Nonsuicidal Self-injury Episodes Research Articles

Alcohol use prior to episodes of nonsuicidal self-injury in women with borderline personality disorder participating in a randomized clinical trial of dialectical behavior therapy.

Alcohol use is an important, but understudied, risk factor for nonsuicidal self-injury (NSSI), defined as deliberate physical harm to oneself without intent to die. Alcohol use may facilitate engagement in NSSI by increasing impulsivity and physical pain tolerance. Limited data also suggest that people engage in more medically severe NSSI under the influence of alcohol. This secondary analysis study examined the use of alcohol prior to NSSI in a sample of 79 female patients with borderline personality disorder who were enrolled in a randomized clinical trial of dialectical behavior therapy. We used multilevel modeling (MLM) to examine preregistered hypotheses that alcohol use prior to NSSI would be related to the impulsivity of NSSI, physical pain experienced during NSSI, and the medical severity of injuries from NSSI. Participants endorsed alcohol use prior to 21.96% (47/221) of NSSI episodes, and roughly one third of participants (n = 27) reported at least one episode of NSSI preceded by alcohol use. For NSSI episodes preceded by alcohol use, more than half (52.38%) of participants reported using alcohol up to the moment of initiating NSSI. Alcohol use was significantly associated with higher impulsivity of NSSI episodes (b = 1.16, p = .041), but not physical pain from NSSI or medical severity of NSSI. Findings need to be replicated but indicate that alcohol use occurs frequently prior to NSSI and could be a target for reducing impulsive episodes of NSSI. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Supplemental Material for Alcohol Use Prior to Episodes of Nonsuicidal Self-Injury in Women With Borderline Personality Disorder Participating in a Randomized Clinical Trial of Dialectical Behavior Therapy

Supplemental Material for Alcohol Use Prior to Episodes of Nonsuicidal Self-Injury in Women With Borderline Personality Disorder Participating in a Randomized Clinical Trial of Dialectical Behavior Therapy

Nonsuicidal self-injury in sexual minorities in Korea: the mediating role of intrapersonal functions and depression

A growing body of literature indicates that individuals belonging to sexual minority groups are at an increased risk of severe nonsuicidal self-injury (NSSI) behaviors. This study aimed to examine the potential factors mediating sexual minority status and more severe NSSI behaviors. A total of 296 self-identified sexual minorities and 206 heterosexuals who reported engaging in at least five-lifetime NSSI episodes were recruited online. The participants completed an online survey that included demographics, measures of depressive symptoms, and the frequency and functions of NSSI behaviors. Serial mediation analyses indicated that the association between sexual minority status and more frequent NSSI behaviors was mediated by depressive symptoms and intrapersonal functions of NSSI. Further analyses revealed that NSSI functions may vary by minority status, with individuals reporting a sexual minority status showing more frequent endorsements of intrapersonal functions. This study’s findings contribute to the literature by elucidating the complex role of clinical factors that mediate the relationship between sexual minority status and increased risk of engaging in more frequent NSSI behaviors. Our findings underscore the importance of developing a comprehensive perspective on NSSI behaviors, including the characteristics of NSSI functions and current clinical symptoms, as well as disadvantaged backgrounds, such as minority status.

Online and school bullying roles: are bully-victims more vulnerable in nonsuicidal self-injury and in psychological symptoms than bullies and victims?

