prevalence of NSSI disorder was 8.4% in emerging adults aged 18 to 26 years old. Higher anxiety levels were related to NSSI engagement, but only depressive symptoms and NSSI versatility were consistently associated with more recent NSSI and NSSI disorder. A stepped-care approach may be required in addressing NSSI among emerging adults.
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Affiliation(s)
- Serafine Dierickx
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Expertise Unit Resilient People, University Colleges Leuven-Limburg, Leuven, Belgium
| | - Laurence Claes
- Expertise Unit Resilient People, University Colleges Leuven-Limburg, Leuven, Belgium
- Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Antwerp, Belgium
| | - Tinne Buelens
- Department of Clinical Psychology, University of Amsterdam, Amsterdam, Netherlands
| | - Dirk Smits
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Research Department, Odisee University of Applied Sciences, Brussel, Belgium
| | - Glenn Kiekens
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Department of Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
- Department of Medical and Clinical Psychology, Tilburg University, Tilburg, Netherlands
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Meisler S, Sleman S, Orgler M, Tossman I, Hamdan S. Examining the relationship between non-suicidal self-injury and mental health among female Arab minority students: the role of identity conflict and acculturation stress. Front Psychiatry 2023; 14:1247175. [PMID: 38025473 PMCID: PMC10669148 DOI: 10.3389/fpsyt.2023.1247175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 10/23/2023] [Indexed: 12/01/2023] Open
Abstract
Background and objective Research suggests that individuals from minority backgrounds, including immigrants and ethnic minorities, may be at a higher risk for non-suicidal self-injury (NSSI). The aim of the present research is to examine the relationship between non-suicidal self-injury (NSSI) and identity conflict and acculturation stress, depression, and risk behaviors among female Arab minority students. Methods The sample analyzed consisted of 1,529 female Arab students (85.8% B.A. students, 14% M.A. students) aged 21-54 (M = 23, SD = 4.17). The participants completed self-reported questionnaires assessing NSSI engagement, identity conflict and acculturation stress, depression, and risky substance use behavior. Results As expected, we found a significant positive association between NSSI and identity crisis. In addition, an identity conflict and acculturation stress impact the effect of depression and risky substance use behaviors in engaging in self-injury. Namely, participants were more likely to engage in NSSI when they also experienced identity conflict and acculturation stress and exhibited depressive symptoms and tended to display risky substance use behavior. Conclusion These findings provide evidence that the relationship between depression, risky substance use behavior, and NSSI may be stronger among individuals who experience higher levels of identity conflict and acculturation stress. Implications for intervention and future research are briefly presented.
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Affiliation(s)
| | | | | | | | - Sami Hamdan
- The School of Behavioral Sciences, The Academic College of Tel Aviv-Yafo, Tel Aviv-Yafo, Israel
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16
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Claréus B, Daukantaité D. Off track or on? Associations of positive and negative life events with the continuation versus cessation of repetitive adolescent nonsuicidal self-injury. J Clin Psychol 2023; 79:2459-2477. [PMID: 37178314 DOI: 10.1002/jclp.23533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Revised: 02/13/2023] [Accepted: 05/03/2023] [Indexed: 05/15/2023]
Abstract
OBJECTIVE This study examined how patterns of repetitive (≥5 instances) nonsuicidal self-injury (NSSI) associate with measures of resilience and life events retrospectively reported to have occurred within the last year, 1 to <5 years ago, and 5 to <10 years ago. METHOD Life events reported by 557 young adults (mean [SD] age 25.3 [0.68]; 59.2% women) were classified as positive, negative, or profoundly negative based on their relationship to participants' mental health and well-being. We subsequently examined how these categories, together with resilience, were cross-sectionally associated with reporting no NSSI, and the (full/partial) cessation/continuation of repetitive NSSI from adolescence to young adulthood. RESULTS Repetitive NSSI in adolescence was associated with (profoundly) negative life events. Relative to cessation, NSSI continuation was significantly associated with more kinds of negative life events (odds ratio [OR] = 1.79) and fewer kinds of positive life events 1 to <5 years ago (OR = 0.65) and tended to be associated with lower resilience (b = -0.63, p = 0.056). Neither life events nor resilience significantly differentiated individuals reporting full or partial cessation. CONCLUSION Resilience appears important for the cessation of repetitive NSSI, but contextual factors must still be considered. Assessing positive life events in future studies holds promise.
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Li X, Liu S, Tian Y, He J, Chen H, Ning M, Chen Z, Yang J, Li Y, Zhou J. Challenges for psychiatric nurses working with non-suicidal self-injury adolescents: a qualitative study. BMC Nurs 2023; 22:382. [PMID: 37833692 PMCID: PMC10571286 DOI: 10.1186/s12912-023-01542-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Psychiatric nurses play a crucial role in treating and supporting adolescents with non-suicidal self-injury (NSSI) in China. However, few studies have explored their experiences and challenges. OBJECTIVES The aim of this qualitative study was to describe the challenges experienced by psychiatric nurses when working with adolescents having NSSI behaviors. METHODS This was a descriptive qualitative study using phenomenological approach. 18 psychiatric nurses from psychiatric wards were recruited from a tertiary hospital from Changsha, Hunan province, China. In-depth interview was performed for each participant collecting information about their feelings and experiences taking care of NSSI adolescents. ATLAS.ti 8 was used to enter data and perform thematic analysis following the six-phased process described by Braun and Clarke. RESULTS Two main themes and five sub-themes were summarized in this study. Nurses experienced both (1) Internal challenges (Lacking knowledge and skills to deal with NSSI adolescents and Feeling hard and stressful working with NSSI adolescents) and (2) External barriers (Unrealistic high expectations from family and schools, Uncooperative parents and Little help from communities and schools). CONCLUSIONS Psychiatric nurses had to face with their own negative feelings, insufficient knowledge and skills, alongside with pressures and little help from family, schools and communities when working with NSSI adolescents. Targeted training programs of treating NSSI adolescents and their supporting systems be performed in nurses, furthermore, family, schools and societies should also be raised.
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Affiliation(s)
- Xuting Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, China
- Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Shiyan Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yusheng Tian
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Juan He
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Hui Chen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Meng Ning
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Zengyu Chen
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Jiaxin Yang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yamin Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Jiansong Zhou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, China.
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Kiekens G, Claes L, Hasking P, Mortier P, Bootsma E, Boyes M, Myin-Germeys I, Demyttenaere K, Cuijpers P, Kessler RC, Nock MK, Bruffaerts R. A longitudinal investigation of non-suicidal self-injury persistence patterns, risk factors, and clinical outcomes during the college period. Psychol Med 2023; 53:6011-6026. [PMID: 36325723 DOI: 10.1017/s0033291722003178] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Although non-suicidal self-injury (NSSI) is known typically to begin in adolescence, longitudinal information is lacking about patterns, predictors, and clinical outcomes of NSSI persistence among emerging adults. The present study was designed to (1) estimate NSSI persistence during the college period, (2) identify risk factors and high-risk students for NSSI persistence patterns, and (3) evaluate the association with future mental disorders and suicidal thoughts and behaviors (STB). METHODS Using prospective cohorts from the Leuven College Surveys (n = 5915), part of the World Mental Health International College Student Initiative, web-based surveys assessed mental health and psychosocial problems at college entrance and three annual follow-up assessments. RESULTS Approximately one in five (20.4%) students reported lifetime NSSI at college entrance. NSSI persistence was estimated at 56.4%, with 15.6% reporting a high-frequency repetitive pattern (≥five times yearly). Many hypothesized risk factors were associated with repetitive NSSI persistence, with the most potent effects observed for pre-college NSSI characteristics. Multivariate models suggest that an intervention focusing on the 10-20% at the highest predicted risk could effectively reach 34.9-56.7% of students with high-frequency repetitive NSSI persistence (PPV = 81.8-93.4, AUC = 0.88-0.91). Repetitive NSSI persistence during the first two college years predicted 12-month mental disorders, role impairment, and STB during the third college year, including suicide attempts. CONCLUSIONS Most emerging adults with a history of NSSI report persistent self-injury during their college years. Web-based screening may be a promising approach for detecting students at risk for a highly persistent NSSI pattern characterized by subsequent adverse outcomes.
