Psychotherapeutic approaches to non-suicidal self-injury in adolescents.
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ABSTRACT:
SUBMITTER: Washburn JJ
PROVIDER: S-EPMC3782878 | biostudies-literature | 2012 Mar
REPOSITORIES: biostudies-literature
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Psychotherapeutic approaches to non-suicidal self-injury in adolescents.
Washburn Jason J JJ Richardt Sarah L SL Styer Denise M DM Gebhardt Michelle M Juzwin K R KR Yourek Adrienne A Aldridge Delia D
Child and adolescent psychiatry and mental health 20120330 1
Non-suicidal self-injury (NSSI) among adolescents is gaining increasing attention in both clinical and scientific arenas. The lifetime prevalence of NSSI is estimated to vary between 7.5% to 8% for preadolescents, increasing to between 12% and 23% for adolescents. Despite the prevalence and the increasing interest in NSSI, few psychotherapeutic treatments have been designed specifically for NSSI, and no treatments have been evaluated specifically for the treatment of NSSI among adolescents. Cons ...[more]
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Project description:BACKGROUND:Non-suicidal self-injury (NSSI) is a significant mental health problem among adolescents. Research is needed to clarify the neurobiology of NSSI and identify candidate neurobiological targets for interventions. Based on prior research implicating heightened negative affect and amygdala hyperactivity in NSSI, we pursued a systems approach to characterize amygdala functional connectivity networks during rest (resting-state functional connectivity [RSFC)]) and a task (task functional connectivity [TFC]) in adolescents with NSSI. METHOD:We examined amygdala networks in female adolescents with NSSI and healthy controls (n = 45) using resting-state fMRI and a negative emotion face-matching fMRI task designed to activate the amygdala. Connectivity analyses included amygdala RSFC, amygdala TFC, and psychophysiological interactions (PPI) between amygdala connectivity and task conditions. RESULTS:Compared to healthy controls, adolescents with NSSI showed atypical amygdala-frontal connectivity during rest and task; greater amygdala RSFC in supplementary motor area (SMA) and dorsal anterior cingulate; and differential amygdala-occipital connectivity between rest and task. After correcting for depression symptoms, amygdala-SMA RSFC abnormalities, among others, remained significant. LIMITATIONS:This study's limitations include its cross-sectional design and its absence of a psychiatric control group. CONCLUSIONS:Using a multi-modal approach, we identified widespread amygdala circuitry anomalies in adolescents with NSSI. While deficits in amygdala-frontal connectivity (driven by depression symptoms) replicates prior work in depression, hyperconnectivity between amygdala and SMA (independent of depression symptoms) has not been previously reported. This circuit may represent an important mechanism underlying the link between negative affect and habitual behaviors. These abnormalities may represent intervention targets for adolescents with NSSI.
| S-EPMC5555154 | biostudies-literature
Project description:Non-suicidal self-injury (NSSI) in adolescents is an increasing public health problem in China. We conducted a meta-analysis of studies on NSSI in Chinese adolescents (between 10 and 19 years) to examine factors associated with NSSI. Twenty-five papers including 30 separate studies with 186,447 participants were included for analysis. The results from a random-effects model showed a weak, but significant overall prediction of NSSI (OR = 1.734). There were significant associations between the following seven factors and NSSI (ranking by the effect sizes, in descending order): adverse life events (OR = 2.284), negative coping style (OR = 2.040), problematic internet use (OR = 2.023), sleep disturbance (OR = 1.734), traumatic experiences (OR = 1.728), problematic parent-child relationship (OR = 1.585), mental health problems (OR = 1.578). Additionally, NSSI sample type moderated these effects. These findings highlight factors significantly associated with NSSI in Chinese adolescents. Parent-child relationship and mental health of the only children and left-behind children in China deserve more attention. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019123508.
