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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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2
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Cheung JC, Sorgi-Wilson KM, Ciesinski NK, McCloskey MS. Examining the relationship between subtypes of rumination and non-suicidal self-injury: A meta-analytic review. Suicide Life Threat Behav 2024; 54:528-555. [PMID: 38411021 DOI: 10.1111/sltb.13051] [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: 11/01/2022] [Revised: 10/24/2023] [Accepted: 01/09/2024] [Indexed: 02/28/2024]
Abstract
INTRODUCTION Non-suicidal self-injury (NSSI) is a highly prevalent maladaptive behavior, often used to cope with intense negative affect. Rumination is an emotion regulation strategy that leads to fixation on and exacerbation of (typically) negative affective states. However, studies examining the relationship between rumination and NSSI have yielded mixed results, showing high degrees of heterogeneity. METHODS The present study conducted meta-analyses (k = 50) of the association between overall rumination and NSSI, and independent meta-analyses for each of four subtypes of rumination (general, depressive, brooding, reflection rumination). Potential moderators that may influence the magnitude of these relationships were also examined. RESULTS A small-to-moderate positive association between rumination and NSSI was found independent of rumination subtype. Moderating effects included NSSI outcome measure and study design for overall rumination and general rumination, respectively. Race was found to moderate the relationships between both brooding and depressive rumination and NSSI, though in inverse directions. An analysis of effect heterogeneity across studies suggested that undetected moderators may be present. CONCLUSION Results of this study support the relationships between rumination subtypes and NSSI and identify factors that may impact these relationships. Continued research is needed to understand this association, particularly in more varied subtypes of rumination and cognitive-affective moderators.
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Affiliation(s)
- Joey C Cheung
- Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA
| | | | - Nicole K Ciesinski
- Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA
| | - Michael S McCloskey
- Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA
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3
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Lin L, Liu Y, Qiu S, Yang Y, Yang Y, Tian M, Wang S, Zhang J, Bai X, Xu Z. Orbital frontal cortex functional connectivity during gain anticipation linking the rumination and non-suicidal self-injury in late adolescence. J Affect Disord 2024; 350:673-680. [PMID: 38228278 DOI: 10.1016/j.jad.2024.01.117] [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: 05/08/2023] [Revised: 12/22/2023] [Accepted: 01/09/2024] [Indexed: 01/18/2024]
Abstract
OBJECTIVE Non-suicidal self-injury (NSSI) is prevalent and especially among the adolescence population. It has been argued that abnormal brain activations in reward processing could be regarded as objective biomarkers in NSSI, but the evidence is mixed. This study aims to explore the reward processing mechanism of NSSI from the perspective of functional brain circuitry and investigate the role of a cognitive factor (rumination). METHOD Seventy-one 17-21 years old participants performed a monetary incentive delay (MID) task during functional magnetic resonance imaging scanning. Psychophysiological interaction (PPI) analysis was used to test the inner-group differences of brain functional connectivity. In addition, a mediation model was established with the mediation effect of rumination on the relationship between functional brain circuitry and NSSI. RESULTS PPI analysis suggested that functional connectivity of the orbital frontal cortex (OFC) (with precuneus, SMA) was significantly enhanced in NSSI in the gain > loss contrast, but not in the loss > gain contrast. Mediation analysis revealed that rumination mediated the relationship between NSSI and the OFC- precuneus functional connectivity in the gain > loss contrast. CONCLUSION Our research revealed that the abnormal OFC functional connectivity in gain (not loss) anticipation can be served as the sensitive biomarkers of NSSI. And there was a chain path for NSSI, that was from functional brain circuitry to negative cognition and then to problem behavior.
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Affiliation(s)
- Lin Lin
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin 300387, China; Center of Cooperative Innovation for Assessment and Promotion of National Mental Health under Ministry of Education, Tianjin 300387, China; Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
| | - Yu Liu
- Intelligent Laboratory of Child and Adolescent Mental Health and Crisis Intervention of Zhejiang Province, Zhejiang Normal University, Jinhua 321004, Zhejiang, China; Department of Psychology, Zhejiang Normal University, Jinhua 321004, Zhejiang, China
| | - Shaojie Qiu
- Faculty of Psychology, Beijing Normal University, Beijing 100875, China
| | - Yanan Yang
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin 300387, China; Center of Cooperative Innovation for Assessment and Promotion of National Mental Health under Ministry of Education, Tianjin 300387, China; Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
| | - Yang Yang
- Collaborative Innovation Center of Assessment Toward Basic Education Quality, Beijing Normal University, Beijing 100875, China
| | - Mingyangjia Tian
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin 300387, China; Center of Cooperative Innovation for Assessment and Promotion of National Mental Health under Ministry of Education, Tianjin 300387, China; Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
| | - Song Wang
- Huaxi MR Research Center (HMRRC), Department of Radiology, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China; Research Unit of Psychoradiology, Chinese Academy of Medical Sciences, Chengdu 610041, Sichuan, China; Functional and Molecular Imaging Key Laboratory of Sichuan Province, West China Hospital of Sichuan University, Chengdu 610041, Sichuan, China
| | - Jie Zhang
- Central University of Finance and Economics, Beijing 100081, China; Buffalo State Department of Sociology, State University of New York, Buffalo 10001, USA
| | - Xuejun Bai
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin 300387, China; Center of Cooperative Innovation for Assessment and Promotion of National Mental Health under Ministry of Education, Tianjin 300387, China; Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China
| | - Zhansheng Xu
- Key Research Base of Humanities and Social Sciences of the Ministry of Education, Academy of Psychology and Behavior, Tianjin Normal University, Tianjin 300387, China; Center of Cooperative Innovation for Assessment and Promotion of National Mental Health under Ministry of Education, Tianjin 300387, China; Faculty of Psychology, Tianjin Normal University, Tianjin 300387, China.
