Non-suicidal Self-harm Behavior Research Articles

Examining the relationship between non-suicidal self-harm and suicidality within the past 12-months and gaming problems in Norwegian full-time students

BackgroundAlthough gaming problems are associated with poor mental health, few population-based studies have examined its association with self-harm and suicidality. This study investigates the association between gaming problems, non-suicidal self-harm and suicidality within the past year, stratified by sex among Norwegian full-time students.MethodsData derived from the Norwegian Students’ Health and Wellbeing Study 2022 (N = 59,544). The respondents were categorized into non-gamers, recreational gamers, engaged gamers, problematic gamers, and addicted gamers based on the Game Addiction Scale for Adolescents. Log-link binomial regression models, stratified by sex, adjusted for age, were used to estimate the risk ratio of non-suicidal self-harm (ideation and behavior) and suicidal behaviors (ideation and attempt) across different levels of gaming problems.ResultsAmong females, the risk of non-suicidal self-harm and suicidal ideation increased from non-gamer to problem gamer, with no differences between problem and addicted gamers. Among males, the risk of non-suicidal self-harm increased from non-gamers to engaged gamers, but no differences were observed between engaged, problematic, and addicted gamers. No sex × gaming category interaction was observed for suicide attempts. Engaged and addicted gamers had higher risks of suicide attempt than non-gamers and recreational gamers.ConclusionsGaming problems are associated with increased risk of non-suicidal self-harm and suicidal ideation among females. Among males, no differences were observed between engaged, problem and addicted gamers. The results highlight sex when studying health related outcomes and their association to level of gaming problems. Longitudinal studies are warranted to uncover the temporal mechanisms between IGD, non-suicidal self-harm and suicidality.

Suicidal and non-suicidal self-harm behaviors in victims of sexual violence against children

Sexual violence against children and suicidal and non-suicidal self-injurious behaviors are two social and health problems that have increased. Sexual assaults have an impact, affecting the tendency to carry out autolytic behaviors. Therefore, it was intended to study the relationship between having been a victim of sexual violence in their childhood and the probability of engaging in suicidal and non-suicidal self-injurious behaviors in adolescence and early adulthood. For this, a systematic review has been carried out, through the Pubmed and PsycInfo databases of articles published between 2015 and 2022. A significant relationship has been found between both problems, observing that the suicide attempts of these victims were intrinsically related to their experiences of aggression. Thus, it has been found that variables such as gender, rumination, emotional dysregulation, social support, and characteristics of aggression mediate the relationship between sexual violence against children and suicidal and non-suicidal autolytic behaviors. This type of investigation helps us to establish the focus of intervention in the cases of victims of child sexual assault, but it should also help to give visibility to the problem and promote preventive intervention protecting children.

Trait Emotional Intelligence, Social Desirability and Non-Suicidal Self-harm Behavior among Adolescents: A Cross-Sectional Study

Non-suicidal self-injury (NSSI) is the intentional and acute harm done to one's body without the intention of committing suicide. Suicidal behavior (SB) and non-suicidal self-injury (NSSI) are the two primary health issues affecting teenagers. Despite increasing attention to such issues, very little work is done regarding these issues in Pakistan. The objective of this research was to determine the incidence of non-suicidal self-harm in adolescents and to find an association between non-suicidal self-injury and traits of emotional intelligence and social desirability in Pakistani adolescents who made up a typical sample of the general community. For this purpose, 195 participants were selected from different hospitals and areas of Islamabad and Rawalpindi. The non-suicidal self-injury student questionnaire, the trait emotional intelligence questionnaire (TEIQue-SF), and the social desirability scale (SDS-17) were used to collect data. According to the findings, people who were more socially desirable and have lower emotional intelligence traits were more likely to engage in NSSI. The results of this research provide insight into the intricate interactions among these factors and how they affect NSSI. Mental health practitioners can improve their capacity to recognize and assist people who are experiencing NSSI, thereby, supporting their well-being and recovery, by developing a deeper understanding of these aspects.

