Five-Year Follow-Up Study of Adolescents With Nonsuicidal Self-Injury.

Difficulties in impulse control in adolescents with problematic use of the internet and self-injurious behaviors

Individuals with a borderline personality disorder (BPD) or BPD traits usually have a lifetime history of harmful behaviors. Emotion regulation difficulties are a risk factor for suicide, whereas adequate family functioning and well-being play an important protective role. This study aims to determine the role of emotion regulation difficulties, well-being, and family functioning in the suicide risk and non-suicidal self-injury (NSSI) in adolescents and young people with BPD traits. From a sample of 285 young people, 103 (36.1%) had BPD traits (mean age = 16.82, SD = 2.71), and 68.93% were females. The results showed significant differences in personal and family variables according to the type of harmful behavior. Suicide attempts (SA) were mainly predicted by difficulties in impulse control, whereas NSSI was predicted by low family satisfaction. Programs designed to prevent SA and NSSI should consider individual differences, as well as the type of harmful behaviors exhibited.

Nonsuicidal self-injury (NSSI) is a prevalent and impairing condition that was newly included in DSM-5 in the section III criteria for further research. Difficulties in emotion regulation play an important role in the development and maintenance of NSSI. This study investigated the emotion regulation in female adolescents with NSSI according to DSM-5 (n=55), clinical control adolescents with mental disorders without NSSI (n=30), and nonclinical control adolescents (n=58) using self-report questionnaires and interviews. As expected, results indicated that adolescents with NSSI have significantly more difficulties in emotion regulation compared to healthy controls. In addition, adolescents with NSSI reported also significantly more difficulties in impulse control, lack of emotional clarity, difficulties engaging in goal-directed behavior, and limited access to emotion regulation strategies compared to nonclinical and clinical controls. Adolescents with NSSI felt significantly more often sadness compared to clinical controls (d=0.66) and compared to other emotions. Adolescents with NSSI indicated significantly less often happiness compared to nonclinical controls (d=1.83). Results support that adolescents with NSSI have difficulties in emotion regulation and that these difficulties are even more pronounced than in adolescents with other mental disorders. Clinical implications will be discussed.

Objective Anxiety sensitivity, distress tolerance, and emotion regulation difficulties have each demonstrated significant individual associations with problematic alcohol use and negative reinforcement motives for alcohol use among college students. However, extant research has yet to examine these three factors simultaneously with regard to the possibility of differential associations with alcohol consumption, alcohol-related problems and coping and conformity motives for alcohol use. As such, the present study sought to examine whether such differential associations exist within a sample of undergraduates reporting past year alcohol use. Methods: Participants were 379 undergraduate students reporting alcohol use in the past year who completed self-report measures for course credit. Results: After controlling for the effects of sex, lifetime marijuana use status, and negative affectivity, greater anxiety sensitivity social concerns and difficulties with emotional awareness were associated with more alcohol-related problems. Greater anxiety sensitivity social concerns and impulse control difficulties were associated with greater conformity alcohol use motives, and greater impulse control and emotional clarity difficulties were associated with greater coping motives. Conclusions: These findings suggest that greater fears of anxiety symptoms because of their potential negative social consequences and certain emotion regulation difficulties (i.e., impulse control, emotional clarity, emotional awareness) may be particularly problematic because they are associated with alcohol-related problems and negative reinforcement motives for use among undergraduates.

Impulse control difficulties while distressed: A facet of emotion dysregulation links to Non-Suicidal Self-Injury among psychiatric inpatients at military treatment facilities

Difficulties in emotion regulation and suicide ideation and attempt in adolescent inpatients