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De Luca L, Giletta M, Nocentini A, Menesini E. Non-Suicidal Self-Injury in Adolescence: The Role of Pre-Existing Vulnerabilities and COVID-19-Related Stress. J Youth Adolesc 2022; 51:2383-2395. [PMID: 35986870 PMCID: PMC9392436 DOI: 10.1007/s10964-022-01669-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Accepted: 08/02/2022] [Indexed: 11/28/2022]
Abstract
AbstractFor many adolescents, the COVID-19 pandemic represents a uniquely challenging period, and concerns have been raised about whether COVID-19-related stress may increase the risk for self-injurious behaviors among adolescents. This study examined the impact of pre-existing vulnerabilities on the occurrence and frequency of Non-Suicidal Self-Injury (NSSI) through COVID-19-related stress, and whether the impact of COVID-19-related stress on NSSI was buffered by the perceived social support during the pandemic. Participants were 1061 adolescents (52.40% females; Mage = 15.49 years, SD = 0.76) from a two-wave longitudinal study, which included assessments before the COVID-19 onset and one year later the declaration of the pandemic. Path analyses showed that adolescents with a prior history of NSSI, higher levels of internalizing symptoms, and poor regulatory emotional self-efficacy before the COVID-19 pandemic reported higher levels of COVID-19-related stress which in turn increased their risk to engage in NSSI. Besides, the findings did not support the role of social support as a moderator of the association between COVID-19 related stress and the occurrence/frequency of NSSI. These findings suggest that enhanced stress perception may serve as a key pathway for the continuation and development of NSSI among vulnerable adolescents facing adverse life events.
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Affiliation(s)
- Lisa De Luca
- Department of Education, Languages, Intercultures, Literatures and Psychology, University of Florence, Florence, Italy.
| | - Matteo Giletta
- Department of Developmental, Personality and Social Psychology, Ghent University, Ghent, Belgium
| | - Annalaura Nocentini
- Department of Education, Languages, Intercultures, Literatures and Psychology, University of Florence, Florence, Italy
| | - Ersilia Menesini
- Department of Education, Languages, Intercultures, Literatures and Psychology, University of Florence, Florence, Italy
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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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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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Wu R, Huang J, Ying J, Gao Q, Guo J, You J. Behavioral inhibition/approach systems and adolescent nonsuicidal self-injury: The chain mediating effects of difficulty in emotion regulation and depression. PERSONALITY AND INDIVIDUAL DIFFERENCES 2021. [DOI: 10.1016/j.paid.2021.110718] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Self-Critical and Self-Punishment Cognitions Differentiate Those With and Without a History of Nonsuicidal Self-Injury: An Ecological Momentary Assessment Study. Behav Ther 2021; 52:686-697. [PMID: 33990242 DOI: 10.1016/j.beth.2020.08.006] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 07/13/2020] [Accepted: 08/30/2020] [Indexed: 12/20/2022]
Abstract
The aim of this study was to examine trait, state, and temporal instability measures of self-critical and self-punishment cognitions to evaluate their respective roles in nonsuicidal self-injury (NSSI). Participants were university students with a history of NSSI (n = 64) and those with no history of NSSI (n = 59). At baseline, participants completed measures assessing history of NSSI behavior, as well as trait measures of self-criticism and self-punishment. After completion of baseline procedures, participants subsequently participated in a 10-day ecological momentary assessment protocol in which self-critical and self-punishment cognitions were assessed in real time three times daily. Employing bivariate and multivariate frameworks, our results demonstrate that both trait and state levels of self-critical and self-punishment cognitions robustly differentiate between young adults with and without a lifetime history of NSSI. The present results also confirm that the temporal instability of these cognitive states also meaningfully differentiate between groups, such that those who exhibit greater fluctuations in these cognitive states are more likely to have a history of NSSI. The current findings suggest that trait, state, and temporal instability of negative self-focused cognitions may be vulnerability factors for engagement in NSSI.
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Profiles of Emotion Dysregulation Among University Students Who Self-Injure: Associations with Parent-Child Relationships and Non-Suicidal Self-Injury Characteristics. J Youth Adolesc 2021; 50:767-787. [PMID: 33449284 DOI: 10.1007/s10964-020-01378-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 12/15/2020] [Indexed: 10/22/2022]
Abstract
More research is needed to understand the different vulnerability profiles of university students who engage in non-suicidal self-injury (NSSI). This study sought to classify university students (n = 479; 83.8% female) aged 17-25 years (M = 18.77; SD = 1.42) who had engaged in NSSI within the past year into latent profiles based on their self-perceived difficulties in regulating both positive and negative emotions. Independent samples of students who had a past history of NSSI but had not self-injured within the previous year (n = 439; 82.9% females; Mage = 19.03, SD = 1.62) and who had no history of NSSI (n = 1551; 69.9% females; Mage = 19.02, SD = 1.55) were recruited for comparison purposes. Latent cluster analyses revealed three emotion regulation profiles within the NSSI sample-the Average Difficulties (47.4%), Dysregulated (33.0%), and Low Difficulties (19.6%) profiles-each of which differed meaningfully from both comparison samples on mean emotion regulation difficulties. Students across profiles also differed in their self-reported experiences with parents, particularly with fathers (pressure, antipathy, unresolved attachment, psychological control), and in the extent to which they felt alienated from parents. Lastly, students across profiles differed in the frequency, methods, functions, and addictive properties of their NSSI. Findings highlight that university students who self-injure experience distinct patterns of difficulties with emotion regulation, which are associated with variation in parent-child relational risk factors and NSSI outcomes.
