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1.
J Nerv Ment Dis ; 211(1): 5-10, 2023 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-36596286

RESUMO

ABSTRACT: Gatekeepers play a pivotal role in protecting individuals under their care and are central to keeping people safe and away from harm. In the field of nonsuicidal self-injury (NSSI), a range of gatekeepers exist, including those who protect access to vulnerable research participants, those who protect school children, those charged with making decisions about funding priorities, and those in charge of clinical care for people who self-injure. The aim of this commentary is to outline the roles these different gatekeepers have in protecting access to research participants, access to NSSI knowledge, and access to clinical care for individuals who self-injure. We provide examples in which gatekeepers may present barriers and offer solutions for how to work with gatekeepers for mutual benefit.


Assuntos
Comportamento Autodestrutivo , Criança , Humanos , Tomada de Decisões
2.
Rev. psicol. clín. niños adolesc ; 10(1): 53-67, Enero 2023. graf, tab
Artigo em Espanhol | IBECS | ID: ibc-214144

RESUMO

Los comportamientos autolesivos y suicidas en adolescentes, por su creciente prevalencia como por sus fatales consecuencias, son en nuestrosdías un problema de salud pública que requiere de intervenciones eficaces. Con el objetivo de dilucidar los tratamientos psicológicos que, hasta lafecha, mejor funcionan para reducir o eliminar estos comportamientos, se realizó una revisión de estudios de metaanálisis y revisiones sistemáticasen las bases de datos PsycArticles, PsycInfo y MEDLINE. Los criterios de elegibilidad establecidos permitieron la selección final de 10 registros.Los resultados mostraron una elevada heterogeneidad y un alcance limitado de los tratamientos psicológicos con tamaños del efecto de pequeñosa moderados tanto para las conductas autolesivas, como para la ideación suicida, la suicidabilidad y especialmente para la intención suicida. Estosefectos tendían a debilitarse o desaparecer en el medio y largo plazo. La Terapia Dialéctica Conductual (TDC) resultó ser comparativamente la quemejores resultados obtuvo de las intervenciones analizadas. El alcance restringido de los resultados y las importantes limitaciones metodológicashalladas alertan de la necesidad de más investigación, así como del futuro diseño de intervenciones específicas para este tipo de problemas. (AU)


Self-injurious and suicidal behaviors in adolescents are nowadays a public health problem that requires effective interventions. In order to elucidate the psychological treatments that, to date,work best to reduce or eliminate these behaviors, a review of meta-analysis and systematic reviews was carried out in the PsycArticles, PsycInfo andMEDLINE databases. The established eligibility criteria allowed the final selection of 10 records. The results showed high heterogeneity and poorresults for the psychological treatments with small to moderate effect sizes for self-injurious behaviors, suicidal ideation, suicidality and especiallyfor suicidal attempts. These effects tended to weaken or disappear in the medium to long term. Dialectical Behavior Therapy (DBT) proved to becomparatively the best performing of the interventions analyzed. The limited scope of the results and the important methodological limitations alertus to the need for further research and the future design of specific interventions for this type of problems. (AU)


Assuntos
Humanos , Adolescente , Psicoterapia/métodos , Psicoterapia/tendências , Comportamento Autodestrutivo/psicologia , Comportamento Autodestrutivo/terapia , Suicídio/psicologia , Adolescente , Literatura de Revisão como Assunto , Resultado do Tratamento
3.
BMJ Open ; 13(1): e066043, 2023 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-36631233