Self-Harm Behaviors, Suicide Attempts, and Suicidal Ideation in a Clinical Sample of Children and Adolescents with Psychiatric Disorders

Suicidal ideation and self-harm behaviors have been found to be important risk factors for suicide. The aim of this study was to explore the rates of psychiatric disorders among different groups of patients with suicidal ideation, suicide attempts, and non-suicidal self-harm behaviors and to identify the associated socio-demographic and clinical variables. We conducted a cross-sectional study with emergency-admitted patients presenting with non-suicidal self-harm behaviors, suicide attempts, or suicidal ideation to the emergency room of the Child and Adolescent Psychiatry Clinic in Cluj-Napoca, Romania. Data were collected from the patients' charts using a questionnaire that contained socio-demographic and clinical variables. A total of 95 patients aged between 6 and 18 years were included in the study. Ingesting medication and cutting were the most frequently used methods to attempt suicide. Depression and mixed affective and conduct disorders were the diagnoses most commonly associated with suicidal behavior. Girls with depressive symptoms were more probable to have suicide attempts than boys, and girls with depressive symptoms and behavioral problems registered more self-harm behaviors. Further research should systematically examine the relationship between self-harm behaviors and suicide attempts and the profile of patients at risk of future suicide attempts.

Feasibility and acceptability of a hospital‐at‐home program for adolescents with eating disorders: Making progress in community/family‐based treatments

To explore the feasibility and acceptability of a novel hospital-at-home (HaH) program for adolescent patients with a severe eating disorder (ED). Retrospective description of the program during its first year of activity. The feasibility construct is based on accessibility, recruitment, rate of retention, avoidance of hospital stays, and management of crisis situations. Caregivers completed a satisfaction questionnaire on discharge, including an item on perceived safety. All patients referred to the program were included. Fifty-nine female patients with a mean age of 14.69 years (SD=1.67) were admitted. The mean stay was 39.14 days (SD=14.47). On admission, 32.2% of patients presented nonsuicidal self-harm behavior and 47.5% had comorbid mental disorders. All patients were screened in the first 48 h after referral, and the program retention rate was 91.52%. As for use of health services, 2016.03 hospital stays were avoided, and only 16.12% of the 31 calls received for urgent care required emergency department visits. Families gave the program an overall satisfaction score of 4.95/5, and all described it as "very safe." The HaH program described is a feasible and acceptable care model in adolescents with severe EDs and comorbidities. Effectiveness studies should be performed. Eating disorders are a major concern for public health. The adolescent HaH program presented marks an advance in intensive community treatments for patients with severe EDs and comorbidities.

Subcortical volume analysis in non-suicidal self-injury adolescents: A pilot study

Given the high prevalence of non-suicidal self-injury (NSSI) among teenagers worldwide, the underlying mechanisms promoting such behavior must be urgently investigated. This study aimed to investigate neurobiological changes in the regional brain in adolescents with NSSI by comparing the volumes of the subcortical structures of 23 female adolescents with NSSI and 23 healthy controls with no history of psychiatric diagnosis or treatment. The NSSI group comprised those who underwent inpatient treatment for non-suicidal self-harm behavior at the Department of Psychiatry at Daegu Catholic University Hospital from July 1, 2018, to December 31, 2018. The control group comprised healthy adolescents from the community. We compared differences in the volume of the bilateral thalamus, caudate, putamen, hippocampus, and amygdala. All statistical analyses were conducted using SPSS Statistics Version 25. The NSSI group exhibited decreased subcortical volume in the left amygdala and marginally decreased subcortical volume in the left thalamus. Our results provide important clues about adolescent NSSI's underlying biology. Analysis of subcortical volumes between the NSSI and normal groups revealed subcortical volume differences in the left amygdala and thalamus, part of the core cerebral regions responsible for emotional processing and regulation, which may help explain the neurobiological mechanism of NSSI.

Relationship between thyroid hormone and sex hormone levels and non-suicidal self-injury in male adolescents with depression.

