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Byeon H. Can decoding the complex web of non-suicidal self-injury in adolescents pave the way for tailored interventions? World J Psychiatry 2025; 15:103258. [PMID: 40110013 PMCID: PMC11886340 DOI: 10.5498/wjp.v15.i3.103258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2024] [Revised: 01/03/2025] [Accepted: 01/11/2025] [Indexed: 02/26/2025] Open
Abstract
Non-suicidal self-injury (NSSI) is a prevalent and concerning issue in adolescent mental health, often intertwined with depressive symptoms. Despite extensive research on NSSI, a comprehensive understanding of its multifaceted nature and the intricate interplay of risk and resilience factors remains crucial. This Letter to the Editor examines a novel study by Yang et al, which utilized latent profile analysis and network analysis to delineate distinct NSSI subtypes within a Chinese adolescent population and investigate the underlying dynamics of associated factors. The study identifies three distinct NSSI subtypes: NSSI with depression, NSSI without depression, and neither, underscoring bullying as a prominent risk factor. Concurrently, the findings emphasized the pivotal role of emotional regulation and family support as protective factors. The focus of this article is to contextualize these findings within the broader framework of adolescent mental health and to highlight their implications for developing targeted interventions. These insights not only advance our understanding of adolescent NSSI but also provide a foundation for the development of targeted interventions that address the identified risk and protective factors. By focusing on these critical areas, mental health professionals can implement more effective strategies to mitigate NSSI behaviors and cultivate resilience in this vulnerable population.
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Affiliation(s)
- Haewon Byeon
- Workcare Digital Health Lab, Department of Convergence, Korea University of Technology and Education, Cheonan 31253, South Korea
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Tan J, Shu Y, Li Q, Liang L, Zhang Y, Zhang J, Wu G, Luo Y. Global, regional, and national burden of self-harm among adolescents aged 10-24 years from 1990 to 2021, temporal trends, health inequities and projection to 2041. Front Psychiatry 2025; 16:1564537. [PMID: 40225845 PMCID: PMC11986636 DOI: 10.3389/fpsyt.2025.1564537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2025] [Accepted: 02/26/2025] [Indexed: 04/15/2025] Open
Abstract
Background Self-harm ranks as the third leading cause of disability-adjusted life years (DALYs) among adolescents globally, imposing substantial disease and economic burdens. Comprehensive analyses of global temporal trends, health inequities, and future projections are crucial for developing effective public health policies and interventions. Methods This study analyzed the global, regional, and national age-standardized incidence, mortality, and DALYs for self-harm among adolescents using data from the Global Burden of Disease (GBD) 2021 database. Significant disease burdens and temporal trends were assessed. Projections and evaluations employed a combination of health inequities analysis, age-period-cohort (APC) analysis, socio-demographic index (SDI) analysis, Joinpoint regression analysis, and Bayesian APC modeling. Results The global burden of self-harm among adolescents demonstrated an overall downward trend. However, in 2021, the burden increased with age and is projected to decline further by 2041. Joinpoint regression analysis revealed a generally decreasing temporal trend, although some regions exhibited stable or slightly increasing trends. Significant regional and national heterogeneities were identified. The High SDI region showed a slight upward trend in incidence, Southern Latin America experienced the largest increase, and the Middle SDI region showed the largest decrease. Conversely, East Asia demonstrated the most significant reductions in both incidence and mortality. Age effects were most pronounced in Low-middle SDI regions, while period and cohort effects exhibited greater fluctuations in High SDI regions. Notably, SDI analysis revealed a positive, fluctuating nonlinear relationship with age-standardized DALYs (r = 0.324, P < 0.001). Gender and regional disparities were also significant. Male adolescents in Middle and High SDI regions bore a higher burden of mortality, whereas female adolescents in Low SDI regions experienced a disproportionately high incidence. Adolescents aged 15-24 carried the greatest burden, with females exhibiting a higher incidence and males experiencing higher mortality rates. Conclusion Despite an overall decline, significant gender and regional disparities persist. Male adolescents in higher SDI regions and females in lower SDI regions are particularly vulnerable. These findings underscore the need for targeted interventions addressing gender and regional inequalities, optimizing healthcare resource allocation, improving health education, and reducing the socioeconomic costs associated with self-harm in adolescents.
