Self-harm Research Articles

Prevalence of self-harm among children and adolescents in the Republic of Ireland: a systematic review

Abstract Objectives: Youth self-harm (SH) is viewed as a public health concern and one of the main reasons for urgent psychiatry assessment. This systematic review sought to establish prevalence of SH among youth in Ireland. Methods: A systematic review using pre-defined search terms was conducted (Jan 1980–March 2024). Results: From a total of 204 papers identified, 18 were included. Significant variation in rates of SH was found. Limiting data to adolescent years (15–18), best estimates for overall lifetime rates of SH ranged from 1.5% (when rates of SH were reported based on a two-stage study design), to 23% (where SH was limited to non-suicidal SH). SH was typically higher in females, impulsive in nature, and occurred in the home setting. Whilst almost half of youth sought help before (43.7%) or after (49.8%) the SH episode, this was most often to a friend or family member. Overall rates of professional help seeking were low. Conclusions: Robust studies using clear definitions of terms, separately capturing SH with and without suicidal intent, and distinguishing SH in the context of a mental illness, are required to inform service developments. Given the frequent occurrence of SH among youth accompanied by predominance of help seeking via friends and family, it is imperative that psychoeducation is delivered to families and peers. Out of hours community and specialist mental health services are essential to address this important issue.

Trajectory of Non-suicidal Self-Injury among adolescents with borderline personality disorder over a 5-year period

Trajectory of Non-suicidal Self-Injury among adolescents with borderline personality disorder over a 5-year period

How does emotional insecurity affect non-suicidal self-injury among Chinese early adolescents: a longitudinal study.

Non-suicidal self-injury (NSSI) is a serious public health concern. Emotional insecurity is a crucial predictor of NSSI among adolescents. However, few studies have elucidated the specific mechanisms between emotional insecurity and NSSI. This study employed a longitudinal research design, using a sample of 886 Chinese early adolescents (Mage at T1 = 10.62 years, SD = 0.77 years; 47.40% females), and conducted two surveys six months apart to examine the mediating role of peer exclusion between emotional insecurity and NSSI, as well as the moderating effect of school climate. The results indicated that peer exclusion significantly mediated the connection between emotional insecurity and adolescent NSSI. Moreover, school climate significantly moderated the connection between emotional insecurity and peer exclusion. Specifically, the impact of emotional insecurity on peer exclusion was significant only in adolescents who reported a negative school climate, but non-significant in those who reported a positive school climate. These findings provide a robust theoretical foundation and practical insights to help inform the prevention of and interventions for NSSI in adolescents.

Temperament and the Experience of Tension and Self-Injurious Behaviour in Adolescents—The Mediating Role of Maladaptive Perfectionism

Temperament and the Experience of Tension and Self-Injurious Behaviour in Adolescents—The Mediating Role of Maladaptive Perfectionism

The efficacy of P0.1-guided sedation protocol in critically ill patients receiving invasive mechanical ventilation: A randomized controlled trial

