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1.
BMC Public Health ; 24(1): 1263, 2024 May 08.
Artigo em Inglês | MEDLINE | ID: mdl-38720265

RESUMO

BACKGROUND: Suicide among male construction workers are reported to be disproportionally high compared to the working age population. However, there is minimal understanding of the prevalence and associated factors for suicidal ideation, non-suicidal self-injury, and suicide attempt among this occupational group globally. METHODS: A cross-sectional study was conducted on a large sample of male construction workers in Ireland (n = 1,585). We investigated the prevalence of suicidal ideation, non-suicidal self-injury and suicide attempts and sociodemographic, occupational, and mental health factors associated with these three outcomes. Multivariable Poisson regression was performed to estimate the prevalence rate ratio of suicidal ideation (model 1 primary outcome), while multivariable logistic regression was used to estimate the odds ratio of non-suicidal self-injury (model 2 primary outcome), and suicide attempt (model 3 primary outcome). RESULTS: The lifetime prevalence rate for suicidal ideation was 22%, 6% for non-suicidal self-injury, and 6% for suicide attempt. In univariate modelling, socio-demographic and occupation-specific factors associated with the three outcomes included younger age (suicidal ideation and non-suicidal self-injury), not being in a relationship (suicide attempt) and working 35-44 h per week (suicidal ideation and suicide attempt). The mental health factors generalized anxiety disorder, depression, and suicide bereavement were significantly associated with increased risk of the three outcomes. In fully adjusted multivariable models, increasing severity of generalized anxiety disorder and depression were associated with an increased prevalence rate ratio of suicidal ideation, and a higher odds ratio of non-suicidal self-injury and suicide attempt. CONCLUSION: Suicidal ideation, non-suicidal self-injury and suicide attempt are significant issues for male construction workers that require specific attention. Findings highlight a need to support younger male construction workers and those bereaved by suicide. They also highlight the need for the early detection and treatment of generalized anxiety disorder and depression in order to intervene in, and potentially prevent, suicidality among male construction workers.


Assuntos
Comportamento Autodestrutivo , Ideação Suicida , Tentativa de Suicídio , Humanos , Masculino , Tentativa de Suicídio/estatística & dados numéricos , Tentativa de Suicídio/psicologia , Adulto , Irlanda/epidemiologia , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/psicologia , Estudos Transversais , Prevalência , Fatores de Risco , Pessoa de Meia-Idade , Adulto Jovem , Indústria da Construção , Adolescente
2.
JMIR Ment Health ; 11: e53730, 2024 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-38722220

RESUMO

Background: There is growing concern around the use of sodium nitrite (SN) as an emerging means of suicide, particularly among younger people. Given the limited information on the topic from traditional public health surveillance sources, we studied posts made to an online suicide discussion forum, "Sanctioned Suicide," which is a primary source of information on the use and procurement of SN. Objective: This study aims to determine the trends in SN purchase and use, as obtained via data mining from subscriber posts on the forum. We also aim to determine the substances and topics commonly co-occurring with SN, as well as the geographical distribution of users and sources of SN. Methods: We collected all publicly available from the site's inception in March 2018 to October 2022. Using data-driven methods, including natural language processing and machine learning, we analyzed the trends in SN mentions over time, including the locations of SN consumers and the sources from which SN is procured. We developed a transformer-based source and location classifier to determine the geographical distribution of the sources of SN. Results: Posts pertaining to SN show a rise in popularity, and there were statistically significant correlations between real-life use of SN and suicidal intent when compared to data from the Centers for Disease Control and Prevention (CDC) Wide-Ranging Online Data for Epidemiologic Research (⍴=0.727; P<.001) and the National Poison Data System (⍴=0.866; P=.001). We observed frequent co-mentions of antiemetics, benzodiazepines, and acid regulators with SN. Our proposed machine learning-based source and location classifier can detect potential sources of SN with an accuracy of 72.92% and showed consumption in the United States and elsewhere. Conclusions: Vital information about SN and other emerging mechanisms of suicide can be obtained from online forums.


