The role of reward sensitivity and childhood maltreatment in predicting nonsuicidal self-injury

Predictors of non-suicidal self-injury in adolescents with depressive disorder: the role of alexithymia, childhood trauma, and body investment

Purpose

This study analyzes the relationship of alexithymia, childhood trauma, and body investment to non-suicidal self-injury (NSSI) behaviors in adolescents with depressive disorder and whether they have predictive and diagnostic value for non-suicidal self-injury (NSSI) behaviors in adolescents with depressive disorder.

Patients and methods

A total of 225 patients with a diagnosis of adolescent depressive disorder were included in the study and were divided into two groups according to the DSM-5 criteria: 98 cases without NSSI and 127 cases with NSSI. Compare the demographic data, 24-item Hamilton Depression Scale (HAMD-24), 20-item Toronto Alexithymia Scale (TAS-20), Childhood Trauma Questionnaire-Short Form (CTQ-SF), and Body Investment Scale (BIS) scores between two groups. Binary logistic regression was used to analyze the independent risk factors contributing to NSSI behaviors in adolescents with depression, and establish four predictive models. Based on the models' predictive probability, the ROC curves were plotted to calculate the value of the predictive diagnostic effect.

Results

The group without NSSI had lower scores than the group with NSSI on HAMD-24 total score, TAS-20 total score, difficulty identifying feelings, difficulty describing feelings, and externally focused thinking, as well as lower scores on CTQ-SF total score, physical neglect, emotional neglect, physical abuse, and emotional abuse. In contrast, the BIS total score, body image feelings and attitudes, body care, and body protection factor scores were higher for the group without NSSI. The BIS body care factor score and the CTQ-SF emotional abuse factor score were significantly linked with adolescents diagnosed with depressive disorder who exhibited NSSI behaviors. These results provide a good diagnostic model for adolescents with depressive disorder.

Conclusion

Low levels of body care and childhood emotional abuse may independently contribute to the implementation of NSSI in adolescents with depressive disorder. Body investment and childhood trauma are valuable in diagnosing and predicting NSSI behaviors and should be considered as potentially important factors in clinical treatment.

Mediating role of anxiety and impulsivity in the association between child maltreatment and lifetime non-suicidal self-injury with and without suicidal self-injury

BACKGROUND

Child maltreatment can increase the risk of lifetime non-suicidal self-injury (NSSI) and suicidal self-injury (SSI), but there is limited knowledge regarding the differences of potentially psychological mechanisms between NSSI with and without SSI.

METHODS

Participants, 3918 community-based Chinese young men aged 18-34 years in Chengdu, were included in this study. We investigated the association between depression, anxiety, psychosis, child maltreatment, adulthood traumatic events, impulsivity, alcohol dependence, drug abuse, and lifetime of NSSI among participants with and without SSI. Parallel mediation analysis was utilized to explore the mediators for the relation between child maltreatment and NSSI.

RESULTS

The prevalence of lifetime NSSI was 6.1 % (95 % CI: 5.4 %-6.9 %) among young men. Anxiety and impulsivity partially mediated the effect of child maltreatment on NSSI either with (indirect effect: 51.2 %) or without SSI (indirect effect: 34.3 %). Depression was independently and significantly associated with only NSSI but not with NSSI+SSI. Alcohol dependence and psychosis were independently and significantly associated with NSSI+SSI and mediated the effect of child maltreatment on NSSI+SSI.

LIMITATIONS

The cross-sectional survey data limits the robustness of the proof to the causal relationships.

CONCLUSIONS

Anxiety and impulsivity are associated with NSSI either with or without SSI and partially mediate the effect of child maltreatment on NSSI. Depression is associated with only NSSI, while alcohol dependence and psychosis are only associated with NSSI+SSI. It could be crucial to improve treatment and recovery of alcohol dependence and psychosis for preventing young men engaged in NSSI from attempting SSI.

Reporting Ethical Procedures in Suicide Prevention Research: Current Status and Recommendations

OBJECTIVE

Ethical concerns frequently arise in suicide prevention research regarding participant safety and confidentiality. Despite a substantial literature on managing and navigating ethical concerns in suicide research, little attention has been paid to the reporting of ethical procedures. Furthermore, standard procedures for reporting ethical risk management procedures have not been developed.