RESUMO

OBJECTIVES: Non-suicidal self-injury (NSSI) is a complex issue affecting Aboriginal and/or Torres Strait Islander Peoples in Australia. We evaluated the effects of an Aboriginal and Torres Strait Islander Mental Health First Aid (AMHFA) training course on assisting an Aboriginal and/or Torres Strait Islander person engaging in NSSI, including the effects on stigmatising attitudes, confidence in ability to assist, and intended and actual assisting actions. DESIGN: Uncontrolled trial with precourse and postcourse measurement (n=49) and 6-month follow-up (n=17). SETTING: Participants attended courses that were run in Queensland and Victorian communities and through one national organisation. PARTICIPANTS: Participants were 49 adults who worked directly with Aboriginal and/or Torres Strait Islander Peoples. INTERVENTION: The 5-hour 'Talking About Non-Suicidal Self-Injury' course was delivered by accredited AMHFA instructors and teaches people how to support an Aboriginal and/or Torres Strait Islander person who is engaging in NSSI. PRIMARY AND SECONDARY OUTCOME MEASURES: The outcome measures were stigmatising attitudes, confidence in ability to assist, and intended and actual actions to assist a person engaging in NSSI. RESULTS: Improvements were observed in stigmatising attitudes, with significant changes from precourse in both the 'weak-not-sick' (postcourse p<0.0623; follow-up p=0.0058) and 'dangerous/unpredictable' (postcourse p<0.0001; follow-up p=0.0036) subscales. Participants' confidence in ability to assist increased significantly both postcourse (p<0.0001) and at follow-up (p<0.0001). Despite a high level of endorsement for the nine recommended assisting actions at precourse, significant improvements (p<0.05) were observed in endorsement for six and four of the assisting actions postcourse and at follow-up, respectively. Course content was rated as being somewhat (3.4%), mostly (13.8%) or very (82.7%) culturally appropriate by participants who identified as Aboriginal and/or Torres Strait Islander. CONCLUSIONS: The results of this uncontrolled trial were encouraging, suggesting that the Talking About Non-Suicidal Self-Injury course was able to improve participants' attitudes, confidence and intended assisting actions.


Assuntos
Serviços de Saúde do Indígena , Comportamento Autodestrutivo , Adulto , Humanos , Saúde Mental , Primeiros Socorros/métodos , Seguimentos , Havaiano Nativo ou Outro Ilhéu do Pacífico/psicologia , Comportamento Autodestrutivo/terapia
4.
PLoS One ; 18(1): e0278446, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-36602997

RESUMO

There has been limited longitudinal investigation to date into the association between bullying, self-harm, and suicidality in Australia and the impact of specific demographic differences on this relationship. This is despite the continued rise in the incidence of bullying, self-harm, and suicide. As such, the current study draws on data from the Longitudinal Survey of Australian children (LSAC) to examine the association between bullying, self-harm, and suicidality and explore the impact of demographic differences across three bullying related behaviors (being bullied, bullying others and being both bullied and bullying others). The evidence indicates that bully-victims exhibit the highest risk of self-harm and suicidality in Australia. When considering demographic differences, it was identified that females and adolescents aged 16-17-years-of-age had the highest risk of self-harm and suicidality. Further, a direct curvilinear relationship between age and the categories of self-harm was identified with an inflection point around 16-17 years. The study supports the need for further investigation into the association between bullying, self-harm, and suicidality longitudinally with a particular focus on other moderators.


Assuntos
Bullying , Vítimas de Crime , Comportamento Autodestrutivo , Suicídio , Adolescente , Feminino , Humanos , Criança , Estudos de Coortes , Austrália/epidemiologia , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/etiologia
5.
BMC Psychiatry ; 23(1): 50, 2023 Jan 18.
Artigo em Inglês | MEDLINE | ID: mdl-36653769

RESUMO

BACKGROUND: Interpersonal problems are one of the factors for understanding the complex issues that result in suicide attempts and self-injury by poisoning. The quality of familial relationships is a predictor of the occurrence and outcome of suicide attempts. This study aimed to explore motives for self-poisoning suicide attempts amongst young adults. METHOD: This research was a qualitative study conducted using semi-structured interviews in 2019 in Kermanshah Province, Iran. Eighteen participants who had attempted suicide by self-poisoning were interviewed, and information was collected until data saturation was achieved. The interviews were recorded and transcribed, and the data were analyzed through content analysis. RESULTS: The results included the category of instability in emotional relationships with the three sub-categories of 1- Emotional failure, 2- Emotional trauma, and 3- Loss of emotional resilience (caused by emotional failure and emotional trauma within the previous few months). Instability in emotional relationships creates feelings of disgrace, humiliation, burdensomeness, worthlessness, and insignificance, which increases the chances of attempting suicide. CONCLUSION: The study results provided an in-depth understanding of romantic, and unstable familial relationships as a significant factor in suicide attempts, demonstrating the role of emotional stress in attempting suicide. The present study provided information on the risk factors and warning signs for psychiatrists and nurses dealing with suicidal patients to take effective measures to prevent suicide through social support.


