Self-harm Behaviors Research Articles

Self-harm in sexually abused adolescents: The role of posttraumatic symptoms, emotional impulsivity, and negative cognition.

Posttraumatic symptoms, emotional impulsivity, and negative cognition have been proposed as pathways in explaining why individuals have experienced trauma are at increased risk for self-harm. The present study examined whether emotional impulsivity (i.e., negative and positive urgency) and negative cognition (i.e., personal attribution and feeling different from peers) mediate the path from posttraumatic symptoms to self-harm in sexually abused adolescents, a population at the highest risk for self-harm. One hundred and thirty-one sexually abused youths aged 10-18 years in South Korea completed the Self-Harm Inventory, UPPS-P (urgency-premeditation-perseverance-sensation seeking-positive urgency) Impulsive Behaviors Scales for use with children, and Children's Attribution and Perception Scale, and their parents completed the Korean version of the parent report of posttraumatic symptoms. Among the adolescent participants, 77.1% (n = 101) reported engaging in at least one self-harm behavior, and 61.8% (n = 81) reported engaging in deliberate self-injury. Mediation model analyses showed that parent-reported posttraumatic symptoms predicted more self-harm behaviors among sexually abused adolescents. The indirect effect of parent-reported posttraumatic symptoms on self-harm through adolescents' negative cognition was significant, but the indirect effect through emotional impulsivity was not. The results indicate that, at least among sexually abused adolescents, posttraumatic symptoms lead to self-harm via negative cognition rather than increased emotional impulsivity. These findings suggest that sexually abused adolescents suffering from posttraumatic symptoms are more likely to engage in self-harm in response to negative cognition of themselves and the world rather than as an impulsive response to intense emotions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Is a smartphone application (BlueIce) acceptable and safe for university students who self-harm: an open study

BackgroundMany university students self-harm but few receive support. Smartphone apps have been identified as acceptable sources of support for students who self-harm, but the use of supportive self-harm apps is...

Attention deficit hyperactivity disorder in adults : prevalence and association with addictive disorders

Introduction Attention deficit hyperactivity disorder (ADHD) is a neurobehavioral disorder witch assumed to be a disorder of childhoood but recently has been shown to persist into adulthood. As in children, core features of adult ADHD include inattention, impulsivity, and/or hyperactivity.Despite growing interest in adult ADHD, little is known about its prevalence or correlates.ObjectivesWe aimed to estimate the prevalence of ADHD in adult outpatient psychiatric care at the university hospital of Gabes (southern Tunisia) and to explore its association with addictive disorders.MethodsWe conducted a cross-sectional, descriptive, and analytical observation study,in the outpatient psychiatry department of the Gabes university hospital, during the period ranging from 1/1/2023 to 30/06/2023. We used an anonymous pre-established information sheet exploring the socio-demographic, clinical, therapeutic data of the patients, lifestyle habits and substance use, the DSM-5 to classify diagnoses, CGI-S to rate the severity of overall mental illness, Fagerström test to assess the nicotine dependence, Adult ADHD Self-Report Scale (ASRS) in its validated Arabic version to screen ADHD and the Diagnostic Interview for ADHD in Adults (DIVA) to confirm the ADHD diagnosis. Data entry and analysis were performed using Statistical Package for Social Sciences (SPSS) version 21.0.Results The response rate in our study was around 64.5%, 205 patients were included.The mean age of the patients was 48years ±14.9, the male/female ratio was 1.The estimated prevalence of adult ADHD according to the DIVA was 5.9% (male/female ratio=1/2). At the uni-variate study, significant associations were found between ADHD and the age category (p=0), the marital status (OR=0.14; CI [0.03- 0.55], p=0.003), theFagestrom score (p=0.01), cannabis consumption (OR=19; CI [1.8-201], p=0.018), psychotropic drugs consumption (OR=39; CI[3-196], p=0.02), self-harm behavior (OR=6.9, CI[1.9-26], p=0.01), excessive use of internet and screens (OR=38, CI[7-179],p=0). At the multivariate study, two determining factors were found: cannabis consumption(OR=8 [1- 58]; p=0.031), and the excessive use of internet and screens (OR=25 [4-144]; p=0).Conclusions Regarding our findings and the important prevalence of the adult ADHD,more efforts are needed to increase the detection and treatment of this disorder, in order to set up an early intervention before major impairments and complications become irreversible.Disclosure of InterestNone Declared

