Co-occurrence Of Non-suicidal Self-injury Research Articles

A new integrative model for the co-occurrence of non-suicidal self-injury behaviours and eating disorder symptoms

ObjectiveThe high co-occurrence of non-suicidal self-injury (NSSI) behaviours and eating disorder (ED) symptoms suggests these conditions share common aetiological processes. We assessed a new integrative model of shared factors for NSSI and ED symptoms, where affect dysregulation, impulsivity, self-esteem, and body dissatisfaction mediated the relationship between insecure attachment and maladaptive schemas and NSSI and ED symptoms. A further aim of the study was to assess whether the model behaved similarly across a clinical eating disorder (ED) and a community sample.Method123 females with a lifetime ED diagnosis and 531 female individuals from the community completed an online survey, which included measures assessing the variables of interest. A cross-sectional single time point analysis was used.ResultsInvariance testing indicated that the model was structurally non-invariant (different across groups). The proposed integrative model was a good fit for the ED group, but for the community sample only a revised model reached an acceptable fit. Both attachment and maladaptive schemas, included early in the model, were implicated in the pathways leading to ED and NSSI symptoms in the ED and community groups. In the community group, impulsivity, a mediator, was a shared predictor for NSSI and bulimic symptoms. No other mediating variables were shared by NSSI and ED symptoms in the two groups. Overall, the proposed model explained slightly more variance for the ED group relative to the community group in drive for thinness (R2 = .57 vs .51) and NSSI (R2 = .29 vs .24) but less variance in bulimic symptoms (R2 = .33 vs .39).ConclusionWe conclude that the current model provides only limited support for explaining the comorbidity between NSSI and ED symptoms. It is vital to consider both common (e.g., attachment and maladaptive schemas) and specific factors (e.g., impulsivity) to better understand the pathways that lead to the co-occurrence of NSSI and ED symptoms.A new integrative model assessed whether emotion dysregulation, impulsivity, self-esteem, and body dissatisfaction were mediators in the relationship between insecure attachment and maladaptive beliefs about the world and the self and subsequent eating disorder and self-harm symptoms. A further aim was to assess whether the proposed model differed between a clinical eating disorder and a community sample. All participants were female and included 123 patients with a lifetime eating disorder and 531 individuals from the community. Participating individuals completed an online survey at one timepoint, which included measures assessing the variables of interest. The findings of the current study indicated that the proposed model was a good match for the clinical eating disorder sample, but for the community sample only a revised model yielded acceptable statistical fit. Both insecure attachment and maladaptive beliefs about the world and the self, included early in the model, were indirectly related to eating disorder and self-harm symptoms for both the eating disorder and the community groups. Impulsivity, a mediator, was the only shared predictor for self-harm, and bulimic symptoms in the community group. We conclude that the current model provides only limited support for explaining the comorbidity between self-harming behaviours and disordered eating symptoms.

Non-suicidal self-injury (NSSI) in adult psychiatric outpatients – A nationwide study

BackgroundNon-suicidal self-injury (NSSI) is a highly prevalent behavioural problem among people with mental illness, yet many fundamental aspects of NSSI remain unknown. We studied the prevalence of NSSI, and its relationship with suicide ideation (SI) and suicide attempts (SA) among adult psychiatric outpatients, with a special focus on patients with personality disorders compared with patients with other disorders. MethodDuring a 14-day period, data were collected on all available patients in all outpatient psychiatric clinics in Norway. This national clinical unselected cross-sectional dataset from 23,124 outpatients was used to generate proportional Venn diagrams of the prevalence of NSSI, SI and SA and their co-occurrence over the last four weeks. Differences in the risk for these behaviours across diagnoses were tested, both with and without adjustments for demographic and socio-demographic characteristics. ResultsOver the previous four-week period, 8.1% of the patients had experienced at least one episode of NSSI, 17.3% had SI and 0.6% had made at least one SA. Among patients with NSSI, 27.8% had co-occurring SI, and among patients with SI, 13% had co-occurring NSSI. The prevalence of SA was more than seven times higher among patients with NSSI behaviour than among patients without NSSI behaviour. Patients with a diagnosis of personality disorder had a significantly higher prevalence of SI, NSSI, and NSSI with co-occurring SI, than all other diagnostic groups; however, they were not systematically different from patients with other diagnoses in their prevalence of NSSI without co-occurring SI. These findings remained statistically significant even when controlling for socio-demographic variables. ConclusionsThe prevalence of recent NSSI is high in patients receiving outpatient psychiatric treatment in Norway. NSSI is significantly more prevalent in patients with personality disorders than in patients with other diagnoses, mainly due to the significantly higher prevalence of NSSI with co-occurring SI in patients with personality disorders. The co-occurrence of NSSI and SI is also prevalent in all diagnostic groups, but both NSSI and SI appear alone more often than together. The strong association between NSSI and SA calls for a more proactive focus on NSSI behaviour in mental health clinical settings as an important suicide preventive measure.