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Affiliation(s)
- Jiang Tan
- School of Psychology, Guizhou Normal University, Guiyang, China
- Key Laboratory of Brain Function and Brain Disease Prevention and Treatment of Guizhou Province, Guiyang, China
| | - Yanping Shu
- Department of Psychiatry, The Second People’s Hospital of Guizhou Province, Guiyang, China
| | - Qing Li
- The Second Clinical Medical College, Guizhou University of Traditional Chinese Medicine, Guiyang, China
| | - Lifan Liang
- College of Inland Open Economics, Guizhou University of Commerce, Guiyang, China
| | - Yu Zhang
- School of Psychology, Guizhou Normal University, Guiyang, China
- Key Laboratory of Brain Function and Brain Disease Prevention and Treatment of Guizhou Province, Guiyang, China
| | - Jiyuan Zhang
- School of Psychology, Guizhou Normal University, Guiyang, China
- Key Laboratory of Brain Function and Brain Disease Prevention and Treatment of Guizhou Province, Guiyang, China
| | - Gang Wu
- Department of Psychiatry, The Second People’s Hospital of Guizhou Province, Guiyang, China
| | - Yu Luo
- School of Psychology, Guizhou Normal University, Guiyang, China
- Key Laboratory of Brain Function and Brain Disease Prevention and Treatment of Guizhou Province, Guiyang, China
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Tian X, Huang H, Lu W, Zhang R, Wang R, Li X, Li D, Gao Y, Wu S, Xu G, Shao R, Lin K. Non-suicidal self-injury in adolescence: a validation of the Chinese version of the Inventory of Statements About Self-Injury in student populations. Front Psychiatry 2025; 16:1510681. [PMID: 40084054 PMCID: PMC11903741 DOI: 10.3389/fpsyt.2025.1510681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2024] [Accepted: 02/06/2025] [Indexed: 03/16/2025] Open
Abstract
Background The Inventory of Statements About Self-Injury (ISAS) is a widely utilized scale for evaluating the 13 potential functions that motivate non-suicidal self-injury(NSSI) behaviors. However, its validation for assessing such motivation in a Chinese context is still lacking. Aims The main objective was to access the validation of ISAS as an instrument in Chinese young population. Method A total of 1,106 completed online self-report questionnaires were collected, with 167 reporting a history NSSI. The age range of these individuals was 12 to 24 years old, comprising 74 female and 93 male participants. The factor structure and construct validity were calculated using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). The correlations of the Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder-7 (GAD-7), the Brief Self-Control Scale (BSCS), the Self-Rating Idea of Suicide Scale (SIOSS), and the Chinese version of the ISAS were tested using bivariate correlation analyses. Results The internal consistencies of the Chinese version of the ISAS were good to excellent, with 0.788- 0.950 and 0.80-0.949 in the sports group and the junior high school group, respectively. EFA and CFA exhibited a good two-factor structure model (NFI = 0.942, CFI = 0.974, IFI = 0.974, RMSEA = 0.068, SRMR = 0.043, CMIN/DF = 1.762). Moreover, the scores of the functions of the ISAS were correlated with depression (r=0.208, p<0.01), anxiety (r=0.223, p<0.01), suicidal ideation (r=0.322, p<0.01), and low self-control (r=-0.230, p<0.01). Conclusion This study validates the Chinese ISAS as a reliable NSSI measure, identifies a two-factor structure, and aims to inform targeted interventions and future research on self-injury behaviors among Chinese adolescents.