Assuntos
Comportamento Autodestrutivo , Tentativa de Suicídio , Adulto Jovem , Humanos , Adolescente , Tentativa de Suicídio/psicologia , Comportamento Autodestrutivo/psicologia , Ideação Suicida , Fatores de Risco , Emoções
6.
Int J Geriatr Psychiatry ; 38(1): e5876, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36655812

RESUMO

OBJECTIVES: Self-harm and suicide are closely related in older adults, highlighting the opportunity for Aftercare interventions in targeted suicide prevention. The study aims were to explore strengths and shortfalls of current Aftercare services for older adults from the perspective of key stakeholders and researchers; and inform a set of guiding principles for older persons' Aftercare. METHODS: Semi-structured interviews were undertaken with a convenience sample of older people with lived experience of self-harm, clinicians and suicide researchers (n = 22). Interviews were focussed on current practice (strengths and limitations), potential improvements, and identifying the core components of an acceptable Aftercare model. Interviews were audio-recorded, transcribed and subjected to a reflexive thematic analysis grounded in interpretive description. RESULTS: Current practice strengths included validation, a person-centred approach and optimising aftercare delivery. Limitations included ageism, practical limitations (lack of service awareness, fragmented service provision, barriers to access, and traumatising approaches), and limited services, funding and training. Overarching themes included anti-ageism; anti-stigma; empowerment and agency; conveying hope; patience and pace; accessible; and finding purpose: connections and meaningful activity. CONCLUSIONS: Older people who have self-harmed have complex, individualised needs. They sit within intersecting systems traversing healthcare, support services, family, and the social environment. Systemic, coordinated Aftercare founded upon core principles of anti-ageism, anti-stigma, partnership, empowerment, accessibility and provision of connections and meaning are needed.


Assuntos
Comportamento Autodestrutivo , Suicídio , Humanos , Idoso , Idoso de 80 Anos ou mais , Assistência ao Convalescente , Comportamento Autodestrutivo/prevenção & controle , Pesquisa Qualitativa
7.
Artigo em Inglês | MEDLINE | ID: mdl-36674021

RESUMO

Suicide is a major public health issue and a leading cause of death among children and young people (CYP) worldwide. There is strong evidence linking adverse childhood experiences (ACEs) to an increased risk of suicidal behaviours in adults, but there is limited understanding regarding ACEs and suicidal crises in CYP. This study aims to examine the ACEs associated with CYP presenting at Emergency Departments for suicidal crises, and specifically the factors associated with repeat attendances. This is a case series study of CYP (aged 8-16) experiencing suicidal crisis who presented in a paediatric Emergency Department in England between March 2019 and March 2021 (n = 240). The dataset was subjected to conditional independence graphical analysis. Results revealed a significant association between suicidal crisis and several ACEs. Specifically, evidence of clusters of ACE variables suggests two distinct groups of CYP associated with experiencing a suicidal crisis: those experiencing "household risk" and those experiencing "parental risk". Female sex, history of self-harm, mental health difficulties, and previous input from mental health services were also associated with repeat hospital attendances. Findings have implications for early identification of and intervention with children who may be at a heightened risk for ACEs and associated suicidal crises.