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Affiliation(s)
- Glenn Kiekens
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Center for Contextual Psychiatry, KU Leuven, Leuven, 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
| | - Penelope Hasking
- Curtin enAble Institute & School of Population Health, Curtin University, Perth, Australia
| | - Philippe Mortier
- Health Services Research Unit, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
- CIBER en Epidemiología y Salud Pública, Madrid, Spain
| | - Erik Bootsma
- Laboratory of Molecular Bacteriology, Department of Microbiology and Immunology, Rega Institute, KU Leuven, Leuven, Belgium
- The KU Leuven - VIB Center for Microbiology, Leuven, Belgium
| | - Mark Boyes
- Curtin enAble Institute & School of Population Health, Curtin University, Perth, Australia
| | | | | | - Pim Cuijpers
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Ronald C Kessler
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
| | - Matthew K Nock
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Ronny Bruffaerts
- Center for Public Health Psychiatry, KU Leuven, Leuven, Belgium
- Institute for Social Research, Population Studies Center, University of Michigan, Ann Arbor, MI, USA
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Barclay N, Kelley KA, Brausch AM, Muehlenkamp JJ, Nadorff MR. Changes in the suicide risk behaviors of American college students over time: An analysis of three universities. Suicide Life Threat Behav 2023; 53:764-775. [PMID: 37515442 DOI: 10.1111/sltb.12981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 06/06/2023] [Accepted: 07/10/2023] [Indexed: 07/30/2023]
Abstract
INTRODUCTION Suicide-related behaviors are prevalent among college students, and several mental health problems associated with increased suicide risk have increased over time. Furthermore, notable cultural events (e.g., political changes, COVID-19) have occurred in the past decade, which likely impact trends in suicide-related behaviors. The current study examined how the prevalence of nonsuicidal self-injury (NSSI), suicidal ideation (SI), and suicide attempts has changed from 2012 to 2022 across three different universities. METHOD Archival datasets from multiple years of college student survey data were compiled, and different measures of NSSI, SI, and suicide attempts were dichotomized to assess prevalence. Chi-square goodness-of-fit tests were used to identify changes in suicide-related behaviors across time. RESULTS Results indicated significant increases in the prevalence of most behaviors across each university, with most increases occurring after 2018. Despite sharing a general trend of increased suicide-related behaviors, each university differed considerably in their respective trends between various timepoints, suggesting that unique factors may differentially contribute to growing risk among college students. CONCLUSION Overall, the current study identifies increasing trends in suicide-related behaviors over the past decade and highlights the value of investigating these behaviors at the university level.
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Affiliation(s)
- Nathan Barclay
- Department of Psychology, Mississippi State University, Starkville, Mississippi, USA
| | - Karen A Kelley
- Department of Psychology, Mississippi State University, Starkville, Mississippi, USA
| | - Amy M Brausch
- Department of Psychological Sciences, Western Kentucky University, Bowling Green, Kentucky, USA
| | - Jennifer J Muehlenkamp
- Department of Psychology, University of Wisconsin-Eau Claire, Eau Claire, Wisconsin, USA
| | - Michael R Nadorff
- Department of Psychology, Mississippi State University, Starkville, Mississippi, USA
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Robinson K, Dayer KF, Mirichlis S, Hasking PA, Wilson MS. Who are we missing? Self-selection bias in nonsuicidal self-injury research. Suicide Life Threat Behav 2023; 53:843-852. [PMID: 37555729 DOI: 10.1111/sltb.12987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 07/24/2023] [Accepted: 07/24/2023] [Indexed: 08/10/2023]
Abstract
BACKGROUND Despite the threat of self-selection bias to the generalizability of research findings, remarkably little is known about who chooses to take part in non-suicidal self-injury (NSSI) research specifically. We aimed to establish the extent of willingness to take part in NSSI research within a commonly sampled population before assessing whether individual differences in demographic characteristics, NSSI lived experience, and participation experiences were associated with willingness to take part in future NSSI research. METHODS New Zealand university students (n = 3098) completed self-report measures of their NSSI, psychological distress, emotional dysregulation, experience of their participation in the current study, and willingness to participate in future NSSI research. RESULTS Most participants (78.2%) indicated that they were willing to take part in future NSSI research. Men, older participants, people with NSSI lived experience, and those with more frequent past-year NSSI were more likely to be willing to take part in future NSSI research. Participants who reported a more positive subjective experience of the current study also indicated greater willingness. CONCLUSIONS Findings demonstrate systematic differences in who is willing to take part in NSSI research. Future research should implement methodological and statistical approaches to mitigate the impact of self-selection bias on NSSI research.
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Affiliation(s)
- Kealagh Robinson
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Koosje F Dayer
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Sylvanna Mirichlis
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Penelope A Hasking
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, Australia
- enAble Institute, Faculty of Health Sciences, Curtin University, Perth, Australia
| | - Marc S Wilson
- School of Psychology, Victoria University of Wellington, Wellington, New Zealand
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Al-Dajani N, Czyz EK, Eisenberg D, Zheng K, King CA. A latent profile analysis of at-risk first-year undergraduate students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-8. [PMID: 37722880 PMCID: PMC10947455 DOI: 10.1080/07448481.2023.2252909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Accepted: 08/20/2023] [Indexed: 09/20/2023]
Abstract
Objective: We examined whether meaningful subgroups of self-injurious behaviors (SIBs) would emerge within a pool of first-year college students already deemed at elevated risk. Participants: First-year undergraduates (N = 1,068) recruited in 2015-2018 Fall terms. Methods: Past-year nonsuicidal self-injury (NSSI) frequency, past-year number of NSSI methods used, lifetime suicide attempt (SA) history, and recency of SA were included in a latent profile analysis. Results: Four subgroups emerged: low SIB (n = 558, 52%), high NSSI only (n = 182, 17%), high SIB (n = 141, 13%), and high SA only (n = 187, 18%). Students in the high SIB group reported higher levels of suicidal ideation at baseline and follow-up in comparison to all groups. Those in the high NSSI only or high SIB groups had relatively higher levels of NSSI at baseline and follow-up. Conclusions: Findings highlight the amount of heterogeneity within a high-risk group, along with the importance of considering distal and proximal SIBs in university screening efforts.