Non-suicidal self-injury (NSSI) is the intentional and repeated direct injury to one's bodily tissues or organs without the intent to die, which is not socially sanctioned and does not result in death. This study will be the first to explore the relationship between NSSI behavior and thyroid hormone and sex hormone levels in male adolescents with depression. Among the inpatients in the children's ward of Shandong Mental Health Center, eighty male patients with first-episode depressive disorder were randomly selected. Forty male adolescent depressed patients with NSSI behaviors were set as the NSSI group, and forty male adolescent depressed patients without NSSI behaviors were set as the No-NSSI group. Their thyroid hormones (free triiodothyronine, free thyroxine, and thyroid stimulating hormone) and sex hormones (estradiol, progesterone, and testosterone) were measured, and the severity of self-injury in the NSSI group was assessed using the Adolescent Self-Injury Questionnaire. The NSSI group was tested again after 6 weeks of sertraline treatment for biological indicators and assessed by the Self-Injury Questionnaire to compare the hormonal differences between the NSSI group and the No-NSSI group and compare the differences of each index before and after treatment in the NSSI group. T3/T4 (p = 0.001) and FT3 (p = 0.023), TSH levels (p < 0.001) were lower in the NSSI group than in the No-NSSI group before treatment, and FT4 (p = 0.036) and T (p < 0.001) levels were higher than in the No-NSSI group. T3/T4 levels were higher in the NSSI group after treatment (p < 0.001). FT4 (p < 0.001) and T (p = 0.001) levels and self-injury questionnaire scores (p < 0.001) decreased after treatment in the NSSI group. In the NSSI group at baseline, FT4 levels were negatively correlated with self-injury questionnaire scores (r = -0.459, p = 0.003) and testosterone levels were positively correlated with self-injury questionnaire scores (r = 0.383, p = 0.015), and in the NSSI group after treatment, FT4 difference was negatively correlated with self-injury questionnaire score reduction rate (r = -0.037, p = 0.019), and testosterone difference was positively correlated with self-injury questionnaire score reduction rate (r = 0.424, p = 0.006). Logistic regression analysis showed that low TSH and high testosterone levels were independent risk factors for the development of non-suicidal self-harming behaviors in male adolescent depressed patients. Changes in thyroid hormone and sex hormone levels may be associated with non-suicidal self-injurious behavior in male adolescent depressed patients.

Digital Sexual Violence and Suicide Risk in a National Sample of Sexual Minority Adolescents.

This paper aimed to examine the association between digital sexual violence (threat to post or nonconsensual posting of sexually explicit media) and suicidal (ideation, planning, and attempt) and non-suicidal self-harm behavior. The data for the current analysis come from an online sample of sexual minority adolescents (aged 14-17) recruited from across the United States (n = 970). Multivariate logistic regressions were used to examine the association between digital sexual violence with suicide (ideation, planning, and attempt) and self-harm. In the sample, 9.1% of participants reported being threatened to have their sexually explicit media posted without their consent, while 6.5% reported their sexually explicit media had been posted without their consent. Threat to post sexually explicit media without consent was associated with higher odds of reporting suicidal ideation (odds ratio [OR] = 1.88), suicide plan (OR = 2.12), suicide attempt (OR = 3.56), and self-harm (OR = 1.96). While nonconsensual posting of sexually explicit media was associated with higher odds of reporting suicidal ideation (OR = 1.82) and suicide attempt (OR = 2.20). All models controlled for age, assigned sex at birth, sexual identity, and race and ethnicity. These findings underscore important considerations and future research directions. Given the associations between digital sexual violence and suicide risk among sexual minority adolescents, suicide prevention efforts with adolescents must be responsive to the needs of sexual minority adolescents and the changing landscape of sexual violence in digital spaces. Future research should examine the trajectories of digital sexual violence among adolescents and comparative analyses by demographic subgroups to better understand changes in these processes over time.

Suicidal and nonsuicidal self-harming thoughts and behaviors in clinically referred children and adolescents with gender dysphoria.