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Affiliation(s)
- Xinhe Tian
- Department of Affective Disorder, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Hebin Huang
- Department of Affective Disorder, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Weicong Lu
- Department of Affective Disorder, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Ruoxi Zhang
- Department of Affective Disorder, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Runhua Wang
- Department of Affective Disorder, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Xiaoyue Li
- Department of Affective Disorder, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Danping Li
- Department of Affective Disorder, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Yanling Gao
- Department of Affective Disorder, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Shiyun Wu
- Department of Affective Disorder, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Guiyun Xu
- Department of Affective Disorder, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Robin Shao
- Department of Affective Disorder, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
- State Key Laboratory of Brain and Cognitive Sciences, Department of Psychology, University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Kangguang Lin
- Department of Affective Disorder, The Affiliated Brain Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China
- Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, Guangzhou Medical University, Guangzhou, Guangdong, China
- School of Health and Life Sciences, University of Health and Rehabilitation Sciences, Qingdao, Shandong, China
- Department of Neurology, Lecong Hospital of Shunde, Foshan, Guangdong, China
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Liang H, Liu Z, Li X, An J, Zhao L, Chen L. Risk factors for suicidal ideation among survivors of suicide loss using a psychological support hotline. Front Psychiatry 2025; 16:1513838. [PMID: 40034182 PMCID: PMC11873561 DOI: 10.3389/fpsyt.2025.1513838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2024] [Accepted: 01/29/2025] [Indexed: 03/05/2025] Open
Abstract
Introduction Suicide of a loved one significantly affects the physical and mental well-being of close friends and family members, potentially escalating to suicidal ideation in severe cases. Suicidal ideation among survivors of suicide loss is influenced by a multitude of factors. This study aims to investigate the prevalence and risk factors of suicidal ideation among survivors of suicide loss utilizing a psychological support hotline. Methods This study included calls identified as survivors of suicide loss from the Beijing Psychological Support Hotline between 2009 and 2023 and evaluated the suicidal ideation of callers. General demographic data and common risk factors of survivors of suicide loss were collected. A comparison was conducted between survivors of suicide loss with and without suicidal ideation. Logistic regression was used to analyze the risk factors for suicidal ideation among survivors of suicide loss. Finally, we evaluated both multiplicative and additive interactions among the risk factors. Results Among the 308 calls from survivors of suicide loss, 174 (56.5%) exhibited suicidal ideation. Survivors who had experienced chronic negative life events (P=0.019), severe depression (P =0.010), or high levels of hopelessness (P=0.008) were more likely to develop suicidal ideation. The interaction between depression severity and hopelessness was additive, resulting in a 14.56-fold increase in the risk of developing suicidal ideation when both factors are present compared to their absence. Conclusions In the context of psychological support, chronic life events, high levels of hopelessness, and severe depression are risk factors for suicidal ideation among survivors of suicide loss. Moreover, hopelessness and depression demonstrate an additive interaction effect, substantially increasing the risk of suicidal ideation.
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Affiliation(s)
- Hong Liang
- Beijing Suicide Research and Prevention Center, Beijing Huilongguan Hospital, Beijing, China
- World Health Organization Collaborating Center for Research and Training in Suicide Prevention, Beijing, China
| | - Zikang Liu
- Beijing Suicide Research and Prevention Center, Beijing Huilongguan Hospital, Beijing, China
- World Health Organization Collaborating Center for Research and Training in Suicide Prevention, Beijing, China
- Department of Psychology, Chengde Medical University, Chengde, China
| | - Xingxue Li
- Beijing Suicide Research and Prevention Center, Beijing Huilongguan Hospital, Beijing, China
- World Health Organization Collaborating Center for Research and Training in Suicide Prevention, Beijing, China
- Department of Psychology, Chengde Medical University, Chengde, China
| | - Jing An
- Beijing Suicide Research and Prevention Center, Beijing Huilongguan Hospital, Beijing, China
- World Health Organization Collaborating Center for Research and Training in Suicide Prevention, Beijing, China
| | - Liting Zhao
- Beijing Suicide Research and Prevention Center, Beijing Huilongguan Hospital, Beijing, China
- World Health Organization Collaborating Center for Research and Training in Suicide Prevention, Beijing, China
| | - Lin Chen
- Beijing Suicide Research and Prevention Center, Beijing Huilongguan Hospital, Beijing, China
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Shen G, Li CH, Ruan QN, Xu S, Yan WJ. Assessing the contributions of gender, clinical symptoms, and psychometric traits to non-suicidal self-injury behaviors in Chinese adolescents: a nomogram approach. Child Adolesc Psychiatry Ment Health 2024; 18:139. [PMID: 39501322 PMCID: PMC11536789 DOI: 10.1186/s13034-024-00832-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2024] [Accepted: 10/24/2024] [Indexed: 11/09/2024] Open
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) behaviors among adolescents with mood disorders represent a significant global public health concern. This study aimed to assess the prevalence and identify key predictors of NSSI behaviors in Chinese adolescents diagnosed with depressive or bipolar disorders, addressing a critical gap in the literature. METHOD Data from 2343 participants in the Chinese Adolescent Depression Cohort (CADC) were analyzed. The study employed a comprehensive approach, utilizing medical records, clinical assessments, and validated psychometric instruments. Statistical analyses included chi-square tests, logistic regression, and ROC curve analyses, culminating in the development of a predictive nomogram. RESULTS The prevalence of NSSI behaviors was strikingly high at 73.32%. Significant predictors included female gender (AOR = 2.14, 95% CI [1.70, 2.68]), presence of hallucinations (AOR = 1.52, 95% CI [1.18, 1.97]), borderline personality features (AOR = 1.03, 95% CI [1.01, 1.08]), and childhood trauma (AOR = 1.02, 95% CI [1.01, 1.03]). The study's key contribution is a predictive nomogram with an AUC of 0.74, demonstrating good efficacy in predicting NSSI behaviors. CONCLUSION This research reveals an alarmingly high prevalence of NSSI behaviors in Chinese adolescents with mood disorders and identifies critical predictors spanning demographic, clinical, and psychometric domains. The developed nomogram offers a novel approach for risk assessment, highlighting the importance of comprehensive evaluations in adolescent mental healthcare. These findings have significant implications for developing targeted interventions and improving risk assessment strategies in clinical practice.