Revealing complexity: beyond the whole—segmentation of hippocampal subfields in adolescents with depression and its relationships with cognition

IntroductionThe occurrence of depression in adolescence, a critical period of brain development, linked with neuroanatomical and cognitive abnormalities. Neuroimaging studies have identified hippocampal abnormalities in those of adolescent patients. However, few studies have investigated the atypically developmental trends in hippocampal subfields in adolescents with depression and their relationships with cognitive dysfunctions.ObjectivesTo explore the structural abnormalities of hippocampal subfields in patients with youth depression and examine how these abnormalities associated with cognitive deficits.MethodsWe included a sample of 79 first-episode depressive patients (17 males, age = 15.54±1.83) and 71 healthy controls (23 males, age = 16.18±2.85). The severity of these adolescent patients was assessed by depression scale, suicidal risk and self-harm behavior. Nine cognitive tasks were used to evaluate memory, cognitive control and attention abilities for all participants. Bilateral hippocampus were segmented into 12 subfields with T1 and T2 weighted images using Freesurfer v6.0. A mixed analysis of variance was performed to assess the differences in subfields volumes between all patients and controls, and between patients with mild and severe depression. Finally, LASSO regression was conducted to explore the associations between hippocampal subfields and cognitive abnormalities in patients.ResultsWe found significant subfields atrophy in the CA1, CA2/3, CA4, dentate gyrus, hippocampal fissure, hippocampal tail and molecular layer subfields in patients. For those patients with severe depression, hippocampal subfields showed greater extensive atrophy than those in mild, particularly in CA1-4 subfields extending towards the subiculum. These results were similar across various severity assessments. Regression indicated that hippocampal subfields abnormalities had the strongest associations with memory dysfunction, and relatively week associations with cognitive control and attention. Notably, CA4 and dentate gyrus had the highest weights in the regression model.ConclusionsAs depressive severity increases, hippocampal subfield atrophy tends to spread from CA regions to surrounding areas, and primarily affects memory function in patients with youth depression. These results suggest hippocampus might be markers in progression of adolescent depression, offering new directions for early clinical intervention.Disclosure of InterestNone Declared

Enhancing Arabic offensive language detection with BERT-BiGRU model

With the advent of Web 2.0, various platforms and tools have been developed to allow internet users to express their opinions and thoughts on diverse topics and occurrences. Nevertheless, certain users misuse these platforms by sharing hateful and offensive speeches, which has a negative impact on the mental health of internet society. Thus, the detection of offensive language has become an active area of research in the field of natural language processing. Rapidly detecting offensive language on the internet and preventing it from spreading is of great practical significance in reducing cyberbullying and self-harm behaviors. Despite the crucial importance of this task, limited work has been done in this field for nonEnglish languages such as Arabic. Therefore, in this paper, we aim to improve the results of Arabic offensive language detection without the need for laborious preprocessing or feature engineering work. To achieve this, we combine the bidirectional encoder representations from transformers (BERT) model model with a bidirectional gated recurrent unit (BiGRU) layer to further enhance the extracted context and semantic features. The experiments were conducted on the Arabic dataset provided by the SemEval 2020 Task 12. The evaluation results show the effectiveness of our model compared to the baseline and related work models by achieving a macro F1- score of 93.16%.

Examining strength at home couples to prevent intimate partner violence on a military installation: A randomized controlled trial.