BackgroundYoung transgender or gender nonconforming (TGNC) children and adolescents or those with a gender dysphoria (GD) diagnosis show an increased risk of suicidal and nonsuicidal self-harming thoughts and behaviors (STBs). Data from German-speaking regions on this topic and studies comparing self- and parent-reported STBs have been scarce. The study aims were therefore to examine: (a) frequencies of self- and parent-reported STBs in a German clinical sample of children and adolescents with GD and (b) differences between age and gender groups, as well as between self- and parent-reports.MethodsTwo items from the Child Behavior Checklist (CBCL) and the Youth Self-Report (YSR) were used to assess self- and parent-reported STBs in a sample of 343 adolescents and 49 children who presented to the Hamburg Gender Identity Service (Hamburg GIS) between 2013 and 2019. Seventy-eight percent of the analysis sample was assigned female at birth (AFAB), and 22% were assigned male at birth (AMAB).ResultsParents reported STBs on the CBCL for 16% and 6% of the cases in childhood and for 20% and 29% of the adolescent cases, respectively. STBs were self-reported by 38% and 45% of the adolescents who could report on the YSR. STBs were higher among adolescents than among children and in self-reports (YSR) compared to parent reports (CBCL). AFAB adolescents reported higher degrees of STBs than AMAB adolescents.ConclusionsChildren and adolescents with GD are a high-risk population for STBs, especially pubescent and AFAB individuals. Mental health professionals should screen early for STBs to prevent possible suicidal ideation-to-action transitions.

Book Reviews

McKnight SE. Sigma Theta Tau International Honor Society of Nursing; 2019. Paperback; 296 pages.Nurses are front and center in health care facilities; they maintain the contact with patients, families, and visitors. This position puts nurses at risk for physical and verbal abuse. The American Association of Critical-Care Nurses released a position statement in 2019 on preventing violence against health care providers.1 According to this position statement, As with many other situations, COVID-19 has put a spotlight on the gaps in health care systems’ processes to prepare for and prevent violence against health care workers. De-escalating Violence in Healthcare can help nurses understand de-escalation techniques in detail and prepare them for success when facing a potentially harmful situation.This book, which contains 20 chapters, informs readers about therapeutic de-escalation and effective communication. The first chapter provides an overview, and the next few chapters describe variables and risk factors for aggression and how to assess an escalating situation for early intervention. Then the author discusses de-escalation techniques, focusing on therapeutic communication, stress management, conflict resolution, and crisis intervention. Two chapters are dedicated to managing mental health emergencies and performing a detailed mental status assessment. The author highlights how to apply de-escalation techniques for patients with mental disorders; those exhibiting nonsuicidal self-harm behavior, dementia, and delirium; and difficult or angry patients. An entire chapter is dedicated to staying safe during de-escalation. The final chapters describe processes for debriefing, reporting, and documenting; creating and fostering a calm, caring, and healing environment; and bringing it all together to create a comprehensive prevention plan for health care violence.Nurses need to understand the material presented in this book for their own protection. You may feel that your hospital’s method to prevent violence in health care is sufficient or that you are not responsible for developing a violence prevention plan. Even so, this book will strengthen your awareness and knowledge of de-escalation methods on the basis of the latest evidence. In addition, after reading this book, you could contribute ideas to improve the current violence prevention plan at your facility.Love R, Hanrahan N, Ackerman ML, Lawlor FA, Taylor AR, Toner E. Springer Publishing Company; 2020. Paperback; 184 pages.Are you feeling like you are unsure what is next in your career journey? The Rebel Nurse Handbook is a collection of stories by nurses who have stepped outside their comfort zone to progress in their careers. Nurses in many different roles are represented in the book; they come from diverse backgrounds and have different levels of experience, but they all felt the desire and passion to make a change. Nurse clinicians, leaders, and entrepreneurs tell the story of their journey. Each story is brief yet thorough. The final chapter includes resources to help you drive your nursing career and the field of nursing forward. This book will inspire you to impact nursing—both the art and the science.Wright D. Creative Health Care Management; 2022. Paperback; 220 pages.The Ultimate Guide to Competency Assessment in Health Care provides everything you need to create a competency assessment process that is effective, efficient, and meaningful. In this book, the author presents a systematic approach to competency assessment; she moves beyond the technical skills checklist and includes assessment of critical thinking and interpersonal skills. Numerous examples of competency verification methods provide ideas to create competency assessments. The concept of including team accountability in competency assessment is woven throughout the book, making it a must-have for every nurse who manages or creates competency assessments.Rea R, Douglas K. Independently published; 2020. Paperback; 114 pages.Witnessing suffering has been both a privilege and painful for nurses. During the COVID-19 pandemic, nurses have witnessed overwhelming suffering, which has left many of them with unprocessed grief. Nurses Cry Too is not a traditional self-help book. Rea and Douglas have included poetry and imagery in this short book, imparting beauty, a sense of grace, and raw authenticity. Nurses Cry Too is an easy read meant to guide suffering nurses through loss and grief to selfcare.