Assuntos
Experiências Adversas da Infância , Comportamento Autodestrutivo , Suicídio , Adulto , Humanos , Criança , Feminino , Adolescente , Ideação Suicida , Comportamento Autodestrutivo/psicologia , Características da Família
8.
Artigo em Inglês | MEDLINE | ID: mdl-36674195

RESUMO

Drawing on the resilience-oriented socioecological framework, the current study contributes to scarce scholarship by exploring intrapersonal (i.e., gratitude) and interpersonal (i.e., parental autonomy support) factors in the longitudinal association between bullying victimization and adolescent non-suicidal self-injury (NSSI). Participants were 238 Chinese adolescents (Mage at Time 1 (T1) = 13.45 years; 106 girls and 132 boys) based on a two-wave prospective design with data spanning one year. At T1, adolescents self-rated all study variables, and at Time 2 (T2), youth again reported their NSSI. The results showed a significant main effect (b = 0.12, SE = 0.05, p = 0.04), indicating that bullying victimization was positively related to T2 NSSI one year later, even controlling for T1 NSSI. Moderation analyses further indicated that parental autonomy support buffered against the positive association between bullying victimization and T2 NSSI, but only when adolescents experienced lower levels of gratitude. Specifically, for adolescents with lower levels of gratitude, high levels of parental autonomy support, in a compensatory way, prevented adolescents from NSSI after victimization occurred (b = -0.03, SE = 0.09, p = 0.78); by contrast, for those with higher levels of gratitude, bullying victimization was not significantly related to T2 NSSI, regardless of the levels of parental autonomy support (b = 0.07, SE = 0.04, p = 0.59 for higher parental autonomy support; b = 0.01, SE = 0.07, p = 0.93 for lower parental autonomy support). These findings suggest that gratitude and parental autonomy support, manifesting in a compensatory interaction pattern, could serve as targeted agents for breaking the vicious linkage between bullying victimization and NSSI.


Assuntos
Comportamento do Adolescente , Bullying , Vítimas de Crime , Comportamento Autodestrutivo , Masculino , Feminino , Humanos , Adolescente , Comportamento Autodestrutivo/epidemiologia
9.
Artigo em Inglês | MEDLINE | ID: mdl-36674270

RESUMO

(1) Introduction: Around a million people are reported to die by suicide every year, and due to the stigma associated with the nature of the death, this figure is usually assumed to be an underestimate. Machine learning and artificial intelligence such as natural language processing has the potential to become a major technique for the detection, diagnosis, and treatment of people. (2) Methods: PubMed, EMBASE, MEDLINE, PsycInfo, and Global Health databases were searched for studies that reported use of NLP for suicide ideation or self-harm. (3) Result: The preliminary search of 5 databases generated 387 results. Removal of duplicates resulted in 158 potentially suitable studies. Twenty papers were finally included in this review. (4) Discussion: Studies show that combining structured and unstructured data in NLP data modelling yielded more accurate results than utilizing either alone. Additionally, to reduce suicides, people with mental problems must be continuously and passively monitored. (5) Conclusions: The use of AI&ML opens new avenues for considerably guiding risk prediction and advancing suicide prevention frameworks. The review's analysis of the included research revealed that the use of NLP may result in low-cost and effective alternatives to existing resource-intensive methods of suicide prevention.


Assuntos
Processamento de Linguagem Natural , Comportamento Autodestrutivo , Humanos , Inteligência Artificial , Ideação Suicida
10.
Child Adolesc Ment Health ; 28(1): 76-82, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36495068

RESUMO

BACKGROUND: Growing public concern about the safety and security of schools has led many schools and school districts within the United States to hire private companies to monitor students' online interactions and the content they create, including on social media. The use of such technologies supposedly increases schools' awareness of what students are doing online and, thus, helps to identify and prevent potential issues such as mental health problems, cyberbullying, or self-harm that might otherwise go unnoticed. However, there is currently no evidence to support that social media surveillance or content monitoring is able to effectively address these public health and safety issues. METHODS: Thus, our study explores how the different voices present in the discourse - students, school officials, privacy advocates, and service providers' representatives - justify or condemn the surveillance of student-produced online content in publicly available news media articles. We adopt a critical discursive psychology approach to study news articles, which were published in international media in the last 3 years (2019 N = 53; 2020 N = 56; 2021 N = 77), reporting on the use of digital surveillance technologies targeting student-produced content. RESULTS AND CONCLUSIONS: Three dominant interpretive repertoires emerged from the analyzed news media articles: 'silenced students, expert adults', 'a solution in search of a problem', and 'the normalization of surveillance for a good cause'. Our findings show that, under the auspices of protecting children, schools are actively engaged in 'doom-monitoring', which is the indiscriminate and inaccurate surveillance of people in anticipation of the next bad thing. The opinions and views of adults, including school officials, vendors, and civil liberties advocates, dominate over the voices of students.