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Affiliation(s)
| | - Ewa K. Czyz
- Department of Psychiatry, University of Michigan
| | - Daniel Eisenberg
- Department of Health Management and Policy, School of Public Health, University of Michigan
| | - Kai Zheng
- Department of Informatics, Donald Bren School of Information and Computer Sciences, University of California, Irvine
| | - Cheryl A. King
- Department of Psychiatry, University of Michigan
- Depression Center, University of Michigan
- Injury Prevention Center, University of Michigan
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22
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Li L, Yang H. Heterogeneity in Adolescents' Non-Suicidal Self-Injury Behaviour Trajectories Based on the Group-Based Trajectory Model and a Decision Tree Analysis of Family-Related Determinants. Psychol Res Behav Manag 2023; 16:3359-3371. [PMID: 37654969 PMCID: PMC10465360 DOI: 10.2147/prbm.s427090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 08/19/2023] [Indexed: 09/02/2023] Open
Abstract
Background Non-suicidal self-injury (NSSI) is a global public health problem. While some studies have noted the importance of behavioural development patterns in NSSI, most NSSI research is based on cross-sectional survey data. Few studies explore the time-series heterogeneity of trajectories of NSSI symptoms and family-related influencing factors of NSSI. Aim The purpose of the study was to identify the heterogeneity in trajectories of adolescents' NSSI behaviour and their family-related influencing factors. Methods The group-based trajectory model (GBTM) was used to identify the heterogeneity in the NSSI behaviour trajectories of 208 adolescents in China. Next, the decision tree model (DTM) was used to analyse which family related factors influence the trajectory type. Results The GBTM revealed two heterogeneous trajectories of NSSI behaviour: the high-risk and low-risk NSSI behaviour groups. Next, DTM's average accuracy was 83.2%. A total of seven independent variables were used for the DTM: gender, number of NSSIs in the past month, and family economic, family structure, family conflict, parental psychological control, parental behavior control and family intimacy risks. Family conflict risk was located at the root node and was the most important factor. Conclusion Heterogeneity within the population should be considered in the management of adolescents' NSSI behaviours. Further, from the perspective of family system theory and cumulative risk, focusing on the adverse effect of multiple risk factors on adolescents' NSSI addiction is more meaningful rather than the impact of single risk factors. Studies that use time series data should focus on the trend of dynamic changes in NSSI addiction characteristics over time.
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Affiliation(s)
- Linbo Li
- College of Nursing, Shanxi Medical University, Taiyuan, Shanxi, People’s Republic of China
| | - Hui Yang
- College of Nursing, Shanxi Medical University, Taiyuan, Shanxi, People’s Republic of China
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23
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Muehlenkamp JJ, Brausch AM, Littlefield A. Concurrent changes in nonsuicidal self-injury and suicide thoughts and behaviors. Psychol Med 2023; 53:4898-4903. [PMID: 35768888 PMCID: PMC9800642 DOI: 10.1017/s0033291722001763] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Nonsuicidal self-injury (NSSI) is a risk factor for suicide, yet how changes in NSSI engagement relate to suicide ideation, planning, and attempts remains largely unknown. The current study aims to fill this gap by examining how changes in NSSI frequency over time related to concurrent changes in suicide thoughts and behaviors. METHODS Data came from a sample of 403 self-injuring young adults who completed assessments of NSSI and suicide thoughts and behaviors at baseline, 6, and 12 months. Bivariate latent growth modeling, adjusting for covariates of lifetime NSSI frequency and treatment status, was used to examine the extent to which changes in NSSI frequency related to suicide ideation and suicide planning. RESULTS The frequency of NSSI declined across the study period. The slopes of NSSI and suicide ideation were significantly correlated, suggesting individuals with sharper declines in NSSI across time also showed sharper declines in suicide ideation. The intercepts between NSSI and suicide planning were significantly correlated, suggesting those with high NSSI frequency at baseline tended to report higher suicide planning across time. After covariate adjustment, the intercept of suicide planning marginally (p = 0.08) correlated with the slope of NSSI, tentatively suggesting that those who had less reductions in NSSI tended to have higher frequencies of suicide planning. CONCLUSION These results provide new evidence that changes in NSSI are related to subsequent changes in suicide thoughts and behaviors. Monitoring suicide risk among those with NSSI is important and treatment aiming to reduce NSSI may also reduce suicide risk.
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Affiliation(s)
- Jennifer J Muehlenkamp
- Department of Psychology, University of Wisconsin-Eau Claire, 105 Garfield Ave, Eau Claire, WI 54701, USA
| | - Amy M Brausch
- Department of Psychological Sciences, Western Kentucky University, 1906 College Heights Blvd, Bowling Green, KY 42101, USA
| | - Andrew Littlefield
- Department of Psychological Sciences, Texas Tech University, Box 42051, Lubbock, TX 79409-2051, USA
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Mirichlis S, Boyes M, Hasking P, Lewis SP. What is important to the decision to disclose nonsuicidal self-injury in formal and social contexts? J Clin Psychol 2023; 79:1816-1825. [PMID: 36872900 PMCID: PMC10952367 DOI: 10.1002/jclp.23503] [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: 05/25/2022] [Revised: 01/11/2023] [Accepted: 02/24/2023] [Indexed: 03/07/2023]
Abstract
OBJECTIVE Disclosure of nonsuicidal self-injury (NSSI) is associated with a range of both positive (e.g., help-seeking) and negative (e.g., discrimination) outcomes. The aim of this study was to assess the importance of a range of factors concerned with: NSSI experiences, self-efficacy to disclose self-injury, interpersonal factors, and reasons for or expectations of disclosure, to the decision to disclose self-injury to friends, family members, significant others, and health professionals. METHODS Three hundred seventy-one participants with lived experience of NSSI completed a survey in which they rated the importance of the aforementioned factors to the decision of whether to disclose NSSI to different people. A mixed-model analysis of variance was conducted to investigate whether the factors differed in importance and if this importance differed across relationship types. RESULTS All factors held importance, though to differing degrees, with those related to relationship quality being most important overall. Generally, factors relating to tangible aid were considered more important when considering disclosure to health professionals than to other people. Conversely, interpersonal factors, particularly trust, were more important when disclosing to individuals in social or personal relationships. CONCLUSION The findings provide preliminary insight into how different considerations may be prioritized when navigating NSSI disclosure, in a way that may be tailored to different contexts. For clinicians, the findings highlight that clients may expect tangible forms of support and nonjudgment in the event that they disclose their self-injury in this formal setting.
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Affiliation(s)
- Sylvanna Mirichlis
- Discipline of Psychology, School of Population HealthCurtin UniversityPerthAustralia
| | - Mark Boyes
- Curtin enAble Institute, Faculty of Health SciencesCurtin UniversityPerthAustralia
| | - Penelope Hasking
- Curtin enAble Institute, Faculty of Health SciencesCurtin UniversityPerthAustralia
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Kiekens G, Claes L, Schoefs S, Kemme NDF, Luyckx K, Kleiman EM, Nock MK, Myin-Germeys I. The Detection of Acute Risk of Self-injury Project: Protocol for an Ecological Momentary Assessment Study Among Individuals Seeking Treatment. JMIR Res Protoc 2023; 12:e46244. [PMID: 37318839 DOI: 10.2196/46244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 04/24/2023] [Indexed: 06/17/2023] Open
Abstract
BACKGROUND Nonsuicidal self-injury (NSSI) is a major mental health concern. Despite increased research efforts on establishing the prevalence and correlates of the presence and severity of NSSI, we still lack basic knowledge of the course, predictors, and relationship of NSSI with other self-damaging behaviors in daily life. Such information will be helpful for better informing mental health professionals and allocating treatment resources. The DAILY (Detection of Acute rIsk of seLf-injurY) project will address these gaps among individuals seeking treatment. OBJECTIVE This protocol paper presents the DAILY project's aims, design, and materials used. The primary objectives are to advance understanding of (1) the short-term course and contexts of elevated risk for NSSI thoughts, urges, and behavior; (2) the transition from NSSI thoughts and urges to NSSI behavior; and (3) the association of NSSI with disordered eating, substance use, and suicidal thoughts and behaviors. A secondary aim is to evaluate the perspectives of individuals seeking treatment and mental health professionals regarding the feasibility, scope, and utility of digital self-monitoring and interventions that target NSSI in daily life. METHODS The DAILY project is funded by the Research Foundation Flanders (Belgium). Data collection involves 3 phases: a baseline assessment (phase 1), 28 days of ecological momentary assessment (EMA) followed by a clinical session and feedback survey (phase 2), and 2 follow-up surveys and an optional interview (phase 3). The EMA protocol consists of regular EMA surveys (6 times per day), additional burst EMA surveys spaced at a higher frequency when experiencing intense NSSI urges (3 surveys within 30 minutes), and event registrations of NSSI behavior. The primary outcomes are NSSI thoughts, NSSI urges, self-efficacy to resist NSSI, and NSSI behavior, with disordered eating (restrictive eating, binge eating, and purging), substance use (binge drinking and smoking cannabis), and suicidal thoughts and behaviors surveyed as secondary outcomes. The assessed predictors include emotions, cognitions, contextual information, and social appraisals. RESULTS We will recruit approximately 120 individuals seeking treatment aged 15 to 39 years from mental health services across the Flanders region of Belgium. Recruitment began in June 2021 and data collection is anticipated to conclude in August 2023. CONCLUSIONS The findings of the DAILY project will provide a detailed characterization of the short-term course and patterns of risk for NSSI and advance understanding of how, why, and when NSSI and other self-damaging behaviors unfold among individuals seeking treatment. This will inform clinical practice and provide the scientific building blocks for novel intervention approaches outside of the therapy room that support people who self-injure in real time. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/46244.