Background: Mechanical ventilation is a lifesaving treatment in patients with acute respiratory failure. Despite optimal support, some patients still exhibit excessive respiratory drive, leading to patient self-inflicted lung injury (P-SILI) and diaphragmatic dysfunction. Sedation and muscle relaxants are commonly used to reduce respiratory efforts and manage patient-ventilator asynchrony (PVA). Conventionally, sedative drugs are adjusted based on the sedation level assessed by the Richmond Agitation-Sedation Scale (RASS), which may not correlate with the patient’s respiratory drive. Drop in airway pressure at the first 100 milliseconds of the beginning of the inspiration after the end-expiratory occlusion (P0.1) is a simple and reliable method of respiratory drive monitoring by mechanical ventilation at the bedside and may be the more suitable sedation target. Objectives: To assess the efficacy of a sedation protocol targeting optimal P0.1 and RASS score compared to conventional sedation strategy in patients requiring invasive mechanical ventilation in the medical intensive care units in terms of successful extubation. Methods: This is an open-labeled, single-center, randomized controlled trial conducted in medical intensive care units at a tertiary care hospital in Bangkok, Thailand. We randomly allocated mechanically ventilated patients in a 1:1 ratio to receive a sedation protocol targeting both optimal respiratory drive measured by P0.1 (intervention group) and light sedation (RASS 0 to -2) or standard of care (control group targeting RASS alone). The primary outcome is the rate of successful extubation within 14 days after randomization. Hypothesis: We hypothesize that sedation protocol targeting optimal P0.1 and light sedation will increase the rate of successful extubation at 14 days in mechanically ventilated patients compared to conventional sedation strategy. Conclusions: This study aims to evaluate the efficacy of a sedation protocol using P0.1 measurement to monitor and target optimal respiratory drive, in conjunction with sedation scores, in critically ill patients receiving invasive mechanical ventilation. Ethics and dissemination: This study protocol was approved by the Human Research Protection Unit of the Faculty of Medicine, Siriraj Hospital, Mahidol University (Certificate of Approval no. Si 915/2023). Trial registration: NCT06203405

The School Bullying Victimization in Adolescents With Non-Suicidal Self-Injury: The Role of Coping Strategies and Emotion Regulation.

The present study aimed to investigate the relationship between school bullying victimization and non-suicidal self-injury (NSSI) frequency, taking into consideration the mediating roles of coping strategies and emotional regulation. Participants were 12-18-year-old outpatients and inpatients who met the NSSI and depressive disorder criteria according to the DSM-5. Assessments included the Multidimensional Peer-Victimization Scale, Coping Style Scale for Middle School Students, Emotion Regulation Questionnaire for Children and Adolescents, and the Functional Assessment of Self-Mutilation to examine the bullying victimization, coping strategies, emotion regulation, and NSSI behaviour. Serial multiple mediation effects of coping strategies and emotion regulation between bullying victimization and NSSI frequency were analysed using the SPSS macro PROCESS programme. A total of 2335 participants were included in this study. Bullying victimization significantly predicted NSSI frequency (B=0.191, p<0.001). Both coping strategies and emotion regulation were important mediators in the relationship between bullying victimization and NSSI frequency. Bullying victimization indirectly affected NSSI through two serial mediation pathways: (1) bullying victimization → problem-focused coping → cognitive reappraisal → NSSI frequency, and (2) bullying victimization → emotion-focused coping→ expressive suppression → NSSI frequency. The study revealed a positive association between bullying victimization and the frequency of NSSI among adolescents with depressive disorder. Strategies of coping and emotional regulation significantly mediated the link between bullying victimization and the frequency of NSSI. The findings suggested that supporting adolescents in adopting effective coping and emotional regulation strategies could be a crucial approach to mitigate the impact of bullying victimization on the frequency of NSSI.

The influence of parenting styles and coping strategies on anxiety symptoms in adolescents: a comparative study of groups with and without non-suicidal self-injury behavior

Background During the COVID-19 pandemic, the global incidence of non-suicidal self-injury (NSSI) has been increasing year by year, especially among adolescents, and it is highly correlated with the level of anxiety among teenagers, particularly within Chinese cultural contexts where parenting styles significantly influence adolescent behavior. Objective This study examines the role of culturally-influenced parenting styles and adolescent coping strategies in relation to anxiety and NSSI behavior, aiming to clarify these multivariate interactions for better understanding and intervention. Methods A cross-sectional survey was conducted with NSSI-diagnosed adolescents from Affiliated Kangning Hospital, Ningbo, China, and healthy adolescents from urban schools. Data on background, parenting styles, coping strategies, and anxiety levels were analyzed using chi-square tests, independent sample t-tests, MANOVA, and regression analysis. Results Adolescents with NSSI reported higher anxiety levels, more punishment and interference, and less emotional warmth from their fathers compared to the non-NSSI group (p &lt; 0.001). The NSSI group also relied more on emotion-oriented coping strategies, while the non-NSSI group favored problem-oriented approaches (p &lt; 0.001). Multivariate analyses confirmed significant effects of NSSI behavior, parenting styles, and coping strategies on anxiety levels. Conclusion This study found that the anxiety levels of NSSI adolescents were significantly higher than those of non-NSSI adolescents in China, which was closely related to less emotional warmth from parents, more punishment and interference, and emotion-focused coping strategies. The results demonstrate that family environment and coping strategies play a critical role in NSSI behavior and anxiety levels, highlighting the importance of emphasizing emotional support and positive coping strategies in the prevention and intervention of NSSI behavior.