In this study, the effectiveness of a couples-based group intervention to prevent intimate partner violence (IPV), Strength at Home Couples (SAH-C), was examined on a military installation relative to a comparison intervention, Supportive Prevention (SP). It was expected that greater reductions in use of physical, psychological, and sexual IPV behaviors, as well as reduced suicidality, would be found among service members and their partners in SAH-C relative to SP. Participants included 138 couples randomized to SAH-C and SP through a clinical controlled trial embedded in a hybrid effectiveness implementation study which took place on a military installation. The Revised Conflict Tactics Scales and Multidimensional Measure of Emotional Abuse were used to measure IPV, and 13 Military Suicide Research Consortium common data elements were used to assess suicidality. Service members randomized to SAH-C evidenced greater reductions based on effect sizes across the assessment time points for all IPV variables, including use of overall physical IPV, severe physical IPV, sexual IPV, psychological IPV, and coercive control IPV relative to those randomized to SP. Partners of service members demonstrated a similar general pattern for reductions in use of IPV, but findings were not as robust as for service members. Both service members and partners demonstrated greater reductions in suicidality based on effect sizes when randomized to SAH-C relative to SP. Findings extend prior work demonstrating the promising effects of SAH-C delivered in the military context and highlight the possible benefits of SAH-C in preventing self-harm thoughts and behaviors. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The relationship between non-suicidal self-injury and suicidal ideation in patients with borderline personality disorder treated at the Arrazi psychiatric hospital in Salé

IntroductionNon-suicidal self-harm, i.e. the intentional self-infliction of bodily harm without apparent suicidal intent, is a powerful risk factor for suicidal ideation and behavior [1]. Although non-suicidal self-harm and suicidal behaviour are distinct concepts, the two forms of deliberate self-harm frequently coexist and share key instrumental functions, such as escaping aversive internal states, reducing dysphoria or communicating distress, especially in patients with personality disorders. [2]Some individuals also report using non-suicidal self-harm to ameliorate suicidal thoughts or urges [2].ObjectivesTo assess the relationship between non-suicidal self-harm and suicidal ideation in patients with borderline personality disorder followed at the Arrazi psychiatric hospital in Salé.MethodsThis was a descriptive cross-sectional study using a questionnaire including sociodemographic criteria, clinical criteria and the Beck suicidal intentionality scale to assess the relationship between non-suicidal self-harm and suicidal ideation in patients with borderline personality disorder followed and hospitalised at the Arrazi psychiatric hospital in Salé.The inclusion criteria were as follows: both sexes with a diagnosis of borderline personality disorder according to DSM 5 criteria.Exclusion criteria were current psychosis and severe intellectual disability.ResultsWe collect 63 participants.The average age of the participants was 23, and they were predominantly female (89%). About 85% were single and 97% had no occupation. The majority of participants had a substance use disorder.All participants had a history of non-suicidal self-harm and 36% had a history of suicide attempts.Suicidal intent was strong in 45% of participants who had already attempted suicide.Approximately 46% of participants reported that non-suicidal self-harm was intended to alleviate suicidal ideation and approximately 27% of participants reported having experienced suicidal ideation shortly after non-suicidal self-harm.Conclusions Non-suicidal self-harm is very common in patients with borderline personality disorder often considered to have a mitigating effect on the internal stress of these patients and sometimes even neglected. The relationship between non-suicidal self-harm and suicidal ideation is an important one, and may reduce suicidal ideation in the short term but subsequently encourage further self-harm, thereby increasing the risk of suicide.Particular attention must be paid to these patients and their self-harm, and specialised, comprehensive care is required.Disclosure of InterestNone Declared

Narcissistic predispositions of self-harm in young women with and without depression

