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Kudinova AY, Brick LA, Armey M, Nugent NR. Micro-sequences of anger and shame and non-suicidal self-injury in youth: an ecological momentary assessment study. J Child Psychol Psychiatry 2024; 65:137-147. [PMID: 37525367 PMCID: PMC10828100 DOI: 10.1111/jcpp.13869] [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] [Accepted: 06/07/2023] [Indexed: 08/02/2023]
Abstract
OBJECTIVE Non-suicidal self-injury (NSSI) is a significant mental health concern with the highest prevalence among adolescents. NSSI has been conceptualized as one of the maladaptive strategies to cope with challenging affect or a form of self-punishment. Although characterizing moment-to-moment associations between shame and NSSI in individuals' real-world environment and partitioning between- and within-person effects is critical for mobile and timely interventions, most studies examined habitual experiences of negative affective states and focused on adults. METHOD In this study, we focused on in vivo anger at self and others and shame and NSSI among 158 adolescents 3 weeks following their psychiatric hospitalizations using ecological momentary assessment (EMA) technology. RESULTS We found that greater between-person levels of anger at self and others were linked to a higher number of subsequent NSSI occurrences within a day. These findings remained primarily unchanged when we statistically adjusted for participants' age, sex assigned at birth, the number of current psychiatric diagnoses, EMA response rates, and youth lifetime history of SI. Within-person increases in NSSI were linked to increased anger at self over and beyond between-person average levels of NSSI. CONCLUSIONS These findings highlight the potential regulatory role of NSSI to decrease negative affective states and point to the clinical utility of assessing and early mobile interventions targeting challenging affect in youth.
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Affiliation(s)
- Anastacia Y Kudinova
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- Division of Child Psychiatry, Bradley Hospital, Providence, RI, USA
| | - Leslie A Brick
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Michael Armey
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
| | - Nicole R Nugent
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
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Geng S, Wang L, Sun J, Xu M, Zhang L, Yi Z, Ji J, Zhang X. Risk factors and protective factors for nonsuicidal self-injury in adolescents: A hospital- and school-based case-control study. Clin Child Psychol Psychiatry 2023; 28:1321-1332. [PMID: 37038624 DOI: 10.1177/13591045231169087] [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] [Indexed: 04/12/2023]
Abstract
OBJECTIVE Nonsuicidal Self-Injury (NSSI) in China has increasingly interested clinicians, although few studies have investigated its risk and protective factors. This study examined the risk factors of NSSI among Chinese adolescents. METHODS The researchers recruited adolescent participants with NSSI from a hospital outpatient clinic to form a case group and recruited adolescents without NSSI who provided informed consent from the school to form a control group. Participants completed a questionnaire, and data were analyzed using logistic regression. RESULTS A total of 138 cases and 276 controls participated in this study. Binary multivariate logistic regression analysis with adjusting for age and sex showed that domestic violence (OR = 8.615, 95%CI: 3.081-24.091), parental overconcern (OR = 6.995, 95%CI: 3.447-14.192), guilt (OR = 4.949, 95%CI: 2.227-10.996), and school bullying (OR = 21.676, 95%CI: 6.799-69.109) increased the risk of NSSI, while peer support (OR = 0.068, 95%CI: 0.030-0.150) and living in an urban environment (OR = 0.157, 95%CI: 0.056-0.437) decreased the risk of NSSI. CONCLUSION Some psychosocial factors were confirmed to be independent risk and protective factors for NSSI in this study. However, the clinical significance of the results needs to be interpreted with caution due to sample size limitations.
