Structural adverse childhood experiences associated with suicidal ideation, suicide attempts, and repetitive nonsuicidal self-injury among racially and ethnically minoritized youth

INTRODUCTION

High rates of suicidal ideation (SI), suicide attempts (SA), and repetitive nonsuicidal self-injury (NSSI) among some ethnoracially minoritized United States youth populations may be related to adverse childhood experiences (ACEs) with structural roots.

METHODS

Using the 2013-2019 Minnesota Student Surveys, we assessed associations of student-reported structural ACEs (parental incarceration, housing instability, food insecurity, and foster care involvement) with SI, SA, and repetitive NSSI within the past 12 months using multilevel logistic regression stratified by ethnoracial group (American Indian/Alaskan Native [AIAN], Hmong, other Asian, Black Latino, other Latino, Somali, other Black/African American [AA], Native Hawaiian/Pacific Islander [NHPI], and multiracial), and adjusted for sex, grade, ACEs experienced within one's household, mental health treatment, and perceived safety.

RESULTS

Structural ACEs were strongly associated with increasing SI, SA, and NSSI. At ≥2 structural ACEs, repetitive NSSI rates ranged from 7% to 29% (female), 8% to 20% (male); SA rates ranged from 13% to 35% (female), 10% to 22% (male); and SI rates ranged from 31% to 50% (female), 20% to 32% (male). Black Latino, NHPI, AIAN, and Black/AA students most often reported structural ACE exposures.

CONCLUSION

Reducing structural ACEs may reduce SI, SA, and repetitive NSSI among ethnoracially minoritized youth populations. Disaggregating diverse youth groups revealed variations in these outcomes that remain hidden when subpopulations are aggregated.

How to survive the long night? Longitudinal relationship between sleep problems and suicidal behavior among adolescents: The serial mediating roles of negative emotion, self-control, and nonsuicidal self-injury

OBJECTIVE

Sleep problems are a significant risk factor for identifying and preventing suicidal involvement among adolescents. However, there is limited evidence to assess the underlying mechanisms between them. This study investigated the longitudinal relationship between sleep problems and suicidal behavior and examined whether this relationship was moderated by negative emotions, low self-control, and nonsuicidal self-injury (NSSI).

METHODS

From December 2020 onward, we assessed 1214 Chinese secondary school adolescents (60.7% were boys, aged 13-19 years) three times, 6 months apart.

RESULTS

In the direct effects model, sleep problems were found to have a positive impact on adolescent suicidal behavior. In the indirect effects model, we observed that sleep problems were associated with an elevated risk of suicidal behavior through several pathways: one-mediator path of negative emotions, low self-control, and NSSI, respectively; two-mediator path of negative emotions via low self-control, negative emotions via NSSI, and low self-control via NSSI, and three-mediator path from negative emotions to NSSI via low self-control.

CONCLUSIONS

This longitudinal study provides evidence that sleep problems in adolescents may increase suicidal behavior by exacerbating negative emotions, weakening self-control, and promoting NSSI. The findings suggest sleep problems should be addressed in suicide prevention and intervention efforts for adolescents.

A pilot study examining hemomania behaviors in psychiatry outpatients engaged with nonsuicidal self-injury

BACKGROUND

This study aims to conduct the first-ever evaluation of our previously proposed behaviors of "hemomania" in individuals engaged with nonsuicidal self-injury (NSSI).

METHODS

The study encompassed 130 outpatients engaged with NSSI who applied at the psychiatry outpatient clinic. NSSI behaviors were assessed using the Inventory of Statements About Self-Injury, while psychiatric diagnoses were evaluated using the Structured Clinical Interview for DSM-5 Disorders-Clinician Version. Subsequently, participants completed the Depression Anxiety Stress Scale-21 and Short Form of Barratt Impulsiveness Scale.

RESULTS

The prevalence of at least one hemomania behavior including seeing blood, tasting blood, bloodletting, and blood-drinking was observed to be 43.1% in individuals with NSSI. When participants were divided into two groups, individuals with hemomania exhibited: (1) a higher incidence of psychiatric comorbidities, increased suicide attempts, and more severe symptoms of depression, anxiety, stress, and impulsivity, (2) higher comorbidity rates of borderline personality disorder, body-focused repetitive behaviors, and dissociative disorders, and (3) elevated frequencies of certain NSSI behaviors, including cutting, biting, needle-ticking, and carving, compared to those without.

CONCLUSION

Hemomania could be considered a specific impulse control disorder, characterized by heightened impulsivity and a persistent urge to obtain one's own blood. However, further studies are needed to validate this hypothesis.