Eating Disorder-Related Symptom Reduction, Suicidal/Self-Injurious Behavior, Emotional Dysregulation and Interpersonal Difficulties in an Eating Disorder-Specific Treatment - A Clinical Study

This study exploratively investigated a possible relationship between suicidal/self-injurious behavior and the change in self-reported eating disorder symptoms as well as emotional dysregulation and interpersonal difficulties during eating disorder-specific treatment. For this purpose, the symptom index of the Eating Disorder Inventory-2 (EDI-SI) and the scale for the assessment of impulsivity and emotional dysregulation of borderline personality disorder (IES-27) with its subscales suicidal and self-injurious behavior (SVV/SEV), emotional dysregulation (EmotDys) and interpersonal difficulties (BezSchw) were collected from 167 female patients at a psychosomatic clinic. The participants were divided into four groups depending on the occurrence of SVV/SEV before the start and/or end of treatment. A one-way multivariate analysis of variance (MANOVA) with repeated measures showed an interaction of time and SVV/SEV group with regard to EDI-SI, EmotDys and BezSchw. The effect sizes of the pre-post comparison of the EDI-SI were very different in the groups divided according to the occurrence of SVV/SEV (0.27<g*< 1.32). No significant improvement in the EDI-SI was found on average for people with new occurrence of SVV/SEV during the course of treatment. People who were able to cease SVV/SEV in the course of treatment also benefited in terms of the EDI-SI. The decisive factor for the consideration of SVV/SEV in patients with eating disorders appears to be less the SVV/SEV reported before the start of treatment, but rather newly occurring or persistent SVV/SEV during the course of treatment.

Characterization and Outcomes of Profoundly and Non-profoundly Autistic Individuals Admitted to a Specialized Psychiatric Inpatient Unit.

The prevalence of autism spectrum disorder (ASD) is currently estimated to be 1 in 36 children. While much is known about the impact of ASD on family and community functioning as well as treatment outcomes, less is known about a relatively new categorization of ASD, called "profound autism." The current study evaluated 14 consecutively admitted patients meeting criteria for profound autism to a specialized psychiatric inpatient and partial hospitalization program. We then selected 15 non-profoundly autistic youth admitted immediately before or after each profoundly autistic youth to serve as a comparison. Patient caregivers completed measures about parental stress and the severity and frequency of patient problem behavior, and patients participated in functional analyses of problem behavior and function-based treatment programs during their admission. Results showed profoundly autistic youth spent an average of 14 more days admitted to the psychiatric unit, and they engaged in higher parent-reported severity and frequency of self-injurious and stereotypic behavior. Functional analysis results for profoundly autistic youth showed a higher occurrence of automatically reinforced problem behavior but otherwise similar results. As well, profoundly autistic youth showed a lower percentage reduction in problem behavior at the end of the psychiatric hospitalization than their non-profoundly autistic peers. Profoundly autistic youth seem to require a high level of behavioral support, even after psychiatric hospitalization. Insurance companies and therapists need to recognize these challenges and invest sufficient resources to meet their treatment needs.

Telehealth Brief Cognitive Behavioral Therapy for Suicide Prevention: A Randomized Clinical Trial.