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Affiliation(s)
- Shuo Geng
- Department of Clinical Psychology, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Lin Wang
- Sleep Medicine Center, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jinping Sun
- Department of Neurology, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Mingdong Xu
- Department of Clinical Psychology, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Li Zhang
- Department of Psychology, Qingdao University, Qingdao, China
| | - Zhi Yi
- Department of Pediatric Neurology, the Affiliated Hospital of Qingdao University, Qingdao, China
| | - Jun Ji
- College of Computer Science and Technology, Qingdao University, Qingdao, China
| | - Xu Zhang
- Department of Clinical Psychology, the Affiliated Hospital of Qingdao University, Qingdao, China
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Haliczer LA, Dixon-Gordon KL. Social stressors, emotional responses, and NSSI urges and behaviors in daily life. J Affect Disord 2023; 338:601-609. [PMID: 37364658 DOI: 10.1016/j.jad.2023.06.043] [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: 02/03/2023] [Revised: 05/21/2023] [Accepted: 06/20/2023] [Indexed: 06/28/2023]
Abstract
BACKGROUND The defective self model of nonsuicidal self-injury (NSSI) theorizes that individuals who are highly self-critical are more likely to choose NSSI to regulate emotions. This model indirectly suggests that individuals who engage in NSSI may experience more self-conscious emotions in response to negative social feedback, increasing risk for near-term NSSI. This study examined (1) whether individuals with a history of NSSI (vs. without) display greater self-conscious and negative emotional reactions to daily social stressors, and more problematic features of these daily social stressors, and (2) whether greater-than-usual negative emotional reactions and social stressor features predict NSSI urges and behaviors in daily life. METHODS Participants were 134 female college students with recent, recurrent NSSI (n = 77) or no NSSI history (n = 57). Participants completed baseline measures of socioemotional functioning and a two-week daily diary protocol. RESULTS The NSSI (vs. no NSSI) group reported significantly greater self-conscious and negative emotional reactions to daily social stressors, and social stressors characterized by greater dysfunction. In the NSSI group, experiencing social stressors characterized by greater distress than one's average during the daily diary period was associated with same-day NSSI urges and behavior, greater confusion than one's average predicted same-day NSSI urges, and greater conflict than one's average predicted same-day NSSI behavior. Greater self-conscious and negative emotional reactions to these stressors than one's average predicted same-day NSSI urges and behavior. LIMITATIONS Limitations include reliance on self-report, a once-daily assessment, and lack of generalizability to other samples. CONCLUSIONS Interpersonal conflict and increased self-conscious emotions pose vulnerability for NSSI. Prevention and intervention efforts would benefit from including a focus on interpersonal functioning.
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Affiliation(s)
- Lauren A Haliczer
- University of Massachusetts Amherst, USA; Massachusetts General Hospital/Harvard Medical School, USA.
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Sun K, Li A, Li Y, Xie J, Tong Y, Ma J, Wu Y. A cross-sectional study of non-suicidal self-injury in a Chinese adolescent inpatient cohort. Front Psychiatry 2023; 14:1109334. [PMID: 37293407 PMCID: PMC10244503 DOI: 10.3389/fpsyt.2023.1109334] [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: 11/27/2022] [Accepted: 05/05/2023] [Indexed: 06/10/2023] Open
Abstract
Background Non-suicidal self-injury (NSSI) is a significant predictor of completed suicide and is increasingly recognized as a serious public health concern. Multiple factors, including social, familial, mental, and genetic factors could influence the occurrence of this behavior. Identifying the early risk factors is important for screening and preventing this behavior. Methods Here, we recruited a total of 742 adolescent inpatient participants from a mental health center and conducted a series of diagnostic interviews and questionnaires to assess NSSI behavior and other events. Bivariate analysis was used to detect differences between groups in NSSI and non-NSSI. Then, binary logistic regression was fitted to identify predictors of NSSI as a function of these questionnaire scores. Results Of the 742 adolescents examined, a total of 382 (51.5%) participants engaged in NSSI. Bivariate analysis showed that age, gender, depression, anxiety, insomnia, and childhood trauma was significantly associated with NSSI. Logistic regression results suggested that females had 2.43 higher odds of engaging in NSSI when compared to their male counterparts (OR = 3.43, 95%CI = 2.09-5.74, p = 1.70 × 10-6). Depression was a primary risk predictor for NSSI with each additional increase in symptoms of depression increasing the odds of engaging in NSSI by 18% (OR = 1.18, 95%CI = 1.12-1.25, p = 2.25 × 10-8). Conclusion More than half of the adolescent inpatients with psychiatric disorders have NSSI experience. Depression and gender were the risk factors for NSSI. Age at a specific range had a high prevalence of NSSI.
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Affiliation(s)
- Ke Sun
- Department of Child and Adolescent Psychiatry, Wuhan Mental Health Center, Wuhan, Hubei, China
| | - Anni Li
- Department of Child and Adolescent Psychiatry, Wuhan Mental Health Center, Wuhan, Hubei, China
| | - Yichen Li
- Department of Child and Adolescent Psychiatry, Wuhan Mental Health Center, Wuhan, Hubei, China
| | - Jun Xie
- Department of Child and Adolescent Psychiatry, Wuhan Mental Health Center, Wuhan, Hubei, China
| | - Yonghao Tong
- Department of Child and Adolescent Psychiatry, Wuhan Mental Health Center, Wuhan, Hubei, China
| | - Jun Ma
- Department of Child and Adolescent Psychiatry, Wuhan Mental Health Center, Wuhan, Hubei, China
- Affiliated Wuhan Mental Health Center, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Yong Wu
- Research Center for Mental Health and Neuroscience, Wuhan Mental Health Center, Wuhan, Hubei, China
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Grove JL, Carlson SE, Parkhurst KA, O’Neill JC, Smith TW. Nonsuicidal self-injury, sleep quality, and shame response to a laboratory stress task. J Clin Psychol 2023; 79:871-885. [PMID: 36223526 PMCID: PMC9925399 DOI: 10.1002/jclp.23450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 07/26/2022] [Accepted: 09/30/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Nonsuicidal self-injury (NSSI) frequently functions to regulate shame-based emotions and cognitions in the context of interpersonal stress. The present study sought to examine how sleep quality (SQ) may influence this process in a laboratory setting. METHODS Participants included 72 adults (Mage = 24.28; 36 with a lifetime history of NSSI) who completed a self-report measure of prior month SQ and engaged in a modified Trier social stress task (TSST). State shame ratings were collected immediately before and following the TSST, as well as 5 min post-TSST, to allow for the measurement of shame reactivity and recovery. RESULTS No significant results emerged for NSSI history and SQ as statistical predictors of shame reactivity. However, NSSI history was significantly associated with heightened shame intensity during the recovery period of the task, and this was moderated by SQ. Simple slopes analyses revealed a conditional effect whereby poorer SQ (1SD above the mean) was associated with greater intensity of shame during recovery, but only for those with a history of NSSI. CONCLUSION Poor SQ may contribute to worrisome emotional responses to daytime stressors in those at risk for NSSI.