Implementation of brief dialectical behavior therapy skills training among borderline personality disorder patients in Malaysia: feasibility, acceptability, and preliminary outcomes

Aim/backgroundEven though dialectical behavior therapy (DBT) has received substantial empirical support in treating patients with borderline personality disorder (BPD), fewer studies have evaluated whether a brief DBT skills group may be effective in improving clinical outcomes in this population. Further, less is known regarding the feasibility and outcomes of DBT beyond Euro-American contexts. This paper describes outcomes from a pilot study examining the feasibility, acceptability, and clinical outcomes following completion of a shortened, 14-week DBT skills group in a sample of Muslim-majority BPD patients in Malaysia.MethodsTwenty patients were recruited from a public hospital and attended DBT skills groups in an outpatient clinic. Participants completed measures assessing psychological symptoms, self-harm behaviors, suicidal ideation, emotion regulation difficulties, self-compassion, and well-being pre- and post-intervention.ResultsThere were significant reductions in depressive symptoms, stress, and emotion regulation difficulties, as well as increases in self-compassion and well-being from pre- to post-intervention. A trend was found for decreases in frequency and types of non-suicidal self-harm behaviors, suicidal ideation, and anxiety symptoms. Qualitative content analyses of participants’ feedback indicated that the vast majority of participants perceived a positive impact from the skills group, with mindfulness and distress tolerance being rated frequently as skills that were beneficial.ConclusionThese preliminary findings suggest that DBT skills training is feasible and acceptable in a Muslim-majority, low resource clinical setting, and holds promise in improving clinical outcomes among BPD patients in Malaysia.

Analysis of risk factors of non-suicidal self-harm behavior in adolescents with depression.

Adolescents are a high-risk group for non-suicidal self-injury (NSSI), which seriously affects their physical and mental health. This study aimed to explore the risk factors for depressive adolescents with NSSI. A total of 153 adolescents with depression were divided into the NSSI group (n=65) and non-NSSI group (n=88) according to the criteria stipulated by Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5). The Beck scale for suicidal ideation (BSS), adolescent self-rating life events checklist (ASLEC), family adaptability and cohesion evaluation scale II-Chinese version (FACES II-CV), childhood trauma questionnaire short form (CTQ SF), and multidimensional scale of perceived social support (MSPSS) were applied to evaluate suicidal ideation, frequency and intensity of stressful life events, family functions, childhood trauma, and perceived support, respectively. We applied two-dimensional logistic regression to identify risk factors for NSSI. Female gender ratio, suicidal ideation, and attempted suicide were significantly higher in the NSSI group than in the non-NSSI group (all P<0.05). Scores of interpersonal relationships in ASLEC, emotional abuse, and emotional neglect in the CTQ-SF were significantly higher in the NSSI group than those in the non-NSSI group (all P<0.001). The scores of family cohesion (P=0.001) and family adaptability (P=0.01) were significantly lower in the NSSI group than in the non-NSSI group. The MSPSS was used to assess support from the family, and the index was significantly lower in the NSSI group (P<0.001). After adjusting for age and gender, BSS score, interpersonal relationship score, emotional abuse score, and emotional neglect score were identified as independent risk factors for NSSI. The rate of NSSI in adolescents with depression is high. Higher scores of BSS, interpersonal relationship, emotional abuse, and neglect were independently associated with NSSI.