Introduction Diagnostic criteria for narcissistic personality disorder primarily focus on grandiosity and significance. In psychotherapeutic work, it is important to distinguish two subtypes of pathological narcissism: narcissistic grandiosity and narcissistic vulnerability. One of the manifestations of narcissistic traits is unstable or unformed self-esteem, manifested in attempts to conform to ideals. A part of modern society perceives the female body as an object that “needs to be looked at”. Self-objectification refers to a learned pattern of self-assessment of the importance of one’s body and appearance compared to other aspects of the self. Self-observation and comparison of oneself with others is one of the manifestations of self-objectification. With acts of auto aggression, the body becomes a tool or a means to solve psychological problems. In order for this to become possible, the ability to objectify your body “to look at it from the outside” plays an important role.ObjectivesAnalysis of the relationship between non-suicidal self-injurious behavior and narcissistic personality traits in young women with depression and young women without a psychiatric diagnosis.MethodsТhe study included 49 women divided into two groups. The first group included 24 patients with depression undergoing inpatient treatment (mean age 18.4). The second group included 25 healthy subjects (mean age 18 years). The methods: The answer to the question “Sometimes I purposely injure myself” was used as an indicator of self-harm (NSSI) (five-point Likert scale); “Ich structure test” (ISTA); “Physical Appearance Comparison Scale-Revised” (PACS-R).Results In the clinical group, a significant association of severity of NSSI with indicators of “deficit narcissism” was revealed (Spearman r=,534*). Correlations were found between the severity of NSSI and PACS-R (r=,344**). In the clinical group, there was no connection between “Comparison with others” and narcissistic traits. In a group of healthy subjects, significant associations of NSSI severity with “destructive narcissism” (,572**) and PACS-R (,576**) were revealed. In the clinical group, the severity of NSSI is associated with a more serious pathology - the lack of formation of “normal” narcissism, and in the healthy group it is more likely to be deformed narcissism. Self-objectification and comparison of oneself with others in the clinical group is not associated with manifestations of narcissistic traits, such connections are demonstrated in the group of healthy young women.ConclusionsIt is shown that in the clinical group of depressed young women, the severity of self-harming behavior is associated with “deficit narcissism”, and in healthy young women, first of all, with “destructive narcissism” with an increased need to compare themselves with others.Disclosure of InterestNone Declared

Pharmacotherapy and psychotherapy interventions in patients with borderline personality disorder in outpatient clinical practice

IntroductionDespite the high prevalence of borderline personality disorder (BPD) in the population, the evidence regarding approaches to therapy for BPD is inconsistent. No psychopharmacological medications are approved for the treatment of BPD, yet most patients with BPD are treated with pharmacotherapy. Meanwhile, psychotherapy is the method of choice for the treatment of BPD. Little is known about the clinical practice of BPD treatment in Russia, since most studies have been conducted in Western countries.ObjectivesThe aim of the study: analysis of approaches to treatment of BPD in real outpatient clinical practice in Saint-Petersburg, Russia.MethodsFifty patients (72% female; n=36; mean age 22.4±4.3) who were treated in an outpatient community care were included in the study. Diagnosis was made according to the ICD-10 criteria (F60.31), as it does in clinical practice in Russia. Research methods included a clinical-catamnestic method.ResultsAll examined patients received pharmacotherapy. Twenty-four patients (48.0%) received monotherapy with a selective serotonin reuptake inhibitor antidepressant. The remaining patients (52.0%) received two or more psychotropic medications simultaneously. The most frequent combination of psychopharmacotherapeutic agents was a combination of an antidepressant and a mood stabilizer. Analysis of therapy revealed that antipsychotics (always of the second generation) as well as mood stabilizers were prescribed to target emotional instability and impulsivity as symptoms of BPD, as well as increased self-harming behavior in order to reduce impulsivity. Despite the assumption that the simultaneous prescription of several medications to patients with BPD was due to the presence of a comorbid psychiatric diagnosis, this was not confirmed (p>0.05). Most of the patients (n=42; 84.0%) received individual and group psychotherapy (cognitive-behavioral with elements of dialectical-behavioral therapy). It was found that patients who received psychotherapy had a faster response to pharmacotherapy (p<0.05).ConclusionsAn analysis of approaches to the treatment of BPD in outpatient clinical practice in Saint-Petersburg, Russia, showed a predominance of medication-assisted psychopharmacotherapy (selective serotonin reuptake inhibitors, antipsychotics, mood stabilizers) over the frequency of prescription of psychotherapeutic care. In none of the cases was a first-line psychotherapy method (with proven efficacy for BPD) used. An assessment of the availability of psychotherapeutic care for patients with BPD is required. An earlier initiation of psychotherapeutic care after the BPD diagnosis is recommended, which may lead to an increase in the effectiveness of psychiatric care for patients with BPD in outpatient clinical practice.Disclosure of InterestNone Declared