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Kennedy-Turner J, Sawrikar V, Clark L, Griffiths H. Do attachment-related differences in reflective functioning explain associations between expressed emotion and youth self-harm? CURRENT PSYCHOLOGY 2022; 42:1-15. [PMID: 36043216 PMCID: PMC9411045 DOI: 10.1007/s12144-022-03614-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2022] [Indexed: 11/03/2022]
Abstract
Youth self-harm is associated with poor health outcomes and attempted and completed suicide. Associations exist between self-harm and expressed emotion (EE), attachment insecurity, and reflective functioning (RF), but these associations are poorly understood. This study evaluates a mediation model in which perceived caregiver EE (pEE) exerts an indirect effect on youth self-harm through attachment insecurity and RF uncertainty. 461 participants aged 16-24 years completed an online survey. Statistical analyses revealed significant direct effects of pEE on attachment insecurity, and of RF uncertainty on self-harm; however, some direct effects were specific to pEE from female caregivers, and attachment insecurity in youth relationships with female caregivers. A significant direct effect of pEE on self-harm was found for pEE from male caregivers only. Significant indirect effects of pEE on self-harm through attachment anxiety and RF uncertainty were found only in relation to female caregivers. The findings encourage family-, attachment-, and mentalization-based approaches to preventing and treating youth self-harm, with a recommendation that caregivers are given adequate support, education, and skills-based training following youth disclosures of self-harm. Supplementary Information The online version contains supplementary material available at 10.1007/s12144-022-03614-w.
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Affiliation(s)
- Jamie Kennedy-Turner
- Clinical Psychology Department, School of Health in Social Science, The University of Edinburgh, Doorway 6, Elsie Inglis Quad, Old Medical School, Teviot Place, Edinburgh, EH8 9AG UK
- Pennywell All Care Centre, CAMHS North Edinburgh, 1 Macmillan Crescent, Edinburgh, EH4 4WL UK
| | - Vilas Sawrikar
- Clinical Psychology Department, School of Health in Social Science, The University of Edinburgh, Doorway 6, Elsie Inglis Quad, Old Medical School, Teviot Place, Edinburgh, EH8 9AG UK
| | - Lucy Clark
- NHS Education for Scotland, 102 West Port, Edinburgh, EH3 9DN UK
| | - Helen Griffiths
- Clinical Psychology Department, School of Health in Social Science, The University of Edinburgh, Doorway 6, Elsie Inglis Quad, Old Medical School, Teviot Place, Edinburgh, EH8 9AG UK
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Tschan T, Pfeiffer S, Gutzweiler R, In-Albon T. A comparison of expressed emotion between mothers and their adolescent daughters with and without a history of nonsuicidal self-injury. Child Adolesc Psychiatry Ment Health 2022; 16:64. [PMID: 35941688 PMCID: PMC9361609 DOI: 10.1186/s13034-022-00500-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 07/29/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Expressed Emotion refers to the extent to which close relatives express critical/hostile and/or emotionally overinvolved attitudes and feelings when speaking about a family member. High Expressed Emotion is a valuable predictor of clinical outcomes and is related to the presence of various mental disorders, including nonsuicidal self-injury (NSSI). Interpersonal factors have been shown to be relevant in initiating and in maintaining with NSSI, as interpersonal difficulties are often reported as triggers for emotional dysregulation. The parental role in the etiology and treatment of NSSI needs to be further investigated. This study assesses Expressed Emotion in adolescents who engage in NSSI and their mothers. METHOD We examined Expressed Emotion levels of mother-daughter dyads among adolescents who engage in NSSI, clinical controls (CCs), and nonclinical controls (NCs). The sample consisted of 70 female adolescents aged 12-20 years (M = 15.28 years, SD = 1.81; NSSI: n = 21, CC: n = 17, NC: n = 32) and 24 mothers aged 38-56 years (M = 46.47 years, SD = 4.61) using The Five-Minute Speech Sample (FMSS). RESULTS Adolescents who engage in NSSI exhibited significantly more covert criticism and critical tone toward their mothers than CCs (d = 0.65, d = 1.10) and NCs (d = 1.30, d = 1.10). CONCLUSION The findings highlight the importance of family-based interventions for the treatment of NSSI in order to enhance a positive relationship quality between parents and adolescents.
