Predictors Of Non-suicidal Self-injury Research Articles

Empathic Disequilibrium as a Predictor of Nonsuicidal Self-Injury in Autistic and Nonautistic People

Empathic Disequilibrium as a Predictor of Nonsuicidal Self-Injury in Autistic and Nonautistic People

The role of cognitive disengagement syndrome in non-suicidal self-injury among adolescents with attention deficit hyperactivity disorder.

We aimed to investigate the relationship between Cognitive Disengagement Syndrome (CDS) and non-suicidal self injury (NSSI) in adolescents with attention deficit hyperactivity disorder (ADHD). A semi-structured psychiatric interview and an NSSI screening questionnaire were conducted. Questionnaires assessing CDS (with daydreamer, sleepy, and slow subdimensions), depression, anxiety, self-esteem, emotion regulation, coping strategies, and loneliness were administered. Among 104 participants (n: 63, 60.6% girls), the combined type of ADHD was the most common (66.3%), and 35 adolescents (27 girls) were in the NSSI+ group. Although only depression and ADHD were found to be predictors of NSSI in ADHD, CDS was associated with many risk factors of NSSI in ADHD: depression, anxiety, emotion dysregulation, low self-esteem, and emotion-oriented coping ways. After controlling for the effects of cognitive problems/inattentiveness, depression, and anxiety, CDS still correlated with low self-esteem and emotion dysregulation. The daydreamer and slow sub-dimensions of CSD differed between NSSI+ and NSSI- groups, while sleepy did not. CDS is associated with several relevant factors, indirectly relating it to self-harm in ADHD. CDS increases the vulnerability to mental health changes that could lead to NSSI in adolescence with ADHD.

Predictors of non-suicidal self-injury in adolescents with depressive disorder: the role of alexithymia, childhood trauma, and body investment.

This study analyzes the relationship of alexithymia, childhood trauma, and body investment to non-suicidal self-injury (NSSI) behaviors in adolescents with depressive disorder and whether they have predictive and diagnostic value for non-suicidal self-injury (NSSI) behaviors in adolescents with depressive disorder. A total of 225 patients with a diagnosis of adolescent depressive disorder were included in the study and were divided into two groups according to the DSM-5 criteria: 98 cases without NSSI and 127 cases with NSSI. Compare the demographic data, 24-item Hamilton Depression Scale (HAMD-24), 20-item Toronto Alexithymia Scale (TAS-20), Childhood Trauma Questionnaire-Short Form (CTQ-SF), and Body Investment Scale (BIS) scores between two groups. Binary logistic regression was used to analyze the independent risk factors contributing to NSSI behaviors in adolescents with depression, and establish four predictive models. Based on the models' predictive probability, the ROC curves were plotted to calculate the value of the predictive diagnostic effect. The group without NSSI had lower scores than the group with NSSI on HAMD-24 total score, TAS-20 total score, difficulty identifying feelings, difficulty describing feelings, and externally focused thinking, as well as lower scores on CTQ-SF total score, physical neglect, emotional neglect, physical abuse, and emotional abuse. In contrast, the BIS total score, body image feelings and attitudes, body care, and body protection factor scores were higher for the group without NSSI. The BIS body care factor score and the CTQ-SF emotional abuse factor score were significantly linked with adolescents diagnosed with depressive disorder who exhibited NSSI behaviors. These results provide a good diagnostic model for adolescents with depressive disorder. Low levels of body care and childhood emotional abuse may independently contribute to the implementation of NSSI in adolescents with depressive disorder. Body investment and childhood trauma are valuable in diagnosing and predicting NSSI behaviors and should be considered as potentially important factors in clinical treatment.