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Affiliation(s)
| | - Cheng-Han Li
- Third Affiliated Hospital of Wenzhou Medical University, Wenzhou, China
| | | | - Su Xu
- Department of Psychology, School of Education, Wenzhou University, Wenzhou, China.
| | - Wen-Jing Yan
- Wenzhou Key Laboratory of Basic and Translational Research for Mental Disorders, Wenzhou Medical University, Wenzhou, China.
- Zhejiang Provincial Clinical Research Centre for Mental Illness, Affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou, China.
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Yue L, Zhao R, Zhuo Y, Kou X, Yu J. Experiences and attitudes of psychiatric nurses in caring for patients with repeated non-suicidal self-injury in China: a qualitative study. BMC Psychiatry 2024; 24:629. [PMID: 39334168 PMCID: PMC11438181 DOI: 10.1186/s12888-024-06064-9] [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: 05/10/2024] [Accepted: 09/09/2024] [Indexed: 09/30/2024] Open
Abstract
BACKGROUND The incidence of non-suicidal self-injury (NSSI) is high and often occurs repeatedly. Psychiatric nurses play a vital role in the care and treatment of NSSI patients, as they have the most frequent contact with patients. The experiences and attitudes of nurses has a direct affect on the quality of care they provide to patients. Negative care experiences and attitudes of patient aversion on behalf of nurses may delay the observation and treatment of changes in the patient's condition, leading to irreversible risks. Although cross-sectional studies have investigated the attitudes of medical staff toward NSSI patients, quantitative research results cannot comprehensively reflect the emotional experiences and complex psychological changes of the study subjects. A few studies have focused on the psychiatric nurses' care experiences and attitudes toward patients with repeated NSSI. OBJECTIVE This study aimed to explore psychiatric nurses' care experiences and attitudes toward patients during repeated NSSI. METHODS A thematic analysis qualitative study was used. Using purposive sampling, 18 psychiatric nurses were recruited from a mental health center in Chengdu, China. Semi-structured interviews were conducted and audio-recorded. Audio-recordings were transcribed verbatim and analyzed using six-phase thematic analysis. RESULTS Four themes emerged from the analysis: psychiatric nurses' care experiences, perceptions, care attitudes and coping style toward repeated NSSI patients. Psychiatric nurses have experienced negative care experiences and severe career burnout during the patient's repeated NSSI. Nurses' attitudes toward NSSI patients changed during repeated NSSI, from understanding to indifference to anger and resentment. At the same time, it was found that nurses' coping style with NSSI patients could be divided into three stages, namely, active coping, neglect and perfunctory, and criticism and punishment. CONCLUSIONS The findings have implications for health care systems regarding interventions to improve nurses' care experiences and attitudes toward repeated NSSI patients. These findings suggest that enhancing nurses' understanding of NSSI, establishing standardized emergency response and intervention programs, guiding positive professional values and responsibility, and improving nurses' caring attitudes can promote the early detection and timely intervention of NSSI.