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Affiliation(s)
- Taru Tschan
- grid.5892.60000 0001 0087 7257Clinical Child and Adolescent Psychology, University of Koblenz-Landau, Landau, Ostbahnstraße 12, 76829 Landau, Germany
| | - Simone Pfeiffer
- grid.5892.60000 0001 0087 7257Clinical Child and Adolescent Psychology, University of Koblenz-Landau, Landau, Ostbahnstraße 12, 76829 Landau, Germany
| | - Raphael Gutzweiler
- grid.5892.60000 0001 0087 7257Clinical Child and Adolescent Psychology, University of Koblenz-Landau, Landau, Ostbahnstraße 12, 76829 Landau, Germany
| | - Tina In-Albon
- Clinical Child and Adolescent Psychology, University of Koblenz-Landau, Landau, Ostbahnstraße 12, 76829, Landau, Germany.
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Wei C, Li Z, Ma T, Jiang X, Yu C, Xu Q. Stressful life events and non-suicidal self-injury among Chinese adolescents: A moderated mediation model of depression and resilience. Front Public Health 2022; 10:944726. [PMID: 35991060 PMCID: PMC9387939 DOI: 10.3389/fpubh.2022.944726] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2022] [Accepted: 07/15/2022] [Indexed: 11/13/2022] Open
Abstract
Stressful life events are associated with an increased risk of non-suicidal self-injury (NSSI) in adolescence, but the mechanisms explaining this association are unclear. Based on the experiential avoidance model of NSSI, and the protective factor model of resilience, the current study tested depression as a mediator and resilience as a moderator of this association. Chinese adolescents (N = 643; Mage = 15.91; 52.10 % female), anonymously completed self-report measures in classrooms. Results showed that stressful life events was linked to adolescent NSSI in part because of adolescent depression, and resilience was a protective factor that buffered this effect. These findings can inspire practitioners to pay attention to the interaction of risk factors and protective factors when providing prevention and intervention for adolescent NSSI.
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Affiliation(s)
- Chang Wei
- Research Center for Rural Educational and Cultural Development of Key Research Base of Humanities and Social Sciences in Hubei Province, School of Education, Hubei University of Science and Technology, Xianning, China
- School of Psychology, South China Normal University, Guangzhou, China
| | - Zhiyong Li
- College of Education Science, Hubei Normal University, Huangshi, China
| | - Tao Ma
- School of Psychology, South China Normal University, Guangzhou, China
| | - Xiaxia Jiang
- Research Center for Rural Educational and Cultural Development of Key Research Base of Humanities and Social Sciences in Hubei Province, School of Education, Hubei University of Science and Technology, Xianning, China
- School of Psychology, Central China Normal University, Wuhan, China
- *Correspondence: Xiaxia Jiang
| | - Chengfu Yu
- School of Education, Guangzhou University, Guangzhou, China
| | - Qian Xu
- Research Center for Rural Educational and Cultural Development of Key Research Base of Humanities and Social Sciences in Hubei Province, School of Education, Hubei University of Science and Technology, Xianning, China
- Qian Xu
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Kim H, Hur JW. What's Different About Those Who Have Ceased Self-Injury? Comparison Between Current and Lifetime Nonsuicidal Self-Injury. Arch Suicide Res 2022; 27:718-733. [PMID: 35446236 DOI: 10.1080/13811118.2022.2064256] [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: 12/29/2022]
Abstract
OBJECTIVE The current study aimed to investigate the sociodemographic and psychological variables as well as the function of NSSI related to the cessation of NSSI by analyzing the difference between those currently engaged in nonsuicidal self-injury (NSSI) and those who have stopped NSSI behaviors. METHODS A total of 490 adults with a history of NSSI (359 females) were assigned to one of two groups: NSSI engagement within the last 12 months or "current NSSI" (n = 402) vs. no episode of NSSI in the previous 12 months or "lifetime NSSI" (n = 88). RESULTS There were no significant group differences in sex or socioeconomic status, while individuals with current NSSI were slightly younger than those who had ceased NSSI behavior. Regarding the functions of NSSI, the current NSSI group endorsed more intrapersonal functions. Moreover, the participants who had ceased NSSI behavior reported significantly less perceived stress, dysfunctional attitudes, alexithymia, emotion reactivity, and suicidal ideation. On the other hand, the lifetime NSSI group showed greater psychological resources such as self-esteem, distress tolerance, and resilience. CONCLUSIONS We revealed apparent differences in NSSI functions, clinical symptoms, and psychological resources depending on the maintenance and cessation of NSSI. This study highlights the need for a better understanding of the factors that stop as well as those that continue NSSI behaviors. HIGHLIGHTSThe lifetime NSSI group reported less intrapersonal NSSI functions.The current NSSI group suffered from more clinical symptoms.Individuals who ceased NSSI had more psychological resources.
