Non-Suicidal Self-Injury: A School-Based Peer Education Program for Adolescents During COVID-19 Pandemic.
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ABSTRACT:
SUBMITTER: Cipriano A
PROVIDER: S-EPMC8793799 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description: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. Consequently, child and adolescent clinicians are left with little evidence-based guidance for treating this challenging population. To provide some guidance, evaluations of treatments for adults with NSSI and for adolescents with related conditions, such as deliberate self-harm and borderline personality disorder, are reviewed. Clinical guidelines and resources are also discussed to assist with the gaps in the knowledge base for treatment of NSSI among adolescents.
| S-EPMC3782878 | biostudies-literature
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.
| S-EPMC7298560 | biostudies-literature
Project description:To evaluate the effectiveness of a peer-led asthma self-management program for adolescents.Randomized controlled trial comparing a peer-led asthma program (intervention group) and a conventional adult-led asthma program (control group). Each program was implemented at a full-day camp.A city and adjacent suburbs in upstate New York.A total of 112 adolescents aged 13 to 17 years with persistent asthma.A peer-led asthma self-management program implemented at a day camp.The Child Attitude Toward Illness Scale and the Paediatric Asthma Quality of Life Questionnaire were administered at baseline and immediately and 3, 6, and 9 months after the intervention. Spirometry was conducted twice: before and 9 months after the intervention.The intervention group reported more positive attitudes at 6 months (mean difference, 4.11; 95% confidence interval [CI], 0.65-7.56) and higher quality of life at 6 months (difference, 11.38; 95% CI, 0.96-21.79) and 9 months (difference, 12.97; 95% CI, 3.46-22.48) than the control group. The intervention was found to be more beneficial to adolescents of male gender or low family income, as shown by greater improvement in positive attitudes toward asthma and quality of life than their counterparts.An asthma self-management program led by peer leaders is a developmentally appropriate approach that can be effective in assisting adolescents with asthma in improving their attitudes and quality of life, particularly for males and those of low socioeconomic status.clinicaltrials.gov Identifier: NCT01161225.
| S-EPMC3252732 | biostudies-literature
Project description:Frequent use of health-care services associated with pediatric asthma places substantial economic burden on families and society. The purpose of this study is to examine the cost-saving effects of a peer-led program through reduction in health-care utilization in comparison to an adult-led program.Randomly assigned adolescents (13-17 years) participated in either peer-led (n = 59) or adult-led (n = 53) asthma self-management program. Health-care utilization data were collected at baseline and at 3-, 6-, and 9-months post-intervention. Negative binomial regression models were conducted to examine the effects of the peer-led program on health-care utilization. Net cost savings were estimated based on the differences in program costs and health-care utilization costs between groups.Significant group differences were found in acute office visits and school clinic visits after controlling for race and socioeconomic status. The incidence rate of acute office visits was 80-82% less for the peer-led group during follow-ups. The peer-led group was four to five times more likely to use school clinics due to asthma than the adult-led group during follow-ups. The non-research cost of peer-led program per participant was lower than the adult-led program, $64 versus $99, respectively. The net cost saving from the reduction in acute office visits and the lower program costs of the peer-led program was estimated $51.8 per person for a 3-month period.An asthma self-management program using peer leaders can potentially yield health-care cost savings through the reduction in acute office visits in comparison to a traditional program led by health-care professionals.
| S-EPMC3434702 | biostudies-literature
Project description:BackgroundNon-suicidal self-injury (NSSI) is defined as the repetitive, direct, and deliberate destruction of one's body tissue without an intention to die. Existing cross-sectional research indicates that the association between maternal/peer attachment and NSSI is mediated by identity synthesis and confusion. However, longitudinal confirmation of the aforementioned mediation models is necessary as cross-sectional models are known to be biased. Consequently, the aim of the present study was to investigate whether identity formation mediates the association between attachment and NSSI in a longitudinal design.MethodsThree waves of self-report questionnaires data (1 year apart) were collected on maternal and peer attachment, identity, and NSSI from students of a high school in Belgium (at Time 1: Mean age?=?15.0 years, SD?=?1.85, range?=?11-19 years, 50.6% female). Both cross-lagged (between-person) and parallel process latent growth curve (within-person) mediation analyses were used to test the mediation models.ResultsFindings of the cross-lagged analyses indicated unidirectional associations among the study variables, that is, from attachment to identity to NSSI. Parallel process latent growth mediation analyses showed that the association between the slope of maternal attachment and the slope of NSSI was mediated by the slopes of identity synthesis and confusion. Peer attachment models did not fit the data.ConclusionThe current work demonstrated that dysfunctional maternal and peer attachment may lead to disturbances in identity formation, which, in turn, may lead to increased NSSI. Additionally, within-person analysis indicated that the growth rate of maternal attachment predicted the growth rate of NSSI through the growth rate of identity synthesis and confusion. The clinical relevance of these findings is discussed.