Assuntos
Processamento de Linguagem Natural , Comportamento Autodestrutivo , Nitrito de Sódio , Humanos , Comportamento Autodestrutivo/epidemiologia , Suicídio/tendências , Suicídio/psicologia , Adulto , Internet , Masculino , Feminino , Mídias Sociais , Adulto Jovem
3.
CNS Neurosci Ther ; 30(5): e14684, 2024 05.
Artigo em Inglês | MEDLINE | ID: mdl-38739217

RESUMO

AIMS: Limited understanding exists regarding the neurobiological mechanisms underlying non-suicidal self-injury (NSSI) and suicide attempts (SA) in depressed adolescents. The maturation of brain network is crucial during adolescence, yet the abnormal alternations in depressed adolescents with NSSI or NSSI+SA remain poorly understood. METHODS: Resting-state functional magnetic resonance imaging data were collected from 114 depressed adolescents, classified into three groups: clinical control (non-self-harm), NSSI only, and NSSI+SA based on self-harm history. The alternations of resting-state functional connectivity (RSFC) were identified through support vector machine-based classification. RESULTS: Convergent alterations in NSSI and NSSI+SA predominantly centered on the inter-network RSFC between the Limbic network and the three core neurocognitive networks (SalVAttn, Control, and Default networks). Divergent alterations in the NSSI+SA group primarily focused on the Visual, Limbic, and Subcortical networks. Additionally, the severity of depressive symptoms only showed a significant correlation with altered RSFCs between Limbic and DorsAttn or Visual networks, strengthening the fact that increased depression severity alone does not fully explain observed FC alternations in the NSSI+SA group. CONCLUSION: Convergent alterations suggest a shared neurobiological mechanism along the self-destructiveness continuum. Divergent alterations may indicate biomarkers differentiating risk for SA, informing neurobiologically guided interventions.


Assuntos
Encéfalo , Imageamento por Ressonância Magnética , Comportamento Autodestrutivo , Tentativa de Suicídio , Humanos , Comportamento Autodestrutivo/psicologia , Adolescente , Masculino , Feminino , Tentativa de Suicídio/psicologia , Encéfalo/diagnóstico por imagem , Encéfalo/fisiopatologia , Rede Nervosa/diagnóstico por imagem , Rede Nervosa/fisiopatologia , Depressão/psicologia , Depressão/fisiopatologia , Depressão/diagnóstico por imagem , Vias Neurais/fisiopatologia , Vias Neurais/diagnóstico por imagem , Criança
4.
BMC Psychiatry ; 24(1): 332, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38693475

RESUMO

BACKGROUND: Adverse childhood events (ACEs), psychopathy, and self-harming behaviours are prevalent among individuals in the forensic psychiatry system. While existing literature suggests that ACEs, self-harm, and psychopathy are interrelated, little is known about the interplay of psychopathic traits in this relationship. The present study aimed to determine the mediating role of psychopathy in the relationship between ACEs and self-harming behaviours in forensic patients. METHODS: This was a retrospective study of patients under the Ontario Review Board (ORB) between 2014 and 2015. In the analysis, we included patients with complete data on ACEs, self-harming behaviours, and a Psychopathy Checklist-Revised (PCL-R) score - a measure of psychopathic traits and their severity conducted during the reporting period. Mediation analysis was based on the Baron and Kenny approach, and sensitivity analysis was performed based on the types of ACEs. RESULTS: ​​​The sample population (n = 593) was made up of adults, with a mean age of 41.21 (± 12.35) years and were predominantly males (92.37%). While there was a partial mediating effect of psychopathy on the relationship between ACEs and incidents of self-harming behaviours in the past year, the mediation was complete in the relationship between ACEs and a lifetime history of self-harming behaviours. Following sensitivity analysis based on the types of ACE, the mediating effects were more attributed to specific ACEs, especially having experienced child abuse or having an incarcerated household member before 18 years. CONCLUSION: Among forensic patients in Ontario, psychopathy mediates​ ​the relationship between experiencing ACEs and engaging in self-harming behaviours. Effective intervention to mitigate self-harming behaviours in this population should consider the potential role of psychopathy, especially among individuals who have experienced ACEs involving a history of child abuse and a family who was incarcerated.