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Serra M, Presicci A, Quaranta L, Caputo E, Achille M, Margari F, Croce F, Marzulli L, Margari L. Assessing Clinical Features of Adolescents Suffering from Depression Who Engage in Non-Suicidal Self-Injury. CHILDREN (BASEL, SWITZERLAND) 2022; 9:children9020201. [PMID: 35204921 PMCID: PMC8870312 DOI: 10.3390/children9020201] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Revised: 01/20/2022] [Accepted: 02/02/2022] [Indexed: 01/09/2023]
Abstract
Depressive disorders (DDs) and non-suicidal self-injury (NSSI) are important juvenile mental health issues, showing alarming increasing rates. They frequently co-occur, mainly among adolescents, increasing the suicide risk. We aimed to compare the clinical features of two groups of adolescents with DDs, differed by their engagement or not in NSSI (“DD + NSSI” and “DD”). We hypothesized that NSSI would characterize particularly severe forms of DDs suitable for becoming specific phenotypes of adolescent depression. We enrolled 56 adolescents (11–17 years) diagnosed with a DD according to the DSM-5 criteria. They were assessed for NSSI endorsement (Ottawa Self-Injury Inventory), depressive symptoms (Children’s Depression Inventory 2), emotional dysregulation (Difficulties in Emotional Regulation Scale), and anxiety symptoms (Screen for Child Anxiety-Related Emotional Disorders). The two groups accounted for 31 (“DD + NSSI”) and 25 (“DD”) individuals. The “DD + NSSI” group had significantly higher suicidal ideation (p 0.0039), emotional dysregulation (p 0.0092), depressive symptoms (p 0.0138), and anxiety symptoms (p 0.0153) than the “DD” group. NSSI seemed to characterize more severe phenotypes of adolescent depression, applying for a potential role as a “specifier” of DDs, describing relevant information for their management. Further studies are needed to support this hypothesis and its potential opportunities for prevention and treatment.
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Affiliation(s)
- Maria Serra
- Department of Pharmacy-Pharmaceutical Sciences, University of Bari “Aldo Moro”, Via Edoardo Orabona 4, 70125 Bari, Italy
- Correspondence:
| | - Anna Presicci
- Department of Neuroscience, Sense Organs and Locomotor System, University Hospital “Policlinico”, Piazza Giulio Cesare 11, 70124 Bari, Italy;
| | - Luigi Quaranta
- Department of Computer Science, University of Bari “Aldo Moro”, Via Edoardo Orabona 4, 70125 Bari, Italy;
| | - Elvita Caputo
- Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy; (E.C.); (M.A.); (L.M.)
| | - Mariaclara Achille
- Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy; (E.C.); (M.A.); (L.M.)
| | - Francesco Margari
- Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy; (F.M.); (F.C.); (L.M.)
| | - Federica Croce
- Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy; (F.M.); (F.C.); (L.M.)
| | - Lucia Marzulli
- Department of Basic Medical Science, Neuroscience and Sensory Organs, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy; (F.M.); (F.C.); (L.M.)
| | - Lucia Margari
- Department of Biomedical Sciences and Human Oncology, University of Bari “Aldo Moro”, Piazza Giulio Cesare 11, 70124 Bari, Italy; (E.C.); (M.A.); (L.M.)
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James KM, Foster CE, Tsypes A, Owens M, Gibb BE. Maternal criticism and children's neural responses to reward and loss. J Exp Child Psychol 2021; 211:105226. [PMID: 34252754 PMCID: PMC9887476 DOI: 10.1016/j.jecp.2021.105226] [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: 08/09/2020] [Revised: 06/08/2021] [Accepted: 06/10/2021] [Indexed: 02/02/2023]
Abstract
Parental criticism is linked to a number of detrimental child outcomes. One mechanism by which parental criticism may increase risk for negative outcomes in children is through children's neural responses to valenced information in the environment. The goal of the current study, therefore, was to examine the relation between maternal criticism and children's neural responses to monetary gains and losses. To represent daily environmental experiences of reward and punishment, we focused on reactivity to monetary gains versus losses in a guessing task. Participants were 202 children and their mothers recruited from the community. The average age of the children was 9.71 years (SD = 1.38, range = 7-11), with 52.0% of them male and 72.8% Caucasian. Mothers completed the Five Minute Speech Sample to assess expressed emotion-criticism, and of these dyads 51 mothers were rated as highly critical. In addition, children completed a simple guessing game during which electroencephalography was recorded. Children of critical mothers displayed less neural reactivity to both monetary gain and loss than children without critical mothers. Our results were at least partially independent of children's and mothers' current levels of internalizing psychopathology. These findings suggest that children exposed to maternal criticism may exhibit disruptions in adaptive responses to environmental experiences regardless of valence. Targeted interventions aimed at reducing expressed emotion-criticism may lead to changes in a child's reward responsiveness and risk for psychopathology.
