Clinical Correlates of Deliberate Self-Harm Among Migrant Trauma-Affected Subgroups.

Francesca Baralla,Martina Ventura,Concetta Mirisola,Marco Sarchiapone,Anteo Di Napoli,Nikolay Negay,Alessio Petrelli

doi:10.3389/fpsyt.2021.529361

Francesca Baralla, Martina Ventura + Show 5 more

Open Access

https://doi.org/10.3389/fpsyt.2021.529361

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Abstract

Introduction: Studies have shown that exposure to potentially traumatic events (PTEs) during the migration process has serious consequences on mental health. Migrants with a history of PTEs are more likely to inflict deliberate self-harm (DSH), a spectrum of behavior that includes non-suicidal self-injury (NSSI). With reference to a nonclinical sample of trauma-exposed migrants, this study aims to explore the prevalence of DSH and to assess the association with sociodemographic characteristics and clinical conditions, with particular attention to post-traumatic stress disorder (PTSD) symptoms, resilience capabilities, and feelings of hopelessness.Methods: A sample of migrants underwent a baseline evaluation at an outpatient department of the National Institute for Health, Migration and Poverty (INMP). Migrants with a history of torture, rape, or other severe forms of psychological, physical, or sexual violence were invited to undergo screening at the Institute's Mental Health Unit. Trauma-exposed migrants completed a series of self-report questionnaires that assessed the presence of PTSD, depression, anxiety, suicidal ideation, resilience, and feelings of hopelessness, in addition to DSH. Univariate and multivariate log-binomial regression models were used to test the association of age and clinical characteristic of migrants with DSH. Prevalence ratio (PR) with 95% confidence intervals (95% CI) and p-values were estimated.Results: A total of 169 migrants (76.9% males), aged between 18 and 68 years, M = 28.93; SD = 8.77), were selected. Of the sample, 26.6% were frequently engaging in some form of DSH, and 30.2% were diagnosed with at least one trauma-related disorder. DSH behaviors were most common in single and unemployed migrants as well as in subjects with post-traumatic stress symptoms, feelings of anxiety, hopelessness, low capability of resilience, and suicidal ideation. Taking into account age and hopelessness, we found that PTSD and low resilience capabilities were associated with a higher risk of DSH [PR adj: 2.21; 95% CI: (1.30–3.75) and PR adj: 2.32; 95% CI: (1.16–4.62), respectively].Conclusion: Given the association between trauma exposure and DSH among migrants, exploring the presence of DSH behavior within the immigrant community is crucial for the implementation of measures to develop intervention in a clinical setting.

Highlights

Studies have shown that exposure to potentially traumatic events (PTEs) during the migration process has serious consequences on mental health
Literature has shown that patients with suicidal intent constitute a more severe group, and self-injuring patients with suicidal ideation (SUI) differ from patients who have not attempted suicide, in terms of greater severity of psychopathology in the former [15]
The current study aims to explore the frequency of deliberate self-harm (DSH) and document the prevalence of post-traumatic stress disorder (PTSD), depression, and anxiety in a nonclinical convenience subgroup of trauma-affected migrants

Summary

Introduction

Studies have shown that exposure to potentially traumatic events (PTEs) during the migration process has serious consequences on mental health. Migrants with a history of PTEs are more likely to inflict deliberate self-harm (DSH), a spectrum of behavior that includes non-suicidal self-injury (NSSI). With reference to a nonclinical sample of trauma-exposed migrants, this study aims to explore the prevalence of DSH and to assess the association with sociodemographic characteristics and clinical conditions, with particular attention to post-traumatic stress disorder (PTSD) symptoms, resilience capabilities, and feelings of hopelessness. Deliberate self-harm (DSH) refers to the intentional direct (e.g., destruction of one’s own body tissue without suicidal intent) and indirect damage to an individual’s body (e.g., severe substance abuse, overdosing, or ingestion of sharp implements), including suicidal behavior [1]. SUI is widely acknowledged to be a major risk factor for suicide and seems to be prevalent among firstand second-generation migrants [11]. Literature has shown that patients with suicidal intent constitute a more severe group, and self-injuring patients with SUI differ from patients who have not attempted suicide, in terms of greater severity of psychopathology in the former [15]

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