BackgroundBullying leads to adverse mental health outcomes and it has also been linked to nonsuicidal self-injury (NSSI) in community adolescents. It is not clear whether different roles of bullying (bully, victim, bully-victim) are associated with NSSI, furthermore the same associations in cyberbullying are even less investigated.MethodsThe aim of the current study was to test whether students involved in school or online bullying differed from their not involved peers and from each other in psychological symptoms (externalizing and internalizing problems) and in NSSI severity (number of episodes, number of methods). Furthermore, mediation models were tested to explore the possible role of externalizing and internalizing problems in the association of school and online bullying roles with NSSI. In our study, 1011 high school students (66.07% girls; n = 668), aged between 14 and 20 years (Mage = 16.81; SD = 1.41) participated.ResultsLifetime prevalence of at least one episode of NSSI was 41.05% (n = 415). Students involved in bullying used more methods of NSSI than not involved adolescents. In general, victim status was associated mostly with internalizing symptoms, while bully role was more strongly associated with externalizing problems. Bully-victims status was associated with both types of psychological problems, but this group did not show a significantly elevated NSSI severity compared to other bullying roles. Externalizing and internalizing problems mediated the relationship between bullying roles and NSSI with different paths at different roles, especially in case of current NSSI that happened in the previous month.ConclusionsResults highlight that students involved in bullying are more vulnerable to NSSI and to psychological symptoms compared to their peers who are not involved in bullying. It is suggested that bullying roles, especially bully-victim status, need to be identified in school and online settings and thus special attention should be addressed to them to reduce psychological symptoms and NSSI, for example by enhancing adaptive coping skills.

Quantitative Characteristics of Small Extracellular Vesicles from the Blood of Patients with Non-Suicidal Self-Harm

Objective of the study – determination of quantitative characteristics of small extracellular vesicles (sEV) in the blood of patients with non-suicidal self-injury (NSSI) and comparison of the concentration and size of sEV’s in patients with major depressive disorder (MDD) with and without NSSI, as well as an assessment of the relationship between the sizes and concentrations of sEV in the sample with such parameters as the severity of situational and personal anxiety, depression and suicidal risk. The study included 28 patients (11 m./17 f.) with a current episode of major depression and at least five episodes of NSSI in the last 12 months (main group, mean age 28.3 years) and 28 patients with major depression identical in sex and age without NSSI throughout life (comparison group). Patient mental status was assessed using the MINI interview, the Beck Depression Inventory II (BDI II), and the Spielberger Anxiety Scale. Isolation of sEV from blood was carried out using polyethylene glycol (PEG) precipitation and gel filtration. The size and concentration of isolated particles were estimated using dynamic light scattering (DLS) and nanoparticle tracking analysis (ATN). The groups differed significantly in the severity of depression according to the BDI-II questionnaire, the Spielberger Situational Anxiety Scale, and the Spielberger Personality Anxiety Scale. The assessment of suicidal risk, carried out according to the corresponding module of the MINI questionnaire, revealed a significantly larger number of participants with medium and high suicidal risk in the group of patients with NSSI. The sEV fraction was isolated from the blood of the patients of the main group and the comparison group. There were no differences in the concentration and size of sEV between groups of patients with depression with and without NSSI. In our study, the dependence of the concentration and size of sEV on the severity of depression, situational and personal anxiety, and the severity of suicidal risk wasn’t revealed. Conclusion: NSSI in individuals with major depressive disorder is associated with a more severe course of the disorder (greater severity of depression, situational and personal anxiety), as well as a higher risk of suicide. Our study did not reveal any differences in the quantitative characteristics of sEV in patients with a depressive episode with and without NSSI. Future studies should focus on investigating the structural differences and functional features of sEV in NSSI.

Examining the association between exposure to major stressful life events and non-suicidal self-injury

Experiencing major stressful life events (SLEs) may contribute to risk for non-suicidal self-injury (NSSI). Prior research has established that a higher number of SLEs is linked with more frequent NSSI episodes among young adults. However, life stress is typically assessed with checklist approaches; these methods introduce frequent idiosyncratic misinterpretations of stress categories (e.g., major illness). Coupled with the unclear boundary of what constitutes SLEs, relying on participants’ subjective appraisals of stress severity attenuates validity. Specifically, individuals with a history of NSSI may have certain cognitive characteristics that contribute to an over-appraisal of event severity. Interview-based, contextual life stress systems overcome these limitations by having third-party raters blind to participant characteristics determine stress severity based on a standardized set of circumstances. Accordingly, this study used the Life Events and Difficulties Schedule 2 (LEDS-II), which is a gold-standard, semi-structured life stress interview and rating system. Specifically, we focused on the cumulative severity of episodic stressors (i.e., SLEs whose major features occur within a 2-week period). In preliminary analyses of 53 participants (Mage= 20.17, SDage= 2.51), cumulative stress severity (M =2.96, SD =3.20) was not significantly associated with the number of NSSI episodes participants reported in the past year (M = 22.75, SD = 67.46), r(53) = .13 p = .370. Data collection is ongoing, and we anticipate adding 30 participants (total n=83) to the analyses. Current findings do not align with previous literature on the association between SLEs and NSSI. However, they provide a methodological foundation for how to improve future research on SLEs and NSSI in young adults through the application of gold-standard life stress measures.