Suicide rates continue to increase in the US. Evidence-based treatments for suicide risk exist, but their effectiveness when delivered via telehealth remains unknown. To test the efficacy of brief cognitive behavioral therapy (BCBT) for reducing suicide attempts and suicidal ideation among high-risk adults when delivered via telehealth. This 2-group parallel randomized clinical trial comparing BCBT with present-centered therapy (PCT) was conducted from April 2021 to September 2023 with 1-year follow-up at an outpatient psychiatry and behavioral health clinic located in the midwestern US. Participants reporting suicidal ideation during the past week and/or suicidal behavior during the past month were recruited from clinic waiting lists, inpatient service, intermediate care, research match, and direct referrals from clinicians. A total of 768 participants were invited to participate, 112 were assessed for eligibility, and 98 were eligible and randomly assigned to a treatment condition. Data analysis was from April to September 2024. Participants received either BCBT, an evidence-based suicide-focused treatment that teaches emotion regulation and reappraisal skills, or PCT, a goal-oriented treatment that helps participants identify adaptive responses to stressors. Participants were randomized using a computerized stratified randomization algorithm with 2 strata (sex and history of suicide attempts). The primary outcome was suicide attempts as measured by the Self-Injurious Thoughts and Behaviors Interview-Revised. The secondary outcome was severity of suicidal ideation as measured by the Scale for Suicide Ideation. Participants included 96 adults (mean [SD] age, 31.8 [12.6] years; 64 female [66.7%] and 32 male [33.3%]), with 51 receiving BCBT and 45 receiving PCT. Of all participants, 85 (88.5%) completed at least 1 session. From baseline to 12 months, 12 participants receiving PCT (estimated percentage, 35.6%) made 56 suicide attempts and 11 participants receiving BCBT (estimated percentage, 30.0%) made 36 suicide attempts. Participants randomized to BCBT made significantly fewer suicide attempts than participants randomized to PCT (mean [range], 0.70 [0.00-8.00] attempts per participant vs 1.40 [0.00-10.00] per participant) and had a 41% reduced risk for suicide attempts (hazard ratio, 0.59; 95% CI, 0.36-0.96; P = .03). Severity of suicidal ideation significantly decreased in both treatments (F4,330 = 50.1; P < .001) but did not differ between groups (F4,330 = 0.2; P = .91). The findings of this randomized clinical trial suggest that BCBT delivered via video telehealth is effective for reducing suicide attempts among adults with recent suicidal thoughts and/or behaviors. ClinicalTrials.gov Identifier: NCT04844294.

Effect of sense of self on nonsuicidal self-injury in college students: a regulated mediating model.

This study aims to examine the relationship and mechanism between sense of self and nonsuicidal self-injury among college students, providing a new theoretical basis for predicting and preventing such behavior. A total of 1350 college students completed the Sense of Self scale, nonsuicidal self-injury questionnaire, frustration scale, and social problem-solving questionnaire. (1) Negative Sense of Self predicts frustration, and frustration positively predicts nonsuicidal self-injury. (2) Frustration serves as a partial mediator in the relationship between sense of self and nonsuicidal self-injury. (3) The impulsive-negligent social problem-solving style regulates the first half of the mediation model by influencing the relationship between sense of self and frustration. Frustration, mediated by sense of self, increases the risk of nonsuicidal self-injury, and this relationship is moderated by the impulsive-negligent social problem-solving style. Sense of Self is a necessary but not sufficient condition for nonsuicidal self-injury, indirectly influencing such behavior through frustration triggered by stress events.