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Affiliation(s)
- Leiyu Yue
- Mental Health Center of West China Hospital, Sichuan University, No. 28 South Dianxin Street, Chengdu, 610041, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Rui Zhao
- Geriatric Psychiatric Ward 2, The Fourth People's Hospital of Chengdu, Chengdu, PR China
| | - Yu Zhuo
- Mental Health Center of West China Hospital, Sichuan University, No. 28 South Dianxin Street, Chengdu, 610041, China
| | - Xiaomin Kou
- Mental Health Center of West China Hospital, Sichuan University, No. 28 South Dianxin Street, Chengdu, 610041, China
| | - Jianying Yu
- Mental Health Center of West China Hospital, Sichuan University, No. 28 South Dianxin Street, Chengdu, 610041, China.
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Li Y, Wan Z, Gong X, Wen L, Sun T, Liu J, Xie X, Zhang C, Cai Z. The association between child maltreatment, cognitive reappraisal, negative coping styles, and non-suicidal self-injury in adolescents with major depressive disorder. BMC Psychiatry 2024; 24:592. [PMID: 39223473 PMCID: PMC11370082 DOI: 10.1186/s12888-024-06041-2] [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] [Received: 01/30/2024] [Accepted: 08/22/2024] [Indexed: 09/04/2024] Open
Abstract
BACKGROUND Non-suicidal self-injury (NSSI) is a significant public health concern among adolescents with major depressive disorders (MDD). Although previous research has linked child maltreatment (CM) to NSSI, the precise mechanisms remain unclear. This study aims to investigate the association between CM, cognitive reappraisal (CR), negative coping styles (NC) and NSSI in adolescents with MDD, from the perspectives of both Latent Variable Theory and the Network Theory of Mental Disorder. METHODS A sample of 651 adolescents with MDD was recruited from January to December 2023. Data on CM, CR, NC, and NSSI were collected through paper-based self-reported questionnaires. Data analysis primarily involved structural equation modeling and network analysis. RESULTS The reporting rate of NSSI among adolescents with MDD was 48.2%. CM showed a significant positive correlation with NSSI. NSSI was affected by CM through three paths: the mediating role of CR, the mediating role of NC, and the chain mediating role of both CR and NC. Emotional abuse (EA) was the central node, while NSSI, EA, and "The urge to cry quietly when faced with troubles"(NC10) were the key bridge nodes. CONCLUSIONS This study is the first to use both structural equation modeling and network analysis to explore the explore the relationship between CM, CR, NC, and NSSI in adolescents with MDD, providing a theoretical basis for future early prevention and targeted interventions for adolescents with MDD.
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Affiliation(s)
- Yinglin Li
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Zhiying Wan
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Xuan Gong
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Li Wen
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Ting Sun
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Jingfang Liu
- Department of Psychiatry, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Xiangying Xie
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Chunlong Zhang
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, 430060, China
| | - Zhongxiang Cai
- Department of Nursing, Renmin Hospital of Wuhan University, Wuhan, 430060, China.
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Huang L, Hou D, Xiao Q, Huang X. Associations Among Psychological Resilience, Self-Esteem, Social Support, and Non-Suicidal Self-Injury Behaviors in Adolescents Receiving Inpatient Psychiatric Care. J Psychosoc Nurs Ment Health Serv 2024; 62:47-54. [PMID: 38451118 DOI: 10.3928/02793695-20240301-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
PURPOSE To explore associations among psychological resilience, self-esteem, social support, and non-suicidal self-injury (NSSI) behaviors in adolescents receiving inpatient psychiatric care. METHOD In this cross-sectional study, 505 Chinese adolescents (aged 10 to 19 years) receiving inpatient psychiatric care completed a general characteristics questionnaire, the Psychological Resilience Scale (PRS), Self-Esteem Scale (SES), and Child and Adolescent Social Support Scale (CASSS). Statistical tests were used to compare NSSI incidence, scale scores, and factors influencing NSSI. RESULTS The incidence rate of NSSI was 77.82% (n = 393). Total and dimension scores on the PRS, SES, and CASSS in the NSSI group were significantly lower than those in the non-NSSI group (p < 0.01). Binary logistic multifactorial regression analysis showed that participants who were female and aged 10 to 14 years were more prone to NSSI behavior (p < 0.05). Having close friends, high parental expectations, and moderate to high self-esteem were protective factors for NSSI behavior (p < 0.05). CONCLUSION Nursing personnel should prioritize enhancing psychological resilience, self-esteem, and social support in adolescents receiving inpatient psychiatric care to mitigate the risk of NSSI and ensure the safety of hospitalized individuals. [Journal of Psychosocial Nursing and Mental Health Services, 62(9), 47-54.].