The Epidemic of Non-Suicidal Self-Harm in Adolescents and Young Adults in the Kyrgyz Republic

Introduction During the last two years, many young people and adolescents in the Kyrgyz Republic started to visit specialists due to Non-suicidal self-harm. A significant rise in the amount of such cases allowed specialists from the Republican Center of Psychiatry in Bishkek to think about an “epidemic “of self-harming behavior. Non-suicidal self-harm (NSSH) is defined as repeated, deliberate, direct injury to the body without suicidal intent that is not socially acceptable (Nixon et al., 2002) to reduce psychological discomfort in the absence of a conscious intention to take one’s life (ICD-10 codes X60-X84, and ICD-11 codes PB80-PD3Z).ObjectivesTo determine the causes of NSSH among adolescents and young adults who approached specialists in mental health sphere at Institute of Behavioral Health at the American University of Central Asia.MethodsOver two years, forty-five adolescents and young adults under twenty-five who had committed self-harm visited specialists from the Behavioral Health Institute at the American University of Central Asia.All the patients received either dialectical behavioral treatment or cognitive processing treatment, medication (paroxetine) was used in three cases.ResultsThirty patients were girls under twenty-one, and fifteen were boys and young male adults. The overwhelming majority (40 people) had self-inflicted cuts, two had imposed burns with matches and cigarettes, and one had used self-suffocation without a bond. Reasons for self-harm were the following: releasing internal tension and anxiety, getting some rest from intrusive thoughts, relieving the inner pain, and a desire to “feel as a whole person.” All the patients underlined that they did not want to attract attention from their family members; moreover, they tried to hide the consequences of self-harm. Teens and young adults (twelve patients) from Kyrgyz traditional families visited a consultant or psychiatrist after a long drive through conventional or religious healers. All of the patients knew that they were addicted to self-harm, wanted to stop a problematic behavior, and could not stop it on their own. Ten patients have been diagnosed with borderline personality disorder. Two of them also had eating disorders. Five patients had PTSD, and five had social phobia. The others had recognizable anxiety symptoms.ConclusionsThe enormous rise of non-suicidal self-harm is a phenomenon that needs further research. Those cases often resist treatment due to the “addictive” component in the pathogenesis.Disclosure of InterestNone Declared

비자살적 자해행동 청소년의 푸드아트테라피 사례

This study is a case study of the forgiveness experience of food art therapy foradolescents with non-suicidal self-injurious behavior. We would like to examine changesin whether adolescents with non-suicidal self-injurious behavior can reduce or stop theirself-injurious behavior by resolving internalized anger and experiencing forgiveness. Thesubjects of the study were four male students from J High School in K City, and a total of16 sessions were conducted from April to August 2023. Food Art Therapy is a study thatexamined the experience of forgiveness and the effects of growth in adolescents withnon-suicidal self-injurious behavior. Food art therapy had an impact on reducingself-harm behavior by increasing the level of forgiveness experience in adolescents withnon-suicidal self-harm behavior. Therefore, it will be possible to understand theself-harming behavior factors of adolescents with non-suicidal self-harming behavior anduse food art therapy to find ways to prevent adolescent self-harming behavior.

