Advancing a temporal framework for understanding the biology of nonsuicidal self- injury: An expert review.
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ABSTRACT:
SUBMITTER: Kaess M
PROVIDER: S-EPMC8783544 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:ObjectiveNonsuicidal self-injury (NSSI), the deliberate, self-inflicted damage of bodily tissue without the intent to die, is associated with various negative outcomes. Although basic and epidemiologic research on NSSI has increased during the last 2 decades, literature on effective interventions targeting NSSI is still emerging. Here, we present a comprehensive, systematic review of existing psychological and pharmacological treatments designed specifically for NSSI, or including outcome assessments examining change in NSSI.MethodWe conducted a systematic search of PsycINFO, MEDLINE, and ERIC databases to retrieve relevant articles that met inclusion criteria; specifically, uncontrolled and controlled trials that 1) presented quantitative outcome data on NSSI, and 2) clearly differentiated NSSI from suicidal self-injury (SSI). Consistent with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, definition of NSSI, we excluded studies examining populations with developmental or intellectual disabilities, or with psychotic disorders.ResultsSeveral interventions appear to hold promise for reducing NSSI, including dialectical behaviour therapy, emotion regulation group therapy, manual-assisted cognitive therapy, dynamic deconstructive psychotherapy, atypical antipsychotics (aripiprazole), naltrexone, and selective serotonin reuptake inhibitors (with or without cognitive-behavioural therapy). Nevertheless, there remains a paucity of well-controlled studies investigating treatment efficacy for NSSI.ConclusionsStructured psychotherapeutic approaches focusing on collaborative therapeutic relationships, motivation for change, and directly addressing NSSI behaviours seem to be most effective in reducing NSSI. Medications targeting the serotonergic, dopaminergic and opioid systems also have demonstrated some benefits. Future studies employing controlled designs as well as a clear delineation of NSSI and SSI will improve knowledge regarding treatment effects.
| S-EPMC4244876 | biostudies-literature
Project description:Nonsuicidal self-injury (NSSI) and suicidal behaviors, both important issues in adolescent health care, are frequently associated and possibly clinically related. Our objective was to explore the views of relations between nonsuicidal self-injury and suicidal behaviors during adolescence and young adulthood (11-25 years) expressed in the scientific (medical and psychological) literature. We adopted a textual approach to the process of synthesis to tell the story of the findings from the included studies. Our narrative systematic review of 64 articles found that they share the same risk factors. Integrated models envision nonsuicidal self-injury as a gateway enabling teens to acquire the capability for suicide. Because suicidal behavior short-circuits thought, it is difficult to conceive an intention to die during adolescents' acts of self-injury. Intention is constructed by the narrative of the act, influenced by numerous elements from the psychopathologic, cultural, religious, and philosophic context. Techniques of mentalizing-based treatments and work on the meaning that adolescents attribute to their behaviors might improve care.
| S-EPMC4835048 | biostudies-literature
Project description:BackgroundWe aimed to identify profiles of ambivalence among individuals with a history of non-suicidal self-injury (NSSI) and tested whether profiles differed across various theoretically informed constructs: NSSI-related characteristics, cognitive (outcome expectancies, self-efficacy to resist NSSI), emotional (psychological distress, difficulties in emotion regulation), personality, and incentives to engage/not engage in NSSI.MethodsIndividuals with a lifetime history of NSSI (n = 224) reported the extent to which they wanted to and did not want to engage in NSSI and completed well-validated measures of the constructs of interest.ResultsLatent profile analysis indicated four ambivalence profiles (avoid: n = 39; moderately ambivalent: n = 85; highly ambivalent: n = 30; approach: n = 70). The profiles differed across a number of NSSI-related characteristics, cognitive, emotional, and incentive-related variables. Differences between the ambivalence profiles and the avoid/approach profiles varied across constructs. For example, the ambivalence and approach profiles were similar for NSSI-related outcome expectancies, but the ambivalence and avoidance profiles were similar for self-efficacy to resist NSSI.ConclusionFindings highlight variation between the desire to engage or not engage in NSSI that are consistent with the notion of ambivalence. Understanding these differences may allow for a more person-centered approach in treatment for NSSI.
| S-EPMC10952785 | biostudies-literature
Project description:Nonsuicidal self-injury (NSSI) and disordered eating (DE) are highly comorbid and may be regarded as belonging to a spectrum of self-harm behaviors. We investigated self-criticism as a transdiagnostic correlate of these behaviors, in keeping with etiological theories of both NSSI and DE. We reviewed the literature and meta-analyzed the relation of self-criticism to both NSSI (15 studies; 17 effect sizes) and DE (24 studies; 29 effect sizes). Results showed equivalent, moderate-to-large effects for the relation of self-criticism to NSSI (r = .38; CI: .29-.46) and DE (r = .40; CI: .34-.45). The relation of NSSI to self-criticism generalized across multiple potential moderators. DE behavior type moderated the relation of self-criticism to DE, with a stronger relation emerging for purging than restriction. Findings support self-criticism as a possible candidate for transdiagnostic pathways to self-harm.