Nonsuicidal self-injury (NSSI) has become a major public health issue in adolescents. This cross-sectional case-controlled study aims to assess the impact of identity diffusion, psychopathology, and mentalization on NSSI in adolescence. The study sample consisted of 153 adolescents (76.5% girls; Mage = 15.6 years). The sample included 56 clinical cases of NSSI, 45 psychiatric cases without NSSI, and 52 healthy controls, all recruited in Ankara, Türkiye, from June 1, 2022, to August 31, 2022. Mentalization was assessed by "The Movie for the Assessment of Social Cognition" (MASC) which categorizes mentalizing as "correct mentalizing" "hypermentalizing" "undermentalizing" and "no-mentalizing". All participants filled in the Self-Injurious Behavior Screening Questionnaire, Assessment of Identity Development in Adolescence (AIDA), and Youth Self Report (YSR), and Inventory of Statements About Self-injury (ISAS). The NSSI group showed lower mentalizing capacity than the healthy control group (p = .011), and more no-mentalizing errors than the other two groups (p = .014). Identity diffusion scores were higher in the NSSI group than in the other two groups (p < .001). Multivariate logistic regression analysis showed that the presence of maternal psychiatric disorder (p = .019, OR = 5.21), identity diffusion (p = .007, OR = 1.02), no mentalizing (p = .049, OR = 1.28), and total psychopathology symptoms (p = .009, OR = 1.12) had a significant impact on NSSI. Current findings suggest that transdiagnostic approaches, including mentalization and identity diffusion, may contribute to a more comprehensive understanding of NSSI and to the development of clinical interventions.

Introduction: Various factors, including personality characteristics, are involved in addiction and perpetuation of it. Emotions and the way they are felt and responded are a part of personality that may play a role in showing tendency to drug abuse and perpetuation of this behavior. The present study aimed at investigating emotional difficulties in drug addicts. Methodology: The statistical population of this cross-sectional study included 268 individuals, of which 166 individuals were drug dependence who visited medical centers in Zahedan and Iranshahr. The remaining 120 individuals had no addiction history and were assessed with difficulty in emotion regulation scale. Sample selection was done through convenience sampling technique. Findings: Results suggested that drug-dependent people had significant difference from nondependent individuals in five aspects, namely nonacceptance of emotional responses, difficulty engaging in goal-directed behaviors, difficulty in impulse control, limited access to emotion regulation strategies, and lack of emotional clarity (P 0.05). Evaluation of emotional difficulties and gender showed a difference between men and women in nonacceptance of emotional responses, difficulty in impulse control, limited access to emotion regulation strategies (P

BackgroundThis study aims to examine the underlying associations between eating, affective and metacognitive symptoms in patients with binge eating disorder (BED) through network analysis (NA) in order to identify key variables that may be considered the target for psychotherapeutic interventions.MethodsA total of 155 patients with BED completed measures of eating psychopathology, affective symptoms, emotion regulation and metacognition. A cross-sectional network was inferred by means of Gaussian Markov random field estimation using graphical LASSO and the extended Bayesian information criterion (EBIC-LASSO), and central symptoms of BED were identified by means of the strength centrality index.ResultsImpaired self-monitoring metacognition and difficulties in impulse control emerged as the symptoms with the highest centrality. Conversely, eating and affective features were less central. The centrality stability coefficient of strength was above the recommended cut-off, thus indicating the stability of the network.ConclusionsAccording to the present NA findings, impaired self-monitoring metacognition and difficulties in impulse control are the central nodes in the psychopathological network of BED whereas eating symptoms appear marginal. If further studies with larger samples replicate these results, metacognition and impulse control could represent new targets of psychotherapeutic interventions in the treatment of BED. In light of this, metacognitive interpersonal therapy could be a promising aid in clinical practice to develop an effective treatment for BED.

Brain Mechanisms of Borderline Personality Disorder at the Intersection of Cognition, Emotion, and the Clinic

Acceptance and commitment therapy has been used to treat anxiety disorders recently. The purpose of this study was to investigate the effectiveness of acceptance and commitment therapy for psychological symptoms in students with social anxiety disorder, including difficulty in emotion regulation, psychological flexibility based on experiential avoidance, self-compassion, and external shame. This study was a semi-experimental clinical trial. Twenty four students with social anxiety disorder were randomly divided into two groups after initial evaluations: an experimental group (12 subjects) and a control group (12 subjects). The experimental group received 12 treatment sessions based on a protocol of acceptance and commitment therapy for anxiety disorders, and the control group was put on a waiting list. Self-Compassion (SCS), Difficulty in Emotion Regulation (DERS), External Shame (ESS), Social Anxiety (SPIN), and Acceptance and Action (AAQ-II) questionnaires were used to assess participants. Data were analyzed using SPSS. Acceptance and commitment therapy was shown to be effective at the post-test and follow up stages for reducing external shame, social anxiety, and difficulty in emotion regulation and its components, and for increasing psychological flexibility and self-compassion (p < 0.05). The largest effect size of treatment was for increase of psychological flexibility and the lowest efficacy was for the components "difficulty in impulse control" and "limited access to emotional strategies" at the post-test and follow-up stages, respectively. Acceptance and commitment therapy may be an appropriate psychological intervention for reducing the symptoms of students with social anxiety disorder and helping them to improve psychological flexibility. Emotion and related problems can be identified as one of the main targets of this treatment. Iranian Registry of Clinical Trials, IRCT20180421039369N1.