Assuntos
Experiências Adversas da Infância , Comportamento Autodestrutivo , Humanos , Masculino , Comportamento Autodestrutivo/psicologia , Comportamento Autodestrutivo/epidemiologia , Feminino , Ontário/epidemiologia , Adulto , Estudos Retrospectivos , Experiências Adversas da Infância/psicologia , Experiências Adversas da Infância/estatística & dados numéricos , Pessoa de Meia-Idade , Transtorno da Personalidade Antissocial/psicologia , Transtorno da Personalidade Antissocial/epidemiologia , Psiquiatria Legal , Criança
5.
Rev Col Bras Cir ; 51: e20243665, 2024.
Artigo em Inglês, Português | MEDLINE | ID: mdl-38716915

RESUMO

INTRODUCTION: burns represent a pivotal component of trauma in Brazil, accounting for 2 million incidents and 2,500 deaths annually. Self-intentional burns are associated with a worse prognosis, larger burned surface area, higher infection rates, and death. The lack of studies on the issue of self-immolation raises epidemiological questions regarding Brazilian victims. This study aimed to investigate the profile of burn events associated with self-injurious behavior among Brazilian victims. METHODS: this systematic review was performed according to PRISMA 2020 guidelines and evaluated the correlation between self-injurious behavior as a cause of burns in Brazilian victims and its epidemiological implications in the last 20 years (2003-2023). The MeSH terms "Burns", "Self-Injurious Behavior", "Epidemiology" and "Brazil" were queried in the PubMed/MEDLINE, SciELO, and Cochrane Library databases, and, after selection by inclusion/exclusion criteria, the most relevant studies were critically analyzed. RESULTS: From 1,077 pre-selected studies, 92 were potentially eligible, resulting in 7 manuscripts incorporated in this review. From 3,510 burned victims assembled in the pool of selected studies, 311 cases displayed self-injurious behavior. Burned patients who attempted to burn their lives have a higher risk of death (p<0.05; RR=5.1 [3.2-8.1]) and larger burned surface area (p<0.05; MD=19.2 [10-28.2]), compared to accidental cases. Moreover, the female gender was at a higher risk of attempting self-immolation (p<0.05; RR=4.01 [2.9-5.5]). CONCLUSION: our results show that self-inflicted burn cases were associated with a larger burned surface area and a higher risk of death, and the female gender was identified as a relevant risk factor in Brazil.


Assuntos
Queimaduras , Comportamento Autodestrutivo , Humanos , Brasil/epidemiologia , Queimaduras/epidemiologia , Queimaduras/mortalidade , Comportamento Autodestrutivo/epidemiologia , Feminino , Masculino
6.
Medicine (Baltimore) ; 103(18): e37896, 2024 May 03.
Artigo em Inglês | MEDLINE | ID: mdl-38701288

RESUMO

RATIONALE: Low-velocity penetrating head injury (PHI) is rare, comprising 0.2% to 0.4% of head traumas, but can be devastating and is associated with significant morbidity and mortality. No previous case of very-low-velocity PHI due to self-inflicted stabbing with a gimlet has been reported. PATIENT CONCERNS: A 62-year-old man was admitted to the hospital with bleeding head and abdominal wounds after stabbing his abdomen with a gimlet, and then hammering the same gimlet into his forehead and removing the gimlet himself. DIAGNOSES: Upon examination at admission, stab wounds were present on the forehead and the right upper quadrant. Computed tomography (CT) of the head revealed a bone defect in the left frontal bone and showed the intracranial path of the gimlet surrounded by mild hemorrhage and pneumocephalus. Magnetic resonance imaging (MRI) confirmed a small amount of hemorrhage with pneumocephalus but no vascular injury. INTERVENTIONS: Conservative treatment without surgery. OUTCOMES: Follow-up MRI on hospital day 58 showed no abscess or traumatic intracranial aneurysm. The patient achieved full recovery of motor and mental functions with conservative treatment and was discharged on hospital day 69. LESSONS: Very-low-velocity PHI might be successfully treated with conservative treatment.