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Affiliation(s)
- Glenn Kiekens
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Laurence Claes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Steffie Schoefs
- Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Nian D F Kemme
- Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Koen Luyckx
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
- University of the Free State, Bloemfontein, South Africa
| | - Evan M Kleiman
- Rutgers, The State University of New Jersey, New Jersey, NJ, United States
| | - Matthew K Nock
- Department of Psychology, Harvard University, Cambridge, MA, United States
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Ma Y, Li Y, Xie X, Zhang Y, Ammerman BA, Lewis SP, Chen R, Yu Y, Li F, Tang J. The role of depressive symptoms and social support in the association of internet addiction with non-suicidal self-injury among adolescents: a cohort study in China. BMC Psychiatry 2023; 23:322. [PMID: 37161436 PMCID: PMC10169141 DOI: 10.1186/s12888-023-04754-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 04/05/2023] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Both internet addiction (IA) and non-suicidal self-injury (NSSI) are major public health concerns among adolescents, however, the association between IA and NSSI was not well understood. We aimed to investigate the association between IA and NSSI within a cohort study, and explore the mediated effect of depressive symptoms and the moderating effect of social support in the association. METHODS A total of 1530 adolescents aged 11-14 years who completed both the baseline (T1) and 14-month follow-up (T2) survey of the Chinese Adolescent Health Growth Cohort were included for the current analysis. IA, NSSI, depressive symptoms and social support were measured at T1; depressive symptoms and NSSI were measured again at T2. Structural equation models were employed to estimate the mediated effect of depressive symptoms and the moderating effect of social support in the association between IA and NSSI at T2. RESULTS IA was independently associated with an increased risk of NSSI at T2, with the total effect of 0.113 (95%CI 0.055-0.174). Depressive symptoms mediated the association between IA and NSSI at T2, and social support moderated the indirect but not the direct effect of IA on NSSI at T2. Sex differences were found on the mediated effect of depressive symptoms and the moderated mediation effect of social support. CONCLUSIONS Interventions that target adolescents' NSSI who also struggle with IA may need to focus on reducing depressive symptoms and elevating social support.
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Affiliation(s)
- Ying Ma
- Department of Child Healthcare, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, P.R. China
| | - Yanqi Li
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Room 507, Block 2, Jinxiu Road, Xinzao, Panyu District, Guangzhou, 511436, P.R. China
| | - Xinyi Xie
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Room 507, Block 2, Jinxiu Road, Xinzao, Panyu District, Guangzhou, 511436, P.R. China
| | - Yi Zhang
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Room 507, Block 2, Jinxiu Road, Xinzao, Panyu District, Guangzhou, 511436, P.R. China
| | - Brooke A Ammerman
- Department of Psychology, University of Notre Dame, Notre Dame, IN, USA
| | - Stephen P Lewis
- Department of Psychology, University of Guelph, Guelph, ON, Canada
| | - Ruoling Chen
- Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton, UK
| | - Yizhen Yu
- Department of Maternal and Child Healthcare, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, P.R. China
| | - Fenghua Li
- Zhongshan Health Care Center for Primary and Secondary Schools, Zhongshan City, P.R. China
| | - Jie Tang
- Department of Preventive Medicine, School of Public Health, Guangzhou Medical University, Room 507, Block 2, Jinxiu Road, Xinzao, Panyu District, Guangzhou, 511436, P.R. China.
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Bantjes J, Hunt X, Stein DJ. Anxious, Depressed, and Suicidal: Crisis Narratives in University Student Mental Health and the Need for a Balanced Approach to Student Wellness. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4859. [PMID: 36981766 PMCID: PMC10049682 DOI: 10.3390/ijerph20064859] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 03/06/2023] [Accepted: 03/08/2023] [Indexed: 06/18/2023]
Abstract
There is growing global awareness of the poor mental health of university students, as well as the need to improve students' access to services and expand the range of available evidence-based interventions. However, a crisis narrative is emerging, particularly in the wake of the COVID-19 pandemic, that runs the risk of positioning all students as potential patients in need of formal psychiatric interventions. Our aim in this commentary is to critically present the evidence that supports increased attention to student mental health, while also raising a concern that the crisis narrative may itself have unintended harmful consequences. We highlight some of the potential dangers of overtly medicalizing and thus pathologizing students' experiences of everyday distress, inadequacies of formal diagnostic categories, limitations of focusing narrowly on psychotherapeutic and psychiatric interventions, and the short-sightedness of downplaying key social determinants of students' distress. We argue for an integrative and balanced public health approach that draws on the rigor of psychiatric epidemiology and the advances that have been made to identify evidence-based interventions for students, while simultaneously being mindful of the shortcomings and potential dangers of working narrowly within the paradigm of diagnostic labels and psychotherapeutic interventions.
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Affiliation(s)
- Jason Bantjes
- Alcohol, Tobacco and Other Drug Research Unit, South African Medical Research Council, Cape Town 7505, South Africa
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Stellenbosch 7602, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town 7700, South Africa
| | - Xanthe Hunt
- Institute for Life Course Health Research, Department of Global Health, Stellenbosch University, Stellenbosch 7602, South Africa
| | - Dan J. Stein
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town 7700, South Africa
- SAMRC Unit on Risk and Resilience in Mental Disorders, Stellenbosch University, Stellenbosch 7602, South Africa
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Bond N, McLafferty M, Lapsley C, Ennis E, Murray E, Heenan D, O’Neill S. Familial and Bullying Victimisation: The Impact of Early Adversity Within the Home and Peer Settings on Late Adolescence and Adult Psychopathology. JOURNAL OF CHILD & ADOLESCENT TRAUMA 2023; 16:43-53. [PMID: 36776629 PMCID: PMC9908779 DOI: 10.1007/s40653-022-00481-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/15/2022] [Indexed: 06/18/2023]
Abstract
BACKGROUND Awareness of adverse childhood experiences and their impact on adult psychopathology primarily focuses on adversities within the home. There is limited insight into the impact of adversities across peer environments. OBJECTIVE This study investigates 19 items related to adverse experiences across the home, school and peer environments and their relationship to 12-month and lifetime psychopathology. DATA Secondary analysis of the Ulster University Student Well-being Study. The dataset included completed responses across all selected variables for 729 participants. METHOD AND RESULTS Latent profile analysis identified a low adversity profile, bullying adversity profile and higher prevalence adversity profile. Regression analysis of the three profiles and demographics variables indicated their impact on adult psychopathology lifetime and 12-month prevalence rates. CONCLUSION Schools and HE institutions should acknowledge the impact of childhood adversities. In doing so, it is important to consider the deeper impact of bullying due to its links with psychopathology across the lifespan. Educational institutions should take appropriate steps to mitigate continued exposure as students' progress through the education system.