Are Demoralization and Insight Involved in Suicide Risk? An Observational Study on Psychiatric Inpatients

Introduction: Several features contribute to determining suicide risk. This study was designed with the aim of evaluating whether insight into illness and demoralization are involved in suicide risk (active suicidal ideation or behavior). Methods: For this purpose, in a sample of 100 adult psychiatric inpatients, we used the Columbia Suicide Severity Rating Scale to assess suicide risk, the Demoralization Scale for demoralization symptoms, and the Insight Scale to assess illness insight. We also investigated several demographic and clinical features, including gender, age, duration of untreated illness, previous suicide attempts, and nonsuicidal self-injurious behavior. Results: The results demonstrated that patients with higher scores on the insight-high dimension had 1.35 greater odds of having a higher suicide risk, and those with lifetime suicide attempts had 7.45 greater odds of having a higher suicide risk. Among the various clinical factors, the study indicated that only nonsuicidal self-harm behaviors in the last 3 months was a risk factor for suicide risk. Conclusions: The results indicated that greater illness insight is involved in suicide risk regardless of demoralization.

Are demoralization and insight involved in suicide risk? An observational study on psychiatric inpatients

IntroductionAlthough several authors have investigated the relationship between demoralization, insight, and suicide risk, the role of these factors in determining suicide risk in patients with psychiatric disorders is still unclear [Berardelli et al., 2019; Costanza et al., 2020].ObjectivesThe main aim of this study was therefore to determine whether suicide risk was associated with better insight and worse demoralization in a sample of 100 adult psychiatric inpatients.MethodsThe study was performed on 100 psychiatric hospitalized adult patients consecutively enrolled between January 2019 and April 2020 at psychiatric units of Sant’Andrea Medical Center, Sapienza University of Rome. The Columbia Suicide Severity Rating Scale (C-SSRS) was used to assess suicide risk, Demoralization was assessed using the Demoralization Scale (DS) [Kissane et al., 2004] and for the assessment of insight we used the The Insight Scale (IS).ResultsOnly age was significantly associated with higher suicide risk (χ2=9.07, p&lt;0.01). The variable mood disorder was significantly associated with higher suicide risk (χ22=7.50, p&lt;0.05). Non-suicidal self-harm behaviors in the last 3 months (χ2=5.89, p&lt;0.05) and lifetime suicide attempts (χ2=21.80, p&lt;0.001) were significantly associated with higher suicide risk. Only the insight-high dimension (χ2=8.01, p&lt;0.01) and lifetime suicide attempts (χ2=12.33, p&lt;0.001) were significantly associated with higher suicide risk.ConclusionsOur results don’t confirm the role of demoralization in suicide risk. In our sample of patients, only high insigth of illness and other psychological variables are involved in suicide risk.DisclosureNo significant relationships.