Joint Trajectories of Depression and Rumination: Experiential Predictors and Risk of Nonsuicidal Self-Injury

Nonsuicidal self-injury (NSSI) is common in adolescence. Rumination is a key risk factor and often co-occurs with depressive symptoms. This is the first study to examine the joint longitudinal trajectories of rumination and depressive symptoms as predictors of NSSI, and the adverse experiences associated with these trajectories. A community sample of 1,835 adolescents (55.9% male participants, 12.3 ± 0.5 years of age) completed questionnaires to assess adverse childhood experiences, rumination, depressive symptoms, and NSSI. Assessments were made 4 times over 18 months. A parallel process growth mixture model showed that youth with high trajectories of rumination but low trajectories of depression had moderately increased odds of NSSI (2.43-fold, 95% CI 1.53-3.91) compared with adolescents with low trajectories of both rumination and depression. Odds ratios (ORs) in adolescents with low trajectories of rumination but increasing or high trajectories of depression were similarly elevated, suggesting that high trajectories of rumination or depression were risk factors in isolation. However, odds were 10.06-fold greater (95% CI 5.68-18.02) when high trajectories of rumination occurred in tandem with high trajectories of depression. Multinomial logistic regression showed that male sex (OR 10.54, 95% CI 5.66-19.63), peer victimization (OR 2.25, 95% CI 1.72-2.96), and parental alienation (OR 1.94, 95% CI 1.46-2.57) were key determinants of membership in the highest risk group. Risk for NSSI is markedly increased in adolescents with high longitudinal trajectories of depression and rumination. Reducing exposure to peer victimization, cyber victimization, emotional abuse, parental alienation, and interparental conflict may reduce risk.

Prediction of non-suicidal self-injury in adolescents at the family level using regression methods and machine learning

BackgroundAdolescent non-suicidal self-injury (NSSI) is a major public health issue. Family factors are significantly associated with NSSI in adolescents, while studies on forecasting NSSI at the family level are still limited. In addition to regression methods, machine learning (ML) techniques have been recommended to improve the accuracy of family-level risk prediction for NSSI. MethodsUsing a dataset of 7967 students and their primary caregivers from a cross-sectional study, logistic regression model and random forest model were used to test the forecasting accuracy of NSSI predictions at the family level. Cross-validation was used to assess model prediction performance, including the area under the receiver operator curve (AUC), precision, Brier score, accuracy, sensitivity, specificity, positive predictive value and negative predictive value. ResultsThe top three important family-related predictors within the random forest algorithm included family function (importance:42.66), family conflict (importance:42.18), and parental depression (importance:27.21). The most significant family-related risk predictors and protective predictors identified by the logistic regression model were family history of mental illness (OR:2.25) and help-seeking behaviors of mental distress from parents (OR:0.65), respectively. The AUCs of the two models, logistic regression and random forest, were 0.852 and 0.835, respectively. LimitationsThe key limitation is that this cross-sectional survey only enabled the authors to examine predictors that were considered to be proximal rather than distal. ConclusionsThese findings highlight the significance of family-related factors in forecasting NSSI in adolescents. Combining both conventional statistical methods and ML methods to improve risk assessment of NSSI at the family level deserves attention.

The Prediction Model of Non-Suicidal Self-Injury in Psychiatric Patients Using Decision Tree Analysis.

The prevalence rate of non-suicidal self-injury (NSSI) in the clinical population is higher than that in the community sample, necessitating the need to investigate the predicting factors of NSSI in this group. The present study aimed to develop a prediction model of NSSI among psychiatric patients in Korea. Decision tree analysis was conducted on a sample of 224 psychiatric patients. Emotion regulation strategies (rumination, cognitive reappraisal, and expressive suppression), impulsivity, problematic alcohol use, working memory, depressive mood, and gender were included in the model as predictors of NSSI. Results indicated that rumination, problematic alcohol use, and working memory predicted lifetime NSSI engagement among psychiatric patients. The best predictor of lifetime NSSI engagement was rumination. Specifically, when the level of rumination was high, the level of working memory was lower, and the risk of NSSI was higher. In the case of low levels of rumination, the higher the level of problematic alcohol use, the higher the risk of NSSI. The highest prevalence of lifetime NSSI engagement was found in a subgroup of patients with high levels of rumination and low levels of working memory. The major contribution of this study is finding a combination of factors to predict the high-risk group of NSSI among psychiatric patients in Korea. This study provides evidence on the effect of rumination, working memory, and problematic alcohol use on NSSI. It is suggested that clinicians and researchers should pay more attention to emotion regulation and related vulnerabilities in preventing and treating NSSI.