Are the functions of non-suicidal self-injury associated with its persistence and suicide risk in university students? Insights from a network analysis

BackgroundTo date, a number of intra- and interpersonal functions of non-suicidal self-injury (NSSI) have been identified. Yet, their association with persistence of NSSI and suicide risk remains unknown. The study aimed to investigate which functions of NSSI are associated with its persistence and suicide risk in university students using a network analysis.MethodsAltogether, 830 university students reporting a lifetime history of NSSI were enrolled. The persistence of NSSI was defined as its presence over preceding 12 months.ResultsPersistent NSSI was directly connected to the nodes representing two functions of NSSI: affect regulation and self-punishment. Suicide risk was directly connected to the anti-suicide function of NSSI. The shortest pathway from persistent NSSI to suicide risk led through depressive symptoms. Other likely pathways (three mediating nodes) led through the functions of NSSI (affect regulation or self-punishment, anti-dissociation, and anti-suicide). Depressive symptoms had the highest centrality. However, it did not differ significantly compared to some functions of NSSI (marking distress, anti-dissociation, toughness, and affect regulation).DiscussionIn university students, persistent NSSI might be directly associated with its functions related to affect regulation and self-punishment, while suicide risk might be directly associated with the anti-suicide function. The observations posit a role of intrapersonal functions in shaping the outcomes of NSSI. Depressive symptoms and some NSSI functions might be the most promising targets for interventions in this population.

Joinpoint analyses of rates on hospital-recorded deliberate self-harm: an update on Danish national trends.

Deliberate self-harm (DSH) is a public health concern and the high rates among adolescents and females warrant continuous monitoring. The aim of this study was to determine trends in DSH rates by gender and age in Denmark during 2000-2021 using joinpoint regression analysis. A cohort design was applied to national register data on all individuals aged 10 + years living in Denmark during 2000-2021. DSH episodes were identified in somatic and psychiatric hospital data. Sex- and age-specific incidence rates (IR) were calculated by calendar years. Using joinpoint regression analyses, segments of change and their annual percent change (APC) were identified. The highest DSH rates were observed for males and females aged 19-24 years with IRs of 146.8 (95% CI 142.9-150.7) and 378.6 (95% CI 372.1-385.0) per 100,000 person-years, respectively. Major changes in DSH rates were found for the youngest age groups. A step decrease was found for males aged 19-24 years (-18.4; 95% CI -31.9- -2.3; p = < 0.030) during 2012 to 2015. A significant decline was observed during 2012-2016 for females aged 19-24 years (-18.9; 95% CI -26.8 - -10.2; p = 0.001). Poisoning was the most frequently used method. Seemingly, the financial recession in 2008 did not affect Danish DSH rates. Significant declines were observed for females in the years where means restrictive measures had been installed; thus, supporting their potential effect. Fluctuations in DSH rates among adolescents and young adults in recent years underscore the importance of continued monitoring.

A bibliometric analysis and visualization of non-suicidal self-injury in adolescents

BackgroundNon-suicidal self-injury(NSSI)is a widespread occurrence among adolescents, and this behavior can bring serious consequences. In recent years, the prevalence of NSSI continues to rise, which has attracted the attention of many researchers. But currently there is no research exploring the overall research distribution of NSSI in adolescents through quantitative analysis. Therefore, it is necessary to understand the status of development and main research hotspots of NSSI in adolescents via bibliometric analysis.MethodsWe searched the relevant studies from the Web of Science Core Collection(WoSCC)from January 1, 2014 to December 31, 2023. Using CiteSpace and VOSviewer visual analysis tools, we analyzed studies from the perspectives of country, region, institution, journal, author, and keywords.ResultA total of 2177 studies related to NSSI in adolescents were included. USA and Harvard University were the leading country and institution in this research field. Penelope Hasking was the most prolific author. Frontiers in Psychiatry and the Journal of Affective Disorders were the most productive journals. The most high-frequency keywords were ‘depression’, ‘mental health’, ‘emotion regulation’ and ‘borderline personality disorder’. ‘mindfully’, ‘intervention’, ‘self-compassion’ and ‘ecological momentary assessment’ were the emerging keywords.ConclusionsExploring the relevant factors and mechanisms of comorbidities, identifying etiology and risk/protective factors, and finding the impact of NSSI on adolescents are the hot topics. Moreover, intervention measures and interdisciplinary collaborative research for NSSI in adolescents will emerge as frontiers in the future.