Clinical and psychopatological features of endogenous depressions in young women

To study the features of psychopatological structure of endogenous depression in young women and to identify correlations between various clinical types of depression and their nosological affilation. The results of clinical/psychopathological examination of 107 female patients, aged 16 to 25 years, with endogenous depression with one of the following ICD-10 diagnosis: (F34.0; F31.3-F31.5; F21.3-F.21.4+F31.3-F31.5; F60.X+F31.3-F31.5) were analyzed. Several types of endogenous depression were identified: 1) hysterical depression with hysterical-conversions, and also the phenomena of delusional fantasies; 2) dysmorphic depression with predominance of over-valued ideas of physical disability, self-inferiority and eating disorder; 3) depersonalization depression with depersonalization-derealization symptoms; 4) psychopath-like depression with exaggerated behavior, opposition and impulsivity; 5) existential depression with a feeling of losing the life meaning and often pessimistic worldview; 6) psychasthenic depression with the low self-esteem and exaggerated introspection combined with obsessive-phobic disorder; 7) anxious-melancholic depression with anxiety, melancholy and ideas of self-accusation and self-inferiority; 8) depression with symptoms of adolescent asthenic insolvency with difficulties of understanding information, increasing intellectual exhaustion. We revealed differences in motives for committing non-suicidal self-harm behavior and suicidal behavior in typological variants of depressions. Hysteroform and psychopathic depressions prevail in personality disorders, while psychosthenic-like, anxious-melancholic and existential depressions are more frequent in affective disorders. Depersonalization depressions are more common in schizotypal disorder. When comparing the types of depressions in boys as reported in previous research with those in girls, the prevalence of hysteroform and anxious-melancholic variants in girls is revealed.

Evaluation of the Frequency of Suicidal Thoughts and Attempts and Related Factors in Female Adolescents with Anorexia Nervosa

Objective: Although anorexia nervosa (AN) has been associated with increased suicidal attempts, clinical variables that that influence this relationship still remains to be elucidated. The aim of this study is to examine the frequency of suicide attempts in females with AN, and the general psychopathology and associated clinical variables in patients with anorexia nervosa who do and do not attempt suicide.Methods: In this study, archive files and reports of 43 females with AN admitted to the department of child and adolescent psychiatry between 2015 and 2020 were analyzed retrospectively. Participants' socio-demographic variables (age, peer relationships, psychiatric comorbidity, abuse history, history of suicidal thought and/or plan, family history of AN, etc.) and clinical (subtypes of AN, clinical features, response to treatment, the presence of suicidal ideation/attempts, etc.) characteristics were investigated. Also, the Children's Depression Inventory (CDI) and the State-Trait Anxiety Inventory (STAI) were used.Results: Our results revealed that 18.8% of patients with restricting AN, 81.3% of patients with purging or binging/purging AN, and 37.2% of the entire sample had at least one suicidal attempt, and 39.5% of the patients engaged in nonsuicidal self-injury behaviors. Further, binge-eating/purging AN type, more severe forms of AN, treatment resistance and poor insight or lack of insight, the presence of physical and emotional abuse, domestic violence, and the existence of psychiatric comorbidity markedly elevated the risk of suicide.Conclusion: The present study shows that patients with AN should be investigated not only for problems with eating and weight but also for possible non-suicidal self-harm behaviors, suicidal attempts.

Patterns of dating violence moderate the effect of child maltreatment on suicide risk among disadvantaged minority female adolescents with depressive symptoms.

Childhood maltreatment is associated with increased suicide risk. However, not all maltreated children report self-injurious thoughts and behaviors, highlighting the presence of other risk factors. Notably, adolescent dating violence (ADV) and child maltreatment are highly comorbid, with ADV also linked to suicide risk among adolescents. Current research further suggests that distinct patterns of ADV involvement are differentially related to adolescent mental health. To date, it is unknown whether differences in ADV patterns moderate changes in suicide risk for adolescents with and without a maltreatment history. This study aims to advance the literature by identifying patterns of ADV in a unique sample of adolescents and by determining the differential association between maltreatment and suicidal ideation and non-suicidal self-harming behaviors based on ADV profiles. Participants were racially and ethnically diverse low-income non-treatment-seeking adolescent females with elevated depressive symptoms, ages 13-16 (N=198). Using latent class analysis, we found support for a 3-class model of dating violence: adolescent females without ADV involvement, those in relationships with mutual verbal abuse, and those in romantic relationships with multiple and more severe forms of ADV, such as verbal abuse and physical violence. A series of latent class moderation models indicated that the effect of child maltreatment on suicidal ideation significantly differed based on ADV class membership. Results highlight the importance of considering different ADV patterns and maltreatment as interactive risk factors for increased self-injurious thoughts and behaviors. Intervention and prevention approaches relevant to maltreated youths are discussed for families and practitioners.