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Kautz MM, Burke TA, Siegel DM, Case J, Alloy LB. The role of reward sensitivity and childhood maltreatment in predicting nonsuicidal self-injury. Suicide Life Threat Behav 2020; 50:1250-1263. [PMID: 33135809 DOI: 10.1111/sltb.12718] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 06/07/2020] [Accepted: 06/24/2020] [Indexed: 01/25/2023]
Abstract
OBJECTIVE Findings from prior research on reward sensitivity in nonsuicidal self-injury (NSSI) have been mixed. Childhood maltreatment is an independent risk factor for NSSI and for hyposensitivity to rewards. This study aimed to disentangle the role of reward sensitivity as a predictor of NSSI for those with an elevated severity of childhood maltreatment. METHOD In a diverse undergraduate sample (N = 586), trait reward sensitivity (i.e., behavioral approach system subscales) and the severity of maltreatment were assessed as predictors of a lifetime history of NSSI. In a subset of this sample (n = 51), predictors of NSSI urge intensity were measured using ecological momentary assessment. RESULTS Individuals with elevated maltreatment who reported less positive responsiveness to rewards were more likely to have a lifetime history of NSSI. Those with elevated maltreatment who reported a lower likelihood to approach rewards experienced more intense NSSI urges across the ten-day observation period. However, those with elevated maltreatment who reported a greater likelihood to approach rewards experienced less intense NSSI urges. CONCLUSIONS The role of reward sensitivity as a cognitive risk factor for NSSI varies depending on childhood maltreatment history. Findings indicate that, for those with elevated maltreatment, hypersensitivity to approaching rewards may decrease risk for NSSI urges.
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Affiliation(s)
- Marin M Kautz
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - Taylor A Burke
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - David M Siegel
- Graduate School of Applied and Professional Psychology, Rutgers The State University of New Jersey, New Brunswick, NJ, USA
| | - Julia Case
- Department of Psychology, Temple University, Philadelphia, PA, USA
| | - Lauren B Alloy
- Department of Psychology, Temple University, Philadelphia, PA, USA
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Santamarina-Perez P, Mendez I, Singh MK, Berk M, Picado M, Font E, Moreno E, Martínez E, Morer A, Borràs R, Cosi A, Romero S. Adapted Dialectical Behavior Therapy for Adolescents with a High Risk of Suicide in a Community Clinic: A Pragmatic Randomized Controlled Trial. Suicide Life Threat Behav 2020; 50:652-667. [PMID: 31944371 DOI: 10.1111/sltb.12612] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 11/05/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study is a pragmatic randomized controlled trial, which compares the effectiveness of an adapted form of Dialectical Behavior Therapy for Adolescents (DBT-A) and treatment as usual plus group sessions (TAU + GS) to reduce suicidal risk for adolescents in a community health mental clinic. METHOD Thirty-five adolescents from a community outpatient clinic, with repetitive NSSI alone or with SA over the last 12 months and with current high suicide risk as assessed by the Columbia-Suicide Severity Rating Scale (C-SSRS), were enrolled. Participants were randomly assigned to undergo either DBT-A (n = 18) or TAU + GT (n = 17) treatments over a 16-week period. Primary outcomes were the difference between NSSI and SA recorded during the first 4 weeks and the final 4 weeks of treatment. Secondary outcomes included changes in Children's Global Assessment Scale (C-GAS), Suicidal Ideation Questionnaire (SIQ-JR), and Beck Depression Inventory-II (BDI-II). RESULTS Dialectical Behavior Therapy for Adolescents was more effective than TAU + GS at reducing NSSI, use of antipsychotics, and improving C-GAS. No SAs were reported in the two groups at the end of the treatment. Both treatments were equally effective in decreasing SIQ-JR and BDI-II scores. CONCLUSIONS These findings support the feasibility and effectiveness of DBT-A for adolescents at high risk of suicide in community settings.
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Affiliation(s)
- Pilar Santamarina-Perez
- Department of Child and Adolescent Psychiatry and Psychology, 2017S GR88, Institute of Neuroscience, Hospital Clínic, Barcelona, Spain
| | - Iria Mendez
- Department of Child and Adolescent Psychiatry and Psychology, 2017S GR88, Institute of Neuroscience, Hospital Clínic, Barcelona, Spain
| | - Manpreet K Singh
- Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Stanford University, Stanford, California
| | - Michele Berk
- Department of Psychiatry and Behavioral Sciences, Division of Child and Adolescent Psychiatry, Stanford University, Stanford, California
| | - Marisol Picado
- Department of Child and Adolescent Psychiatry and Psychology, 2017S GR88, Institute of Neuroscience, Hospital Clínic, Barcelona, Spain
| | - Elena Font
- Department of Child and Adolescent Psychiatry and Psychology, 2017S GR88, Institute of Neuroscience, Hospital Clínic, Barcelona, Spain
| | - Elena Moreno
- Department of Child and Adolescent Psychiatry and Psychology, 2017S GR88, Institute of Neuroscience, Hospital Clínic, Barcelona, Spain
| | - Esteve Martínez
- Department of Child and Adolescent Psychiatry and Psychology, 2017S GR88, Institute of Neuroscience, Hospital Clínic, Barcelona, Spain
| | - Astrid Morer
- Department of Child and Adolescent Psychiatry and Psychology, 2017S GR88, Institute of Neuroscience, Hospital Clínic, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Roger Borràs
- Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Alexandra Cosi
- Department of Psychology, Universitat Rovira i Virgili, Reus, Spain
| | - Soledad Romero
- Department of Child and Adolescent Psychiatry and Psychology, 2017S GR88, Institute of Neuroscience, Hospital Clínic, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Salud Mental, CIBERSAM, Madrid, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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12
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Peterson AL, Chen JI, Karver MS, Labouliere CD. Frustration with feeling: Latent classes of non-suicidal self-injury and emotion regulation difficulties. Psychiatry Res 2019; 275:61-70. [PMID: 30878858 PMCID: PMC6543814 DOI: 10.1016/j.psychres.2019.03.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 03/08/2019] [Accepted: 03/09/2019] [Indexed: 11/23/2022]
Abstract
Although emotion regulation has been identified as a key function of non-suicidal self-injury (NSSI), it is unclear how specific indices of emotion regulation are associated with particular NSSI methods as markers of risk. This study used latent class analysis (LCA) to identify subgroups of individuals who engage in NSSI and their patterns of emotional regulation difficulties. Undergraduate students in the southeastern United States (N = 326) completed an online survey. LCA was used to identify subgroups of individuals engaging in NSSI and their associated emotion regulation difficulties. These subgroups were then compared across a variety of behavioral health outcomes (e.g. impulsive behavior, disordered eating, problematic alcohol use, suicide attempt history) to characterize specific risk profiles. The LCA revealed four subgroups who engage in NSSI and have specific emotion regulation difficulties. These subgroups were differentially associated with behavioral health outcomes, including suicide risk, disordered eating, and impulsive behavior. Results of this research could aid in clinical identification of at-risk individuals.