Prospectively predicting 6-month risk for non-suicidal self-injury among adolescents after psychiatric hospitalization based on a predictive model

BackgroundIt is challenging to predict the occurrence of non-suicidal self-injury (NSSI) among adolescents over short periods. Moreover, the predictive value of indices for NSSI remains elusive. Thus, this study aimed to identify predictors of NSSI within 6 months among adolescents after psychiatric hospitalization by establishing a risk assessment model.MethodsA total of 632 high-risk participants were included in this study. The distribution characteristics of adolescent NSSI were initially assessed through a cross-sectional survey, following which risk factors were identified using logistic regression analysis. The risk score method was then used to construct a 6-month risk assessment model for NSSI. Lastly, the predictive effect of the model was evaluated by indicators such as the area under the receiver operating characteristic (ROC) curve and the positive predictive value.ResultsAfter 6 months, 412 cases of NSSI were identified. According to the logistic regression model, the frequency of relapses, medication status, and NSSI history were identified as influencing factors. Higher scores on the Impulsive Behavior Scale and Pittsburgh Sleep Quality Index were associated with a higher risk of NSSI. Conversely, higher scores on the Pain and Belief Perception Scale were correlated with a lower risk of NSSI. Moreover, the area under the ROC curve for the predictive model was 0.9989, with a 95% confidence interval of (0.9979, 0.9999), highlighting its high predictive ability and accuracy. The predictive model was validated using 78 patients, yielding an area under the ROC curve of 0.9703 and a 95% confidence interval of (0.9167, 0.9999), demonstrating outstanding predictability.ConclusionThese results collectively showed that the predictive model could accurately predict adolescent NSSI. Thus, the model’s primary variables may be applied to predict the risk of NSSI in the clinical setting.

Symptom Shifting From Nonsuicidal Self-Injury to Substance Use and Borderline Personality Pathology

A decline in nonsuicidal self-injury (NSSI) behavior is often viewed as an indication of mental health improvement when treating adolescents and young adults with borderline personality pathology. However, evidence shows that an initial decrease in NSSI behavior does not always signal recovery, and potential symptom shifting needs to be considered. To examine the codevelopment of NSSI and substance use in adolescents and young adults receiving treatment for NSSI behavior and to explore whether shifting from NSSI behavior to substance use is associated with emerging or persistent borderline personality pathology. This cohort study used data from the AtR!Sk study. The study included a consecutive sample of adolescents and young adults with NSSI behavior who presented to a specialized outpatient clinic for early intervention of borderline personality pathology. A baseline assessment (between May 3, 2016, and December 19, 2019) and 2 annual follow-up assessments were conducted. Data were analyzed from April 15, 2023, to September 5, 2024. The frequencies of NSSI behavior and substance use were self-reported. Diagnostic interviews were carried out to assess borderline personality pathology. Growth mixture models were specified to identify latent classes with different joint trajectories of NSSI behavior and substance use, and the classes were compared for the number of fulfilled borderline personality disorder (BPD) diagnostic criteria. Overall, 277 adolescents and young adults (249 [89.9%] female; mean [SD] age at baseline, 14.9 [1.5] years) were included in the study (number at first follow-up, 135; number at second follow-up, 82). Three latent classes were extracted from the data. A decline in NSSI behavior following treatment was common. Class 1 (estimated class count: 32.5; 11.7% of participants) was further characterized by a decline in substance use; class 2 (210.1; 75.9% of participants), by a moderate increase in substance use; and class 3 (34.4; 12.4% of participants), by a strong increase in substance use. The number of fulfilled BPD diagnostic criteria in class 1 (mean [SE], 4.64 [0.40]; comparison: χ2, 11.64; P < .001) and class 3 (mean [SE], 4.29 [0.41]; comparison: χ2, 5.98; P = .01) was greater than that in class 2 (mean [SE], 3.18 [0.15]) at baseline. The number of fulfilled BPD criteria remained high at the second follow-up assessment in class 3 (mean [SE], 5.15 [0.84]) but not in class 1 (mean [SE], 2.05 [0.54]). In this cohort study of adolescent patients with NSSI behavior, a decline in this behavior was commonly paired with an increase in substance use. This finding suggests that a decrease in NSSI behavior alone may be insufficient to indicate treatment success. Monitoring the joint trajectories of NSSI behavior and substance use may be a promising avenue toward early detection and targeted treatment of adolescent borderline personality pathology.