METHOD

A review of the current literature was performed to examine the current state of reporting of ethical procedures within suicide research. Articles published in 2020 (N = 263) from three suicide-focused publications were screened and then coded (n = 131) to identify reporting of procedures for the ethical conduct of research and suicide risk management steps taken by the research teams.

RESULTS

The majority of articles reported ethical review or approval (84.7%) and reported the use of an informed consent process (77.9%). Only 28.2% included risk mitigation procedures. Of those 29.7% of those articles reported conducting risk evaluation, 66.7% reported resource dissemination, and 51.4% reported an intervention.

CONCLUSION

As empirical support for brief interventions accrues, suicide prevention researchers should consider establishing standards for the reporting of procedures to ensure the safety of participants with suicidal risk.HighlightsReporting suicide safety protocols helps ensure high ethical standards in research.Fewer than 1/3 of articles reviewed reported risk mitigation procedures in 2020.Standard procedures for reporting safety protocols in suicide research are needed.

[Advances in the electrophysiological research on neurocognitive function in adolescents with non-suicidal self-injury]

Non-suicidal self-injury (NSSI) is becoming increasingly common in adolescents and seriously affects their physical and mental health, and it is also a major risk factor for suicide among adolescents. NSSI has now become a public health issue of general concern; however, the identification of cognitive dysfunction in NSSI is still based on neuropsychological cognitive assessment and subjective questionnaire assessment, with a lack of objective evaluation indicators. As a method for studying the cognitive neural mechanism of NSSI, electroencephalography is a reliable tool for finding objective biomarkers of NSSI. This article reviews the recent research on electrophysiology associated with cognitive dysfunction in adolescents with NSSI.

Childhood maltreatment and non-suicidal self-injury among Chinese college students: The moderating roles of social phobia and perceived family economic status

BACKGROUND

Non-suicidal self-injury is a heavy burden on affected college students with rippling effects throughout their lives. Childhood maltreatment is strongly associated with non-suicidal self-injury among college students. However, it remains unclear whether perceived family economic status and social phobia exert significant moderating effects on the relationship between childhood maltreatment and non-suicidal self-injury.

OBJECTIVE

This study aimed to identify the perceived family economic status and social phobia moderating the association between childhood maltreatment and non-suicidal self-injury.

PARTICIPANTS AND SETTING

This study used data (N = 5297) from two local medical colleges in Anhui province, China.

METHODS

Respondents completed questionnaires on childhood maltreatment, non-suicidal self-injury, social phobia and perceived family economic status online. Data were analyzed using Spearman's correlation followed by multiple moderation models.

RESULTS

The association between childhood maltreatment and non-suicidal self-injury was moderated by social phobia (β = 0.03, p < 0.05) and perceived family economic status (β = -0.30, p < 0.05). When considered together, both factors were found to play synergistic roles in the association between childhood maltreatment and non-suicidal self-injury in college students (β = 0.08, p < 0.001).

CONCLUSION

Our findings highlight that experience of childhood maltreatment, elevated social phobia, and low perceived family economic status increase the risk of non-suicidal self-injury. Future researches are recommended to conduct interventions from a more holistic perspective and integrate perceived family economic status as a relevant factor along with social phobia in coping with non-suicidal self-injury in college students.

Prevalence of Adverse Childhood Experiences and Their Associations with Non-Suicidal Self-Injury Among Chinese Adolescents with Depression

