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Non-suicidal Self-Injury in Clinical Practice.

ABSTRACT: 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.

SUBMITTER: Hauber K

PROVIDER: S-EPMC6424099 | biostudies-literature | 2019

REPOSITORIES: biostudies-literature

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Non-suicidal Self-Injury in Clinical Practice.

Hauber Kirsten K Boon Albert A Vermeiren Robert R

Frontiers in psychology 20190307

<b>Background:</b> 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. <b>Methods:</b> In a sample of 140 adolescent inpatients treated for personality disorders, a ...[more]

PMID: 30930814

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Project description:IntroductionAlthough research over the past decade has resulted in significantly increased knowledge about distal risk factors for non-suicidal self-injury (NSSI), little is known about short-term (proximal) factors that predict NSSI thoughts and behaviors. Drawing on contemporaneous theories of NSSI, as well as the concept of ideation-to-action, the present study clarifies (a) real-time factors that predict NSSI thoughts and (b) the extent to which theoretically important momentary factors (i.e., negative affect, positive affect, and self-efficacy to resist NSSI) predict NSSI behavior in daily life, beyond NSSI thoughts.MethodsUsing experience sampling methodology, intensive longitudinal data was obtained from 30 young adults with frequent NSSI episodes in the last year. Participants completed assessments up to eight times per day for 12 consecutive days (signal-contingent sampling). This resulted in the collection of 2,222 assessments (median compliance = 79.2%) during which 591 NSSI thoughts and 270 NSSI behaviors were recorded. Using the dynamic structural equation modeling framework, multilevel vector autoregressive models were constructed.ResultsWithin the same assessment, negative affect was positively associated with NSSI thoughts, whereas positive affect and self-efficacy to resist NSSI were each negatively associated with NSSI thoughts. Across assessments, higher-than-usual negative affect and self-efficacy to resist NSSI were predictive of short-term change in NSSI thoughts. While fluctuations in both negative affect and positive affect prospectively predicted NSSI behavior, these factors became non-significant in models that controlled for the predictive effect of NSSI thoughts. In contrast, self-efficacy to resist NSSI incrementally predicted a lower probability of engaging in NSSI, above and beyond NSSI thoughts.DiscussionThis study provides preliminary evidence that affective fluctuations may uniquely predict NSSI thoughts but not NSSI behaviors, and point to the role of personal belief in the ability to resist NSSI in preventing NSSI behavior. These findings illustrate the need to differentiate between the development of NSSI thoughts and the progression from NSSI thoughts to behavior, as these are likely distinct processes, with different predictors.

Project description:Non-suicidal self-injury (NSSI) is prevalent in adolescence and is associated with increased risk for a variety of subsequent negative mental health outcomes, necessitating an evidence-based preventive approach. This pilot study examines the potential iatrogenic effects and feasibility of an evidence-based school program for the prevention of NSSI. Differences are examined between a general in-classroom prevention program (Happyles) and this program combined with a 1-h in-classroom psychoeducation module on NSSI (HappylesPLUS) in terms of primary (e.g., delay in NSSI onset and decrease in NSSI frequency, urges, probability of future engagement) and secondary outcomes (e.g., psychological distress, emotion regulation, help-seeking, and stigma) using a mixed-method design. A total of 651 secundary school pupils (Mage = 12.85 years; 49.8% female versus 50.2% male) were assigned to the Happyles program and HappylesPLUS. Participants filled out validated self-report questionnaires pre (T0) and post (T1, 6 weeks after T0) the school prevention program, including the Youth Outcome Questionnaire (YOQ), the Brief Non-Suicidal Self-Injury Assessment Test (BNSSI-AT), the Difficulties in Emotion Regulation Scale (DERS), the Attitudes Toward Seeking Professional Psychological Help Scale-Short Form (ATSPPH-SF), and the Peer Mental Health Stigmatization Scale (PMHSS). Qualitative semi-structured interviews (at T2,6 weeks after T1) were conducted with participants with and without a history of NSSI. Overall, results show no iatrogenic effects of the NSSI-focused psychoeducation module. In terms of our primary outcome, both groups reported a reduced likelihood of future NSSI engagement from T0 to T1. Regarding secondary outcome measures, we also observed increased emotional awareness in both groups. The qualitative data suggest that the addition of the NSSI-specific module to the Happyles program may have direct benefits to some students with lived experience, such as increased help-seeking behavior for NSSI. Findings of this pilot study show that incorporating NSSI-specific modules into evidence-based school prevention programs is feasible and does not lead to iatrogenic effects. Future work is needed to evaluate the potential (longer-term) benefits of incorporating NSSI-focused modules to evidence-based mental health programs in the prevention of NSSI.