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Affiliation(s)
- N.I. Bond
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - M. McLafferty
- Centre for Personalised Medicine, Ulster University, Derry/Londonderry, Northern Ireland
| | - C. Lapsley
- Centre for Personalised Medicine, Ulster University, Derry/Londonderry, Northern Ireland
| | - E. Ennis
- School of Psychology, Ulster University, Coleraine, Northern Ireland
| | - E. Murray
- Centre for Personalised Medicine, Ulster University, Derry/Londonderry, Northern Ireland
| | - D. Heenan
- School of Applied Social and Policy Sciences, Ulster University, Jordanstown, Northern Ireland
| | - S.M. O’Neill
- School of Psychology, Ulster University, Coleraine, Northern Ireland
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Bond KS, Lyons JN, Cottrill FA, Sabo AV, Baillie SE, Rossetto A, Kelly L, Kelly CM, Reavley NJ, Jorm AF, Morgan AJ. Evaluation of the Conversations about Non-Suicidal Self-Injury Mental Health First Aid Course: Effects on Knowledge, Stigmatising Attitudes, Confidence and Helping Behaviour. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3749. [PMID: 36834439 PMCID: PMC9963380 DOI: 10.3390/ijerph20043749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/12/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) is a common mental health problem, with a 19% lifetime prevalence in Australian adolescents and 12% in adults. Though rates of professional help-seeking for NSSI are low, disclosure to family and friends is more common, providing opportunities for them to encourage professional support. Mental Health First Aid® Australia's Conversations about Non-Suicidal Self-Injury course provides evidence-based training for the general public to support a person engaging in NSSI. METHODS This uncontrolled trial evaluated the effects of the Conversations about Non-Suicidal Self-Injury course on participants' knowledge, confidence, stigmatising attitudes, and intended and actual helping behaviours. Surveys were administered pre- and post-course, and at a six-month follow-up. A linear mixed-model analysis determined mean change over time, and effect sizes were estimated using Cohen's d. Course satisfaction was assessed using descriptive statistics and summative content analysis of qualitative data. RESULTS The pre-course survey was completed by 147 Australian participants (77.5% female, mean age 45.8 years), 137 (93.2%) at post-course and 72 (49%) at follow-up. Knowledge, confidence, quality of intended helping behaviours, and quality of actual helping behaviours increased significantly at both time points. Social distance decreased significantly at all time points and stigma decreased significantly at post-course. The course was perceived to be highly acceptable by participants. CONCLUSIONS There is initial evidence that the Conversations about Non-Suicidal Self-Injury course is effective and acceptable for members of the public who may support a person engaging in NSSI.
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Affiliation(s)
- Kathy S. Bond
- Mental Health First Aid Australia, Level 18, 150 Lonsdale Street, Melbourne, VIC 3000, Australia
| | - Julia N. Lyons
- Mental Health First Aid Australia, Level 18, 150 Lonsdale Street, Melbourne, VIC 3000, Australia
| | - Fairlie A. Cottrill
- Mental Health First Aid Australia, Level 18, 150 Lonsdale Street, Melbourne, VIC 3000, Australia
| | - Amanda V. Sabo
- Mental Health First Aid Australia, Level 18, 150 Lonsdale Street, Melbourne, VIC 3000, Australia
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC 3010, Australia
| | - Simone E. Baillie
- Mental Health First Aid Australia, Level 18, 150 Lonsdale Street, Melbourne, VIC 3000, Australia
| | - Alyssia Rossetto
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC 3010, Australia
| | - Louise Kelly
- Mental Health First Aid Australia, Level 18, 150 Lonsdale Street, Melbourne, VIC 3000, Australia
| | - Claire M. Kelly
- Mental Health First Aid Australia, Level 18, 150 Lonsdale Street, Melbourne, VIC 3000, Australia
| | - Nicola J. Reavley
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC 3010, Australia
| | - Anthony F. Jorm
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC 3010, Australia
| | - Amy J. Morgan
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Carlton, VIC 3010, Australia
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Reas DL, Wisting L, Lindvall Dahlgren C. Co-occurrence of nonsuicidal self-injury and eating disorder pathology in adolescents. Int J Eat Disord 2023; 56:439-445. [PMID: 36524669 PMCID: PMC10107669 DOI: 10.1002/eat.23826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 09/29/2022] [Accepted: 09/30/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Little is known about the co-occurrence of nonsuicidal self-injurious (NSSI) behaviors and eating disorder (ED) pathology in community samples of adolescents. METHODS A total of 1558 Norwegian upper secondary school students (Grades 11, 12, and 13) completed the Deliberate Self-Harm Inventory and a measure of ED pathology. RESULTS Adolescents (53.1% F, 46.9% M) were a mean age of 17.1 years. A higher level of ED pathology was reported (12.1 vs. 5.3, p < .001) among adolescents who had a history of NSSI. Significantly higher levels of ED pathology were found among females who reported hitting themselves until bruised, head banging, severe scratching, and burning with a lighter, but not cutting, or the other forms of self-injury. Of adolescents with a history of NSSI, 60% of females and 15% of males scored above a cutoff for ED pathology. Of adolescents scoring above a cutoff for ED pathology, 42.5% of females and 37.1% of males had engaged in lifetime NSSI. DISCUSSION Adolescents-in particular, females- with a history of NSSI reported significantly greater ED pathology. Notably, a higher proportion of males with ED pathology reported lifetime self-injury than vice versa, underscoring the importance of carefully screening for the presence of self-harm among males with ED pathology. PUBLIC SIGNIFICANCE STATEMENT Over 1500 upper secondary school students with an average age of 17 years completed an online survey assessing current ED pathology and lifetime NSSI. Adolescents, particularly females, with a history of self-harm reported significantly more ED pathology. Findings also indicated the need to carefully screen for self-harm among males with ED pathology. Parents, schools, and health professionals should be aware that self-harm and ED pathology commonly co-occur and warrant assessment.
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Affiliation(s)
- Deborah Lynn Reas
- Division of Mental Health and Addiction, Regional Department of Eating Disorders, Oslo University Hospital, Oslo, Norway
| | - Line Wisting
- Division of Mental Health and Addiction, Regional Department of Eating Disorders, Oslo University Hospital, Oslo, Norway
| | - Camilla Lindvall Dahlgren
- Division of Mental Health and Addiction, Regional Department of Eating Disorders, Oslo University Hospital, Oslo, Norway.,Department of Psychology, Oslo New University College, Oslo, Norway
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Blessing A, Russell PD, DeBeer BB, Kimbrel NA, Meyer EC, Morissette SB. The influence of cannabis use disorder on post-traumatic stress disorder symptoms, depression symptoms, and non-suicidal self-injury among college students. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2023:1-5. [PMID: 36595655 DOI: 10.1080/07448481.2022.2155471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 10/11/2022] [Accepted: 11/04/2022] [Indexed: 06/17/2023]
Abstract
Objective: The interrelationships between cannabis use disorder (CUD), post-traumatic stress disorder (PTSD) and depressive symptoms, and non-suicidal self-injury (NSSI) were examined. Participants: Undergraduates (N = 363) who reported using cannabis within the past six months were recruited. Method: Mediation analyses was conducted to examine if CUD symptoms were indirectly associated with greater risk for engagement in current NSSI through more severe PTSD and depression symptoms. A factor comprised of PTSD-depression symptoms was created given PTSD and depression symptoms were highly correlated. Results: Greater CUD symptom severity indirectly increased risk for current NSSI via more severe PTSD-depression symptoms, after accounting for gender and alcohol use disorder symptoms. Conclusion: The current study provides preliminary evidence for the negative consequences of CUD on college students' mental health symptoms and engagement in NSSI, and future longitudinal research is needed to examine the dynamic relationships between CUD, PTSD-depression symptoms, and NSSI over time.