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Affiliation(s)
| | | | | | - Max Owens
- University of South Florida, St. Petersburg
| | - Brandon E Gibb
- Binghamton University (State University of New York), Binghamton, NY 13902, USA
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Uncovering the Mystery of Non-Suicidal Self-Injury Among Selected Filipino Adolescents: A Grounded Theory Approach. PSYCHOLOGICAL STUDIES 2021. [DOI: 10.1007/s12646-021-00619-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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13
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Blais RK, Cruz RA, Serang S. More frequent negative social exchanges are associated with higher suicide ideation and risk in men service members/veterans. Suicide Life Threat Behav 2021; 51:755-766. [PMID: 33870554 DOI: 10.1111/sltb.12756] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2020] [Revised: 12/22/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Suicide is a leading cause of death in military service members/veterans (SM/Vs). Positive social exchanges (e.g., emotional support) buffer against suicide risk but the influence of negative social exchanges (e.g., unwanted advice) is understudied. METHOD The current study explored (1) the contributions of positive and negative social exchanges as simultaneous correlates of suicide ideation and risk, (2) whether positive social exchanges mitigated the association of negative social exchanges and suicide ideation and risk, and (3) if facets of social exchanges were uniquely related to suicide ideation and risk. SM/Vs men (N = 508) completed self-report questionnaires. RESULTS Roughly 27% endorsed suicide ideation. Between 23.62 and 41.14% reported elevated suicide risk. Adjusted analyses revealed higher negative social exchanges, particularly insensitive behaviors, and lower positive social exchanges were associated with higher suicide ideation and risk. The magnitude of positive and negative social exchanges with suicide ideation or risk was statistically similar. Higher positive social exchanges did not attenuate the association of negative social exchanges and suicide ideation or risk (p > 0.05). CONCLUSION Higher negative social exchanges are equally strong correlates of suicide ideation and risk as positive social exchanges. Decreasing insensitive behaviors may reduce suicide ideation and risk in men SM/Vs.
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Affiliation(s)
- Rebecca K Blais
- Department of Psychology, Utah State University, Logan, UT, USA
| | - Rick A Cruz
- Department of Psychology, Utah State University, Logan, UT, USA
| | - Sarfaraz Serang
- Department of Psychology, Utah State University, Logan, UT, USA
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14
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Matera E, Margari M, Serra M, Petruzzelli MG, Gabellone A, Piarulli FM, Pugliese A, Tassiello AR, Croce F, Renna C, Margari A. Non-Suicidal Self-Injury: An Observational Study in a Sample of Adolescents and Young Adults. Brain Sci 2021; 11:brainsci11080974. [PMID: 34439593 PMCID: PMC8391479 DOI: 10.3390/brainsci11080974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/18/2021] [Accepted: 07/20/2021] [Indexed: 11/16/2022] Open
Abstract
Non-Suicidal Self-Injury (NSSI) is the self-inflicted destruction of body tissues without suicidal intent with a prevalence of 1.5% to 6.7% in the youth population. At present, it is not clear which emotional and behavioral components are specifically associated with it. Therefore, we studied NSSI in a clinical sample of youth using the Ottawa Self-injury Inventory and the Barratt Impulsiveness Scale 11. The Mann-Whitney test was used to compare the numerical responses provided to the tests. We found 54 patients with NSSI, with a mean age of 17 years. Scores were analyzed in the total sample and in four subgroups. In the total sample, Internal Emotion and External Emotion Regulation, Craving, Non-Planning and Total Impulsivity were significantly associated with NSSI. There were statistically significant differences in Craving between patients with multiple NSSI episodes, suicide attempts and multiple injury modes and patients of other corresponding subgroups, in Internal Emotion Regulation, Sensation Seeking and Motor Impulsivity between NSSI patients with suicide attempts and no suicide attempts, and in Cognitive Impulsivity between NSSI patients with multiple injury modes and one injury mode. It is necessary to carefully evaluate the components underlying NSSI in order to activate personalized treatment options.