Borderline Bireylerde Kendine Zarar Verme Davranışı ve İntihar Girişimine Yönelik Psikolojik Müdahaleler: Sistematik Derleme

Self-harm behaviour and suicide attempts are considered maladaptive coping mechanisms by individuals with a diagnosis of borderline personality disorder (BPD). Numerous studies have demonstrated that individuals with BPD are at a heightened risk for self-harm behaviour and suicide. Therefore, there is a need for intervention efforts aimed at reducing self-harm and suicide attempts in this population by promoting more functional coping strategies. No systematic review has been conducted to explore the effectiveness of such interventions. A systematic review was performed to identify randomized controlled trials of interventions to reduce self-harm and suicide attempts among individuals with BPD, published between 2012 and 2022. PsycARTICLES, PubMed, Web of Science, Science Direct, and Taylor & Francis databases were examined in the review. A total of 6,760 studies were initially screened, only 13 were selected for review based on the inclusion and exclusion criteria. The results indicated that the standard dialectical behaviour therapy protocol, with the addition of psychological intervention components such as skills training, exposure and acceptance, statistically significantly increased recovery. Statistically significant results have been obtained from various psychotherapeutic intervention groups such as schema therapy, cognitive behavioural therapy and emotion regulation therapy However, it was noted that existing protocols might be inadequate in preventing relapse and addressing potential negative outcomes such as premature termination of therapy.

Positive psychotic symptoms as a marker of clinical severity in a transdiagnostic sample of help-seeking adolescents.

The present study aimed to examine the association between the presence, number, and type of positive psychotic symptoms (PPS) and clinical severity in adolescent patients. Five hundred-six patients aged 11-17years were assigned to either the noPPS (n = 341), the delusional beliefs only (del; n = 32), the hallucinations only (hall; n = 80), or the delusional beliefs and hallucinations (del&hall; n = 53) group. Generalized Structural Equation Modeling was applied to identify the best-fitting model representing clinical severity indicated by psychiatric diagnoses, depressivity, personality pathology, non-suicidal self-injury, suicide attempts, perceived stress, and psychosocial impairments, assessed by interviews and questionnaires. The groups were compared concerning the final model's factors. The final model consisted of three factors representing psychopathology and functional impairments, self-harming behavior, and perceived stress (BIC difference to reference model: 103.99). Participants with any PPS scored higher on all factors than the noPPS group (differences in SD: 0.49-1.48). Additionally, the del&hall group scored 1.31 SD higher on psychopathology and functional impairments than the hall group, and 1.16 SD higher on self-harming behavior compared to the del group. Finally, the hall group scored 0.84 SD higher on self-harming behavior than the del group, with no group differences in the other factors. In adolescent patients, the presence of PPS may represent a marker for a more severe form of mental disorder, with hallucinations being indicative of self-harming behavior. Early transdiagnostic assessment of PPS seems indicated as it may inform treatment in the context of clinical staging.

The Journey of Engaging With Web-Based Self-Harm and Suicide Content: Longitudinal Qualitative Study.