Barriers to Youth Disclosing Self-Injurious Thoughts and Behaviors: A Focus on the Therapeutic Context

Objective Disclosure of self-injurious thoughts and behaviors (SITBs) can serve as a catalyst to receiving mental health and lifesaving care; yet, many young people do not disclose these experiences to their therapists. In this study we aimed to identify barriers to adolescents disclosing their SITBs to their therapists and to compare these barriers across non-disclosure of suicidal ideation, suicidal behavior, and non-suicidal self-injury. Method Participants (n = 292) all had lived experience of at least one SITB and were an average age of 15.55 years, with the majority identifying as cisgender girls (68.15%). Using inductive content analysis of open-ended responses, six main categories of disclosure barriers were identified. Results These overarching barriers were: Agency Theft, Irrelevance, Therapeutic (Mis)Alliance, Internalized Stigma, Anticipated Stigma, and Lacking Disclosure Self-Efficacy. The majority (85.29%) of subordinate barriers were common across the three SITBs. Conclusions Adolescents may hesitate to disclose their SITBs to their therapists for many reasons; prioritizing the therapeutic relationship and working collaboratively with adolescents could be instrumental in not only fostering disclosure but also an overall more positive therapeutic experience.

Transoral penetrating craniocerebral injury: a case report and literature review

A penetrating brain injury is a rare type of neurosurgical trauma associated with extremely high mortality and disability rates. Penetrating skull base injuries caused by arrows seldom occur because injuries caused by such weapons are more likely to be accidental. However, the number of self-inflicted injuries is increasing, and these injuries have varying patterns and high mortality rates. We report a case of a transoral penetrating craniocerebral injury caused by an arrow in a suicidal patient. Preoperative imaging is crucial for detecting and planning the surgical approach. Surgery is an effective treatment for this type of injury. Additionally, we reviewed previous case reports on this type of injury to provide recommendations for its clinical detection and treatment.

Self-Injury and the Treatment Gap: An Interdisciplinary Exploration of Beliefs About Causal Variables and Treatment Goals Among Caregivers, Researchers, and Clinicians

ABSTRACT Introduction There is a gap between individuals with intellectual and developmental disabilities (IDD) who need treatment for self-injurious behavior (SIB) and those who receive it. One contributing factor may be a multiplicity of beliefs about the nature of SIB and its treatment. Methods Using reflexive thematic analysis, we interviewed and integrated two knowledge sources: the perspectives of family caregivers for individuals with SIB and IDD and the perspectives of clinicians and researchers who treat and study self-injury. Results We present results from two primary belief categories: perceptions of causal variables and treatment goals. Conclusion By contextualizing the current paradigms of research and practice in self-injury as siloed depending on whether an individual does or does not have IDD, we discuss ways to deepen our understanding of the process of treatment provision for self-injurious behavior to inform efforts to close the treatment gap.

Exploring the Relationship Between Adverse Childhood Experiences and Non-suicidal Self-injury in Young Adults: The Role of Mental Health and Social Support

Exploring the Relationship Between Adverse Childhood Experiences and Non-suicidal Self-injury in Young Adults: The Role of Mental Health and Social Support