Autolesão não Suicida na Adolescência e a Atuação do Psicólogo Escolar: Uma Revisão Narrativa

A autolesão não suicida na adolescência tem recebido atenção de pesquisadores em virtude do aumento de casos relatados nas escolas e mídias sociais, porém, o tema ainda é pouco focalizado na produção científica em Psicologia Escolar. Este artigo configura-se como uma revisão narrativa que visa abordar as possibilidades da atuação do psicólogo escolar frente à temática, buscando também contribuir para o conhecimento nessa área a partir da perspectiva crítica. Inicialmente, abordamos alguns aspectos acerca da autolesão não suicida na adolescência presentes na literatura e sua relação com o campo da Psicologia Escolar. Em seguida, apresentamos uma breve contextualização da referida área e a perspectiva crítica de atuação do psicólogo escolar. Os estudos apontam várias possibilidades de ação do psicólogo relativas ao comportamento autolesivo não suicida no contexto educativo, abrangendo ações dirigidas a alunos, famílias e educadores. Discute-se que a autolesão em adolescentes precisa ser compreendida como sendo configurada a partir dos condicionantes histórico-sociais que permeiam a experiência do que é ser adolescente na sociedade atual e torna-se importante que o psicólogo escolar atue considerando as conjunturas presentes na atualidade e que sua ação se volte para finalidades transformadoras.

Self-harm - an overview of the tools used to assess non-suicidal self-harming behaviors

Abstract Introduction: Non-Suicidal Self-Injury (NSSI) is the deliberate injury to one’s own body intended to cause mental or physical harm to oneself. In view of the growing scale of the NSSI, especially among young people without identifying any other psychiatric disorders, the disorder was included in both DSM-5 and ICD10 as independent diagnostic entity. Many etiopathogenetic hypotheses and research tools assessing various aspects of NSSI have been developed. The aim of the work is to present and discuss the most commonly used scales for NSSI assessment. Method: A review of available literature was made using the databases Medline / PubMed, using the key words: “self injury”, “self-mutilation”, “non-suicidal,”, “NSSI”, “self-harm” and time descriptors: 2005-2017 Results: Available tools were divided into three groups: I- scale of self-assessment made by the patient, II- assessment made by the clinician, and III- auxiliary scale. Conclusions: None of the available scales covers the complexity of the NSSI phenomenon. For the overall NSSI assessment, several NSSI assessment tools are suggested, taking into account both self-assessment scales and clinical evaluation.

The continuity and duration of depression and its relationship to non-suicidal self-harm and suicidal ideation and behavior in adolescents 12–17

BackgroundThere is a significant overlap between non-suicidal self-harm and suicidal ideation and behavior in young people with both symptom continuity and symptom duration implicated in this association. MethodsA population sample of Australian 12–17 year olds. Interviewers collected measures for DSM disorders, symptom duration and continuity, and background information from their parents, while young people self-reported symptoms of depression, non-suicidal self-harm and suicidal ideation and behaviors. This report focusses on the 265 young people who met the DSM criteria for Major Depressive Disorder based on their own self-reports. ResultsRelative to young people who had at least one period 2 months or longer without symptoms since first onset, young people who had the continuous presence of depressive symptoms since their first onset had significantly higher odds for life-time self-harm, 12-month self-harm, multiple self-harm, suicidal ideation and suicide attempt within the past 12 months. The duration of depressive symptoms and the continuity of these symptoms each independently contribute to elevating the risks of non-suicidal self-harming and suicidal ideation and behaviors. LimitationsReliance on self-report from the young people and time constraints prohibiting administering diagnostic modules other than the Major Depressive Disorder and estimating self-reported co-morbidity. ConclusionsAmong young people with a Major Depressive Disorder, self-reports about duration of depressive symptoms as well as the continuity of symptoms, each independently contributes to elevated risks of non-suicidal self-harming and suicidal ideation and behaviors. As well, un-remitting as opposed to episodic symptoms in this group of young people are common and are a powerful indicator of suffering associated with both self-harm and suicidal behavior.