Nonsuicidal Self-Injury in Preadolescents.

There is a dearth of literature on the prevalence and predictors of nonsuicidal self-injury (NSSI) history and onset among preadolescent youth. This gap in the literature is significant given evidence suggesting that NSSI is a robust predictor of negative mental health outcomes, and that early onset NSSI may be associated with a more severe course of self-injurious thoughts and behaviors. This study aimed to evaluate sociodemographic characteristics, psychiatric disorders, and suicidal ideation (SI) in relation to NSSI onset and history in preadolescents. Data were drawn from the Adolescent Brain and Cognitive Development (ABCD) study, which recruited a diverse sample of 11 875 youth aged 9 to 10 years. The primary outcome measures were lifetime history and recent onset of NSSI. Measures included sociodemographics and the K-SADS diagnostic interview assessing psychopathology and SI. Female sex and identifying as Black were associated with lower odds of lifetime NSSI. Identifying as a sexual minority, having unmarried parents, and a low family income were associated with higher odds of lifetime NSSI. Although depression was most predictive of NSSI history and onset, a range of internalizing and externalizing disorders, greater comorbidity, and SI also were predictive. Given that NSSI was associated with a range of mental health disorders and comorbidity, it may be best conceptualized as a transdiagnostic phenomenon. Findings highlight key sociodemographic and diagnostic factors that may help to direct screening efforts in preadolescents, particularly sexual minority status and depression.

Social networking and depressive symptom: Predictors of non-suicidal self-injury among adolescents

Social networking and depressive symptom: Predictors of non-suicidal self-injury among adolescents

Factors Associated With Non-suicidal Self-Injury in Chinese Adolescents: A Meta-Analysis

Non-suicidal self-injury (NSSI) in adolescents is an increasing public health problem in China. We conducted a meta-analysis of studies on NSSI in Chinese adolescents (between 10 and 19 years) to examine factors associated with NSSI. Twenty-five papers including 30 separate studies with 186,447 participants were included for analysis. The results from a random-effects model showed a weak, but significant overall prediction of NSSI (OR = 1.734). There were significant associations between the following seven factors and NSSI (ranking by the effect sizes, in descending order): adverse life events (OR = 2.284), negative coping style (OR = 2.040), problematic internet use (OR = 2.023), sleep disturbance (OR = 1.734), traumatic experiences (OR = 1.728), problematic parent-child relationship (OR = 1.585), mental health problems (OR = 1.578). Additionally, NSSI sample type moderated these effects. These findings highlight factors significantly associated with NSSI in Chinese adolescents. Parent-child relationship and mental health of the only children and left-behind children in China deserve more attention.Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42019123508.

Brief report: Differences in self-injurious thoughts and behaviors between sexual minority and heterosexual adolescent girls

Purpose: Adolescent suicidal ideation (SI) and nonsuicidal self-injury (NSSI) are associated with depression, but few studies adequately represent sexual minorities. This study investigated whether the association between SI/NSSI and depression varies by sexual orientation. Method: SI, NSSI, sexual orientation, and depressive symptoms were measured in a community sample of adolescent girls (n = 1,803). Results: Sexual orientation and depression accounted for unique risk for SI and NSSI in logistic regressions. Sexual orientation moderated the association between depression and NSSI. Conclusions: Results indicate that depression is a less specific predictor of NSSI among sexual minority adolescents compared to their heterosexual peers and indicate a need for future research to delineate which psychosocial factors better account for NSSI risk.