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Affiliation(s)
- Alexis Blessing
- Department of Psychology, The University of Texas at San Antonio, San Antonio, Texas, USA
| | - Patricia D Russell
- VA Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention, Aurora, Colorado, USA
| | - Bryann B DeBeer
- VA Rocky Mountain Mental Illness Research, Education, and Clinical Center for Suicide Prevention, Aurora, Colorado, USA
- Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Nathan A Kimbrel
- Durham Veterans Affairs (VA) Health Care System, Durham, North Carolina, USA
- VA Mid-Atlantic Mental Illness Research, Education, and Clinical Center, Durham, North Carolina, USA
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, North Carolina, USA
| | - Eric C Meyer
- Department of Rehabilitation Science and Technology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Sandra B Morissette
- Department of Psychology, The University of Texas at San Antonio, San Antonio, Texas, USA
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Van Der Poll R, Coetzee B, Bantjes J. Willing and unwilling digital cyborg assemblages: University students talk about mental health apps. Digit Health 2023; 9:20552076231210658. [PMID: 37915793 PMCID: PMC10617263 DOI: 10.1177/20552076231210658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 10/12/2023] [Indexed: 11/03/2023] Open
Abstract
Objective Explore how students talk about mental health mobile applications (i.e., apps). Methods Data collected in focus group interviews with 51 students (all self-identifying as having mental health problems) and analysed using inductive thematic content analysis. Results Participants describe mental health apps as an anti-dote to the loss of control, vulnerability, helplessness, impotence, isolation, conspicuousness, and shame which characterise their experience of mental illness. They describe the on-campus clinic as inaccessible and associated with "serious" problems, while configuring psychologists and psychotherapy as out of reach, scarce, formal, structured and anxiety provoking. In contrast, they imagine mental health apps as informal, relaxed, inviting, and accessible. Participants expressed openness and optimism about using apps to improve their mental health. They idealise technology as a means to connect effortlessly, anonymously, and informally, as well as learn skills, assert agency, and act responsibly. They also articulate reluctance to trust technology, show cognisance of participating in a capitalist economy, demonstrate scepticism about the legitimacy of mental health apps, and call for regulation, thereby resisting the position of responsible neoliberal subjects. Conclusion Participants express ambivalence towards mental health apps without surrendering to either technophobia or technophilia. They express faith in technologies' potential to support mental health while questioning the implicit assumption that people are competent to manage their own mental health. In talking about mental health apps students reproduce broader cultural discourses (including techno-optimism, techno-solutionism, somatopiamism, neo-liberalism, responsibilisationism, technoscepticism, and discourses about neuroplasticity and self-help) thus presenting themselves as both willing and unwilling digital cyborgs.
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Affiliation(s)
- Ryan Van Der Poll
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Bronwyne Coetzee
- Department of Psychology, Stellenbosch University, Stellenbosch, South Africa
| | - Jason Bantjes
- Mental Health, Alcohol, Substance use and Tobacco (MAST) Research Unit, South African Medical Research Council, Cae Town, South Africa
- Department of Psychiatry and Mental Health, University of Cape Town, Rondebosch, South Africa
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Parental pressure and intrapersonal risk factors in relation to non-suicidal self-injury outcomes in university students. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-04173-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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Muehlenkamp JJ, Wagner EM. Yoga and nonsuicidal self-injury: Mediational effects of self-compassion and body appreciation. Body Image 2022; 43:17-24. [PMID: 35994996 DOI: 10.1016/j.bodyim.2022.08.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 10/15/2022]
Abstract
Non-suicidal self-injury (NSSI) is a prevalent maladaptive body-focused behavior among youth and young adults. Yoga is associated with improved mindfulness, body image, and self-compassion; all of which are associated with decreased NSSI. This study evaluated the relationship between yoga and NSSI frequency, and if the relationship would be mediated by mindfulness, self-compassion, and/or body appreciation. Participants were recruited from a random sample of university students via email and included those with some yoga experience (N = 384; Mage = 19.98, SD = 2.20). Participants completed an anonymous online survey assessing their levels of yoga participation, NSSI, mindfulness, self-compassion, and body appreciation. Bias corrected serial mediation regression models indicated the relationship between yoga participation and NSSI frequency was significantly mediated by self-compassion followed by body appreciation. Body appreciation was also a significant single mediator of yoga's relationship with NSSI. Mindfulness was not a significant mediator in any of the analyzes. Yoga practice is associated with reduced NSSI behaviors through its positive relationships with body appreciation and self-compassion. Body appreciation appears to be an important mechanism underlying the link between yoga participation and NSSI behavior suggesting that interventions promoting positive body image, such as yoga, could be innovative strategies for clinicians to consider.
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Affiliation(s)
- Jennifer J Muehlenkamp
- University of Wisconsin Eau Claire, Department of Psychology, 105 Garfield Ave, Eau Claire, WI 54701, the United States of America.
| | - Emily M Wagner
- University of Wisconsin Eau Claire, Department of Psychology, 105 Garfield Ave, Eau Claire, WI 54701, the United States of America
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Mann AJD, Tull MT, Gratz KL. Hiding in the open: Consideration of nonsuicidal self-injury by proxy as a clinically meaningful construct. Suicide Life Threat Behav 2022; 52:1024-1036. [PMID: 35794810 PMCID: PMC9796142 DOI: 10.1111/sltb.12899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 05/17/2022] [Accepted: 06/13/2022] [Indexed: 01/01/2023]
Abstract
Nonsuicidal self-injury (NSSI) is defined as the deliberate destruction of one's own body tissue without suicidal intent and for purposes not socially sanctioned. However, this definition limits the understanding and assessment of NSSI by excluding a clinically relevant form of NSSI that is both self-driven and associated with self-injurious intentions: NSSI by proxy. Specifically, we propose that NSSI by proxy be defined as the intentional destruction of one's own body tissue through the elicitation of another being's (e.g., human, animal) actions, wherein the agency of the person being injured is a critical facet of the behavior. We review the literature supporting the clinical relevance of this behavior, as well as its similarities to traditional NSSI. Next, we propose four behaviors that may be conceptualized as NSSI by proxy, and identify two other behaviors that warrant further investigation. Finally, we identify future directions for research in this area and implications for the assessment and treatment of NSSI.