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Wang Y, Chen X, Song C, Wu Y, Liu L, Yang L, Hao X. A qualitative internet-based study of parental experiences of adolescents suffering from affective disorders with non-suicidal self-injury during the COVID-19 pandemic. Front Psychiatry 2024; 15:1361144. [PMID: 38596632 PMCID: PMC11002897 DOI: 10.3389/fpsyt.2024.1361144] [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: 12/25/2023] [Accepted: 03/12/2024] [Indexed: 04/11/2024] Open
Abstract
Objective Non-suicidal self-injury (NSSI) behaviors of adolescents with affective disorders can directly deteriorate parents' internal experiences, and negative parental experiences can exacerbate or even worsen NSSI behaviors. This study investigates the impact of NSSI behaviors exhibited by adolescents with affective disorders on the internal experiences of parents. Specifically, our research focuses on the inner experiences of parents when their children engage in NSSI behaviors during social isolation of the COVID-19, offering insights for addressing parental mental health issues related to NSSI and developing positive parental behavioral models to optimize adolescent behavior during major public health events. Methods Semi-structured interviews were conducted with 21 parents of adolescents with affective disorders displaying NSSI behaviors during the COVID-19 pandemic. The Colaizzi 7-step analysis was employed to refine and categorize emerging themes. Results Our study revealed that parents of adolescents facing NSSI during the COVID-19 pandemic underwent different internal experiences, which could be classified into four themes: negative experience, high caregiving burden, lack of caregiving capacity, and resilience. Conclusion This Internet-based research is the first to explore the internal experiences of parents of adolescents with affective disorders experiencing NSSI during the COVID-19 pandemic. It sheds light on how parents, in response to their children's NSSI behaviors, undergo resilience following negative experiences, explore more open and supportive family model. Despite these positive outcomes, parents express a need for increased knowledge about NSSI illness care and a desire for professional assistance.
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Affiliation(s)
- Yongna Wang
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, China
| | - Xueqiu Chen
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, China
| | - Chun Song
- Xinjiang Key Laboratory of Neurological Disorder Research, The Second Affiliated Hospital of Xinjiang Medical University, Urumqi, China
| | - Yan Wu
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, China
| | - Lihua Liu
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, China
| | - Lili Yang
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, China
| | - Xuege Hao
- Beijing Hui-Long-Guan Hospital, Peking University, Beijing, China
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Qin Y, Wu D, Liu J, Peng J, Li C. Perspectives of parents of adolescents with repeated non-suicidal self-injury on sharing their caretaking experiences with peers: a qualitative study. Front Psychiatry 2023; 14:1237436. [PMID: 38148747 PMCID: PMC10750419 DOI: 10.3389/fpsyt.2023.1237436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 11/24/2023] [Indexed: 12/28/2023] Open
Abstract
BACKGROUND The prevalence of non-suicidal self-injury among adolescents has increased over the years. Most parents, however, are poorly informed and confused about this behavior. Sharing caretaking experiences with parents in similar situations seems to be beneficial. Nevertheless, few researchers have explored the views of parents who share their caretaking experiences with peers. AIM This study aimed to investigate the perspectives of parents of adolescents with repeated non-suicidal self-injury on sharing their caretaking experiences with peers as well as the motivations for and barriers to this behavior. METHODS This qualitative study adopted a purposive sampling method. Participants (16 mothers and 2 fathers) were recruited from the mental health center of a tertiary hospital in Chengdu, Sichuan, China. A total of 18 semistructured face-to-face individual interviews were conducted. All interviews were audio-recorded and analyzed thematically using NVivo 11. RESULTS Three themes and nine subthemes were identified: (1) sharable caretaking experiences: reflection and transformation, self-emotional management, and diversified support; (2) motivations for sharing: empathy, reciprocity, and meaning; and (3) barriers to sharing: inadequate knowledge, low self-identity, and concerns for children. CONCLUSION Parents accumulate a wealth of experience during their long-term care of adolescents with repeated non-suicidal self-injury. Although most parents are willing to share their caretaking experiences with peers, there are several barriers. Therefore, in order to increase parents' motivation to share, psychological education is necessary.