Assuntos
Cyberbullying , Comportamento Autodestrutivo , Adulto , Criança , Humanos , Estados Unidos , Estudantes/psicologia , Privacidade , Instituições Acadêmicas
11.
Injury ; 54(1): 232-237, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36503837

RESUMO

OBJECTIVES: The objective of this study is to present a retrospective analysis of patients presenting to a Major Trauma Centre (MTC) following deliberate self-harm (DSH) and identifying the precipitants of DSH and psychiatric morbidity that will serve to inform the provision of care for these patients. PATIENTS AND METHODS: This was a retrospective observational study from a London Major Trauma Centre that identified all injured patients that presented with deliberate self-harm. Data was analysed from our established trauma database. The data was analysed using descriptive statistics. RESULTS: This included 347 patients of whom 253 were male and 94 were female. The median age was 36 (range 14-93) years. Penetrating injuries (shooting and stabbing) occurred in 187 (54%) patients and blunt injuries in 160 (46%) patients. Self-stabbing (52%) was the most common cause for presentation followed by jumping from a height (26%). The median Injury Severity Score (ISS) was 4 (range 1-9). The median LOS was 3 days (range 0-109), with a mean stay of 8 days. Over half of the patients (n = 189) had previous contact with mental health services. Social and mental health were the main triggers for DSH. CONCLUSIONS: Societal and economic factors as well as a mental disorder are associated with trauma related DSH. These complex group of patients presenting to MTCs have not only acute surgical needs but social and psychological as well. Raising awareness of patients' mental health needs across the whole pathway for the major trauma patient is crucial to ensure that appropriate risk assessments are undertaken at every stage. It is also essential to provide psychological support to the multi-disciplinary team for their wellbeing.


Assuntos
Comportamento Autodestrutivo , Ferimentos Penetrantes , Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Centros de Traumatologia , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/psicologia , Londres/epidemiologia , Estudos Retrospectivos
12.
J Affect Disord ; 323: 707-715, 2023 Feb 15.
Artigo em Inglês | MEDLINE | ID: mdl-36529405

RESUMO

BACKGROUNDS: PTSD is one of the most common conditions after people have experienced trauma. While previous studies have found a link between PTSD and non-suicidal self-injury, (NSSI), few studies have longitudinally explored this relationship and the underlying mechanisms. AIMS: This study explored adolescent NSSI frequency after COVID-19 lockdown experiences, the relationship with early PTSD symptoms, and the mediating role of depression and sleep problems. METHODS: A cohort of 1609 adolescents completed two surveys during and after the national lockdown in China; one month into the lockdown and six months later; which assessed demographic and pandemic-related exposure variables; PTSD, depression, sleep, and NSSI. Mediation analyses and hierarchical regression were employed to examine the relationships and the paths between these variables. RESULTS: The NSSI rate was found to be 31.9 % after the three-month lockdown, with 20.6 % of adolescent participants reporting sleeping disorders, and 33.9 % indicating probable depression. Adolescents who had earlier PTSD symptoms, often smoked and/or drank, and had current depression and sleep disorders reported greater NSSI. Early PTSD symptoms were found to predict later NSSI and were mediated by sleep problems and depressive symptoms. Specifically, PTSD avoidance and numbing symptoms were significantly associated with NSSI above and beyond the depressive symptoms, sleeping problems, and the other covariables. CONCLUSION: It is necessary to be vigilant about the increased risk of NSSI in adolescents who have experienced extended pandemic lockdowns. Preventing early adolescent PTSD symptoms, especially avoidance and numbness, and helping teenagers quit smoking and drinking could reduce the risk of sleep disorders, depression, and NSSI.