Project description:Background: With around 800,000 people taking their own lives every year, suicide is a growing health concern. Understanding the factors that underlie suicidality and identifying specific variables associated with increased risk is paramount for increasing our understanding of suicide etiology. Neuroimaging methods that enable the investigation of structural and functional brain markers in vivo are a promising tool in suicide research. Although a number of studies in clinical samples have been published to date, evidence about neuroimaging correlates for suicidality remains controversial. Objective: Patients with mental disorders have an increased risk for both suicidal behavior and non-suicidal self-injury. This manuscript aims to present an up-to-date overview of the literature on potential neuroimaging markers associated with SB and NSSI in clinical samples. We sought to identify consistently reported structural changes associated with suicidal symptoms within and across psychiatric disorders. Methods: A systematic literature search across four databases was performed to identify all English-language neuroimaging articles involving patients with at least one psychiatric diagnosis and at least one variable assessing SB or NSSI. We evaluated and screened evidence in these articles against a set of inclusion/exclusion criteria and categorized them by disease, adhering to the PRISMA guidelines. Results: Thirty-three original scientific articles investigating neuroimaging correlates of SB in psychiatric samples were found, but no single article focusing on NSSI alone. Associations between suicidality and regions in frontal and temporal cortex were reported by 15 and 9 studies across four disorders, respectively. Furthermore, differences in hippocampus were reported by four studies across three disorders. However, we found a significant lack of replicability (consistency in size and direction) of results across studies. Conclusions: Our systematic review revealed a lack of neuroimaging studies focusing on NSSI in clinical samples. We highlight several potential sources of bias in published studies, and conclude that future studies should implement more rigorous study designs to minimize bias risk. Despite several studies reporting associations between SB and anatomical differences in the frontal cortex, there was a lack of consistency across them. We conclude that better-powered samples, standardized neuroimaging and analytical protocols are needed to continue advancing knowledge in this field.

Project description:BackgroundNon-suicidal self-injury (NSSI) has recently widely discussed. Independently, mobile phone addiction (MPA) has also attracted academic attention. A few research have examined the correlation between the two. However, there is inadequate knowledge to characterize this relationship altogether. This study further explores the correlation between MPA and NSSI, specifically repeated and severe NSSI.MethodA population-based cross-sectional survey was conducted among 2,719 adolescents in Lincang, Yunnan. The mobile phone addiction index (MPAI) and the Modified Adolescents Self-Harm Survey (MASHS) were administered in combination. The connection between the MPAI and NSSI, as well as both repeated and severe NSSI, was studied using univariate and multivariate logistic regression models. (The copyright holders have permitted the authors to use the MPAI and the MASHS).ResultsThe prevalence of NSSI was 47.11% (95% CI [36.2-58.0%]), and the detection rate of MPA was 11.11% (95% CI [6.7-18.0%]). The prevalence of NSSI among those with MPA was 4.280 times (95% CI [3.480-5.266]) that of respondents not exhibiting MPA. In addition, all subscales of the MPAI, except for the feeling anxious and lost subscale (FALS), were positively correlated with NSSI. Risk factors, represented by odds ratios, of repeated NSSI with the inability to control cravings subscale (ICCS), the FALS, and the withdrawal and escape subscale (WES) was 1.052 (95% CI [1.032-1.072]), 1.028 (95% CI [1.006-1.051]), and 1.048 (95% CI [1.019-1.078]) respectively. Risk factors of these same three subscales for severe NSSI, had odds ratios of 1.048 (95% CI [1.029-1.068]), 1.033 (95% CI [1.009-1.057]), and 1.045 (95% CI [1.018-1.073]).ConclusionMPA was shown to be a risk factor for NSSI in adolescents. Individuals with high scores on the ICCS, the WES, and the FALS were more prone to experience repeated and severe NSSI. As a result, early assessment using the MPAI to determine the need for intervention can contribute to the prediction and prevention of NSSI.

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Non-suicidal Self-Injury in Clinical Practice.

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Non-suicidal Self-Injury in Clinical Practice.

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