Patterns of experience, expression, and physiology of stress relate to depressive symptoms and self-injurious thoughts and behaviors in adolescents: a person-centered approach.

Preliminary evidence shows that discordance in stress experience, expression, and physiology (EEP) in adolescents is linked to depression, suicidal ideation (SI), non-suicidal self-injury (NSSI), and brain functioning. This study employs person-centered analysis to probe the relationship between stress responses, psychopathology, and neural patterns in female adolescents who are oversampled for engagement in NSSI. Adolescent females (N = 109, ages 12-17) underwent a social stress test from which self-report measures of stress experience, observer ratings of stress expression, and physiological metrics of stress (via salivary cortisol) were obtained. Multi-trajectory modeling was employed to identify concordant and discordant stress EEP groups. Depressive symptoms, SI and attempt, NSSI engagement, frontal and limbic activation to emotional stimuli, and resting state fronto-limbic connectivity were examined in the EEP groups derived from the multi-trajectory models. Four groups were identified, three of which demonstrated relatively concordant EEP and one which demonstrated discordant EEP (High Experience-High Expression-Low Physiology). Further, replicating past research, the High Experience-High Expression-Low Physiology discordant group exhibited higher depressive symptoms, SI, suicide attempt, and NSSI episodes (only for sensitivity analyses based on past year) relative to other EEP groups. No significant group differences in brain functioning emerged. Results indicate that within-person, multi-level patterns in stress responding capture risk for dysfunction including depression and self-injurious thoughts and behaviors. Further interrogating of system-level stress functioning may better inform assessment and intervention efforts.

The dynamics of self-injurious and suicidal thoughts and behaviors in adolescence: a narrative review and critical evaluation of ambulatory assessment studies

INTRODUCTION: Suicide is a major public health issue among adolescents, the fourth leading cause of death among 15-19-year-olds. Ambulatory Assessment (AA), or real-time monitoring, refers to a range of techniques (e.g., ecological momentary assessment (EMA), daily diaries) designed to assess individuals’ thoughts, feelings, and behaviors in their natural environment, intensively and repeatedly over time. It represents a suitable approach for capturing these fluctuations and dynamics.EVIDENCE ACQUISITION: The present narrative review aimed to describe all the published studies evaluating AA and suicide-related outcomes in adolescents and to critically evaluate the reported dynamic processes. A PubMed search was performed up to March 2022 to include studies focused on 1) adolescents; 2) any suicide-related outcome; and 3) AA and dynamic processes.EVIDENCE SYNTHESIS: We included 27 studies based on EMA (multiple assessments per day) (k=17), daily diary (one assessment per day) (k=9), or both (k=1). Among EMA studies, different types of sampling strategies were used: signal-contingent (self-report after a notification) (k=11), event-contingent (self-report after the event) (k=1), and mixed-based (k=4) sampling strategies. Nearly half of the studies measured positive and negative affects, while most studies measured suicidal ideation (SI), self-injurious thoughts and non-suicidal self-injury (NSSI). Nineteen studies yielded a dynamic aim, using a nomothetic (k=5) or an idiographic approach (k=22), respectively, a group-based and an individual-based approach.CONCLUSIONS: The shortness of NSSI episodes (from 1 to 30 minutes) and the high SI fluctuation over time suggest the importance of a real-time assessment of these phenomena. However, an idiographic approach to data analysis should accompany this type of monitoring. This approach captures the dynamics underlying these phenomena. It considers their intimate and individual nature, gaining a basic understanding of the phenomenology of both SI and NSSI episodes as they occur in the real world.