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Affiliation(s)
- Amanda L Peterson
- Department of Psychology, University of South Florida, 4202 E. Fowler Ave, PCD4118G, Tampa, FL 33620, USA.
| | - Jason I Chen
- VA HSR&D Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, USA; Department of Psychiatry, Oregon Health & Science University, Portland, OR, USA
| | - Marc S Karver
- Department of Psychology, University of South Florida, 4202 E. Fowler Ave, PCD4118G, Tampa, FL 33620, USA
| | - Christa D Labouliere
- New York State Psychiatric Institue, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
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Wolff JC, Thompson E, Thomas SA, Nesi J, Bettis AH, Ransford B, Scopelliti K, Frazier EA, Liu RT. Emotion dysregulation and non-suicidal self-injury: A systematic review and meta-analysis. Eur Psychiatry 2019; 59:25-36. [PMID: 30986729 DOI: 10.1016/j.eurpsy.2019.03.004] [Citation(s) in RCA: 137] [Impact Index Per Article: 27.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 03/15/2019] [Accepted: 03/17/2019] [Indexed: 10/27/2022] Open
Abstract
BACKGROUND Over the past several years there has been considerable interest in the relation between emotion dysregulation and non-suicidal self-injury (NSSI), particularly given that rates of NSSI have been increasing and NSSI is a critical risk factor for suicidal behavior. To date, however, no synthesis of empirical findings exists. METHODS The present study presents a comprehensive meta-analytic review of the literature on the association between NSSI and emotion dysregulation. A total of 48 publications, including 49 independent samples, were included in this analysis. RESULTS Overall, a significant association was found between emotion dysregulation and NSSI (pooled OR = 3.03 [95% CI = 2.56-3.59]). This association was reduced but remained significant (OR = 2.40 [95% CI = 2.01-2.86]) after adjustment for publication bias. Emotion dysregulation subscales most strongly associated with NSSI included limited access to regulation strategies, non-acceptance of emotional responses, impulse control difficulties, and difficulties engaging goal-directed behavior. Lack of emotional awareness/clarity and cognitive aspects of dysregulation yielded weaker, yet significant, positive associations with NSSI. CONCLUSIONS Findings support the notion that greater emotion dysregulation is associated with higher risk for NSSI among individuals across settings, regardless of age or sex. Furthermore, findings reveal facets of dysregulation that may have unique implications for NSSI. This meta-analysis highlights the importance of better understanding emotion dysregulation as a treatment target for preventing NSSI.
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Affiliation(s)
- Jennifer C Wolff
- The Alpert Medical School of Brown University, 1 Hoppin St, Suite 204, 02093, Providence, RI, United States.
| | - Elizabeth Thompson
- The Alpert Medical School of Brown University, 1 Hoppin St, Suite 204, 02093, Providence, RI, United States
| | - Sarah A Thomas
- The Alpert Medical School of Brown University, 1 Hoppin St, Suite 204, 02093, Providence, RI, United States
| | - Jacqueline Nesi
- The Alpert Medical School of Brown University, 1 Hoppin St, Suite 204, 02093, Providence, RI, United States
| | - Alexandra H Bettis
- The Alpert Medical School of Brown University, 1 Hoppin St, Suite 204, 02093, Providence, RI, United States
| | - Briana Ransford
- The Alpert Medical School of Brown University, 1 Hoppin St, Suite 204, 02093, Providence, RI, United States
| | - Katie Scopelliti
- The Alpert Medical School of Brown University, 1 Hoppin St, Suite 204, 02093, Providence, RI, United States
| | - Elisabeth A Frazier
- The Alpert Medical School of Brown University, 1 Hoppin St, Suite 204, 02093, Providence, RI, United States
| | - Richard T Liu
- The Alpert Medical School of Brown University, 1 Hoppin St, Suite 204, 02093, Providence, RI, United States
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Zelkowitz RL, Cole DA. Self-Criticism as a Transdiagnostic Process in Nonsuicidal Self-Injury and Disordered Eating: Systematic Review and Meta-Analysis. Suicide Life Threat Behav 2019; 49:310-327. [PMID: 29504147 PMCID: PMC6123292 DOI: 10.1111/sltb.12436] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2017] [Accepted: 09/21/2017] [Indexed: 12/14/2022]
Abstract
Nonsuicidal self-injury (NSSI) and disordered eating (DE) are highly comorbid and may be regarded as belonging to a spectrum of self-harm behaviors. We investigated self-criticism as a transdiagnostic correlate of these behaviors, in keeping with etiological theories of both NSSI and DE. We reviewed the literature and meta-analyzed the relation of self-criticism to both NSSI (15 studies; 17 effect sizes) and DE (24 studies; 29 effect sizes). Results showed equivalent, moderate-to-large effects for the relation of self-criticism to NSSI (r = .38; CI: .29-.46) and DE (r = .40; CI: .34-.45). The relation of NSSI to self-criticism generalized across multiple potential moderators. DE behavior type moderated the relation of self-criticism to DE, with a stronger relation emerging for purging than restriction. Findings support self-criticism as a possible candidate for transdiagnostic pathways to self-harm.
