Sporadic and recurrent non-suicidal self-injury before age 14 and incident onset of psychiatric disorders by 17 years: prospective cohort study.

BACKGROUND: Non-suicidal self-injury (NSSI) is highly prevalent in adolescents and may be a behavioural marker for emergent mental illnesses. Aims To determine whether sporadic or recurrent NSSI up to the age of 14 years predicted increased risk of new onset of psychiatric disorder in the subsequent 3 years, independent of psychiatric symptoms and social risk factors. METHOD: In total, 945 individuals aged 14 years with no past/present history of mental illness completed a clinical interview and completed a questionnaire about NSSI at the ages of 14 and 17 years. RESULTS: Recurrent NSSI at baseline predicted total disorders, depression and eating disorders. Sporadic baseline NSSI predicted new onset of anxiety disorders only. CONCLUSIONS: NSSI (especially recurrent NSSI) in the early-adolescent years is a behavioural marker of newly emerging mental illnesses. Professionals should treat both recurrent and sporadic NSSI as important risk factors, and prevention strategies could be targeted at this vulnerable group. Declaration of interest None.

Age and gender effects on non-suicidal self-injury, and their interplay with psychological distress.

INTRODUCTION: NSSI (non-suicidal self-injury) is an important public health issue, with high prevalence and associations with future mental illness and suicide. To date, no large single study has tested age and gender effects on NSSI and their interplay with psychological distress. METHOD: NSSI and psychological distress were ascertained by questionnaire in a community study of 2368 young people aged 14-25; proportions at each age and of each gender were approximately equal. RESULTS: There was a significant quadratic interaction between age and gender on last month NSSI prevalence (p = 0.025): NSSI was more common in females ages 16-19, but there were no significant gender differences at younger/older ages. General distress partially mediated the effects of age and gender on NSSI. The association between general distress and NSSI was not significantly moderated by age, gender nor their interactions. CONCLUSIONS: Gender difference in NSSI is not a static gap, but evolves across time, widening in mid-adolescence and disappearing by early adulthood. Part of the reason for that gender gap being present at those ages is the increase levels of distress in young women at those ages. There was no evidence that the effects of general distress on NSSI differed by age/gender.

Dynamic-relational group treatment for perfectionism: Informant ratings of patient change.

Although now there is accumulating research on the effectiveness of psychotherapy for perfectionism, this research has been based almost exclusively on self-report data. In this article, we describe analyses from the University of British Columbia Perfectionism Treatment Study assessing close other informant ratings of change in perfectionism traits and perfectionistic self-presentation. A total of 61 close other informants of patients who participated in a 10-week dynamic-relational treatment for perfectionism completed measures of patient trait and self-presentational facets of perfectionism at pretreatment, at posttreatment, and at a 4-month follow-up. In support of the effectiveness of the treatment, we found that close other measures of patients' self-oriented perfectionism, other-oriented perfectionism, and all three facets of perfectionistic self-presentation were significantly reduced at posttreatment and follow-up. Close other measures of patients' socially prescribed perfectionism did not show change over the course of treatment and follow-up. The findings are discussed in terms of the effectiveness of the dynamic-relational treatment of perfectionism and the utility of extending research by including close other measures of change in treatment-outcome research. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Hopelessness Predicts Suicide Ideation But Not Attempts: A 10-Year Longitudinal Study.

Hopelessness is one of the most commonly cited risk factors for suicidal behaviors. However, several retrospective studies suggest that hopelessness, while strongly correlated with suicide ideation, does not distinguish attempters from ideators without attempts. This study is the first to utilize a prospective design to disambiguate the relationship of hopelessness to ideation versus attempts. Participants were 142 depressed patients followed up over 10 years. Hopelessness and suicidality (ideation and attempts) were assessed using validated questionnaires and structured interviews. Both retrospective and prospective analyses revealed that hopelessness was higher among those reporting any suicidality (ideation or attempts) compared with nonsuicidal individuals. However, hopelessness failed to meaningfully distinguish attempters from ideators in both retrospective and prospective analyses. Taken together with results from previous studies, our findings suggest hopelessness is best conceptualized as a risk factor for suicide ideation but not progression from ideation to attempts.

Recent advances in differentiating suicide attempters from suicide ideators.

PURPOSE OF REVIEW: This article summarizes findings from recent studies (published since 2015) examining differences between suicide attempters and suicide ideators. RECENT FINDINGS: Converging evidence suggests that the capability to attempt suicide (e.g., acquired capability, painful and provocative experiences, high tolerance for pain and distress) is higher in suicide attempters than suicide ideators. Other psychosocial and biological differences have also been identified but require replication. SUMMARY: Recent literature reviews find that traditional risk factors for suicide - such as depression, hopelessness, most psychiatric disorders, and even impulsivity - robustly predict suicide ideation but poorly predict suicide attempts among ideators. To address this knowledge gap, studies are increasingly employing an ideation-to-action framework. This framework views the development of suicide ideation and the progression from ideation to potentially lethal attempts as distinct processes with distinct explanations and predictors. Converging evidence suggests that factors associated with diminished fear of pain, injury, and death can increase one's capability to attempt suicide and facilitate the progression from suicidal thoughts to suicidal acts. Recent studies have also identified other variables that may differentiate attempters from ideators, but these require replication. Theories of suicide positioned within the ideation-to-action framework provide testable and promising hypotheses about the progression from ideation to attempts. These include the Interpersonal Theory, Integrated Motivational-Volitional Model, and Three-Step Theory.