An experimental investigation of biased attention in non-suicidal self-injury: The effects of perfectionism and emotional valence on attentional engagement and disengagement

Background and objectivesTheoretical models of non-suicidal self-injury (NSSI) propose that individuals who self-injure may find their attention more strongly captured by negative emotion, and that this intensifies distress which leads to episodes of NSSI. Elevated perfectionism is associated with NSSI, and when an individual is highly perfectionistic, a focus on perceived flaws/failures may increase risk of NSSI. We explored how history of NSSI and trait perfectionism are associated with different types of attention bias (engagement vs. disengagement) to stimuli that differ in emotional valence (negative vs positive) and perfectionism relevance (relevant vs irrelevant). MethodsUndergraduate university students (N = 242) completed measures of NSSI, perfectionism, and a modified dot-probe task to measure attentional engagement with and disengagement from both positive and negative stimuli. ResultsThere were interactions between NSSI and perfectionism in attention biases. Amongst individuals who engage in NSSI, those with elevated trait perfectionism exhibit speeded responding to and disengagement from emotional stimuli (both positive and negative). Furthermore, individuals with a history of NSSI and elevated perfectionism were slower to respond to positive stimuli, and faster to negative stimuli. LimitationsThis experiment was cross-sectional in design so does not provide information about temporal ordering of these relationships, and given the use of a community sample, would benefit from replication in clinical samples. ConclusionsThese findings lend support to the emerging idea that biased attention plays a role in how perfectionism is associated with NSSI. Future studies should replicate these findings using other behavioural paradigms and diverse samples.

Nonsuicidal self-injury in a clinical sample of adolescents in Serbia

Background/Aim. Nonsuicidal self-injury (NSSI) among adolescents is recognized as a significant public health concern. Adolescents with mental health problems are at an especially high risk of NSSI. The aim of the study was to assess the sociodemographic and clinical characteristics of patients with NSSI and the features of NSSI, as well as the impact of emotional reactivity and internalizing/externalizing problems on them. Methods. The observational study included a clinical sample of 111 adolescents treated at the Department of Child and Adolescent Psychiatry, Psychiatric Clinic at the University Clinical Center of Vojvodina, from March 2018 to October 2019. The adolescents were divided into two groups: group A comprised of adolescents who had at least one episode of NSSI in the last year, and group B comprised of adolescents who had no NSSI episode in their experience. The following clinical scales were used to examine the differences between adolescents from group A and group B: self-report questionnaires about emotional and behavioral problems (Youth Self-Report ? YSR, Child Behavior Checklist ? CBCL), emotional reactivity (Emotion Reactivity Scale ? ERS), and suicidality (Self- Injurious Thoughts and Behaviors Interview ? SITBI). Results. Group A contained a total of 58 adolescents older than the subjects of group B and was predominated by female participants. They had the first episode of NSSI at 13.05 and the last at 14.80 years. The most common methods of NSSI were cutting, scratching, and biting. Adolescents from group A had higher scores on ERS, higher scores on internalizing and externalizing problems, as well as higher total scores on YSR, but there was no difference between groups regarding scores on the CBCL scale. Conclusion. Due to the results obtained for emotional and behavioral problems, adolescents with NSSI should have a detailed psychiatric assessment, including social support, pharmacotherapy, and psychotherapy, to better understand NSSI and help them develop better coping skills.

Clinical Trajectories in Adolescents with and without a History of Non-Suicidal Self-Injury: The BRIDGES Longitudinal Study.

