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Ahmad SI, Hinshaw SP. A Qualitative Analysis of Perspectives on Self-directed Violence in a Prospective Longitudinal Study of Young Women With and Without Childhood ADHD. J Atten Disord 2024; 28:1255-1266. [PMID: 38294171 PMCID: PMC11168017 DOI: 10.1177/10870547231221729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2024]
Abstract
OBJECTIVE Non-suicidal self-directed violence (NSSDV) is a significant and growing youth public health crisis. Girls with ADHD are at increased risk of engaging in NSSDV, yet qualitative studies with this population-to better understand manifestations, motivations, and developmental course-are lacking. METHOD We conducted semi-structured, qualitative interviews with a sub-sample of 57 young women (32 with childhood ADHD, 25 neurotypical comparisons; mean age of 27 years, part of a larger prospective longitudinal study) regarding histories and manifestations of NSSDV. RESULTS Inductive and deductive analysis revealed several key themes, including self-perceived reasons for engaging in NSSDV (affect regulation, attention seeking, self-punishment, asserting control), impulsivity, secretiveness, and in some cases motivations for desistance. CONCLUSION Findings underscore the importance of early education and screening, especially among high-risk clinical populations. Increased resources and supports for professionals, parents, and peers are indicated, along with countering the persistent stigma associated with ADHD and NSSDV.
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Affiliation(s)
| | - Stephen P. Hinshaw
- University of California, San Francisco, USA
- University of California, Berkeley, USA
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Guo Y, Lu R, Ou Y, Huang Y, Li J, Cui Y, Li D, Zheng Y, Liang X, Qiu S, Liu Y. A study on the association between prefrontal functional connectivity and non-suicidal self-injury in adolescents with depression. Front Neurol 2024; 15:1382136. [PMID: 38711563 PMCID: PMC11070463 DOI: 10.3389/fneur.2024.1382136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Accepted: 04/08/2024] [Indexed: 05/08/2024] Open
Abstract
Objective Among adolescents with depression, the occurrence of non-suicidal self-injury (NSSI) behavior is prevalent, constituting a high-risk factor for suicide. However, there has been limited research on the neuroimaging mechanisms underlying adolescent depression and NSSI behavior, and the potential association between the two remains unclear. Therefore, this study aims to investigate the alterations in functional connectivity (FC) of the regions in the prefrontal cortex with the whole brain, and elucidates the relationship between these alterations and NSSI behavior in adolescents with depression. Methods A total of 68 participants were included in this study, including 35 adolescents with depression and 33 healthy controls. All participants underwent assessments using the 17-item Hamilton Depression Rating Scale (17-HAMD) and the Ottawa Self-Harm Inventory. In addition, functional magnetic resonance imaging (fMRI) data of the participants' brains were collected. Subsequently, the FCs of the regions in the prefrontal cortex with the whole brain was calculated. The FCs showing significant differences were then subjected to correlation analyses with 17-HAMD scores and NSSI behavior scores. Result Compared to the healthy control group, the adolescent depression group exhibited decreased FCs in several regions, including the right frontal eye field, left dorsolateral prefrontal cortex, right orbitofrontal cortex, left insula and right anterior cingulate coetex. The 17-HAMD score was positively correlated with the frequency of NSSI behavior within 1 year (rs = 0.461, p = 0.005). The FC between the right anterior cingulate cortex and the right precuneus showed a negative correlation with the 17-HAMD scores (rs = -0.401, p = 0.023). Additionally, the FC between the right orbitofrontal cortex and the right insula, demonstrated a negative correlation with the frequency of NSSI behavior within 1 year (rs = -0.438, p = 0.012, respectively). Conclusion Adolescents with depression showed decreased FCs of the prefrontal cortex with multiple brain regions, and some of these FCs were associated with the NSSI frequency within 1 year. This study provided neuroimaging evidence for the neurophysiological mechanisms underlying adolescent depression and its comorbidity with NSSI behavior.