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Affiliation(s)
- Rachel L. Zelkowitz
- Department of Psychology and Human Development; Vanderbilt University; Nashville TN USA
| | - David A. Cole
- Department of Psychology and Human Development; Vanderbilt University; Nashville TN USA
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Tsypes A, Owens M, Hajcak G, Gibb BE. Neural reward responsiveness in children who engage in nonsuicidal self-injury: an ERP study. J Child Psychol Psychiatry 2018; 59:1289-1297. [PMID: 29665047 PMCID: PMC6192869 DOI: 10.1111/jcpp.12919] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/01/2018] [Indexed: 12/15/2022]
Abstract
BACKGROUND A better understanding of the correlates of nonsuicidal self-injury (NSSI) in children is important for the identification and prevention of future suicide risk. However, although abnormalities in reward responsiveness might constitute one potential transdiagnostic mechanism of risk for NSSI, no studies have examined initial response to reward in children with a history of NSSI. The goal of the present study was to address this important gap in the literature. To objectively assess initial response to reward, we utilized the feedback negativity (FN) event-related potential, a well-established psychophysiological marker of reward responsiveness. METHODS Participants were 57 children (19 with a history of NSSI and 38 demographically matched controls) between the ages of 7 and 11. Diagnostic interviews were used to assess for current and past DSM-IV mood and anxiety diagnoses and NSSI history. Children also completed a guessing task, during which continuous electroencephalography was recorded. RESULTS Children with a history of NSSI exhibited significantly more negative ΔFN (i.e., FN to losses minus FN to gains) than children without NSSI. These findings appeared to be at least partially independent of children's history of psychopathology and current symptoms, suggesting their specificity to NSSI. CONCLUSIONS These results provide initial evidence for heightened neural initial reward responsiveness to losses versus rewards in children with a history of NSSI. Pending replications and longitudinal studies, the ΔFN might represent a psychophysiological marker of risk for self-harm.
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Affiliation(s)
- Aliona Tsypes
- Center for Affective Science, Binghamton University, Binghamton, NY
| | - Max Owens
- University of South Florida, St. Petersburg, FL
| | - Greg Hajcak
- Stony Brook University, Stony Brook, NY, USA
| | - Brandon E. Gibb
- Center for Affective Science, Binghamton University, Binghamton, NY
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Ammerman BA, Jacobucci R, McCloskey MS. Using Exploratory Data Mining to Identify Important Correlates of Nonsuicidal Self-Injury Frequency. PSYCHOLOGY OF VIOLENCE 2018; 8:515-525. [PMID: 30393574 PMCID: PMC6208147 DOI: 10.1037/vio0000146] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
OBJECTIVE Non-suicidal self-injury (NSSI) has been linked to many adverse outcomes, with more frequent NSSI increasing the likelihood of impairment, severity, and more serious self-harming behavior (e.g., suicidality; Andover & Gibb, 2010; Darke et al., 2010). Despite the determined importance of NSSI frequency in understanding the severity of one's behavior, there is still a need to identify which constructs may be influential in predicting frequency. The current study aimed to fill this gap by identifying which correlates are most important in relation to NSSI frequency through two exploratory data mining methods. METHOD Seven hundred twelve undergraduate students with a history of NSSI completed self-report measures of NSSI behavior, suicidality, cognitive-affective deficits, and psychopathology symptomology. RESULTS Both exploratory data mining methods, lasso regression and random forests, demonstrated number of NSSI methods to be the factor with the most importance in relation to lifetime NSSI frequency. Once this variable was removed, suicide plan and depressive symptomology were significant correlates across methods. CONCLUSIONS The current findings support the literature between NSSI frequency and NSSI methods, but also implicate suicide plans, an often-overlooked factor, and depression in NSSI severity.
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Burke TA, Jacobucci R, Ammerman BA, Piccirillo M, McCloskey MS, Heimberg RG, Alloy LB. Identifying the relative importance of non-suicidal self-injury features in classifying suicidal ideation, plans, and behavior using exploratory data mining. Psychiatry Res 2018; 262:175-183. [PMID: 29453036 PMCID: PMC6684203 DOI: 10.1016/j.psychres.2018.01.045] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 11/29/2017] [Accepted: 01/24/2018] [Indexed: 10/18/2022]
Abstract
Individuals with a history of non-suicidal self-injury (NSSI) are at alarmingly high risk for suicidal ideation (SI), planning (SP), and attempts (SA). Given these findings, research has begun to evaluate the features of this multi-faceted behavior that may be most important to assess when quantifying risk for SI, SP, and SA. However, no studies have examined the wide range of NSSI characteristics simultaneously when determining which NSSI features are most salient to suicide risk. The current study utilized three exploratory data mining techniques (elastic net regression, decision trees, random forests) to address these gaps in the literature. Undergraduates with a history of NSSI (N = 359) were administered measures assessing demographic variables, depression, and 58 NSSI characteristics (e.g., methods, frequency, functions, locations, scarring) as well as current SI, current SP, and SA history. Results suggested that depressive symptoms and the anti-suicide function of NSSI were the most important features for predicting SI and SP. The most important features in predicting SA were the anti-suicide function of NSSI, NSSI-related medical treatment, and NSSI scarring. Overall, results suggest that NSSI functions, scarring, and medical lethality may be more important to assess than commonly regarded NSSI severity indices when ascertaining suicide risk.