Emotion dysregulation and non-suicidal self-injury: A systematic review and meta-analysis

Stress triggers impulsive and addictive behaviors, and alcoholism has been frequently associated with increased stress sensitivity and impulse control problems. However, neural correlates underlying the link between alcoholism and impulsivity in the context of stress in patients with alcohol use disorders (AUD) have not been well studied. This study investigated neural correlates and connectivity patterns associated with impulse control difficulties in abstinent AUD patients. Using functional magnetic resonance imaging, brain responses of 37 AUD inpatients, and 37 demographically matched healthy controls were examined during brief individualized imagery trials of stress, alcohol cue, and neutral-relaxing conditions. Stress-related impulsivity was measured using a subscale score of impulse control problems from Difficulties in Emotion Regulation Scale. Impulse control difficulties in AUD patients were significantly associated with hypo-active response to stress in the ventromedial prefrontal cortex (VmPFC), right caudate, and left lateral PFC (LPFC) compared to the neutral condition (p<0.01, whole-brain corrected). These regions were used as seed regions to further examine the connectivity patterns with other brain regions. With the VmPFC seed, AUD patients showed reduced connectivity with the anterior cingulate cortex compared to controls, which are core regions of emotion regulation, suggesting AUD patients' decreased ability to modulate emotional response under distressed state. With the right caudate seed, patients showed increased connectivity with the right motor cortex, suggesting increased tendency toward habitually driven behaviors. With the left LPFC seed, decreased connectivity with the dorsomedial PFC (DmPFC), but increased connectivity with sensory and motor cortices were found in AUD patients compared to controls (p<0.05, whole-brain corrected). Reduced connectivity between the left LPFC and DmPFC was further associated with increased stress-induced anxiety in AUD patients (p<0.05, with adjusted Bonferroni correction). Hypo-active response to stress and altered connectivity in key emotion regulatory regions may account for greater stress-related impulse control problems in alcoholism.

The 2009 Special Issue of Behavioural Pharmacology will be devoted to a behavioural process that plays a central role in a range of high-profile psychiatric disorders, impulse control. In addition to addiction, which is one of the most productive and prominent areas of behavioural pharmacology, disorders of impulse control also include ADHD, eating disorders (obesity and bulimia), gambling, aggression and self-harm. In each case, other processes are also involved, and impulse control may or may not predominate (for example, aggression may in some instances be carefully planned), but difficulties in impulse control create a dangerous predisposition for all of these disorders and represent a major target for therapeutic interventions. Suitable topics for this Special Issue could include: studies using animal models of addiction or other impulse control disorders; potential pharmacotherapies for addiction or other impulse control disorders; studies involving highly impulsive human participants, or animals selected or engineered for high impulsivity; or research with human or animal models of impulsive behaviour, such as go-no go, waiting, or temporal discounting tasks. We now invite behavioural pharmacologists working in any of these areas to submit reports of original, unpublished empirical studies, for inclusion in the Special Issue. Review papers are also welcome, but as the Special Issue may include a number of invited reviews, these should be discussed with the Editors at an early stage to avoid duplication. Also, ask please one of the Editors if you are uncertain whether a report of your research would be suitable for inclusion. All papers should be submitted online at www.editorialmanager.com/bpharm. There is no formal deadline for submission, but contributors are advised to submit as early as possible, and should aim to do so before the end of March 2009. Later submissions could be accepted, but the later your submission is received, the higher the likelihood that it may miss the publication deadline. We guarantee, however, that any submission that meets quality standards but is accepted too late for inclusion in the Special Issue will be published as soon as possible thereafter. Jack Bergman (Associate Editor) David Sanger (Associate Editor) and Paul Willner (Editor)

ADHD and hypersexual behaviors: The role of impulsivity, depressive feelings, hypomaniacal symptoms and psychotic prodromes