| S-EPMC6339302 | biostudies-literature
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:Suicide is a leading cause of death among youth worldwide, and depressed adolescents are at a significantly elevated risk to report suicidal ideation, planning, and attempts. Peer victimization is a robust predictor of adolescent suicidal thoughts and behaviors (STBs), but little research has focused on why bullying leads to suicidal thoughts and behaviors. To address this empirical gap, we recruited 340 (246 female) depressed adolescents ages 13-19 (M = 15.59, SD = 1.41) within 48 h of admission for acute psychiatric treatment. At the initial assessment, participants were administered clinical interviews characterizing psychopathology, nonsuicidal self-injury, and STBs (ideation, plans, and attempts). Further, they completed questionnaires assessing 3 forms of victimization (overt, relational, and reputational), recent risky behavior engagement, and psychiatric symptom severity. Controlling for internalizing symptoms and age, overt and reputational bullying were associated with more frequent past month suicide attempts, but not suicide ideation. Past month risky behavior engagement, but not NSSI, mediated the relation between victimization and attempts. However, sex differences revealed that this effect only held for males whereas bullying was directly associated with suicide attempts among females. In contrast, overt and relational bullying were non-linearly associated with suicide plans, and these relations were not mediated by risky behaviors or NSSI. Results highlight the complex network of factors that lead victimized adolescents to engage in STBs and may inform targeted suicide prevention and intervention programs.
| S-EPMC5656560 | biostudies-literature
Project description:Non-suicidal self-injury (NSSI) and suicidal behaviour have been witnessed in children as young as 6-7 years of age, but while there are many reviews of preventative interventions for NSSI and suicide in adolescents, few have explored its prevalence in younger children and the potential impact of preventative interventions at this stage of life. NSSI and suicidal behaviour are an increasing concern in schools but school-based programmes can improve knowledge, attitudes and help-seeking behaviours and help prevent escalation of NSSI and later suicide. This scoping review will aim to explore the nature and extent of the evidence on the magnitude of NSSI and suicidal behaviour in primary school children, and to examine whether there are any primary school-based interventions available for the prevention of this phenomenon in 5 to 11-year-olds.A scoping review will be conducted using established methodology by Arksey and O'Malley and the Joanna Briggs Institute. Multiple bibliographic and indexing databases and grey literature will be searched using a combination of text words and index terms relating to NSSI, suicide, primary schools, frequency and intervention. Two reviewers will independently screen eligible studies for study selection and extract relevant data from included studies. A narrative summary of evidence will be conducted for all included studies with results presented in tables and/or diagrams. Inductive content analysis will be used to understand any narrative findings within the included studies.Ethical approval is not required for this scoping review. The results of this review will be disseminated though publication in a peer-reviewed journal and presented at relevant conferences.
| S-EPMC5726135 | biostudies-other
Project description:OBJECTIVE:To analyze the prevalence of suicidal ideation and its associated factors in school adolescents. METHODS:Cross-sectional school-based study with 674 students from public and private schools in Teresina, Piauí, in 2016. Bivariate analysis was performed with the chi-square test and multiple analysis by the Poisson regression model to estimate prevalence ratios (PR) and 95% confidence intervals (95%CI). RESULTS:The study participants were mostly female (56.7%), black (77.4%), who lived with their parents (85%), whose mothers had schooling greater than or equal to 8 years of schooling (68.8%), with family income greater than a minimum wage (58.3%), practitioners of some religion (86.8%) and coming from public school (64.7%). The prevalence of suicidal ideation was 7.9%. Higher frequency of suicidal ideation was reported among female students (10.2%). Suicidal ideation was statistically associated with students who reported not living with their parents (adjusted PR = 2.27; 95%CI 1.26-4.10; p < 0.05) and those who reported having suffered sexual violence by other students, teachers or school staff (adjusted PR = 3.40; 95%CI 1.80-6.44; p < 0.05), among which the prevalence of suicidal ideation was more than three times that observed among those who did not mention this type of violence. CONCLUSION:The prevalence of suicidal ideation in school adolescents was associated with female students, who did not live with parents and have been victim of sexual violence at school. We recommend advising the school community and health professionals to identify signs of suicidal behavior, especially in those with suspicion or proof of the occurrence of sexual violence at school.
| S-EPMC7100950 | biostudies-literature