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Affiliation(s)
- Taylor A Burke
- Temple University, Department of Psychology, Philadelphia, PA, USA.
| | - Ross Jacobucci
- University of Notre Dame, Department of Psychology, Notre Dame, IN, USA
| | | | - Marilyn Piccirillo
- Washington University in St. Louis, Department of Psychology, St. Louis, MO, USA
| | | | | | - Lauren B Alloy
- Temple University, Department of Psychology, Philadelphia, PA, USA
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Burke TA, Ammerman BA, Knorr AC, Alloy LB, McCloskey MS. Measuring Acquired Capability for Suicide within an Ideation-to-Action Framework. PSYCHOLOGY OF VIOLENCE 2018; 8:277-286. [PMID: 29732237 PMCID: PMC5931728 DOI: 10.1037/vio0000090] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Despite the large literature on risk factors for suicide-related outcomes, few studies have examined risk for acting on suicidal thoughts among suicide ideators. The current study aimed to fill this gap by examining the role of acquired capability, as well as its hypothesized facilitator, painful and provocative events (PPEs), as motivators for behavior among individuals along the suicide continuum. METHOD Undergraduates reporting suicidal ideation, suicide plans, suicide attempts without intent to die, or suicide attempts with intent to die (N=546) completed a measure of acquired capability for suicide, as well as assessments of exposure to PPEs. RESULTS Our findings demonstrated that acquired capability for suicide did not distinguish between individuals falling along the ideation-to-action spectrum. Among the several PPEs assessed, the frequency of non-suicidal self-injury, and the presence of childhood emotional abuse, physical abuse, and physical neglect each significantly differentiated between groups, with individuals having a history of a suicide attempt with the intent to die reporting the highest levels. CONCLUSIONS These findings implicate the PPEs that may be most important to assess in determining suicide risk, and, further, call into question the utility of acquired capability in differentiating between individuals along the suicide continuum.
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Burke TA, McArthur BA, Daryanani I, Abramson LY, Alloy LB. Latent classes of trait affect and cognitive affective regulation strategies are associated with depression, non-suicidal self-injury, and well-being. J Affect Disord 2018; 225:180-187. [PMID: 28837951 PMCID: PMC5663635 DOI: 10.1016/j.jad.2017.08.015] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 05/19/2017] [Accepted: 08/10/2017] [Indexed: 02/05/2023]
Abstract
BACKGROUND The present study sought to better understand the unique profiles of late adolescents' affective functioning by exploring patterns of trait affect and cognitive affective regulation strategies. The study also examined whether these unique profiles significantly predicted depressive symptoms, non-suicidal self-injury (NSSI), and well-being outcomes. METHODS Data from a sample of 590 late adolescents were examined (M = 19.14 years, SD = 1.41, 63% Female, 62% Caucasian, 38% African American/Biracial). Participants were followed for an average of 14 months (SD = 2.53) and completed measures of trait affect, cognitive affective regulation, depression, NSSI, and well-being. Data were examined using latent class analysis. RESULTS Five subgroups with unique patterns of affective functioning were identified. Late adolescents who reported above average levels of negative affect, dampening of positive affect, brooding, and reflection, coupled with below average levels of positive affect and positive rumination, were more likely to report having higher levels of depressive symptoms and greater engagement in NSSI during the one-year period prior to baseline. Similarly, the late adolescents fitting this profile also reported lower levels of well-being and were more likely to report engaging in NSSI at the follow-up. LIMITATIONS Limitations include a narrow exploration of affective regulation strategies and the addition of key variables after the initiation of the larger study. CONCLUSIONS These findings shed light on affective regulation factors relevant to the experience of depressive symptoms and NSSI, and the promotion of well-being.
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Affiliation(s)
- Taylor A. Burke
- Department of Psychology, Temple University, Philadelphia PA, USA
| | | | - Issar Daryanani
- Department of Psychology, Temple University, Philadelphia PA, USA
| | - Lyn Y. Abramson
- Department of Psychology, University of Wisconsin-Madison, Madison, WI, USA
| | - Lauren B. Alloy
- Department of Psychology, Temple University, Philadelphia PA, USA
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Tatnell R, Hasking P, Lipp OV, Boyes M, Dawkins J. Emotional responding in NSSI: examinations of appraisals of positive and negative emotional stimuli, with and without acute stress. Cogn Emot 2017; 32:1304-1316. [PMID: 29202639 DOI: 10.1080/02699931.2017.1411785] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Non-suicidal self-injury (NSSI) is commonly used by young adults to regulate emotional responses. Yet, experimental examination of how people who self-injure appraise and respond to emotional stimuli is limited. We examined appraisals of, and responses to, emotive images in young adults who did and did not self-injure, and assessed whether these were impacted by exposure to a stressor. Study 1 (N = 51) examined whether participants differed in their appraisals of emotional images. Study 2 (N = 78) assessed whether appraisals of images changed after exposure to the Trier Social Stress Test. Ratings of emotional valence and arousal were collected in both studies; skin conductance was measured as an indicator of physiological arousal in Study 2. In Study 1 participants reporting NSSI rated positively valenced images as less pleasant than participants not reporting NSSI. In Study 2, after acute stress, participants reporting NSSI displayed dampened physiological reactions to positive images whereas participants who did not self-injure displayed heightened physiological reactions to these and rated them as more pleasant. Individuals who self-injure seem less able to engage in strategic mood repair after exposure to stress compared to people who do not self-injure.