Targeting self-criticism in the treatment of nonsuicidal self-injury in dialectical behavior therapy for adolescents: a randomized clinical trial.

The Benefits and Barriers Model proposes both benefits and barriers associated with nonsuicidal self-injury (NSSI) and that a negative association with the self plays a key role in the initial selection of and acute motivation for NSSI. The current investigation builds upon previous findings by assessing the added benefit of targeting self-criticism in the treatment of NSSI. Sample included 40 participants (30 females; Mage =14.92) enrolled in dialectical behavior therapy for adolescents within a partial hospitalization program. All study participants received dialectical behavior therapy for adolescents, and those randomized to the experimental condition received an additional brief cognitive intervention developed to decrease self-criticism. There was no evidence of an indirect effect of targeting self-criticism upon NSSI at post-treatment via post-treatment self-criticism (b = -0.98, p = .543); however, there was evidence of a significant interaction between treatment condition and self-criticism at pretreatment in the prediction of NSSI at post-treatment (b=0.33, p = .030). Analyses of simple slopes indicated the conditional direct effect of targeting self-criticism varied as a function of patient's level of self-criticism at the onset of treatment, such that individuals -1 SD below the mean (b = -5.76, p = .037) and at average pretreatment levels of self-criticism (b = -4.09, p = .042), but not+1 SD above the mean (b = -2.42, p = .056), experienced fewer incidents of NSSI at post-treatment. The results of this investigation support the added benefit of targeting self-criticism in the treatment of NSSI for adolescents.

Predictors of nonsuicidal self-injury: The independent contribution of benign masochism and antisocial personality

The present research examined the relationships between engagement in nonsuicidal self-injury (NSSI), benign masochism, and antisocial personality traits. Because both benign masochists and individuals who engage in self-injury find pleasure in experiencing pain, we expected a positive relationship between benign masochism and NSSI. We further anticipated NSSI to be positively related to antisocial personality traits due to the shared propensity for aggression and violence. In fact, two studies showed that benign masochism, Machiavellianism, psychopathy, everyday sadism, and trait aggression were positively related to mild forms of injurious self-harm behaviors. Although benign masochism and antisocial personality traits were positively correlated, they independently contributed to an increased risk of engagement in NSSI. Vulnerable narcissism was also positively correlated, whereas a measure of grandiose narcissism revealed less conclusive evidence. Overall, the tendencies to go against oneself in a benign form and to go against others are both predictive of the propensity to engage in mild forms of self-harming behaviors.

Childhood predictors and moderators of lifetime risk of self-harm in girls with and without attention-deficit/hyperactivity disorder.

Attention-deficit/hyperactivity disorder (ADHD) is associated with self-harm during adolescence and young adulthood, especially among females. Yet little is known about the developmental trajectories or childhood predictors/moderators of self-harm in women with and without childhood histories of ADHD. We characterized lifetime risk for nonsuicidal self-injury (NSSI), suicidal ideation (SI), and suicide attempts (SA), comparing female participants with (n = 140) and without (n = 88) childhood ADHD. We examined theory-informed childhood predictors and moderators of lifetime risk via baseline measures from childhood. First, regarding developmental patterns, most females with positive histories of lifetime self-harm engaged in such behaviors in adolescence yet desisted by adulthood. Females with positive histories of self-harm by late adolescence emanated largely from the ADHD-C group. Second, we found that predictors of NSSI were early externalizing symptoms, overall executive functioning, and father's negative parenting; predictors of SI were adverse childhood experiences and low self-esteem; and predictors of SA were early externalizing symptoms, adverse childhood experiences, and low self-esteem. Third, receiver operating characteristics analyses helped to ascertain interactive sets of predictors. Findings indicate that pathways to self-harm are multifaceted for females with ADHD. Understanding early childhood predictors and moderators of self-harm can inform both risk assessment and intervention strategies.