The presence of adverse childhood experiences (ACEs) in adolescents diagnosed with depression has been associated with an extensive range of mental health issues, including non-suicidal self-injury (NSSI). However, there has been a dearth of research into the prevalence of ACEs and their associations with NSSI among depressed adolescent populations in China. This study aimed to investigate the prevalence of different types of ACEs and their associations with NSSI in depressed Chinese adolescents. Utilizing Chi-squared tests, latent class analysis (LCA), and multinomial logistic regression, the prevalence of different types of ACEs and their associations with NSSI were determined in a sample of 562 adolescents with depression. Among depressed adolescents. 92.9% of depressed adolescents reported ACEs, and the prevalence of emotional neglect, physical abuse, caregiver treated violently, and bullying was relatively high. ACEs, including sexual abuse (OR = 5.645), physical abuse (OR = 3.603), emotional neglect (OR = 3.096), emotional abuse (OR = 2.701), caregiver divorce/family separation (OR = 2.5), caregiver treated violently (OR = 2.221), and caregiver substance abuser (OR = 2.117), were associated with increased odds of exposure among depressed adolescents with NSSI. The high ACEs class (19%), the moderate ACEs class (40%), and the low ACEs class (41%) were identified as latent classes. NSSI was more prevalent in the high/moderate ACEs class compared to the low ACEs class, particularly in the high ACEs class. The situation of the prevalence of ACEs among adolescents with depression was unsatisfactory, and certain types of ACEs were associated with NSSI. Eliminating potential risk factors for NSSI requires the early prevention and targeted intervention of ACEs. Moreover, additional large-scale longitudinal studies are necessary to assess the different development trajectories associated with ACEs, such as the relationships between the different development periods of ACEs and NSSI, and to ensure the adoption of evidence-based prevention and intervention strategies.

Intra/interpersonal Functions of Non-suicidal Self-injury in Adolescents with Major Depressive Disorder: The Role of Emotion Regulation, Alexithymia, and Childhood Traumas

Objective: This study examines non-suicidal self-injury (NSSI) behavior, its functions and associated factors like childhood trauma, alexithymia, empathy, and emotion regulation, in adolescents suffering from depression.Method: The study sample consisted of 67 adolescents; 11 boys (mean age = 14.94 ±1.45) and 56 girls (mean age = 14.72 ±1.48), all with major depressive disorder. Standard tests and measurements were used for data collection, including Beck Depression Inventory for identifying depression symptoms; Brief Symptom Inventory for screening psychiatric symptoms; Inventory of Statements About Self Injury (ISAS) to identify the lifetime frequency and functions of NSSI in subjects; Childhood Trauma Questionnaire to evaluate sexual, physical, and emotional abuse plus childhood neglect; Toronto Alexithymia Scale to assess difficulties in identifying and/or describing feelings; Basic Empathy Scale to measure empathy levels within the framework of basic emotions; and the Difficulty of Emotion Regulation Scale to determine the awareness and clarity of emotional response.Results: It was found that 64.1% of adolescents studied have had at least one NSSI to date. The most frequent intrapersonal functions associated with NSSI were Affect Regulation and Marking Distress, and the most common interpersonal functions were Toughness and Interpersonal Boundaries. According to a correlation analysis with ISAS scores, Affect Regulation was associated with obsession-compulsion, anxiety, difficulty identifying feelings and clarity scores. Marking Distress, generating a physical sign of feeling awful, was positively associated with Paranoid Ideation scores and negatively associated with Emotional Neglect scores. The Interpersonal Boundaries was positively associated with Childhood Physical Abuse and Impulse scores.Conclusions: NSSI is realized by different functions in the intrapersonal and interpersonal areas in adolescents with depression. Emotion regulation abilities, alexithymia, and childhood trauma are also associated factors or functions of NSSI.

Impact of Early Life Stress on Reward Circuit Function and Regulation

Early life stress - including experience of child maltreatment, neglect, separation from or loss of a parent, and other forms of adversity - increases lifetime risk of mood, anxiety, and substance use disorders. A major component of this risk may be early life stress-induced alterations in motivation and reward processing, mediated by changes in the nucleus accumbens (NAc) and ventral tegmental area (VTA). Here, we review evidence of the impact of early life stress on reward circuit structure and function from human and animal models, with a focus on the NAc. We then connect these results to emerging theoretical models about the indirect and direct impacts of early life stress on reward circuit development. Through this review and synthesis, we aim to highlight open research questions and suggest avenues of future study in service of basic science, as well as applied insights. Understanding how early life stress alters reward circuit development, function, and motivated behaviors is a critical first step toward developing the ability to predict, prevent, and treat stress-related psychopathology spanning mood, anxiety, and substance use disorders.