Longitudinal Associations Between Nonsuicidal Self-Injury, Depressive Symptoms, Hopelessness, and Emotional Dysregulation in Adolescents.

Nonsuicidal self-injury (NSSI) in adolescents has been associated with increased depressive symptomatology, hopelessness, and emotional dysregulation; however, few studies have examined longitudinal associations between NSSI and these problems. This study examines the longitudinal relationships among these variables in community adolescents and whether the pattern of relationships varies between boys and girls. The participants were 785 adolescents (57.1% girls) aged 13 to 18 years (M = 15.64; SD = 1.08) who completed self-reported measures of NSSI, depression, hopelessness, and emotional dysregulation at least once at two moments separated by 1 year. The longitudinal model was tested through structural equation modeling and multiple group analysis. NSSI predicted increased depressive symptoms, hopelessness, and emotional dysregulation; depressive symptoms predicted NSSI; hopelessness predicted depressive symptoms; and emotional dysregulation predicted depressive symptoms and hopelessness. The pattern was similar for girls and boys, although girls scored higher on all variables. The results underscore the important bidirectional associations between NSSI and other risk factors throughout adolescence. These findings will support prevention and interventions for NSSI and internalizing symptoms in adolescents in school and clinical settings.

HighlightsSometime in the last year, 38.4% of the participating adolescents reported nonsuicidal self-injury (NSSI). The girls scored significantly higher than the boys in NSSI annual presence, depression, hopelessness, and emotional dysregulation.NSSI in the past year increased depressive symptoms, hopelessness, and emotional dysregulation 1 year later; depressive symptoms predicted NSSI; hopelessness predicted depressive symptoms, and emotional dysregulation predicted an increase in depressive symptoms and hopelessness.The predictive model did not differ according to gender.

Nonsuicidal Self-Injury Thoughts and Behavior in Adolescents: Validation of SITBI-NSSI.

BACKGROUND: The lack of knowledge about Nonsuicidal Self-Injury (NSSI) in Spanish adolescents, especially NSSI thoughts may be due to the paucity of NSSI assessment instruments with validity evidence in this sample. The aim of this study was to assess NSSI thoughts and behavior. In addition, the study examined the association between various NSSI features and suicidal behavior and included a preliminary validation of the new Self-Injurious Thoughts and Behaviors Interview - Non-Suicidal Self-Injury (SITBI-NSSI). METHOD: 685 Spanish adolescents between 13 and 18 years old (M = 15.58, SD = 1.08; 60.9% girls) completed measures of NSSI features and suicidal behavior. RESULTS: Among adolescents, 19% thought about self-injury, and 16.8% presented NSSI behaviors. The girls had higher levels of NSSI, as well as greater frequency, number of functions, methods, and suicidal thoughts and desire. Some of the functions, methods, and precipitants differed by sex. Those with ANS had a higher risk of suicidal behavior than the comparison group. The association of SITBI-NSSI with other measures supports the validity of the data. CONCLUSIONS: Most features of NSSI are similar to those found in Spanish and internationally. The SITBI-NSSI could facilitate the evaluation of NSSI in Spanish adolescents.

Nonsuicidal Self-Injury Thoughts and Behavior in Adolescents: Validation of SITBI-NSSI / Pensamientos y Conductas de Autolesión no Suicida en Adolescentes: Validación de la SITBI-NSSI

Background: The lack of knowledge about Nonsuicidal Self-Injury (NSSI) in Spanish adolescents, especially NSSI thoughts may be due to the paucity of NSSI assessment instruments with validity evidence in this sample. The aim of this study was to assess NSSI thoughts and behavior. In addition, the study examined the association between various NSSI features and suicidal behavior and included a preliminary validation of the new Self-Injurious Thoughts and Behaviors Interview - Non-Suicidal Self-Injury (SITBI-NSSI). Method: 685 Spanish adolescents between 13 and 18 years old (M = 15.58, SD = 1.08; 60.9% girls) completed measures of NSSI features and suicidal behavior. Results: Among adolescents, 19% thought about self-injury, and 16.8% presented NSSI behaviors. The girls had higher levels of NSSI, as well as greater frequency, number of functions, methods, and suicidal thoughts and desire. Some of the functions, methods, and precipitants differed by sex. Those with ANS had a higher risk of suicidal behavior than the comparison group. The association of SITBI-NSSI with other measures supports the validity of the data. Conclusions: Most features of NSSI are similar to those found in Spanish and internationally. The SITBI-NSSI could facilitate the evaluation of NSSI in Spanish adolescents.(AU)