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Affiliation(s)
- Ruth Tatnell
- a Centre for Developmental Psychiatry and Psychology, Department of Psychiatry , Monash University , Melbourne , Australia
| | - Penelope Hasking
- b School of Psychology and Speech Pathology , Curtin University , Perth , Australia.,c Department of Psychiatry , Monash University , Melbourne , Australia
| | - Ottmar V Lipp
- b School of Psychology and Speech Pathology , Curtin University , Perth , Australia
| | - Mark Boyes
- b School of Psychology and Speech Pathology , Curtin University , Perth , Australia
| | - Jessica Dawkins
- b School of Psychology and Speech Pathology , Curtin University , Perth , Australia
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Responses to Positive Affect in Daily Life: Positive Rumination and Dampening Moderate the Association Between Daily Events and Depressive Symptoms. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2017. [DOI: 10.1007/s10862-017-9593-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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22
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Initial Psychometric Validation of the Non-Suicidal Self-Injury Scar Cognition Scale. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2017; 39:546-562. [PMID: 28824225 DOI: 10.1007/s10862-017-9595-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Given the growing literature on the detrimental psychological consequences of NSSI, it is surprising that scarce research has focused on the permanent physical consequences of NSSI, scarring to one's tissue (Burke et al. 2015; Lewis 2016). Indeed, with recent research suggesting that upwards of half of those with a history of NSSI bear scarring as a result of the behavior (Burke et al. 2016), the psychological implications of scarring are important to understand. Given preliminary literature suggesting that the vast majority of individuals who bear NSSI scars ascribe a great deal of meaning to their scarring, and that this meaning varies widely, a psychometrically sound scale is needed to comprehensively and systematically assess NSSI scar-related cognitions. The present study examined the psychometric properties of the Non-Suicidal Self-Injury Scar Cognition Scale (NSSI-SCS). A sample of 110 undergraduates with at least one scar from NSSI completed the NSSI-SCS as well as measures of concurrent and divergent validity. Exploratory Factor Analysis was conducted to determine the factor structure of the NSSI-SCS. Results indicated that a five-factor solution offered the best fit for the data. Psychometric analyses support the validity of the NSSI-SCS given evidence of concurrent validity, divergent validity, and reliability. Future research should examine the test-retest reliability of the NSSI-SCS, as well as its sensitivity to change, particularly in the context of treatment research.
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Burke TA, Ammerman BA, Hamilton JL, Alloy LB. Impact of Non-Suicidal Self-Injury Scale: Initial Psychometric Validation. COGNITIVE THERAPY AND RESEARCH 2016; 41:130-142. [PMID: 28824214 DOI: 10.1007/s10608-016-9806-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
The current study examined the psychometric properties of the Impact of Non-Suicidal Self-Injury Scale (INS), a scale developed to assess the social, behavioral, and emotional consequences of engaging in non-suicidal self-injury (NSSI). University students (N=128) who endorsed a history of NSSI were administered the INS, as well as measures of hypothesized convergent and divergent validity. Results suggested that the INS is best conceptualized as a one-factor scale, and internal consistency analyses indicated excellent reliability. The INS was significantly correlated with well-known measures of NSSI severity (i.e., NSSI frequency, NSSI recency), and measures of suicide attempt history and emotional reactivity. Logistic regression analyses indicated that the INS contributed unique variance to the prediction of physical disfigurement (i.e., NSSI scarring) and clinically significant social anxiety, even after taking into account NSSI frequency. Furthermore, the INS demonstrated divergent validity. Implications for research on NSSI disorder and clinical practice are discussed.
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Affiliation(s)
- Taylor A Burke
- Psychology Department, Temple University, Philadelphia, PA, USA
| | | | | | - Lauren B Alloy
- Psychology Department, Temple University, Philadelphia, PA, USA
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Burke TA, Hamilton JL, Ammerman BA, Stange JP, Alloy LB. Suicide risk characteristics among aborted, interrupted, and actual suicide attempters. Psychiatry Res 2016; 242:357-364. [PMID: 27344029 PMCID: PMC5247268 DOI: 10.1016/j.psychres.2016.05.051] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Revised: 05/26/2016] [Accepted: 05/27/2016] [Indexed: 11/28/2022]
Abstract
Few studies have investigated suicide risk characteristics associated with interrupted and aborted suicide attempts. The present study aimed to empirically examine whether assessing a history of interrupted and aborted suicide attempts is valuable when assessing suicide risk, given the relative lack of literature in this area to date. To inform this question, the current study examined differences in risk factors for suicidal behavior among individuals who have carried out a suicide attempt, individuals who report having a history of only interrupted and/or aborted suicide attempts, and non-attempter controls. Approximately 447 undergraduates (M=21.10 years; SD=4.16; 77.6% female) completed measures of carried out suicide attempts, interrupted suicide attempts, aborted suicide attempts, acquired capability for suicide, suicide likelihood, depressive symptoms, suicidal ideation, and non-suicidal self-injury. Results suggest that a faction of individuals endorse interrupted and/or aborted suicide attempts (8.7%), but do not endorse carried out suicide attempts, even in non-clinical samples. Furthermore, results suggest that there are few clinically meaningful differences between those with a history of carried out suicide attempts and interrupted/aborted suicide attempts, suggesting that individuals with a history of these lesser studied suicidal behaviors are an important group to target for suicide risk intervention.