Self-criticism longitudinally predicts nonsuicidal self-injury in eating disorders

ABSTRACTDialectical Behavior Therapy (DBT) has long been successfully applied to such behaviors such as nonsuicidal self-injury (NSSI) and more recently, bulimic behaviors. However, it is less clear how patients experiencing these comorbid symptoms may benefit from this treatment modality. Self-criticism, defined as a highly negative attitude towards the self, has been implicated in both EDs and NSSI and is amenable to DBT; thus, further examination of this construct may be beneficial in informing DBT treatment approaches. However, research has only examined these relationships cross-sectionally and no published research has examined self-criticism as a longitudinal predictor of NSSI and ED symptoms. Thus, this study examined self-criticism as a potential driving factor of NSSI in EDs in order to inform treatments, particularly DBT. Data were collected from 92 treatment-seeking adults at ED treatment facilities in the United States. Participants self-reported ED pathology, NSSI engagement, and self-criticism at baseline and a two-month follow-up. A path analysis revealed that self-criticism at baseline was associated with NSSI frequency at follow-up over and above baseline NSSI and ED symptomology. Self-criticism at baseline was not associated with ED pathology at follow-up. Self-criticism longitudinally predicted NSSI, but not ED pathology, in an ED sample. As such, it may be important for clinicians to assess for self-criticism and consider treatments that target both self-criticism and self-injury, like DBT, for this population.

Attachment Style and alexithymia as predictors of nonsuicidal self-injury in young adults: A pilot study

Il passaggio da trauma infantile ad autolesionismo (NSSI) implica il mettere in evidenza la regolazione emotiva e l’attaccamento che sono stati supportati dalla ricerca che ha indagato le funzioni del NSSI. Il presente studio pilota ha cercato di esplorare piu a fondo questo tema esaminando quali dimensioni specifiche dell’attaccamento e dell’alessitimia predicano comportamenti autolesionistici. Ventisei giovani adulti [eta media (± DS) 21.08 (± 3.95)] con esperienza di autolesionismo son stati comparati con un gruppo di controllo. Sono state somministrate la Toronto Alexithymia Scale (TAS-20) e l’Attachment Style Interview (ASI). I risultati hanno dimostrato livelli di alessitimia signifi-cativamente maggiori, in particolare nell’item difficolta a identificare i sentimenti, nei sog-getti con NSSI rispetto al gruppo di controllo, cosi come sono stati riscontrati punteggi piu alti in relazione alla presenza di uno stile di attaccamento insicuro, in particolare insicuro-ansioso. L’analisi di dimensioni specifiche ha rilevato che la scala ASI inerente al Coerci-zioni alla vicinanza (constraints on closeness) e Paura del rigetto (fear of rejection), forni-scano il modello migliore dell’NSSI. Tali risultati conferiscono prove empiriche riguardo alla funzione regolativa degli NSSI ma mettono anche in evidenza l’importanza della fun-zione dei confini interpersonali che potrebbero fornire un utile focus per l’intervento e il trattamento dei comportamenti autolesionistici.

Perfectionism and Social Problem Solving as Predictors of Nonsuicidal Self-Injury in Ethnoracially Diverse College Students: Findings Controlling for Concomitant Suicide Risk

The present study was designed to examine the extent to which perfectionism and social problem solving add to the prediction model of nonsuicidal self-injury (NSSI), independent of suicide risk, in a sample of 386 ethnoracially diverse college students. Moreover, the authors were interested in whether social problem solving, beyond perfectionism, would account for additional variance in their prediction model. Results indicated that social problem solving did account for significant variance in the prediction model of NSSI, above and beyond perfectionism. Moreover, on controlling for suicide risk, a possible confound for NSSI behaviors, social problem solving was found to account for an additional 4.0 percent of unique variance in the prediction of NSSI, beyond that accounted for by perfectionism. The present findings have theoretical implications for the literature on perfectionism and social problem solving, specifically in relation to NSSI. In addition, the present findings have practical implications for social workers who work with college students engaging in NSSI behaviors.