Non-suicidal self-injury (NSSI) is a highly prevalent clinical concern in adolescents and is associated with impaired functioning and suicide risk. The BRIDGES (BRain Imaging Development of Girls' Emotion and Self) study was designed to collect longitudinal clinical and neurobiological data to advance our understanding of NSSI in adolescents. The purpose of this paper is to describe the clinical data collected as part of this study, including psychiatric diagnoses, depression symptoms, episodes of non-suicidal self-injury, suicidal thoughts and behaviors, childhood trauma, and personality domains. The baseline sample included 164 adolescents aged 12-16 assigned female at birth (Mean age = 14.97, SD = 1.20) with NSSI histories ranging from none to severe. Participants and their parent/guardian were invited to provide data at three time points spaced approximately one year apart. Descriptive analyses were conducted to provide estimates of rates and trajectories of clinical data. Of the 164 study participants, 75.61% and 57.93% completed the second and third time points, respectively. Visual inspection of the data suggests an overall trend of decreasing severity of psychopathology over time, and adolescents with a history of NSSI appeared to have higher rates of psychopathology than those without. This paper describes longitudinal clinical trajectories in adolescents with a range of NSSI histories and presents readers with an overview of the rich, publicly available dataset that we hope will inspire future research to advance the understanding of the neurodevelopmental trajectories associated with NSSI, depression, and suicide risk.

Comparing Differences between Two Groups of Adolescents Hospitalized for Self-Harming Behaviors with and without Personality Disorders.

Self-harm (non-suicidal self-injury (NSSI) and suicidal behavior (SB)) is frequent display during adolescence. Patients with personality disorders (PDs) frequently self-harm. However, few studies have focused on the role of PDs in self-harming adolescents. In this study, we collected 79 adolescents hospitalized due to self-harm (88.6% female; 78.5% Caucasian) and divided them into two groups, with or without a diagnosis of PD. The socio-demographic and psychological-clinical data were collected through a structured interview by clinicians. Univariate, subgroup, and multiple logistic regression analyses were performed. Univariate analysis showed that adolescents with a PD and self-harm had (1) an older age at hospitalization (p < 0.01); (2) experienced physical and sexual abuse (p = 0.05, and p < 0.01, respectively); (3) ADHD (p = 0.05); (4) a greater number of SA (p < 0.01); and (5) probability of being a major NSSI patient (>20 lifetime NSSI episodes) (p < 0.01). After multivariate stratified analysis, the results indicated that an older age, and particularly major NSSI status were predictors of PD diagnosis. Early identification and a better understanding of the characteristics of adolescent PDs can assist clinicians in intervening earlier and developing more rational treatment strategies to reduce the long-term effects of PDs.

Non-suicidal self-injury motivations in the light of self-harm severity indicators and psychopathology in a clinical adolescent sample.

Adolescents with psychiatric problems are also considered a vulnerable population in terms of non-suicidal self-injury (NSSI). In the current study, we examined the associations of interpersonal and intrapersonal NSSI motivations with several NSSI severity indicators and psychopathological characteristics. In a cross-sectional research design, 158 adolescents (83.5% girls; mean age = 16.10 years; SD = 1.49) who have received inpatient or outpatient psychiatric treatment completed the Inventory of Statements About Self-Injury, the Strengths and Difficulties Questionnaire, and the Self-Critical Rumination Scale. More than two-thirds of the sample (75.3%; n = 119) reported at least one episode of NSSI in their life, and 45.38% (n = 54) have engaged in NSSI in the past month (current self-injury). The results indicated that only intrapersonal NSSI functions were linked to NSSI severity indicators (current and repetitive NSSI, versatility), interpersonal functions were not. Furthermore, a number of psychopathological features (co-occurring mental disorders, presence of a mood disorder, more internalizing mental illness symptoms, and more pronounced self-critical rumination) were associated with engaging in NSSI for intrapersonal reasons. We also identified other differences within the specific intrapersonal NSSI motivations. It should be highlighted that the anti-suicide function of NSSI behaved in exactly the opposite way as the other intrapersonal motivations. All this points to the fact that in clinical settings, detailed assessment of NSSI motivations and severity indicators can help to develop a more effective treatment plan.