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Affiliation(s)
| | | | - Kim L. Gratz
- Department of PsychologyUniversity of ToledoToledoOhioUSA
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Sorgi-Wilson KM, Cheung JC, Ciesinski NK, McCloskey MS. Cognition and Non-Suicidal Self-Injury: Exploring Relationships with Psychological Functions. Arch Suicide Res 2022:1-17. [PMID: 35924878 PMCID: PMC9898468 DOI: 10.1080/13811118.2022.2106919] [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: 02/06/2023]
Abstract
OBJECTIVE Non-suicidal self-injury (NSSI) is strongly associated with difficulties in emotion regulation, but its relationships with maladaptive cognitive processes are less clear. METHOD The current study examined relationships between self-reported NSSI (presence, number of methods, frequency, recency, duration, functions) and negative cognitive processes (rumination, worry, self-criticism, perceived burdensomeness, thwarted belongingness) among 1,357 undergraduates. Cognition variables were submitted to exploratory factor analysis (EFA), and relationships were examined between the resulting factors and NSSI history (among the full sample) and NSSI severity and functions (among those with a history of NSSI). RESULTS The EFA derived two higher order cognitive factors: repetitive negative thinking (RNT) and negative self-perception (NSP). Both RNT and NSP were significantly higher among participants with than those without a history of NSSI. Among those with NSSI, NSP, but not RNT, was positively related to lifetime NSSI frequency and number of methods, as well as recency (presence in the past 12 months) and total duration (in years) of NSSI engagement. Moreover, RNT and NSP were positively associated with aggregate intrapersonal (but not interpersonal) functions of NSSI. The two cognitive factors demonstrated differential relationships with the individual intrapersonal NSSI functions. CONCLUSIONS Higher order categories of cognitive risk factors may have unique relationships with functions and severity of NSSI, with possible implications for more targeted approaches to risk assessment and intervention.HighlightsNegative thinking and self-perception were higher in people who engage in NSSI.Negative self-perception was associated with greater NSSI severity.Negative thinking and self-perception had different relations to NSSI functions.
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Kruzan KP, Muehlenkamp JJ, Claes L. Identity, self-blame, and body regard in NSSI: A test of moderated-mediation. Compr Psychiatry 2022; 116:152322. [PMID: 35533434 PMCID: PMC9219562 DOI: 10.1016/j.comppsych.2022.152322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 04/05/2022] [Accepted: 04/13/2022] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Prior work suggests that an unstable identity is an important developmental factor impacting risk for non-suicidal self-injury (NSSI), partly because it can foster lowered self-esteem and self-blame coping styles. Theoretical models suggest that how one regards the self, including experiences of and reactions to one's body (e.g., body regard), impact how factors such as identity instability and coping styles influence NSSI behavior. This study tested whether body regard moderated the mediational effect of self-blame coping on the relationship between poor self-concept clarity and past-year NSSI. METHODS A sample of 1906 university students had complete data from an anonymous online questionnaires measuring self-concept clarity, self-blame coping, and past-year NSSI behaviors. RESULTS Past-year NSSI was reported by 23.5% of the sample. Moderated mediational regression analyses using the PROCESS macro for SPSS were run. Body regard significantly moderated the effects of self-blame coping and poor self-concept clarity on NSSI such that neither risk factor was associated with NSSI when body regard was high. Poor self-concept clarity also retained a significant, although weakened, direct relationship with NSSI in the full model. CONCLUSIONS Positive body regard is protective and appears to mitigate the strength of the relationships between poor self-concept clarity and self-blame coping on past year NSSI. When body regard is low or average, poor self-concept clarity is associated with increased NSSI, partly through the effect of self-blame coping. Treatments that address body- and self-perceptions related to self-concept may enhance the effectiveness of interventions used to reduce NSSI behavior.
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Affiliation(s)
- Kaylee P Kruzan
- Center for Behavioral Intervention Technologies, 446 E. Ontario St., Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
| | - Jennifer J Muehlenkamp
- Department of Psychology, 105 Garfield Ave, University of Wisconsin Eau Claire, Eau Claire, WI 54701, USA.
| | - Laurence Claes
- KU Leuven, Faculty of Psychology and Educational Sciences, Tiensestraat 102, 3000 Leuven, Belgium; University of Antwerp, Faculty of Medicine and Health Sciences, Universiteitsplein 1, 2610 Wilrijk (Antwerp), Belgium
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Tubbs AS, Fernandez FX, Grandner MA, Perlis ML. Emerging evidence for sleep instability as a risk mechanism for nonsuicidal self-injury. Sleep 2022; 45:6572076. [PMID: 35446956 PMCID: PMC9189961 DOI: 10.1093/sleep/zsac095] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Andrew S Tubbs
- Department of Psychiatry, University of Arizona College of Medicine–Tucson , Tucson, AZ , USA
| | | | - Michael A Grandner
- Department of Psychiatry, University of Arizona College of Medicine–Tucson , Tucson, AZ , USA
| | - Michael L Perlis
- Department of Psychiatry, University of Pennsylvania , Philadelphia, PA, USA
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Burke TA, Hamilton JL, Seigel D, Kautz M, Liu RT, Alloy LB, Barker DH. Sleep irregularity and nonsuicidal self-injurious urges and behaviors. Sleep 2022; 45:zsac084. [PMID: 35397476 PMCID: PMC9189944 DOI: 10.1093/sleep/zsac084] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 03/05/2022] [Indexed: 01/13/2023] Open
Abstract
STUDY OBJECTIVES The objectives of this study were to examine the relationships between sleep regularity and nonsuicidal self-injury (NSSI), including lifetime NSSI history and daily NSSI urges. METHODS Undergraduate students (N = 119; 18-26 years), approximately half of whom endorsed a lifetime history of repetitive NSSI, completed a 10-day actigraphy and ecological momentary assessment (EMA) protocol. A Sleep Regularity Index was calculated for all participants using scored epoch by epoch data to capture rapid changes in sleep schedules. Participants responded to EMA prompts assessing NSSI urge severity and negative affect three times daily over the 10-day assessment period. RESULTS Results indicate that individuals with a repetitive NSSI history were more likely to experience sleep irregularity than those without a history of NSSI. Findings also suggest that sleep irregularity was associated with more intense urges to engage in NSSI on a daily basis, even after accounting for average daily sleep duration, sleep timing, negative affect, and NSSI history. Neither sleep duration nor sleep timing was associated with NSSI history nor daily NSSI urge intensity. CONCLUSIONS Findings suggest that sleep irregularity is linked with NSSI, including NSSI history and intensity of urges to engage in NSSI. The present study not only supports the growing evidence linking sleep disturbance with the risk for self-injury but also demonstrates this relationship using actigraphy and real-time assessments of NSSI urge severity. Findings highlight the importance of delineating the nuances in sleep irregularity that are proximally associated with NSSI risk and identifying targets for intervention.
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Affiliation(s)
- Taylor A Burke
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | | | - David Seigel
- Graduate School of Applied and Professional Psychology, Rutgers University
Piscataway, NJ, USA
| | - Marin Kautz
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - Richard T Liu
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Lauren B Alloy
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - David H Barker
- Department of Psychiatry and Human Behavior, The Alpert Medical School of Brown University, Providence, RI, USA
- Department of Psychiatry, Rhode Island Hospital, Providence, RI, USA
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Tubbs AS, Hendershot S, Ghani SB, Nadorff MR, Drapeau CW, Fernandez FX, Perlis ML, Grandner MA. Social Jetlag and Other Aspects of Sleep Are Linked to Non-Suicidal Self-Injury Among College Students. Arch Suicide Res 2022; 27:686-703. [PMID: 35389330 DOI: 10.1080/13811118.2022.2057262] [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: 01/02/2023]
Abstract
INTRODUCTION Disrupted sleep is associated with non-suicidal self-injury (NSSI) in young adults, but many specific features of sleep continuity and timing have yet to be examined. Additionally, the psychological mechanisms linking sleep to NSSI are unclear. The present study evaluated 14 sleep variables as classifiers of lifetime or recent NSSI and examined potential confounding and mediating factors. METHODS A sample of 885 college students provided measures of sleep continuity (e.g., duration, timing, fragmentation), nightmares, insomnia, and perceived sleep control. Lifetime and past 3-month NSSI were measured using a self-report version of the Columbia Suicide Severity Ratings Scale. Bidirectional stepwise regression identified significant sleep classifiers and subsequent models examined their associations with NSSI after adjusting for covariates and through potential psychological mediators. RESULTS Only absolute social jetlag was associated with recent NSSI, even after adjusting for covariates, such that each additional hour difference between weekday and weekend sleep schedules was associated with a 17% greater risk of recent NSSI. Nightmares, weekend sleep efficiency, and perceived sleep control were associated with lifetime NSSI, although only weekend sleep efficiency remained associated after adjusting for covariates. Bootstrap mediations identified negative urgency as a partial mediator for recent and lifetime NSSI, and lack of premeditation and perceived burdensomeness as partial mediators for lifetime NSSI. CONCLUSIONS The timing and consistency of young adults' sleep schedules may be of greater importance to NSSI among college students than insomnia or insufficient sleep. Future studies of sleep and NSSI should include these measures as potential risk factors. HIGHLIGHTSDifferences between weekday/weekend sleep timing are linked to recent NSSI.Negative urgency partially mediates poor sleep on recent and lifetime NSSI.Sleep shares a multifaceted relationship with NSSI risk in college students.