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Affiliation(s)
- Yan Guo
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- State Key Laboratory of Traditional Chinese Medicine Syndrome, Guangzhou, China
- Army Medical Center (Daping Hospital), Army Medical University, Chongqing, China
| | - Ruoxi Lu
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- State Key Laboratory of Traditional Chinese Medicine Syndrome, Guangzhou, China
| | - Yiwen Ou
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Yuxin Huang
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Jianyu Li
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- State Key Laboratory of Traditional Chinese Medicine Syndrome, Guangzhou, China
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Ying Cui
- Cerebropathy Center, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Danian Li
- Cerebropathy Center, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yanting Zheng
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Xinyu Liang
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- State Key Laboratory of Traditional Chinese Medicine Syndrome, Guangzhou, China
| | - Shijun Qiu
- First Clinical Medical College, Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
- State Key Laboratory of Traditional Chinese Medicine Syndrome, Guangzhou, China
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Yujie Liu
- Department of Radiology, The First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China
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Wang L, Zou H, Yang Y, Hong J. Adolescents' attitudes toward non-suicidal self-injury (NSSI) and their perspectives of barriers to seeking professional treatment for NSSI. Arch Psychiatr Nurs 2023; 45:26-35. [PMID: 37544699 DOI: 10.1016/j.apnu.2023.04.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/07/2023] [Accepted: 04/30/2023] [Indexed: 08/08/2023]
Abstract
PURPOSE This study aimed to investigate the attitudes of adolescents toward NSSI, and to explore their perspectives on barriers to seeking professional treatment for NSSI. METHODS A qualitative phenomenological design was used to conduct in-depth interviews with 17 adolescents with NSSI in a psychiatric hospital in Beijing, China. Data from the 17 adolescents were analyzed using Colaizzi's 7-step analysis. RESULTS Two themes were extracted: (1) attitudes toward NSSI (normal, effective, ignorant, disgraceful); (2) subjective/objective barriers to seeking professional treatment (negative attitudes toward NSSI, fear of being regarded as an attention getter, fear of interfering with personal relationships, fear of aggravating the family burden, fear of being criticized by parents, fear of ongoing hospitalization, fear of the side effects of medication, etc.). CONCLUSIONS It is suggested to strengthen the knowledge of NSSI among adolescents, families and society, formulate interventions suitable for Chinese sociocultural backgrounds, and cultivate the specialty literacy of mental health nurses and their abilities to identify the barriers, which are required for eliminating barriers to seeking professional treatment and establishing a system for seeking full coverage of professional treatment.
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Affiliation(s)
- Lu Wang
- School of Nursing, Anhui Medical University, Hefei 230032, Anhui Province, China
| | - Haiou Zou
- School of Nursing, Peking Union Medical College, Beijing 100144, China
| | - Yuan Yang
- Department of Nursing, Beijing An Ding Hospital, Beijing 100088, China
| | - Jingfang Hong
- School of Nursing, Anhui Medical University, Hefei 230032, Anhui Province, China.
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Raffagnato A, Miscioscia M, Fasolato R, Iannattone S, Valentini P, Sale E, Gatta M. Symptomatic, Alexithymic, and Suicidality-Related Features in Groups of Adolescent Self-Harmers: A Case-Control Study. Eur J Investig Health Psychol Educ 2023; 13:883-896. [PMID: 37232705 DOI: 10.3390/ejihpe13050067] [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: 03/20/2023] [Revised: 05/12/2023] [Accepted: 05/15/2023] [Indexed: 05/27/2023] Open
Abstract
Non-suicidal self-injury (NSSI) is an increasing phenomenon among both clinical and nonclinical adolescent groups and is associated with several psychopathological symptoms, in addition to being one of the main risk factors for suicidality. Nevertheless, differences between clinical and nonclinical samples of self-harmers in symptom dimensions, alexithymia, suicidality, and NSSI-related variables are still scarcely investigated. The current study aimed to fill this gap by enrolling a sample of Italian girls (age range: 12-19 years) that included 63 self-harmers admitted to mental health outpatient services (clinical group), 44 self-harmers without admission to mental health services (subclinical group), and 231 individuals without an NSSI history (control group). Questionnaires investigating psychopathological symptoms, alexithymia, and NSSI-related variables were administered. The results highlighted that all symptom-related variables and alexithymic traits were more severe in the NSSI groups than in the control group; in particular, self-depreciation, anxiety, psychoticism, and pathological interpersonal relationships were distinguished between the clinical and subclinical groups. Compared to the subclinical group, the clinical group was characterized by higher NSSI frequency, NSSI disclosure, self-punishment as the main reason for engagement in NSSI, and suicidal ideation. These findings were then discussed in terms of clinical practice and primary and secondary prevention in the adolescent population.