“You leave the chat with a different feeling than when you came in”. A Content Analysis about Negative Experiences Following Instant Messaging among Adolescents with and without a History of Non-Suicidal Self-Injury

BACKGROUND: Instant messaging platforms seem to positively contribute to adolescent emotional well-being. However, some scholars show a link between the use of these platforms and negative emotional experiences. These emotions could be perceived as even more overwhelming for certain subgroups of adolescents, such as those who engage in non-suicidal self-injury (NSSI), and lead to self-injury to deal with otherwise difficult to handle feelings.&#x0D; OBJECTIVE: The current study aimed at providing a deeper understanding of what kind of experiences during instant messaging communications are perceived as emotionally upsetting by adolescents with and without NSSI, and which situations could trigger NSSI thoughts or attempts in adolescents with lived experiences.&#x0D; METHOD: We used content analysis to analyze short interviews conducted with a total of 17 adolescents with and without lived experiences of NSSI.&#x0D; RESULTS: Our results showed that experience of Involvement in conflicts, and especially Name-calling and insults, triggered negative emotional experiences for most adolescents (76.5%). Interpersonal stressors like Name-calling and insults, Disagreements or arguments, Unwanted contact, Friendship break-up and “Ghosting” were identified as major triggers for NSSI.&#x0D; CONCLUSION: These findings could be used for the purpose of facilitating future research into mapping negative experiences adolescents have on instant messaging platforms, as well as used as a clinical guide to identify situations related to NSSI thoughts or episodes.

What’s Different About Those Who Have Ceased Self-Injury? Comparison Between Current and Lifetime Nonsuicidal Self-Injury

ABSTRACTS Objective The current study aimed to investigate the sociodemographic and psychological variables as well as the function of NSSI related to the cessation of NSSI by analyzing the difference between those currently engaged in nonsuicidal self-injury (NSSI) and those who have stopped NSSI behaviors. Methods A total of 490 adults with a history of NSSI (359 females) were assigned to one of two groups: NSSI engagement within the last 12 months or “current NSSI” (n = 402) vs. no episode of NSSI in the previous 12 months or “lifetime NSSI” (n = 88). Results There were no significant group differences in sex or socioeconomic status, while individuals with current NSSI were slightly younger than those who had ceased NSSI behavior. Regarding the functions of NSSI, the current NSSI group endorsed more intrapersonal functions. Moreover, the participants who had ceased NSSI behavior reported significantly less perceived stress, dysfunctional attitudes, alexithymia, emotion reactivity, and suicidal ideation. On the other hand, the lifetime NSSI group showed greater psychological resources such as self-esteem, distress tolerance, and resilience. Conclusions We revealed apparent differences in NSSI functions, clinical symptoms, and psychological resources depending on the maintenance and cessation of NSSI. This study highlights the need for a better understanding of the factors that stop as well as those that continue NSSI behaviors. HIGHLIGHTS The lifetime NSSI group reported more intrapersonal NSSI functions. The current NSSI group suffered from more clinical symptoms. Individuals who ceased NSSI had more psychological resources.

Beneath the surface: clinical and psychosocial correlates of posting nonsuicidal self-injury content online among female young adults

While posting self-injurious content online has skyrocketed over the past decade and is a salient concern among mental health professionals, the stigma surrounding these postings is still prevalent. This study aimed to reduce the stigma by investigating the clinical and psychosocial correlates of posting nonsuicidal self-injury (NSSI) content online. The study participants comprised 249 women who had engaged in five or more episodes of NSSI in the past 12 months. Among them, 67 had posted NSSI content online (NSSI Online), whereas 182 did not (NSSI Only). The two groups were compared using the MANCOVA analysis based on demographic data and clinical and psychosocial features. Additionally, Spearman's correlation and multiple linear regression analyses were used to investigate potential risk factors associated with NSSI postings. Compared to the NSSI Only group, the NSSI Online group showed higher intrapersonal functions of NSSI, self-injury craving, suicidal ideation, and past suicide attempts, along with lower resilience and self-esteem. The clinical risk factor, suicidal ideation, was closely associated with the frequency of these postings. The results suggest that posting NSSI content online is not an attention-seeking behavior, but rather an act that warrants clinical attention.