Assuntos
COVID-19 , Comportamento Autodestrutivo , Transtornos do Sono-Vigília , Transtornos de Estresse Pós-Traumáticos , Humanos , Adolescente , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Pandemias , COVID-19/epidemiologia , Controle de Doenças Transmissíveis , Comportamento Autodestrutivo/epidemiologia , Transtornos do Sono-Vigília/epidemiologia
13.
Am J Emerg Med ; 63: 50-54, 2023 01.
Artigo em Inglês | MEDLINE | ID: mdl-36327749

RESUMO

BACKGROUND: There has been an increasing incidence of self-harm attempts in recent years in the United States. Particularly concerning, there has been a growing trend of self-harm in the adolescent and young adult population. In order to inform initiatives to address this trend, risk factors and substances used for self-harm need to be clarified. METHODS: This is a descriptive retrospective observational study on all cases of self-harm poisoning in patients between the ages of 12 and 25 years reported at the state's only tertiary care center from January 2019 through March 2022. RESULTS: There was an increased incidence of 69% for self-harm poisonings for all ages and a 90% increase in ages 12-17 years between the years 2019 and 2021. Fifty percent of all cases occurred in patients aged 14-17 years, 69% were female, and 22% required an intensive care unit. The top three most common substances used are available without a prescription. DISCUSSION: There was a persistent increase in self-harm attempts via poisoning throughout the study period with a particularly vulnerable period in the adolescent age group.


Assuntos
Comportamento Autodestrutivo , Humanos , Feminino , Adolescente , Criança , Adulto Jovem , Adulto , Masculino , Centros de Atenção Terciária , Comportamento Autodestrutivo/epidemiologia
14.
Psychiatry Res ; 319: 114998, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36535108

RESUMO

Individuals with pre-existing psychiatric diagnoses appear to be vulnerable to worsening mental health symptoms during the coronavirus disease 2019 (COVID-19) pandemic. Furthermore, psychiatric hospitalizations during the pandemic may be complicated by increased risk of SARS-Cov-2 infection and limited social engagement due to changes in hospital policies. The objective of our exploratory study was to determine whether social, economic, and health-related variables were associated with thoughts of suicide and/or self-harm since March 2020 in individuals admitted to a psychiatric inpatient unit during the COVID-19 pandemic. Chi-square tests revealed four variables were significantly associated with thoughts of suicide and/or self-harm: 1) difficulty with cancellation of important events, 2) some form of loneliness, 3) decreased time spent in green spaces, and 4) increased time spent using devices with screens. The logistic regression model showed a significant association between suicidal and/or self-harm thoughts and cancellation of important events. Further investigation of the loneliness variable components revealed a significant association between suicidal and/or self-harm thoughts and feeling a lack of companionship, feeling isolated, and feeling alone. These results suggest that social challenges experienced during the pandemic were associated with negative mental health symptoms of individuals admitted to a psychiatric inpatient unit.


Assuntos
COVID-19 , Comportamento Autodestrutivo , Humanos , Ideação Suicida , Pandemias , Pacientes Internados , SARS-CoV-2 , Comportamento Autodestrutivo/psicologia , Hospitalização
15.
Psychiatry Res ; 319: 115002, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36549098

RESUMO

Nonsuicidal Self-Injury (NSSI), the purposeful harming of one's body tissue without suicidal intent. NSSI frequently co-occurs with other self-destructive forms of psychopathology, such as eating disorders (ED); however, it remains unclear if ED behaviors are used as a form of NSSI. This exploratory study examined the occurrence of Self-Injurious Disordered Eating Symptoms (SIDES), as well as differences in clinical correlates and treatment outcomes between NSSI patients with and without SIDES. Participants included 1,327 patients admitted for partial hospitalization or intensive outpatient treatment for NSSI (87.4% female; 75.3% Non-Hispanic White). Data were collected at admission and discharge as part of routine clinical outcome assessment. Results indicate that 29.5% of the sample engaged in SIDES, while most were not diagnosed with an ED. Patients that engaged in SIDES reported greater clinical severity at baseline, including greater general psychopathology, lower quality of life, and worse functional impairment, as well as more clinically severe NSSI (e.g., greater number of methods, higher urge to self-injure, greater intrapersonal functions). No differences in treatment outcomes were found. These findings suggest that some NSSI patients perceive ED behaviors as a form of NSSI and that SIDES may be a marker for a more severe clinical presentation.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos , Comportamento Autodestrutivo , Humanos , Feminino , Masculino , Qualidade de Vida , Comportamento Autodestrutivo/epidemiologia , Ideação Suicida , Psicopatologia
16.
Asian J Psychiatr ; 79: 103405, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36521403