| S-EPMC8669619 | biostudies-literature
Project description:BackgroundNon-suicidal self-injury (NSSI) in adolescents is a significant mental health problem around the world. Here, we performed a meta-analysis to systematically delineate the risk factors for NSSI.MethodWe searched Medline, Embase, Web of Science and Cochrane for relevant articles and abstracts published prior to 12 November 2021. Pooled odds ratios (ORs) and 95% confident intervals (CIs) were used to assess various risk factors, and publication bias was assessed by Egger's test, the trim and fill method and meta-regression. This study is registered with PROSPERO, CRD42021265885.ResultsA total of 25 articles were eventually included in the analysis. Eighty risk factors were identified and classified into 7 categories: mental disorders (ORs, 1·89; 95% CI, 1·60-2·24), bullying (ORs, 1·98; 95% CI, 1·32-2·95), low health literacy (ORs, 2·20; 95% CI, 1·63-2·96), problem behaviours (ORs, 2·36; 95% CI, 2·00-2·77), adverse childhood experiences (ORs, 2·49; 95% CI, 1·85-3.34), physical symptoms (ORs, 2·85; 95% CI, 1·36-5·97) and the female gender (ORs, 2·89; 95% CI, 2·43-3·43). The range of heterogeneity (I2) was from 20·3% to 99·2%.ConclusionThis meta-analysis found that mental disorders, low health literacy, adverse childhood experiences, bullying, problem behaviours, the female gender and physical symptoms appear to be risk factors for NSSI.
| S-EPMC8938878 | biostudies-literature
Project description:Background: Non-suicidal self-injury (NSSI) among adolescents is a major public health concern and a common problem in clinical practice. The aim of this study was to examine different aspects of NSSI in a high-risk adolescent sample in clinical practice in association with personality disorders, symptoms, and coping skills to enhance the understanding of NSSI and improve treatment interventions. Methods: In a sample of 140 adolescent inpatients treated for personality disorders, assessments were performed pre-treatment and post-treatment using a questionnaire on NSSI developed for clinical practice, the Structured Clinical Interview for DSM personality disorders, the Symptom Check List 90, and the Cognitive Emotion Regulation Questionnaire. Results: NSSI was common (66.4%) among the inpatient adolescents. Of those without NSSI behaviour (n = 47), 10 (21.3%) started NSSI during treatment. NSSI was related to number of personality disorders and not to one specific. Participants who experienced NSSI (n = 93) reported significantly more symptoms and the negative coping strategy self-blame. They scored lower on the positive coping strategies of refocusing and reappraisal. Conclusion: NSSI in adolescent clinical practice is common, not exclusive to borderline personality disorder and could be contagious. Reducing self-blame and enhancing positive refocusing and positive reappraisal seem important treatment targets.
| S-EPMC6424099 | biostudies-literature
Project description:Background:Non-suicidal self-injury (NSSI) is prevalent in adolescents and brings a series of serious consequences to their well-being. However, little is known about parents' attitude toward NSSI in Chinese adolescents. The study aims to investigate the parents' attitudes toward and perceptions of adolescents who have engaged in NSSI behaviors, and the impact of NSSI on their parents. Methods:Purposive sampling was used in the study. The biological parents of adolescents with NSSI were recruited from the psychiatric ward of a tertiary hospital in China. Semi-structured interviews were conducted which contained three aspects, that is the history of NSSI, the process of seeking or maintaining help and the impacts on the family. Each interview typically lasted 40-50 min. All of the interviews were audio-recorded. Their responses were analyzed by the thematic analysis. Results:Twenty participants completed the interview, consisting of 16 mothers and 4 fathers. Three themes and eight sub-themes were extracted: (1) the attitudes to children's NSSI behaviors (ignorance, shame, and stereotype); (2) coping strategies of parents (the initial response to adolescents' NSSI, and the way of help-seeking); (3) the impacts on family (altered parenting and communication styles, limited personal lives, and increased psychological pressure). Conclusion:The results showed that parents lack the knowledge about NSSI and its treatment and are suffering great emotional stress. It is recommended to expand the popularization of knowledge of NSSI in adolescents and more interventions adapted to China's sociocultural climate are required for the well-being of parents and NSSI in adolescents.