| S-EPMC6123292 | biostudies-literature
Project description:Nonsuicidal self-injury (NSSI) is associated with considerable deficits in managing negative self-directed internal experiences. The present study explores the neurophysiological correlates of self-referential processing in individuals with NSSI. A total of 26 individuals with NSSI (≥5 episodes of NSSI behavior in the past year, without suicide attempts) and 35 age-, sex-, education-, and intelligence quotient (IQ)-matched controls participated in this study. Participants underwent fMRI scanning as they performed a personal relevance rating task, which required them to evaluate the personal relevance of emotional words. As predicted, we found that individuals engaging in NSSI tended to rate negative adjectives as more relevant and positive adjectives as less relevant. An analysis of functional neuroimaging data showed that the NSSI group had increased activity relative to the control group in the inferior parietal lobe, inferior temporal gyrus, calcarine, insula, and thalamus in response to positive adjectives. The NSSI group also demonstrated greater activation in the calcarine and reduced activation in the inferior frontal gyrus in response to negative self-referential stimuli compared with the control group. In addition, increased right inferior parietal lobe activity during positive self-referential processing was correlated with reduced suicidal ideation in the NSSI group. Our study provides neural evidence for self-referential processing bias in individuals with NSSI and highlights the need for further research to clarify the pathophysiological features that are specific to NSSI.
| S-EPMC9168135 | biostudies-literature
Project description:OBJECTIVE:Cannabis use, particularly at an early age, has been linked to suicidal thoughts and behavior, but minimal work has examined the association between cannabis use and lifetime nonsuicidal self-injury (NSSI). The current study aims to characterize the overlap between lifetime and early cannabis use and NSSI and to examine genetic and environmental mechanisms of this association. METHOD:Adult male and female twins from the Australian Twin Registry (N = 9,583) were used to examine the odds of NSSI associated with lifetime cannabis use and early cannabis use (i.e., <17 years of age). These associations were also examined within monozygotic (MZ) twins discordant for cannabis use and MZ twins discordant for early cannabis use. Analyses were replicated in an independent sample of female twins (n = 3,787) accounting for the age at onset of cannabis use and NSSI. RESULTS:Lifetime cannabis use (odds ratio [OR] = 2.84, 95% CI [2.23, 3.61]) and early cannabis use were associated with increased odds of NSSI (OR = 2.15, 95% CI [1.75, 2.65]), and this association remained when accounting for covariates. The association was only significant, however, in MZ twin pairs discordant for early cannabis use (OR = 3.20, 95% CI [1.17, 8.73]). Replication analyses accounting for the temporal ordering of cannabis use and NSSI yielded similar findings of nominal significance. CONCLUSIONS:Results suggest that NSSI is associated with cannabis involvement via differing mechanisms. For lifetime cannabis use, the lack of association in discordant pairs suggests the role of shared genes and family environment. However, in addition to such shared familial influences, person-specific and putatively causal factors contribute to the relationship between early cannabis use and NSSI. Therefore, delaying the onset of cannabis use may reduce exposure to influences that exacerbate vulnerabilities to NSSI.
| S-EPMC5088170 | biostudies-literature
Project description:BackgroundThe prevalence of nonsuicidal self-injury (NSSI) is a major concern in public health. Two main factors (individual and environmental) cause NSSI. Studies addressing NSSI often consider it as an emotion regulation strategy. Studying NSSI within the framework of attachment theory is reasonable since the capacities to regulate emotion come into existence in the framework of attachment in the first periods of a child's growth. Primary studies addressing this topic are not frequent, and no systematic review has been conducted.ObjectiveThis systematic review and meta-analysis protocol aims to investigate the relationship between NSSI and attachment style and finding its relationship based on study design, study type, different types of attachments, and gender.MethodsAll studies on the relationship between NSSI and attachment will be included in this systematic review. We will include observational studies (cross-sectional, cohort, and case control) through searches in electronic databases via PubMed, CINAHL, Embase, Web of Science, ProQuest, Scopus, PsycINFO, and Google Scholar as complementary search. Qualitative studies, case studies, case series, and letters to the editor will be excluded. There will be no language limitation. Moreover, there will be no limitations regarding the study participants' age, gender, nationality, sexual orientation, and psychological problems. Funnel plots were examined if 10 or more studies are included, and the Begg and Egger statistical tests were used to assess the risk of bias. All similar data will be combined through the "metan" command by Stata statistical package (StataCorp). A fixed-effects or random-effects model, considering methodological similarities or differences, will be selected to determine a combination model.ResultsWe will summarize the selection of the eligible studies using a flowchart. The results will be presented in a table of evidence. The results of the meta-analysis will be depicted using diagrams and tables.ConclusionsIt seems necessary to carry out such systematic and comprehensive meta-analysis to present a summary of the published articles in terms of the relationship between NSSI and attachment. The results from this review will be used to improve our knowledge of the role of the upbringing of children and NSSI behavior and will help design appropriate interventions to address NSSI.Trial registrationPROSPERO CRD42021226455; https://tinyurl.com/yc77wny8.International registered report identifier (irrid)PRR1-10.2196/40808.