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Affiliation(s)
- Yuan Qin
- School of Nursing, Chengdu Medical College, Chengdu, China
- Chongqing Mental Health Center, Chongqing, China
| | - Dongmei Wu
- Department of Nursing, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
- Nursing Key Laboratory of Sichuan Province, Chengdu, China
| | - Jiao Liu
- School of Nursing, Zunyi Medical University, Zunyi, China
| | - Jianyan Peng
- Department of Nursing, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
| | - Chunya Li
- Department of Nursing, The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Laboratory for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
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Shi Y, Song Y, Wang L, Liu J, Chen IJ. Early maladaptive schemas and the risk of nonsuicidal self-injury in college students: A retrospective study. Medicine (Baltimore) 2023; 102:e35584. [PMID: 38013353 PMCID: PMC10681388 DOI: 10.1097/md.0000000000035584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 09/20/2023] [Indexed: 11/29/2023] Open
Abstract
Early maladaptive schemas (EMSs) may be closely related to nonsuicidal self-injury (NSSI). The present study aimed to discuss the relationship between EMS and a personal history of NSSI. This was a retrospective study. A total of 1339 Chinese college students between 16 and 29 years old were asked to complete a questionnaire survey regarding their personal history of NSSI and EMSs. 116 college students reported a history of NSSI (NSSI group), who differed significantly in terms of all EMS-related scores than non-NSSI group(n = 1223). Logistic regression analysis showed that the scores in the disconnection/rejection schema domain exhibited by subjects who were the only child in their family could help differentiate between college students with or without NSSI. The emotional deprivation schema was significantly associated with the lifetime frequency of NSSI behaviors; the vulnerability to harm or illness schema was significantly associated with the internal emotion regulation function and pain associated with NSSI; and the enmeshment/underdeveloped self schema was significantly associated with the addictive features of NSSI. The self-sacrifice schema was significantly associated with the external emotion regulation function of NSSI; the enmeshment/underdeveloped self schema was positively related with the sensation-seeking function of NSSI; and the abandonment/instability schema was negatively related the sensation-seeking function of NSSI. The disconnection/rejection schema domain was highly related with NSSI behaviors. EMS is significantly associated with the history, functions, addictive features, and severity of NSSI. Every EMS is worthy of further investigation and discussion with patients in the context of NSSI behaviors during clinical therapy.
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Affiliation(s)
- Ying Shi
- Department of Psychology, School of Education, Soochow University, Dushuhu Campus, Suzhou City, China
| | - Yunping Song
- Department of Psychology, School of Education, Soochow University, Dushuhu Campus, Suzhou City, China
| | - Liling Wang
- Department of Psychology, School of Education, Soochow University, Dushuhu Campus, Suzhou City, China
| | - Jingyi Liu
- Department of Psychology, School of Education, Soochow University, Dushuhu Campus, Suzhou City, China
| | - I-Jun Chen
- Department of Psychology, School of Education, Soochow University, Dushuhu Campus, Suzhou City, China
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12
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Li X, Liu S, Tian Y, He J, Chen H, Ning M, Chen Z, Yang J, Li Y, Zhou J. Challenges for psychiatric nurses working with non-suicidal self-injury adolescents: a qualitative study. BMC Nurs 2023; 22:382. [PMID: 37833692 PMCID: PMC10571286 DOI: 10.1186/s12912-023-01542-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Accepted: 09/27/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Psychiatric nurses play a crucial role in treating and supporting adolescents with non-suicidal self-injury (NSSI) in China. However, few studies have explored their experiences and challenges. OBJECTIVES The aim of this qualitative study was to describe the challenges experienced by psychiatric nurses when working with adolescents having NSSI behaviors. METHODS This was a descriptive qualitative study using phenomenological approach. 18 psychiatric nurses from psychiatric wards were recruited from a tertiary hospital from Changsha, Hunan province, China. In-depth interview was performed for each participant collecting information about their feelings and experiences taking care of NSSI adolescents. ATLAS.ti 8 was used to enter data and perform thematic analysis following the six-phased process described by Braun and Clarke. RESULTS Two main themes and five sub-themes were summarized in this study. Nurses experienced both (1) Internal challenges (Lacking knowledge and skills to deal with NSSI adolescents and Feeling hard and stressful working with NSSI adolescents) and (2) External barriers (Unrealistic high expectations from family and schools, Uncooperative parents and Little help from communities and schools). CONCLUSIONS Psychiatric nurses had to face with their own negative feelings, insufficient knowledge and skills, alongside with pressures and little help from family, schools and communities when working with NSSI adolescents. Targeted training programs of treating NSSI adolescents and their supporting systems be performed in nurses, furthermore, family, schools and societies should also be raised.