RESUMO

Descriptive analysis of adolescent mental disorders in Huangshi was performed to explore the gender differences, influencing factors, and abnormal illness behaviors. A total of 674 patients in Huangshi Mental Health Center from 2017 to 2022 were collected. A rising trend of mental disorders has been observed since 2018, especially during the COVID-19 pandemic. More young cases led to suicidal attempts and self-harm, which reflects the severity of mental health in adolescents. This study aims to draw the attention of government, society, families, and schools to care about adolescents, which also provides guidance and references for clinical treatment of mental disorders.


Assuntos
COVID-19 , Transtornos Mentais , Comportamento Autodestrutivo , Humanos , Adolescente , Ideação Suicida , Pandemias , COVID-19/epidemiologia , Transtornos Mentais/epidemiologia , Transtornos Mentais/terapia , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/psicologia , China/epidemiologia , Fatores de Risco
17.
Child Adolesc Ment Health ; 28(1): 22-32, 2023 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-36478091

RESUMO

BACKGROUND: Published systematic reviews provide evidence linking positive and negative digital experiences to adolescent mental health. However, these reviews focus on the general public rather than the digital experiences of adolescents with different pre-existing mental health conditions and so may be limited in their clinical relevance. We review publications relating to anxiety, depression, eating disorders and nonsuicidal self-injury to identify common and condition-specific digital experiences and how these may be implicated in the origins and maintenance of these mental health conditions. METHODS: A systematic literature search using a combination of mental health, digital experience (including social media use), and age of the target population terms was conducted on four databases. Detailed findings from the included studies were summarised using a combination of thematic and narrative methods. RESULTS: Five qualitative and 21 quantitative studies met the eligibility criteria for inclusion (n = 5021). Nine studies included adolescents with depression, one with eating problems, two with nonsuicidal self-injury and 14 with multiple emotional health conditions. The review identified six themes related to the target populations' digital experiences: (a) social connectivity and peer support; (b) escape and/or distraction; (c) social validation and social comparison; (d) accessing/creation of potentially harmful content; (e) cyberbullying; and (f) difficulties with self-regulation during engagement with digital media. CONCLUSIONS: Digital practices of adolescents with pre-existing clinical vulnerabilities are complex and encompass a range of positive and negative experiences, which appear to have common elements across different clinical populations. The literature is currently too limited to identify disorder-specific practices, with too few direct or indirect comparisons between conditions.


Assuntos
Depressão , Comportamento Autodestrutivo , Humanos , Adolescente , Internet , Ansiedade , Transtornos de Ansiedade
18.
J Affect Disord ; 324: 129-135, 2023 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-36586591