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Affiliation(s)
- Taylor A Burke
- Psychology Department, Temple University, Philadelphia, PA, USA.
| | | | | | | | - Lauren B Alloy
- Psychology Department, Temple University, Philadelphia, PA, USA
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Gilbert K, Luking K, Pagliaccio D, Luby J, Barch D. Dampening, Positive Rumination, and Positive Life Events: Associations with Depressive Symptoms in Children at Risk for Depression. COGNITIVE THERAPY AND RESEARCH 2016; 41:31-42. [PMID: 28989209 DOI: 10.1007/s10608-016-9798-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Blunted positive affect is characteristic of depression. Altered positive affect regulation may contribute to this blunting, and two regulation strategies, dampening positive affect and positive rumination, have been implicated in depression. However, the conditions under which these strategies impart risk/protective effects prior to onset of depression are unknown. The current study examined 81 healthy children (age 7-10) at low and high risk for depression on the basis of maternal history of depression and tested how dampening and positive rumination interacted with the experience of recent positive life events to predict depressive symptoms. Children at high and low risk did not differ in their use of dampening or positive rumination. However, elevated use of dampening in the context of many positive life events predicted current depressive symptoms, and specifically anhedonic symptoms, in children at low-risk for depression. These findings held when controlling for negative rumination and negative life events. Positive rumination did not interact with positive life events but was associated with higher depressive symptoms in high-risk children. Results indicate that prior to the onset of depression, positive life events may impart risk when dampening positive affect is utilized in this context, while positive rumination may increase risk for depressive symptoms.
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Affiliation(s)
- Kirsten Gilbert
- Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri
| | - Katherine Luking
- Department of Psychology, Stony Brook University, Stony Brook, New York
| | - David Pagliaccio
- Emotion and Development Branch, National Institute of Mental Health, Bethesda, Maryland
| | - Joan Luby
- Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri
| | - Deanna Barch
- Department of Psychiatry, Washington University in St. Louis, St. Louis, Missouri.,Department of Psychology, Washington University in St. Louis, St. Louis, Missouri.,Department of Radiology, Washington University in St. Louis, St Louis, Missouri
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Ammerman BA, Burke TA, Alloy LB, McCloskey MS. Subjective pain during NSSI as an active agent in suicide risk. Psychiatry Res 2016; 236:80-85. [PMID: 26747213 PMCID: PMC4760627 DOI: 10.1016/j.psychres.2015.12.028] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2015] [Revised: 12/10/2015] [Accepted: 12/19/2015] [Indexed: 11/24/2022]
Abstract
Non-suicidal self-injury (NSSI) has been identified as a correlate and predictor of suicidal ideation and attempts. Given the high-rates of NSSI presence among adolescents and young adults, it is important to identify specific characteristics of NSSI that might place individuals who engage in this behavior at highest risk for suicidal behavior. NSSI is thought to increase the acquired capability for suicide via habituation to self-harm, though the NSSI characteristics most responsible for this relationship are unclear. The current study examined three characteristics of NSSI (frequency, number of methods, and subjective pain) that may help to elucidate this risk relationship. University students (N=997) with a history of NSSI completed measures assessing lifetime NSSI frequency, number of NSSI methods employed, and subjective experience of pain during NSSI, as well as suicide attempt (SA) history. Results indicated that NSSI frequency, number of NSSI methods, and subjective pain experienced during NSSI were each positively associated with SA history. Further, subjective pain experienced during NSSI moderated the relationship between NSSI frequency and SA history, such that the association between NSSI frequency and SA history was stronger for individuals who experienced lower levels of subjective pain.
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Affiliation(s)
- Brooke A. Ammerman
- Correspondence concerning this article should be addressed to Brooke A. Ammerman, Department of Psychology, Temple University, Weiss Hall, 1701 N. 13th St., Philadelphia, PA 19122. Fax: 215-204-7321.
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Burke TA, Hamilton JL, Cohen JN, Stange JP, Alloy LB. Identifying a physical indicator of suicide risk: Non-suicidal self-injury scars predict suicidal ideation and suicide attempts. Compr Psychiatry 2016; 65:79-87. [PMID: 26773994 PMCID: PMC4715861 DOI: 10.1016/j.comppsych.2015.10.008] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Revised: 10/26/2015] [Accepted: 10/28/2015] [Indexed: 10/22/2022] Open
Abstract
BACKGROUND Suicide risk is challenging to quantify due to reliance on self-report, which is limited by individuals' lack of insight and the desire to conceal such intentions. Non-suicidal self-injury (NSSI) is one of the most robust predictors of suicidal ideation (SI) and suicide attempts (SA). Although NSSI often leads to permanent scarring, which can be assessed by objective physical examination, no research has examined whether scarring denotes tangible risk for SI and SA. The present study examined whether NSSI scar presence and number predict current SI and SA history. Further, we examined whether brooding would exacerbate the effects of NSSI scarring on SI or SA. METHODS Young adults (N=231; M=21.24 years; 78% female) completed self-report questionnaires assessing SA history, frequency of NSSI, presence/number of NSSI scars, brooding, current depressive symptoms, and SI. RESULTS NSSI scar presence and number predicted current SI and SA history after controlling for current depressive symptoms. Moreover, scar presence and number predicted current SI over and above the effects of SA history and NSSI frequency, method, and medical severity. Further, NSSI scar presence and number predicted SI more strongly among individuals with greater levels of brooding than among individuals with lower levels of brooding. CONCLUSIONS The presence and number of NSSI scars are objective physical indicators of risk for SI and SAs. Brooding may further heighten the risk of SI for individuals bearing NSSI scars.
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Nelis S, Luyckx K, Feldman G, Bastin M, Raes F, Bijttebier P. Assessing response styles to positive affect: One or two dimensions of positive rumination in the Responses to Positive Affect questionnaire? PERSONALITY AND INDIVIDUAL DIFFERENCES 2016. [DOI: 10.1016/j.paid.2015.09.031] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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