Self-harm and suicide are major public health concerns worldwide, with attention focused on the web environment as a helpful or harmful influence. Longitudinal research on self-harm and suicide-related internet use is limited, highlighting a paucity of evidence on long-term patterns and effects of engaging with such content. This study explores the experiences of people engaging with self-harm or suicide content over a 6-month period. This study used qualitative and digital ethnographic methods longitudinally, including one-to-one interviews at 3 time points to explore individual narratives. A trajectory analysis approach involving 4 steps was used to interpret the data. The findings from 14 participants established the web-based journey of people who engage with self-harm or suicide content. In total, 5 themes were identified: initial interactions with self-harm or suicide content, changes in what self-harm or suicide content people engage with and where, changes in experiences of self-harm or suicide behaviors associated with web-based self-harm or suicide content engagement, the disengagement-reengagement cycle, and future perspectives on web-based self-harm or suicide content engagement. Initial engagements were driven by participants seeking help, often when offline support had been unavailable. Some participants' exposure to self-harm and suicide content led to their own self-harm and suicide behaviors, with varying patterns of change over time. Notably, disengagement from web-based self-harm and suicide spaces served as a protective measure for all participants, but the pull of familiar content resulted in only brief periods of disconnection. Participants also expressed future intentions to continue returning to these self-harm and suicide web-based spaces, acknowledging the nonlinear nature of their own recovery journey and aiming to support others in the community. Within the themes identified in this study, narratives revealed that participants' behavior was shaped by cognitive flexibility and rigidity, metacognitive abilities, and digital expertise. Opportunities for behavior change arose during periods of cognitive flexibility prompted by life events, stressors, and shifts in mental health. Participants sought diverse and potentially harmful content during challenging times but moved toward recovery-oriented engagements in positive circumstances. Metacognitive and digital efficacy skills also played a pivotal role in participants' control of web-based interactions, enabling more effective management of content or platforms or sites that posed potential harms. This study demonstrated the complexity of web-based interactions, with beneficial and harmful content intertwined. Participants who demonstrated metacognition and digital efficacy had better control over web-based engagements. Some attributed these skills to study processes, including taking part in reflective diaries, showing the potential of upskilling users. This study also highlighted how participants remained vulnerable by engaging with familiar web-based spaces, emphasizing the responsibility of web-based industry leaders to develop tools that empower users to enhance their web-based safety.

Translating Suicide Safety Planning Components Into the Design of mHealth App Features: Systematic Review.

Suicide safety planning is an evidence-based approach used to help individuals identify strategies to keep themselves safe during a mental health crisis. This study systematically reviewed the literature focused on mobile health (mHealth) suicide safety planning apps. This study aims to evaluate the extent to which apps integrated components of the safety planning intervention (SPI), and if so, how these safety planning components were integrated into the design-based features of the apps. Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, we systematically analyzed 14 peer-reviewed studies specific to mHealth apps for suicide safety planning. We conducted an analysis of the literature to evaluate how the apps incorporated SPI components and examined similarities and differences among the apps by conducting a comparative analysis of app features. An independent review of SPI components and app features was conducted by downloading the available apps. Most of the mHealth apps (5/7, 71%) integrated SPI components and provided customizable features that expanded upon traditional paper-based safety planning processes. App design features were categorized into 5 themes, including interactive features, individualized user experiences, interface design, guidance and training, and privacy and sharing. All apps included access to community supports and revisable safety plans. Fewer mHealth apps (3/7, 43%) included interactive features, such as associating coping strategies with specific stressors. Most studies (10/14, 71%) examined the usability, feasibility, and acceptability of the safety planning mHealth apps. Usability findings were generally positive, as users often found these apps easy to use and visually appealing. In terms of feasibility, users preferred using mHealth apps during times of crisis, but the continuous use of the apps outside of crisis situations received less support. Few studies (4/14, 29%) examined the effectiveness of mHealth apps for suicide-related outcomes. Positive shifts in attitudes and desire to live, improved coping strategies, enhanced emotional stability, and a decrease in suicidal thoughts or self-harm behaviors were examined in these studies. Our study highlights the need for researchers, clinicians, and app designers to continue to work together to align evidence-based research on mHealth suicide safety planning apps with lessons learned for how to best deliver these technologies to end users. Our review brings to light mHealth suicide safety planning strategies needing further development and testing, such as lethal means guidance, collaborative safety planning, and the opportunity to embed more interactive features that leverage the advanced capabilities of technology to improve client outcomes as well as foster sustained user engagement beyond a crisis. Although preliminary evidence shows that these apps may help to mitigate suicide risk, clinical trials with larger sample sizes and more robust research designs are needed to validate their efficacy before the widespread adoption and use.