Association of the Labor Migration of Parents With Nonsuicidal Self-injury and Suicidality Among Their Offspring in China

The labor migration of parents in China often leaves children behind, which may be adversely associated with children's health. However, few studies have assessed the association of parental migration with nonsuicidal self-injury (NSSI) or with suicidality among their offspring. To examine the associations of parental labor migration with NSSI and with suicidality as well as potential differential associations by sex among offspring left behind. This nationwide cross-sectional study was conducted from February to October 2015 among individuals aged 11 to 20 years from 45 public middle and high schools across 5 provinces of China. Data analysis was performed from November 1, 2020, to March 1, 2021. Parental labor migration, including parental migration status (yes vs no), migration pattern (father, mother, or both), and the child's age at the initial parent-child separation. Less frequent (1-4 episodes) NSSI, more frequent (≥5 episodes) NSSI, suicidal ideation, and suicide attempt in the past year were measured using validated questionnaires. Multinomial or binomial logistic regression analyses were used separately to estimate adjusted odds ratios (aORs) and 95% CIs of the associations between parental migration and NSSI, suicidal ideation, or suicide attempt. Potential covariates (demographic, family-level, and psychological characteristics) were adjusted for in 3 sequential models. A total of 15 312 participants (7904 male [51.6%] and 7408 female [48.4%]) aged 11 to 20 years (mean [SD] age, 15.1 [1.8] years) were included. Of those participants, 5963 (23.3%) experienced parental migration. The 12-month prevalence of less frequent NSSI was 17.2% (2635 of 15 312), the 12-month prevalence of more frequent NSSI was 11.6% (1783 of 15 312), the 12-month prevalence of suicidal ideation was 15.2% (2335 of 15 312), and the 12-month prevalence of suicide attempt was 3.5% (535 of 15 312). Parental migration was associated with less frequent NSSI (adjusted odds ratio [aOR], 1.13; 95% CI, 1.03-1.24); no significant association of parental migration with more frequent NSSI (aOR, 1.01; 95% CI, 0.90-1.13), suicidal ideation (aOR, 1.00; 95% CI, 0.90-1.10), or suicide attempt (aOR, 1.09; 95% CI, 0.90-1.33) was identified. Compared with children whose parents did not migrate, the aOR for less frequent NSSI for participants whose father migrated was 1.18 (95% CI, 1.06-1.31), and the aOR for less frequent NSSI for participants having both parents migrate was 1.12 (95% CI, 1.01-1.28). Compared with children whose parents did not migrate, participants who experienced initial separation from 1 or both parents at preschool age had an aOR for less frequent NSSI of 1.16 (95% CI, 1.03-1.31). No sex disparities were found in these associations except for participants who experienced initial separation from 1 or both migrant parents at preschool age, for which the aOR for more frequent NSSI was higher among male (aOR, 1.27; 95% CI, 1.04-1.55) than female (aOR, 0.96; 95% CI, 0.77-1.19) participants. This cross-sectional study found that parental migration, mainly of the father or of both parents, or an initial separation of children at preschool age from 1 or both parents who migrated was associated with higher odds of experiencing 1 to 4 NSSI episodes in 1 year among offspring. Overall, the associations of parental migration with NSSI and suicidality were similar between male and female participants.

Non-Suicidal Self-Injury: An Observational Study in a Sample of Adolescents and Young Adults.