Antecedentes: La falta de conocimiento sobre la autolesión no suicida (ANS) en adolescentes comunitarios españoles, especialmente los pensamientos ANS, puede deberse a la escasez de instrumentos de evaluación ANS con evidencias de validez. El objetivo del estudio fue evaluar los pensamientos y el comportamiento de ANS. Además, se examinó la asociación entre varias características de ANS y conducta suicida, y se llevó a cabo la validación preliminar de la nueva Entrevista de pensamientos y comportamientos autolesivos - Autolesión no suicida (SITBI-ANS). Método: 685 adolescentes españoles entre 13 y 18 años (M = 15.58, DT = 1.08; 60.9% chicas) completaron medidas de características ANS y conducta suicida. Resultados: El 16.8% presentó conductas ANS y el 19% lo pensó. Las chicas tuvieron mayor presencia de ANS, frecuencia, número de funciones, métodos, pensamientos y deseo suicida. Algunas de las funciones, métodos y precipitantes diferieron según el sexo. Aquellos con ANS tuvieron más riesgo de conducta suicida respecto al grupo de comparación. La asociación de SITBI-ANS con otras medidas apoya la validez de los datos obtenidos. Conclusiones: La mayoría de las características de ANS son similares a las encontradas en español e internacionalmente. SITBI-ANS facilitaría la evaluación de ANS en adolescentes españoles.(AU)

Autolesion no suicida: conceptualización y evaluación clínica en población hispanoparlante / Non-suicidal self-injury: conceptualization and clinical assessment in the spanish-speaking population

La Autolesión No Suicida (ANS) ha variado su conceptualización y evaluación a lo largo de los años. El conocimiento clínico sobre ANS depende de la evaluación y muestra investigada. Sin embargo, la mayoría de revisiones al respecto no cuentan con muestras hispanoparlantes. Este estudio trata de revisar el concepto y la evaluación clínica de ANS en población hispanoparlante desde un punto de vista comprensivo. Mediante revisión sistemática, incluyendo literatura gris, se encontraron 8 instrumentos validados en muestras hispanoparlantes. Se describen en cuanto a su desarrollo, formato, características que mide, aplicabilidad clínica y psicométricos. Siendo mayoría las adaptaciones en adolescentes comunitarios, destaca la creación y adaptación en mexicanos. Aunque con potencial clínico, no son instrumentos suficientemente probados en la intervención de la ANS. Finalmente se discute la evaluación de ANS hispanoparlante y sus posibles mejoras. (AU)

The conceptualization and assessment of non-suicidal self-injury (NSSI) has varied over the years. Clinical knowledge about NSSI depends on the evaluation and the sample investigated. However, the majority of the reviews on this subject do not have Spanish-speaking samples. This study aims to review the concept and clinical assessment of NSSI in the Spanish-speaking population from a comprehensive point of view. Through a systematic review, including the gray literature, 8 validated instruments were found in Spanish-speaking samples. These instruments are described in terms of their development, format, the characteristics that they measure, and their clinical and psychometric applicability. The majority are adaptations for community adolescents, and Mexicans stand out in terms of creation and adaptations. Although they have clinical potential, these instruments have not been sufficiently proven for NSSI intervention. Finally, Spanish-speaking NSSI evaluation and possible improvements are discussed. (AU)

Cyberbullying victimization and nonsuicidal self-injury in adolescents: The role of maladaptive schemas and dispositional mindfulness.

BACKGROUND: Previous research has found associations between cyberbullying victimization and nonsuicidal self-injury (NSSI) in adolescents. Exploration of the possible mediating variables involved is necessary to support intervention with victims. OBJECTIVE: This study examined whether depression and early maladaptive schemas (EMS) mediate the association between cyberbullying victimization and NSSI, along with the potential protective role of dispositional mindfulness. PARTICIPANTS AND SETTING: A total of 742 Spanish adolescents (50.20% girls) between 12 and 17 years old (M = 14.58; SD = 1.00) participated in the final sample. METHOD: Participants completed measures of cyberbullying victimization, NSSI, EMS, depression, and mindfulness facets. Mediational models moderated by facets of mindfulness were tested. RESULTS: Cyberbullying victimization was associated with NSSI through increased depression and EMS. Acting with awareness buffered the association between cyberbullying victimization and NSSI, whereas non-judging increased the association between cyberbullying victimization and depression. CONCLUSIONS: Cybervictimization is associated with NSSI. The mindfulness facet of acting with awareness plays a protector role. Interventions in NSSI and cyberbullying could benefit from these findings.

Clinical assessment of non-suicidal self-injury: A systematic review of instruments.

There has been an increase in the number of assessment instruments for non-suicidal self-injury (NSSI). However, previous reviews are inconsistent and do not provide a comprehensive psychometric assessment of the instruments. This study aimed to systematically assess and compare the psychometric properties of clinically relevant instruments to measure NSSI in any population. Through a systematic review guided by COSMIN and PRISMA, two searches were conducted in English and Spanish in February 2020 in 13 databases including grey literature. Of the 7,813 initial records, 152 validations were extracted. From these, 83 instruments (22 versions or adaptations) were excluded for not measuring NSSI, having no potential clinical utility or not including psychometric properties. Finally, 26 (22 versions, 35 adaptations and 19 creations) instruments measuring NSSI were included. Predominantly, the studies were North American self-reports in English for community adolescents, adaptations or versions emanating from a small number of instruments. Twenty-six indicators were categorized to assess NSSI. The most frequent instruments are structured interviews, and their indicators were related to NSSI function and topography. Evidence of validity and reliability was positive but limited. Despite the high number of instruments and diversity of evaluations, we found no instrument with sufficient evidence for clinical assessment. Findings broadly overview NSSI assessment instruments' current use and future improvement in clinical and research settings.