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Affiliation(s)
- Xuting Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, China
- Department of Thoracic Surgery, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Shiyan Liu
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yusheng Tian
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Juan He
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Hui Chen
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Meng Ning
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Zengyu Chen
- Xiangya School of Nursing, Central South University, Changsha, Hunan, China
| | - Jiaxin Yang
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Yamin Li
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China.
| | - Jiansong Zhou
- Department of Psychiatry, National Clinical Research Center for Mental Disorders, The Second Xiangya Hospital, Central South University, Changsha, China.
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Xiao Q, Song X, Huang L, Hou D, Huang X. Global prevalence and characteristics of non-suicidal self-injury between 2010 and 2021 among a non-clinical sample of adolescents: A meta-analysis. Front Psychiatry 2022; 13:912441. [PMID: 36032224 PMCID: PMC9399519 DOI: 10.3389/fpsyt.2022.912441] [Citation(s) in RCA: 77] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 07/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Adolescents with immature mind and unstable emotional control are high-risk groups of non-suicidal self-injury (NSSI) behavior. We meta-analyzed the global prevalence of NSSI and prevalence of NSSI characteristics in a non-clinical sample of adolescents between 2010 and 2021. Methods A systematic search for relevant articles published from January 1, 2010 to June 30, 2021 was performed within the scholarly database search engines of CBM, CNKI, VIP, Wanfang, PubMed, Web of Science, PsycINFO, and Embase. Eligibility criteria were as follows: provided cross-sectional data on the prevalence of NSSI; the subjects were non-clinical sample adolescents; and a clear definition of NSSI was reported. We used the following definiton of NSSI as our standard: the deliberate, self-inflicted destruction of body tissue, such as cutting, burning, and biting, without attempted suicide. The quality evaluation tool for cross-sectional studies recommended by the JBI was used. The global prevalence of NSSI was calculated based on the random-effects model by Comprehensive Meta-analysis version 3.0. Subgroup analyses were performed to compare the prevalence according to sex, living place, smoking or drinking history, and family structure. Results Sixty-two studies involving 264,638 adolescents were included. The aggregate prevalence of NSSI among a non-clinical sample of adolescents was similar between over a lifetime (22.0%, 95% CI 17.9-26.6) and during a 12-month period (23.2%, 95% CI 20.2-26.5). Repetitive NSSI was more common than episodic NSSI (20.3% vs. 8.3%) but the frequency of mild injury (12.6%) was similar to that of moderate injury (11.6%). Multiple-method NSSI occurred slightly more often compared than one-method NSSI (16.0% vs. 11.1%). The top three types of NSSI in adolescents were banging/hitting (12.0%, 95% CI 8.9-15.9), pinching (10.0%, 95% CI 6.7-14.8), and pulling hair (9.8%, 95% CI 8.3-11.5), and the least common type was swallowing drugs/toxic substances/chemicals (1.0%, 95% CI 0.5-2.2). Subgroup analyses showed that being female, smoking, drinking, having siblings, and belonging to a single-parent family may be linked to higher prevalence of NSSI. Conclusion This meta-analysis found a high prevalence of NSSI in non-clinical sample of adolescents, but there are some changes in severity, methods, and reasons. Based on the current evidence, adolescents in modern society are more inclined to implement NSSI behavior by a variety of ways, which usually are repetitive, and moderate and severe injuries are gradually increasing. It is also worth noting that adolescents with siblings or in single-parent families are relatively more likely to implement NSSI behavior due to maladjustment to the new family model. Future research needs to continue to elucidate the features and risk factors of NSSI so as to intervene in a targeted way. Limitation The limitation of this study is that the heterogeneity among the included studies is not low, and it is mainly related to Chinese and English studies. The results of this study should be used with caution. Systematic review registration [www.crd.york.ac.uk/prospero/], identifier [CRD42022283217].
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Affiliation(s)
- Qingqing Xiao
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Xiaozhen Song
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Lijuan Huang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Dandan Hou
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
| | - Xuehua Huang
- Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
- West China School of Nursing, Sichuan University, Chengdu, China
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