| S-EPMC7373789 | biostudies-literature
Project description:Little is known about the bio-behavioral mechanisms underlying and differentiating suicide attempts from non-suicidal self-injury (NSSI) in adolescents. Adolescents who attempt suicide or engage in NSSI often report significant interpersonal and social difficulties. Emotional face recognition ability is a fundamental skill required for successful social interactions, and deficits in this ability may provide insight into the unique brain-behavior interactions underlying suicide attempts versus NSSI in adolescents. Therefore, we examined emotional face recognition ability among three mutually exclusive groups: (1) inpatient adolescents who attempted suicide (SA, n = 30); (2) inpatient adolescents engaged in NSSI (NSSI, n = 30); and (3) typically developing controls (TDC, n = 30) without psychiatric illness. Participants included adolescents aged 13-17 years, matched on age, gender and full-scale IQ. Emotional face recognition was evaluated using the diagnostic assessment of nonverbal accuracy (DANVA-2). Compared to TDC youth, adolescents with NSSI made more errors on child fearful and adult sad face recognition while controlling for psychopathology and medication status (ps < 0.05). No differences were found on emotional face recognition between NSSI and SA groups. Secondary analyses showed that compared to inpatients without major depression, those with major depression made fewer errors on adult sad face recognition even when controlling for group status (p < 0.05). Further, compared to inpatients without generalized anxiety, those with generalized anxiety made fewer recognition errors on adult happy faces even when controlling for group status (p < 0.05). Adolescent inpatients engaged in NSSI showed greater deficits in emotional face recognition than TDC, but not inpatient adolescents who attempted suicide. Further results suggest the importance of psychopathology in emotional face recognition. Replication of these preliminary results and examination of the role of context-dependent emotional processing are needed moving forward.
| S-EPMC6642805 | biostudies-literature
Project description:Non-suicidal self-injury (NSSI), as a highly prevalent psychiatric symptom in adolescents and young adults, is defined as the deliberate destruction of body tissue without suicidal intent. Impulsivity and dysfunctional response inhibition have been suggested to play a central role in adolescents' vulnerability to self-harm. To investigate the potentially distinct neurobiology of NSSI, we used a well-established Go/No Go task in which activation of the inferior frontal gyrus (IFG) and dorsal anterior cingulate cortex (dACC) is interpreted as a neural correlate of processing failed response inhibition. Task-based functional magnetic resonance imaging data were obtained from 14 adolescents with a diagnosis of major depression and a history of NSSI (MD-NSSI), 13 depressed adolescents without NSSI (MD-only), and 14 healthy controls (HC). In line with hypotheses of dysfunctional response inhibition, we observed increased rates of commission errors in MD-NSSI along with significantly reduced error-related activations of the dACC and IFG. Intact response inhibition, as reflected by low commission error rates not different from HC, was observed in MD-only, along with increased activation of the error-processing network. Our findings support the hypothesis of a distinct neurobiological signature of NSSI. Further research on biomarkers of NSSI could focus on behavioral and neural correlates of failed response inhibition.
| S-EPMC9775576 | biostudies-literature
Project description:Background: Previous studies revealed that female adolescents are more likely than males to engage in non-suicidal self-injury (NSSI) to regulate negative emotions; however, the dimensions of emotion regulation that are associated with NSSI behavior in adolescents require further examination. The present study aimed to identify Taiwanese female adolescent clusters with NSSI engagement frequency and to evaluate the association of specific forms of emotion dysregulation with NSSI. Methods: The participants were 438 female adolescents (mean age = 15.23 years, SD = 1.24, range between 13 and 18) recruited from 11 high schools. Self-report questionnaires assessing NSSI, difficulties in emotion regulation, and positive and negative affect were administered, and 37% of respondents reported a history of NSSI. Results: The analysis of NSSI frequency yielded three groups: severe, moderate, and non-NSSI. High negative affect, low positive affect, and difficulties in all aspects of emotion regulation differentiated female adolescents in the severe NSSI group from their counterparts in the non-NSSI group. The moderate and severe NSSI groups were further distinguished by age of onset, negative affect, emotion regulation strategies, and impulse control. Adolescents classified in the severe group reported earlier onset of NSSI, higher negative affect, less emotion regulation strategies, and more difficulty with impulse control. Conclusions: The results indicate that assessments of NSSI and emotion regulation should be incorporated in youth mental health screening. The clinical implications of NSSI behavior intervention require further discussion.