The co-occurrence of non-suicidal self-injury and attempted suicide among adolescents hospitalized in clinic for mental disorders “Dr Laza Lazarevic”

IntroductionThe phenomenon of non-suicidal self-injury (NSSI) as an act of deliberate destruction of body tissue without suicidal intent is common in adolescence. NSSI and suicide attempts (SA), although distinct behaviors differing in intent, form and function, often co-occur in the same individual.Objective and aimsRecent studies investigate the association between SA and NSSI among adolescent, as well as risk factors associated with these phenomenon. We investigated the co-ccurrence of NSSI and SA among adolescents treated in hospital during the previous year.MethodWe conducted a cross-sectional study among hospitalized adolescents in the Clinic for mental disorde “Dr Laza Lazarevic”, aged 14 to 18 years, in the period from 01.01.2015 to 01.01.2016. The data were obtained from clinical interviews of patients.ResultsStudy included 146 adolescents, 51.4% male and 48.6% female, average age 15.5. We found a statistically significant difference of NSSI (c2 = 9.951, P = 0.002, phi = 0.276) and SA (c2 = 4.517, P = 0.034, fi = 0.192) among female adolescent. The co-occurrence of NSSI and SA was found in 4.8% of adolescents, which does not indicate a statistically significant difference (c2 = 1.009, P = 0.315, phi = –0.101) compared to the total population of hospitalized adolescents.ConclusionAlthough our study did not confirmed a higher incidence of SA in adolescent with NSSI, understanding of what percentage of those engaging in NSSI also make SA, and how they are related have great significance in their prevention taking into account the dangerousness and lethality of those behavior.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Co-occurrence of non-suicidal self-injury and impulsivity in extreme weight conditions

The aims of the present study were to determine the prevalence of non-suicidal self-injury (NSSI) in different eating disorder (ED) groups and morbid obesity, and to investigate whether NSSI in different ED/obesity groups co-occur with impulsivity. We assessed 535 individuals (365 ED and 170 obese patients) by means of a single item assessing lifetime NSSI and the Barratt Impulsivity Scale, which measures different dimensions of impulsivity. The results showed that 19.1% of the ED patients engaged in at least one act of NSSI during their life-time. NSSI was more prevalent in Bulimia Nervosa, Binge Eating Disorder, Eating Disorder Not Otherwise Specified compared to Anorexia Nervosa, Restrictive type and morbid obesity. Finally, ED/obese patients who engaged in NSSI scored significantly higher on the attentional, motor and non-planning subscales than patients without NSSI. The implications of these findings for the treatment of NSSI in binge/purging ED patients are discussed.

The co-occurrence of non-suicidal self-injury and attempted suicide among adolescents: distinguishing risk factors and psychosocial correlates.

Although attempted suicide and non-suicidal self-injury (NSSI) are distinct behaviors differing in intent, form, and function, the behaviors co-occur at a high rate in both adults and adolescents. Researchers have begun to investigate the association between attempted suicide and NSSI among adolescents. The purpose of this paper is to present current research on this association. First, we discuss definitional issues associated with self-injurious behaviors. Next, we present research on the co-occurrence of attempted suicide and NSSI, including prevalence and associations with self-injury characteristics. We then discuss psychosocial variables associated with engaging in both NSSI and attempted suicide or one type of self-injury alone. Finally, we present the research to date on risk factors uniquely associated with either attempted suicide or NSSI. Implications for mental health professionals and future avenues of research are discussed.