RESUMO

OBJECTIVE: Depressive disorders (DD) are highly prevalent among adolescents. While up to 60 % do not respond to treatment, evidence on predictors of treatment non-response in this age group is mixed, impeding meaningful clinical implications. Drawing on a consecutive clinical cohort of adolescents with risk taking and self-injurious behavior, the present study aimed to identify predictors of treatment non-response for female DD in a naturalistic one year follow-up. METHODS: The sample comprised female adolescents with verified DD (n = 152). Patients underwent assessments at baseline (T0) and follow-up (T1). Sociodemographic factors (e.g., age), clinical measures (e.g., symptom severity, trauma), and treatment variables (e.g. number of psychotherapy sessions), were analyzed as potential predictors of treatment non-response in unadjusted analyses and analyses adjusting for treatment intensity and age at baseline. Treatment response was defined based on not fulfilling formal diagnosis for DD at follow-up (52.3 %; n = 80) or the 50 % decrease in self-reported depressive symptoms (21.1 %; n = 32) from T0 to T1. RESULTS: Greater depressive and overall symptom severity, greater frequency of self-injuries, history of suicide attempts and history of childhood trauma at T0 were robustly associated with treatment non-response based on diagnostic interviews. Only a lower number of siblings was robustly associated with treatment non-response based on self-reports. LIMITATIONS: Findings may not generalize to other treatment settings. CONCLUSION: Collectively, our results highlight overall symptom severity as significant predictor of treatment non-response in female adolescents with depression. Methodological differences (interviews versus self-reports) and potential implications from these findings for clinical practice are discussed.


Assuntos
Depressão , Comportamento Autodestrutivo , Humanos , Adolescente , Feminino , Depressão/diagnóstico , Depressão/epidemiologia , Depressão/terapia , Seguimentos , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/terapia , Comportamento Autodestrutivo/diagnóstico , Tentativa de Suicídio/prevenção & controle , Assunção de Riscos
19.
Schizophr Res ; 251: 30-36, 2023 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36529105

RESUMO

There is a well-documented epidemiological association between auditory hallucinations and self-harm in the general population. However, there has been limited research examining specific characteristics of auditory hallucinations (e.g., type, source, or context of voices) as correlates of self-harm. We used prospective data from the Tokyo Teen Cohort to explore whether characteristics of voices reported at age 14 were differentially associated with self-harm behaviors at ages 14 and 16. Among respondents with auditory hallucinations, respondents who experienced voices that "said something bad" about them or commented on their thoughts and actions were most likely to report concurrent self-harm, whereas positive or praising voices were protective. Negative voices continued to predict self-harm two years later, at age 16, even with adjustment for self-harm at age 14. The age of the voices, source of the voices, and context (e.g., falling asleep or while sick) was not associated with likelihood of reporting concurrent or subsequent self-harm behaviors. Assessing for negative voices in particular, rather than auditory hallucinations or psychotic experiences more broadly, may provide a more specific indicator of risk for self-harm among adolescents. The real-world utility of these epidemiological findings should be further examined in clinical settings.


Assuntos
Transtornos Psicóticos , Comportamento Autodestrutivo , Adolescente , Humanos , Transtornos Psicóticos/epidemiologia , Estudos Prospectivos , Alucinações/epidemiologia , Comportamento Autodestrutivo/epidemiologia
20.
Int J Qual Stud Health Well-being ; 18(1): 2152943, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36476045

RESUMO

AIM: To highlight the experiences of family members of people with borderline personality disorder (BPD) and self-harming behaviour who have access to brief admission. METHODS: To understand the families lived experience a phenomenological lifeworld perspective was adopted to this study. Twelve in-depht interviews were performed in November and December 2021 with family members of people with BPD and self-harming behaviour who have accessed BA. The phenomenological life-world perspective guided the analysis. RESULTS: Families' life-world was characterized by anxiety and constant protection of their loved one. They live with constant fear of how their loved ones are feeling and whether they will injure themselves. When access to BA was available this gave hope and provided conditions for families to maintain everyday routines and also enhanced relationships among family members. When families' loved ones were denied BA, they felt betrayed which contributed to negative feelings towards the medical profession, and the families lost confidence in psychiatry. CONCLUSION: By interviewing families of people with BPD and self-harming behaviour who had access to BA, it emerged they possess valuable knowledge. BA can be developed if the needs of families are taken into consideration, and if families are given the opportunity to share emotions and the high burden of responsibility with staff or families in similar situations. If health care staff gives family members a more central role in care and makes their shared life-world visible it could thereby hopefully increase well-being and benefits for the whole family.


Assuntos
Transtorno da Personalidade Borderline , Comportamento Autodestrutivo , Humanos , Transtorno da Personalidade Borderline/psicologia , Família/psicologia , Hospitalização , Relações Familiares
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