| S-EPMC6765909 | biostudies-literature
Project description:BackgroundChildhood abuse has been associated with significant increases in non-suicidal self-injury (NSSI) behaviors in adolescents; however, only general definitions of this risk indicator have been examined. This study identified relationships between specific forms of childhood abuse and NSSI in mainland Chinese adolescents.MethodA total of 14,221 cases were retained from an epidemiological study involving adolescents from junior and senior middle schools. Information relating to the perpetrator, perceived harm, timing of exposure to different types of childhood abuse, and NSSI were obtained. Logistic regression was used to analyze relationships between each form of childhood abuse and NSSI.ResultsApproximately 51.0% of the students reported at least one abusive childhood experience. Nearly one in four students (24.9%) reported that they had engaged in NSSI in the past 12 months. Each type of childhood abuse, occurring at any time within the first 16 years of life, especially in situations of continuous exposure, was significantly associated with NSSI. A significant graded relationship was found between number of abusive childhood experiences and NSSI. Students maltreated by parents or others were at high risk of engaging in NSSI, the risk was greater in students maltreated by both; students who had been exposed to childhood abuse with no perceived harm still demonstrated an elevated risk for NSSI. The pattern of associations did not vary by gender.ConclusionsThese findings suggest that experiencing any of various forms of childhood abuse should be considered a risk factor for NSSI during adolescence. Further research should focus upon psychosocial, neural, and genetic factors that might moderate or mediate the onset of NSSI in adolescents who have experienced childhood abuse.
| S-EPMC4482708 | biostudies-literature
Project description:The prevalence of non-suicidal self-injury (NSSI) is high in adolescents and young adults. However, there is a paucity of evidence-based treatments to address this clinical problem. An open-label, pilot study in the target population showed that treatment with oral N-acetylcysteine (NAC), a widely available dietary supplement, was associated with reduction in NSSI frequency. In preparation for a biologically informed design of an efficacy trial, a critical preliminary step is to clarify NAC's biological signatures, or measures of the mechanisms underlying its clinical effects. Toward that end, we propose a 2-stage project to investigate NAC's biological signatures (changes in glutathione (GSH) and/or glutamate (Glu)) in women with NSSI. The first stage; a double-blind randomized placebo-controlled study will focus on identifying the optimal dose to achieve meaningful change in GSH and Glu during short-term (4 weeks) NAC treatment in 36 women aged 16-24 years with NSSI. Go/No-go criteria to determine if the study will progress to the second stage include pre-specified changes in brain and blood measures of GSH. Changes in the brain GSH are measured through magnetic resonance spectroscopy (MRS). The dose for the stage 2 will be selected based on the biological changes and the tolerability observed in the stage 1. The stage 2 will seek to replicate the biological signature findings in an 8-week trial in a new patient cohort, and examine the relationships among biological signatures, NAC pharmacokinetics and clinical response. This 2-stage project is unique as it unifies clinical psychiatric measurements, quantitative MRS and pharmacological approaches in the first placebo-controlled clinical trial of NAC in young women with NSSI. The stage 1 trial protocol has been registered on https://clinicaltrials.gov/ with ClinicalTrials.gov ID "NCT04005053" (Registered on 02 July 2019. Available from: https://clinicaltrials.gov/ct2/show/NCT04005053).
| S-EPMC8143039 | biostudies-literature