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Affiliation(s)
- Emilia Matera
- Department of Biomedical Sciences and Human Oncology, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy;
- Correspondence:
| | - Mariella Margari
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (M.M.); (M.S.); (M.G.P.); (F.M.P.); (A.P.); (A.R.T.); (F.C.); (A.M.)
| | - Maria Serra
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (M.M.); (M.S.); (M.G.P.); (F.M.P.); (A.P.); (A.R.T.); (F.C.); (A.M.)
| | - Maria Giuseppina Petruzzelli
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (M.M.); (M.S.); (M.G.P.); (F.M.P.); (A.P.); (A.R.T.); (F.C.); (A.M.)
| | - Alessandra Gabellone
- Department of Biomedical Sciences and Human Oncology, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy;
| | - Francesco Maria Piarulli
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (M.M.); (M.S.); (M.G.P.); (F.M.P.); (A.P.); (A.R.T.); (F.C.); (A.M.)
| | - Assunta Pugliese
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (M.M.); (M.S.); (M.G.P.); (F.M.P.); (A.P.); (A.R.T.); (F.C.); (A.M.)
| | - Anna Rita Tassiello
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (M.M.); (M.S.); (M.G.P.); (F.M.P.); (A.P.); (A.R.T.); (F.C.); (A.M.)
| | - Federica Croce
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (M.M.); (M.S.); (M.G.P.); (F.M.P.); (A.P.); (A.R.T.); (F.C.); (A.M.)
| | - Caterina Renna
- Center for Treatment and Research on Eating Disorders Mental Health Department AL, Via Miglietta 5, 73100 Lecce, Italy;
| | - Anna Margari
- Department of Basic Medical Sciences, Neuroscience and Sensory Organs, University Hospital “A. Moro”, Piazza Giulio Cesare 11, 70100 Bari, Italy; (M.M.); (M.S.); (M.G.P.); (F.M.P.); (A.P.); (A.R.T.); (F.C.); (A.M.)
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15
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The Role of Psychological Factors in Non-suicidal Self-injury of Female Adolescents. IRANIAN JOURNAL OF PSYCHIATRY AND BEHAVIORAL SCIENCES 2021. [DOI: 10.5812/ijpbs.101562] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background: Non-suicidal self-injury (NSSI) is defined as inflicting damage to one’s own body. It begins in adolescence and tends to become chronic. Objectives: Considering the high prevalence and chronicity of NSSI among girls, the present study aimed to investigate the factors affecting the prevalence of NSSI in female adolescents from their perspective. Methods: The participants consisted of 604 female high-school students in Saveh, aged 14 - 17 years (14.29 ± 1.11), who were selected via random cluster sampling from November 2018 to January 2019. They answered six questionnaires, including the Inventory of Statements About Self-injury (ISAS), Ways of Coping questionnaire (WCQ), Child Abuse Self-report scale (CASRS), Family Emotional Involvement and Criticism scale (FEICS), Emotion Reactivity scale (ERS), and Aggression questionnaire (AQ). Data were analyzed using logistic regression analysis. Results: The predictor variables of child abuse, emotion reactivity, perceived parental criticism, family emotional involvement, and problem- and emotion-focused coping styles could successfully distinguish NSSI individuals from those without NSSI (P < 0.05). There were no significant differences between minor and moderate groups. Conclusions: Family emotional support is a protective factor, while criticism, child abuse, and emotion-focused coping style are risk factors for NSSI.
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16
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Nitkowski D, Wünsch-Leiteritz W, Braks K, Hristova S, Petermann F. Indirekte und direkte nichtsuizidale Selbstverletzungen bei Mädchen und jungen Frauen mit Essstörungen. KINDHEIT UND ENTWICKLUNG 2019. [DOI: 10.1026/0942-5403/a000293] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Zusammenfassung. Nichtsuizidales selbstverletzendes Verhalten (NSSV) tritt häufig bei Essstörungen auf. Die Befundlage zum Zusammenhang zwischen einem restriktiv-asketischen beziehungsweise bulimischen Essverhalten und NSSV ist jedoch nicht konsistent. Es wird geprüft, ob borderlinespezifische Gedanken die Beziehung zwischen asketischen beziehungsweise bulimischen Essverhalten auf der einen Seite und NSSV auf der anderen Seite mediieren. Eine Stichprobe von 74 Mädchen und jungen Frauen im Alter von 14 bis 21 Jahren ( M = 17.49; SD = 1.85), die eine Anorexie oder eine Bulimie aufweisen, bearbeiteten Fragebögen zu NSSV, borderlinespezifischen Gedanken sowie zu asketischen und bulimischen Verhaltensweisen. Borderline-Gedanken mediierten den Zusammenhang zwischen asketischem Verhalten auf der einen Seite und der Anzahl an bisher genutzten NSSV-Methoden und NSSI zur psychischen Regulation auf der anderen Seite. Bei Bulimie fand sich hingegen keine Mediation. Ein asketisches Verhalten ist bei Mädchen und jungen Frauen mit einer Essstörung über Borderline-Gedankenmuster mit der Anzahl an NSSV-Methoden und der Nutzung von NSSV zur psychischen Regulation verbunden. Ein primär durch Essattacken gekennzeichnetes Verhalten weist keinen Zusammenhang mit NSSV auf. Die verschiedenen Arten von gestörtem Essverhalten sollten separat auf einen Zusammenhang mit NSSV untersucht werden.