Non-Suicidal Self-Injury (NSSI) is the self-inflicted destruction of body tissues without suicidal intent with a prevalence of 1.5% to 6.7% in the youth population. At present, it is not clear which emotional and behavioral components are specifically associated with it. Therefore, we studied NSSI in a clinical sample of youth using the Ottawa Self-injury Inventory and the Barratt Impulsiveness Scale 11. The Mann–Whitney test was used to compare the numerical responses provided to the tests. We found 54 patients with NSSI, with a mean age of 17 years. Scores were analyzed in the total sample and in four subgroups. In the total sample, Internal Emotion and External Emotion Regulation, Craving, Non-Planning and Total Impulsivity were significantly associated with NSSI. There were statistically significant differences in Craving between patients with multiple NSSI episodes, suicide attempts and multiple injury modes and patients of other corresponding subgroups, in Internal Emotion Regulation, Sensation Seeking and Motor Impulsivity between NSSI patients with suicide attempts and no suicide attempts, and in Cognitive Impulsivity between NSSI patients with multiple injury modes and one injury mode. It is necessary to carefully evaluate the components underlying NSSI in order to activate personalized treatment options.

Variability in the Functions of Nonsuicidal Self-Injury: Evidence From Three Real-Time Monitoring Studies

Despite functional models of nonsuicidal self-injury (NSSI) helping to explain why people engage in this perplexing behavior, we still lack an understanding of some of the key properties of NSSI functions. Here, we address three unanswered questions about NSSI functions: how much do distinct NSSI functions (1) vary between people over time, (2) vary within people over time, and (3) simultaneously co-occur over time? Data were drawn from three ecological momentary assessment (EMA) studies of self-injurious adult psychiatric outpatients (n = 7), community-based adolescents (n = 15), and community-based adults (n = 9). Across the three studies, there was a total of 271 NSSI episodes (all with corresponding functions captured by EMA). The vast majority (27 of 31; 87%) of participants exhibited unique patterns of NSSI functions during the monitoring periods, indicating high variability between people. The vast majority (26 of 31; 84%) of participants also showed changes in NSSI functions over time, indicating high variability within people. Although it was most common for only one function to be reported for a given NSSI episode, participants endorsed more than one function for 22% to 43% of NSSI episodes, indicating that different functions did simultaneously co-occur. These results underscore that reinforcement processes for NSSI differ from person-to-person, and are both time-varying and multifaceted, which has implications for personalized assessment and treatment of this clinical phenomenon.

Quality of attachment, trauma, psychopathology, and frequency of non-suicidal self-injury in Mexican adolescents suffering from psychosocial vulnerability: Description of a risk profile

Introduction. Suffering from psychosocial vulnerability, particularly during adolescence, increases the likelihood of experiencing adverse life circumstances, psychiatric conditions, and non-suicidal self-injury (NSSI). Objective. We studied: 1. record-based demographic and clinical characteristics, as well as the frequency of NSSI in adolescents, beneficiaries of services for vulnerable population of one of six Non-Governmental Organizations (NGO’s), we compared by beneficiary type: internal (IB) versus external (EB); 2. predictive relationship of NSSI with depression, difficulties in emotion regulation (DER) and suicidal ideation (administered measures); 3. Comparison of average scores on measures by: quality of attachment (QOA) and presence/absence of NSSI. Method. A convenience sample of 255 adolescents (45.5% women, ages 11-15) answered instruments in institutional facilities (Mexico City and Puebla), where 181 (71%) resided as IB and 74 (29%) resided in family home (EB). The mental health staff of each NGO specified according to the record: demographics, psychiatric diagnoses, history of trauma, and QOA between the minor and his attachment figure. Results. 42% denied NSSI episodes, 16.9% indicated a non-significant pattern, and 35.6% reported a significant and recent pattern. IB presented higher scores in all measurements, higher report of interpersonal trauma, depressive, anxiety, and behavior disorders. Minors with positive QOA obtained significantly lower scores. Discussion and conclusion. Compared to EB’s, adolescents residing in NGOs have a higher risk profile, particularly those without a positive QOA, a fact that is associated with a greater presence of psychopathology and significant and recent NSSI.