| S-EPMC10267785 | biostudies-literature
Project description:Cancer-associated fibroblasts (CAFs) are a key component of the tumour microenvironment with diverse functions, including matrix deposition and remodelling, extensive reciprocal signalling interactions with cancer cells and crosstalk with infiltrating leukocytes. As such, they are a potential target for optimizing therapeutic strategies against cancer. However, many challenges are present in ongoing attempts to modulate CAFs for therapeutic benefit. These include limitations in our understanding of the origin of CAFs and heterogeneity in CAF function, with it being desirable to retain some antitumorigenic functions. On the basis of a meeting of experts in the field of CAF biology, we summarize in this Consensus Statement our current knowledge and present a framework for advancing our understanding of this critical cell type within the tumour microenvironment.
| S-EPMC7046529 | biostudies-literature
Project description:ObjectiveSelf-criticism has been proposed as a transdiagnostic predictor of disordered eating and nonsuicidal self-injury (NSSI). First, this study explored cross-sectional associations of multiple disordered eating behaviors, NSSI, and self-criticism. Second, it tested longitudinal relations of self-criticism with disordered eating and NSSI, adjusting for baseline levels of both behaviors.MethodsIn Sub-study 1, undergraduates (N = 251, 79.5% female, Mage = 19.1 years) completed self-report measures of disordered eating, NSSI, and self-criticism at baseline and after 8 weeks. In Sub-study 2, community-based young adults with histories of disordered eating, NSSI, or both (N = 517, 88.8% female, Mage = 24.7 years) completed measures of disordered eating, NSSI, and self-criticism at baseline and after 4 weeks. All measures were completed online.ResultsIn Sub-study 1, both disordered eating and NSSI showed significant cross-sectional associations with self-criticism, and self-criticism was significantly related to binge eating, fasting, and NSSI at follow-up. In Sub-study 2, both behaviors again showed significant cross-sectional associations with self-criticism. Self-criticism showed significant longitudinal relations with fasting, purging, and excessive exercise. Longitudinal relations of self-criticism with NSSI varied across disordered eating behaviors.DiscussionNSSI showed cross-sectional associations with a range of disordered eating behaviors. Self-criticism reflects a common correlate of both disordered eating and NSSI. Evidence supported transdiagnostic longitudinal impact of self-criticism across multiple forms of disordered eating but provided more limited support for impacts on NSSI.
| S-EPMC7641508 | biostudies-literature
Project description:BackgroundThere is growing interest in the design of digital interventions to improve conditions for young people who engage in high-risk behaviors, like nonsuicidal self-injury (NSSI). However, few studies have focused on how young people self-manage NSSI, or their existing, and historic, use of technologies to support their goals related to NSSI behavior change. Such an understanding has the potential to inform the design of digital interventions that meet this population's unique needs.ObjectivesThis study aims to (a) understand the self-management practices of young adults who engage in NSSI, (b) explore how they currently use technologies for self-injury self-management, and (c) identify the ways they can envision an app-based technology supporting their self-management.Methods and materialsTwenty young adults (aged 18-24) with lived experience of NSSI, and who were not currently enrolled in therapy, were recruited from online venues. Participants completed baseline measures to assess mental health and NSSI characteristics, followed by a virtual 1-h semi-structured interview where they were invited to share their experience of self-management, their goals, and their thoughts on supportive technology. Interview scripts were transcribed and analyzed via thematic analysis.ResultsThemes and sub-themes are organized under two broad domain areas: (1) How young adults self-manage NSSI thoughts and behaviors and (2) Opportunities and challenges for digital interventions to assist young adults in their recovery process. We found that young adults had varied experiences with, and goals related to, NSSI. Participants reported a lack of effective strategies to reduce NSSI urges and a desire for an app-based technology to track patterns and deliver personalized suggestions for self-management. Participants reported existing use of technologies as part of self-management, as well as early information and support seeking for NSSI online.ConclusionsThis study contributes a greater understanding of young people's experiences with self-injury, their self-management practices, and their desire to engage with technology. Our findings highlight the need for design flexibility in developing digital interventions that support individual goals, unique presentations of NSSI, and needs at different phases of recovery. Implications for the design of highly personalized and relevant digital interventions to address NSSI are discussed.
| S-EPMC9278014 | biostudies-literature