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Striley CW, Nutley SK, Hoeflich CC. E-cigarettes and non-suicidal self-injury: Prevalence of risk behavior and variation by substance inhaled. Front Psychiatry 2022; 13:911136. [PMID: 36147965 PMCID: PMC9485578 DOI: 10.3389/fpsyt.2022.911136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Accepted: 07/29/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Nicotine and cannabis inhalation through vaping or electronic delivery systems has surged among young adults in the United States, particularly during the coronavirus disease pandemic. Tobacco and marijuana use are associated with select adverse mental health outcomes, including symptoms of major depressive disorder and suicidal behaviors. Given the need for addiction specialists to treat problematic substance use with an integrated approach, the association between non-suicidal self-injury (NSSI) and use of e-cigarettes, tobacco, marijuana, and alcohol was examined among a diverse sample of college students. METHODS Healthy Minds Study data from 47,016 weighted observations, collected from college students in the 2018-2019 academic year, was used to explore associations between NSSI-related behaviors and past 30-day use of a vaping product (nicotine or marijuana). These relationships were assessed among those using vaping products only, and then among individuals using vaping products and alcohol, conventional cigarettes, and/or marijuana. Hierarchical logistic regression models estimating the relationship between vaping and NSSI were computed to adjust for the effects of demographic factors, symptomatology of psychiatric disorders, and concurrent use of other substances. RESULTS A fifth (22.9%) of respondents disclosed past 12-month NSSI; they were significantly more likely to screen positive for depression or anxiety compared to young adults without NSSI. Rates of using vaping products, conventional cigarettes, marijuana, or other substances were higher among students with NSSI even after controlling for potential cofounders. Additionally, students who used a THC-based liquid in their e-cigarettes were more likely to endorse NSSI in comparison to those who used "just flavoring." However, young adults who vaped were less likely to disclose frequent NSSI-related behaviors than their peers who did not vape. CONCLUSIONS These findings revealed an association between past 12-month NSSI and past 30-day vaping in a sample of young adults. Further surveillance among college populations and examination of potential sociodemographic confounders is necessary to confirm these findings and advance the substance use and addiction field.
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Affiliation(s)
- Catherine W Striley
- Department of Epidemiology, College of Public Health & Health Professions and College of Medicine, University of Florida, Gainesville, FL, United States
| | - Sara K Nutley
- Department of Epidemiology, College of Public Health & Health Professions and College of Medicine, University of Florida, Gainesville, FL, United States
| | - Carolin C Hoeflich
- Department of Epidemiology, College of Public Health & Health Professions and College of Medicine, University of Florida, Gainesville, FL, United States
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Burke TA, Shao S, Jacobucci R, Kautz M, Alloy LB, Ammerman BA. Examining momentary associations between behavioral approach system indices and nonsuicidal self-injury urges. J Affect Disord 2022; 296:244-249. [PMID: 34619451 PMCID: PMC9022186 DOI: 10.1016/j.jad.2021.09.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 08/05/2021] [Accepted: 09/12/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND The current study aimed to examine the concurrent and prospective relationships between the three hypothesized components of behavioral approach system (BAS) sensitivity: drive, reflecting the motivation to pursue one's desired goals; reward responsiveness, reflecting sensitivity to reward or reinforcement; and fun-seeking, reflecting the motivation for pursuing novel rewards in a spontaneous manner, and NSSI urge severity. METHODS A sample of 64 undergraduates with a history of repetitive NSSI completed an ecological momentary assessment protocol. During this period of time, participants reported on the BAS-constructs of drive, reward responsiveness, and fun-seeking, as well as NSSI urge severity on a momentary basis at three random intervals each day for a period of ten-days. RESULTS Drive and reward responsiveness, but not fun-seeking, were concurrently positively associated with NSSI urge severity. However, no associations between BAS facets and prospective NSSI urges were found. LIMITATIONS This study was limited by its use of single items to assess the BAS-constructs of drive, reward responsiveness, and fun-seeking. CONCLUSIONS Our findings indicate that feeling strongly impacted by rewards and having a strong sense of drive toward goal attainment may represent cognitive risk states that are associated with increased within-person NSSI risk. However, their lack of prospective prediction may suggest that these cognitive states are associated only on a momentary basis with NSSI urges and may not confer risk.
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Affiliation(s)
- Taylor A. Burke
- Massachusetts General Hospital,Harvard Medical School, Department of Psychiatry
| | - Sijing Shao
- University of Notre Dame, Department of Psychology
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Renaud J, MacNeil SL, Vijayakumar L, Spodenkiewicz M, Daniels S, Brent DA, Turecki G. Suicidal ideation and behavior in youth in low- and middle-income countries: A brief review of risk factors and implications for prevention. Front Psychiatry 2022; 13:1044354. [PMID: 36561636 PMCID: PMC9763724 DOI: 10.3389/fpsyt.2022.1044354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Accepted: 11/07/2022] [Indexed: 12/12/2022] Open
Abstract
Although global rates of suicide have dropped in the last 30 years, youth in low- and middle-income countries (LMICs) continue to be highly represented in suicide statistics yet underrepresented in research. In this review we present the epidemiology of suicide, suicidal ideation, and suicide attempts among youth in LMICs. We also describe population-level (attitudes toward suicide, socioeconomic, and societal factors) and individual-level clinical and psychosocial risk factors, highlighting specific considerations pertaining to youth in LMICs. These specific considerations in risk factors within this population can inform how multi-level prevention strategies may be targeted to meet their specific needs. Prevention and intervention strategies relying on the stepped-care framework focusing on population-, community-, and individual level targets while considering locally- and culturally relevant practices are key in LMICs. In addition, systemic approaches favoring school-based and family-based interventions are important among youth. Cross-culturally adapted multimodal prevention strategies targeting the heterogeneity that exists in healthcare systems, suicide rates, and risk factors in these countries should be accorded a high priority to reduce the burden of suicide among youth in LMICs.
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Affiliation(s)
- Johanne Renaud
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, QC, Canada.,Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
| | | | | | - Michel Spodenkiewicz
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, QC, Canada.,Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada.,Pôle de Santé Mentale, CIC-EC 1410, Université et CHU de La Réunion Sainte-Pierre, Saint-Pierre, France.,INSERM UMR-1178 Moods Team CESP Le Kremlin-Bicêtre France, Le Kremlin-Bicêtre, France
| | - Sylvanne Daniels
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, QC, Canada.,Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
| | - David A Brent
- Western Psychiatric Institute and Clinic, University of Pittsburgh Medical Center, Pittsburgh, PA, United States
| | - Gustavo Turecki
- McGill Group for Suicide Studies, Douglas Mental Health University Institute, Montréal, QC, Canada.,Department of Psychiatry, Faculty of Medicine and Health Sciences, McGill University, Montréal, QC, Canada
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