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Affiliation(s)
- Alessia Raffagnato
- Department of Woman and Child's Health, Padua University Hospital, 35128 Padua, Italy
| | - Marina Miscioscia
- Department of Developmental Psychology and Socialization, University of Padua, 35131 Padua, Italy
| | - Rachele Fasolato
- Department of Woman and Child's Health, Padua University Hospital, 35128 Padua, Italy
| | - Sara Iannattone
- Department of General Psychology, University of Padua, 35131 Padua, Italy
| | - Perla Valentini
- Department of Communication Sciences, Humanistic and International Studies: History, Culture, Languages, Literature, Arts, Media, University of Urbino 'Carlo Bo', 61029 Urbino, Italy
| | - Eleonora Sale
- Department of Woman and Child's Health, Padua University Hospital, 35128 Padua, Italy
| | - Michela Gatta
- Department of Woman and Child's Health, Padua University Hospital, 35128 Padua, Italy
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Hu Z, Yu H, Zou J, Zhang Y, Lu Z, Hu M. Relationship among self-injury, experiential avoidance, cognitive fusion, anxiety, and depression in Chinese adolescent patients with nonsuicidal self-injury. Brain Behav 2021; 11:e2419. [PMID: 34816613 PMCID: PMC8671785 DOI: 10.1002/brb3.2419] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 09/17/2021] [Accepted: 10/12/2021] [Indexed: 01/21/2023] Open
Abstract
OBJECTIVE To explore relationship among self-injury behavior, experiential avoidance, cognitive fusion, anxiety, and depression in Chinese adolescent patients with nonsuicidal self-injury (NSSI). METHODS Cognitive fusion questionnaire (CFQ), Acceptance and Action Questionnaire-2nd edition (AAQ-II), adolescent nonsuicidal self-injury behavior questionnaire (ANSAQ), Hamilton Anxiety Scale (HAMA), and Hamilton Depression Scale (HAMD) were used as research tools to investigate 120 subjects with NSSI and 130 healthy controls. RESULTS The scores of CFQ and AAQ-II in the NSSI group were significantly higher than those in the healthy control group (p < .001). The results of regression analysis showed that the experiential avoidance score of patients with NSSI could predict the score of self-injury questionnaire (β = 0.585, p < .001); when predicting anxiety, only CFQ (β = 0.361, p < .001) entered the equation, with an explanatory variation of 12.3%; when predicting depression, CFQ (β = 0.287, p < .01) entered the equation, with an explanatory variation of 7.4%. CONCLUSION A high level of cognitive fusion and experiential avoidance may be important factors for the maintenance of self-injury behavior in patients with NSSI.
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Affiliation(s)
- Zhizhong Hu
- Department of Psychosomatic MedicineThe First Affiliated Hospital of Nanchang UniversityNanchangJiangxi ProvinceChina
- School of Public AdministrationNanchang UniversityNanchangJiangxi ProvinceChina
| | - Huijuan Yu
- Department of Psychosomatic MedicineThe First Affiliated Hospital of Nanchang UniversityNanchangJiangxi ProvinceChina
| | - Jingzhi Zou
- Department of Psychosomatic MedicineThe First Affiliated Hospital of Nanchang UniversityNanchangJiangxi ProvinceChina
| | - Yanyan Zhang
- Department of Psychosomatic MedicineThe First Affiliated Hospital of Nanchang UniversityNanchangJiangxi ProvinceChina
- School of Public AdministrationNanchang UniversityNanchangJiangxi ProvinceChina
| | - Zihang Lu
- Department of Psychosomatic MedicineThe First Affiliated Hospital of Nanchang UniversityNanchangJiangxi ProvinceChina
- School of Public AdministrationNanchang UniversityNanchangJiangxi ProvinceChina
| | - Maorong Hu
- Department of Psychosomatic MedicineThe First Affiliated Hospital of Nanchang UniversityNanchangJiangxi ProvinceChina
- School of Public AdministrationNanchang UniversityNanchangJiangxi ProvinceChina
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