Supplemental Material for Model Complexity Improves the Prediction of Nonsuicidal Self-Injury

Supplemental Material for Model Complexity Improves the Prediction of Nonsuicidal Self-Injury

Body image as a predictor of nonsuicidal self-injury in women: A longitudinal study

ObjectivesTo determine whether Body Image Dissatisfaction (BID) predicted NonSuicidal Self-Injury (NSSI) cross-sectionally and longitudinally, independent of comorbidity between NSSI and Disordered Eating (DE). Another aim was to determine whether BID could predict number of NSSI methods present. MethodAdult females completed measures of NSSI and DE (n = 283); and a longitudinal sample (n = 106) completed these measures again one year later. ResultsBID was a small yet significant predictor of NSSI both cross-sectionally and longitudinally. Poorer BID significantly explained a greater number of NSSI methods cross-sectionally and longitudinally. ConclusionsBID explains unique variance in NSSI (including increased number of methods), and is not a function of comorbidity with DE. This has the potential to influence theory, as well as inform early intervention initiatives for BID in females. Further research is required to determine other variables implicated in this relationship, as well as whether these findings are applicable to other groups such as adolescents and males.

Respiratory sinus arrhythmia and adaptive emotion regulation as predictors of nonsuicidal self-injury in young adults.

Research suggests that both respiratory sinus arrhythmia (RSA) and emotion regulation are related to maladaptive outcomes. However, little is known about how these factors jointly contribute to nonsuicidal self-injury (NSSI). We examined how resting RSA and RSA withdrawal to stress predicted NSSI among young adults, and whether adaptive emotion regulation strategies moderated this effect. We examined this relation in a sample of 70 young adults (Mage = 19.25, SDage = 0.92, 94% female), 35 with a recent history of NSSI and 35 who had never engaged in NSSI. Participants completed a baseline questionnaire and lab visit where physiological responses to a social stressor were collected. Results indicated that resting RSA did not predict recent NSSI engagement. However, greater RSA withdrawal to social stress significantly predicted recent NSSI (β = 1.35 [0.57], Wald χ2 = 5.52 p = 0.02). Further, problem-solving moderated the relation between RSA withdrawal and recent NSSI such that individuals with greater levels of RSA withdrawal were significantly more likely to engage in NSSI if they also reported low problem-solving (β = -1.44 [0.64], Wald χ2 = 5.16, p = 0.02). In contrast, the effect of greater RSA withdrawal on NSSI was buffered by high problem-solving. Cognitive reappraisal did not moderate the relation between RSA withdrawal and NSSI. These findings suggest that problem-solving may be an important moderator in the relation between physiological reactivity and NSSI. Interventions should help clients with poor self-regulation develop adaptive problem-solving strategies.

Borderline Personality Disorder: Associations Between Dimensional Personality Profiles and Self-Destructive Behaviors.

Ongoing research is shifting towards a dimensional understanding of borderline personality disorder (BPD). Aim of this study was to identify personality profiles in BPD that are predictive of self-destructive behaviors. Personality traits were assessed (n = 130) according to the five-factor model of personality (i.e., Neuroticism, Extraversion, Openness to Experience, Agreeableness, Conscientiousness) and an additional factor called Risk Preference. Self-destructive behavior parameters such as non-suicidal self-injury (NSSI) and other borderline typical dyscontrolled behaviors (e.g., drug abuse) were assessed by self-report measures. Canonical correlation analyses demonstrated that Neuroticism, Extraversion, and Conscientiousness are predictors of NSSI. Further, Neuroticism, Agreeableness, and Risk Preference were associated with dyscontrolled behaviors. Our results add further support on personality-relevant self-destructive behaviors in BPD. A combined diagnostic assessment could offer clinically meaningful insights about the causes of self-destruction in BPD to expand current therapeutic repertoires.