Exploring the impact of trauma-adapted yoga in forensic psychiatry

The specialized field of forensic psychiatry deals with the care of criminal offenders who suffer from severe mental disorders. As this field is positioned at the intersection of illness, crime, and security, it poses complex challenges. While high-quality clinical studies in forensic psychiatry settings are limited, recent investigations have suggested yoga as a complementary clinical tool within correctional environments. This report of a quasi-experimental study examines the impact of a 10-week trauma-adapted yoga intervention on mental health, antisocial and aggressive behaviors, pain perception, cravings, and character maturity among 56 patients in various forensic psychiatry clinics across Sweden. In the current study, the yoga group demonstrated noteworthy reductions in negative affect states, anxiety, phobic anxiety, paranoid ideations, interpersonal sensitivity, hostility, and overall psychological distress. These reductions were not observed in the comparison group. Additionally, the yoga group exhibited a significant decrease in pain frequency and strengthened self-directedness. However, there were no significant changes in aggressive, antisocial, or self-harm behaviors or cravings in either group. The between-group analyses did not yield significant results, except for pain intensity. The trauma-adapted yoga intervention implemented within forensic psychiatry settings shows feasibility and results in multiple positive changes in patients’ health.

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.

Can Cognitive Behavioral Therapy be Effective for Social Anxiety Disorder with Dissociative and Self-Harm Behaviors in a 15-Year-Old Adolescent?

Can Cognitive Behavioral Therapy be Effective for Social Anxiety Disorder with Dissociative and Self-Harm Behaviors in a 15-Year-Old Adolescent?

"I can't escape my scars, even if I do get better": A qualitative exploration of how adolescents talk about their self-harm and self-harm scars during cognitive behavioural therapy for depression.

Emerging evidence indicates that perceptions of self-harm behaviours and self-harm scars may thwart recovery from depression, yet limited research has explored adolescent accounts of their self-harm and scars during therapy. This study sought to explore how adolescents describe their self-harm behaviours and scars during Cognitive Behavioural Therapy (CBT) and explore the sociocultural discourses that may influence these descriptions. The participants were six female adolescents (aged 14-17years old) with clinical depression, who were engaging in self-harm. All participants accessed CBT as part of clinical trial evaluating three psychological treatments for major depressive disorder in Child and Adolescent Mental Health Services. Audio-taped CBT sessions were analyzed using discourse analysis. Within CBT sessions, adolescents drew upon stigma discourses in talking about their self-harm. Adolescent also described their self-harm scars as shameful and stigmatizing, and as "proof" of the legitimacy of their depression. It is important for CBT practitioners to understand the context of sociocultural discourses around self-harm behaviours and self-harm scars, which are reflected in how adolescents with depression describe these within therapy and may serve to maintain distress. The study indicates that awareness of use of language and intersecting sociocultural discourses can inform CBT practice.

Self-Harming Behaviors and Psychopathy Traits in Abused Children

This study aimed to explore child abuse and neglect in relation to psychopathy and self-harming behaviors. A cross-sectional correlational research design was used to carry out the research. A sample of 100 children (50 boys & 50 girls) was selected at age ranging from 12-18 years through purposive sampling. The data was collected from two NGOs in Lahore through purposive sampling. An adapted and translated Child Abuse Screening Tool was used to identify children with different levels and types of abuse and neglect. Urdu version of the Youth Psychopathy Inventory was used to find out psychopathy traits. The deliberate Self-Harm Inventory was translated into Urdu for the purpose of assessing self-harm behavior in participants along with a demographic questionnaire. Pearson product-moment correlation showed there was no significant relationship between psychopathy and child abuse. It was identified that there were no significant gender differences between psychopathy traits and self-harming behaviors in abused children. The current study is significant because it addresses the pressing public issue prevailing in the country day by day, and it has a negative impact on the victim’s survival. The findings revealed that child abuse leads victims towards self-harm and can develop psychopathic traits. On the basis of results, further study is needed to be conducted on these variables, as self-harm was more reported in abused children as compared to psychopathic traits. The variables used in this study needed to be addressed broadly to evaluate the clear impact of abuse in this study, the limitation was the availability of limited data due to the sensitivity of the topic or legal issues that could be addressed in future studies.