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Affiliation(s)
- Dennis Nitkowski
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen
| | - Wally Wünsch-Leiteritz
- Klinik Lüneburger Heide, Kompetenzzentrum für die Behandlung von Essstörungen und ADHS, Bad Bevensen
| | - Karsten Braks
- Klinik am Korso, Fachzentrum für gestörtes Essverhalten, Bad Oeynhausen
| | - Stella Hristova
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen
| | - Franz Petermann
- Zentrum für Klinische Psychologie und Rehabilitation, Universität Bremen
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17
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Mahtani S, Hasking P, Melvin GA. Shame and Non-suicidal Self-injury: Conceptualization and Preliminary Test of a Novel Developmental Model among Emerging Adults. J Youth Adolesc 2018; 48:753-770. [PMID: 30311043 DOI: 10.1007/s10964-018-0944-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Accepted: 09/26/2018] [Indexed: 11/25/2022]
Abstract
Non-suicidal self-injury (NSSI) is particularly prevalent during adolescence and emerging adulthood. The salience of shame during these developmental periods suggests that shame may be inherently linked to NSSI, and at least partially explain the high rates of NSSI observed among youth. In this article, a theoretical developmental model relating shame and NSSI is proposed, and results from a preliminary test of a sub-set of cross-sectional relationships in this model is presented. In the model tested, it was hypothesized that adverse caregiving experiences in prior development (i.e., childhood to late adolescence) like parental invalidation and child maltreatment, established predictors of NSSI, would be linked to proximal episodes of NSSI (i.e., past year) through current shame-proneness (i.e., experiencing shame in a trait-like manner) and internalizing shame-coping (i.e., responding to shame through attacking one's self and withdrawing). It was also hypothesized that some key proximal predictors of NSSI during youth development, such as low body esteem, increased loneliness and heightened psychological distress, would be linked to proximal NSSI via shame-proneness and internalizing shame-coping. Using structural equation modelling, it was observed that data, obtained via self-reports completed by 573 emerging adults (age in years: M = 20.7, SD= 2.20, 69.1% female, NSSI history: n = 220, where most recent NSSI episode was within a year of study participation) recruited throughout Australia between June 2013 and June 2014, fit the hypothesized model well. Tests of indirect effects indicated that current shame-proneness and internalizing shame-coping significantly linked perceived parental invalidation and prior experiences of child maltreatment to proximal NSSI, though this relationship was, unexpectedly, an inverse one in relation to child maltreatment. Current shame-proneness was also linked to proximal NSSI via internalizing shame-coping, current loneliness, and current psychological distress, but not through current body esteem. Finally, proximal self-evaluations of body esteem, loneliness and increased psychological distress were linked to recent NSSI through internalizing shame-coping. The theory and findings presented in this article contribute to a deeper developmental understanding of NSSI among youth, highlight crucial pathways between adverse caregiving experiences and NSSI, and illuminate important shame-based mechanisms that potentially warrant clinical attention for at-risk individuals. Future research directions and clinical recommendations are discussed.
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Affiliation(s)
- Shireen Mahtani
- Centre for Developmental Psychiatry & Psychology, Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
| | - Penelope Hasking
- School of Psychology, Curtin University, Bentley, WA, Australia.
| | - Glenn A Melvin
- Centre for Developmental Psychiatry & Psychology, Department of Psychiatry, School of Clinical Sciences, Monash University, Clayton, VIC, Australia
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18
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Sisask M, Kõlves K. Towards a Greater Understanding of Suicidal Behaviour and Its Prevention. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081629. [PMID: 30071699 PMCID: PMC6121881 DOI: 10.3390/ijerph15081629] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 07/31/2018] [Indexed: 11/16/2022]
Affiliation(s)
- Merike Sisask
- Estonian-Swedish Mental Health and Suicidology Institute (ERSI), Tallinn 11615, Estonia.
- School of Governance, Law and Society (SOGOLAS), Tallinn University, Tallinn 10120, Estonia.
| | - Kairi Kõlves
- Australian Institute for Suicide Research and Prevention (AISRAP), WHO Collaborating Centre for Research and Training in Suicide Prevention, Griffith University, Mt Gravatt Campus, Mount Gravatt QLD 4122 Australia.
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