Assuntos
Traumatismos Cranianos Penetrantes , Ferimentos Perfurantes , Humanos , Masculino , Pessoa de Meia-Idade , Traumatismos Cranianos Penetrantes/diagnóstico por imagem , Traumatismos Cranianos Penetrantes/complicações , Traumatismos Cranianos Penetrantes/psicologia , Ferimentos Perfurantes/complicações , Ferimentos Perfurantes/diagnóstico por imagem , Tomografia Computadorizada por Raios X , Comportamento Autodestrutivo/psicologia , Imageamento por Ressonância Magnética , Tratamento Conservador/métodos
7.
J Clin Psychiatry ; 85(2)2024 Apr 29.
Artigo em Inglês | MEDLINE | ID: mdl-38696137

RESUMO

Objective: To examine rates of clozapine use among people with psychotic disorders who experience specific indications for clozapine.Methods: Records data from 11 integrated health systems identified patients aged 18 years or older with recorded International Classification of Diseases, Tenth Revision, Clinical Modification, diagnoses of schizophrenia, schizoaffective disorder, or other psychotic disorder who experienced any of the 3 events between January 1, 2019, and December 31, 2019, suggesting indications for clozapine: a diagnosis of self-harm injury or poisoning, suicidal ideation diagnosed or in response to standardized assessments, and hospitalization or emergency department (ED) care for psychotic disorder despite treatment with 2 or more antipsychotic medications. Prescription dispensing data identified all clozapine use prior to or in the 12 months following each indication event. Analyses were conducted with aggregate data from each health system; no individual data were shared.Results: A total of 7,648 patients with psychotic disorder diagnoses experienced at least 1 indication event. Among 1,097 experiencing a self-harm event, 32 (2.9%) had any prior clozapine use, and 10 (0.9%) initiated clozapine during the following 12 months. Among 6,396 with significant suicidal ideation, 238 (3.7%) had any prior clozapine use, and 70 (1.1%) initiated clozapine over 12 months. Among 881 with hospitalization or ED visit despite pharmacotherapy, 77 (8.7%) had any prior clozapine treatment, and 41 (4.7%) initiated clozapine over 12 months. Among those with significant suicidal ideation, rates of both prior clozapine treatment and subsequent initiation varied significantly by race and ethnicity, with rates among Hispanic and non-Hispanic Black patients lower than among non Hispanic White patients.Conclusions: Initiating clozapine treatment is uncommon among people with psychotic disorders who experience events suggesting clozapine is indicated, with even lower rates among Black and Hispanic patients.


Assuntos
Antipsicóticos , Clozapina , Transtornos Psicóticos , Humanos , Clozapina/uso terapêutico , Transtornos Psicóticos/tratamento farmacológico , Masculino , Feminino , Adulto , Antipsicóticos/uso terapêutico , Pessoa de Meia-Idade , Comportamento Autodestrutivo/epidemiologia , Ideação Suicida , Hospitalização/estatística & dados numéricos , Esquizofrenia/tratamento farmacológico , Adulto Jovem , Estados Unidos , Adolescente
8.
Int J Qual Stud Health Well-being ; 19(1): 2353460, 2024 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-38739443

RESUMO

PURPOSE: Brief Admission by self-referral (BA) is a standardized crisis-management intervention for individuals with self-harm and risk for suicide. This study explored relatives' experiences of BA. Relatives' perspectives may contribute to an increased understanding of the effects of BA given the relatives' role as support and informal caregivers as well as being co-sufferers. METHODS: Fourteen relatives to adults with access to BA within one Swedish region participated in focus groups analysed with reflexive thematic analysis. RESULTS: We generated themes evolving around three meaning-based concepts: access (A low threshold to a safe back-up is crucial and obstacles may easily break faith), independence (Trust in their ability with care and respect), and recovery (The rest and relational recovery we all get are needed and invaluable). CONCLUSIONS: BA brings considerable value to users and relatives, by supporting them to take care of themselves and each other. Communication and involvement of relatives may enhance users' ability to overcome obstacles to accessing BA. Implementation and adherence may be strengthened by supervision of BA staff and education of emergency care staff. Resources are needed to improve access. Mapping hurdles to BA, support through peers and targeted psychoeducation may improve recovery for BA users and their relatives.


Assuntos
Intervenção em Crise , Família , Grupos Focais , Pesquisa Qualitativa , Comportamento Autodestrutivo , Ideação Suicida , Humanos , Masculino , Feminino , Adulto , Suécia , Comportamento Autodestrutivo/terapia , Comportamento Autodestrutivo/psicologia , Pessoa de Meia-Idade , Família/psicologia , Idoso , Encaminhamento e Consulta , Cuidadores/psicologia , Adulto Jovem
10.
J Affect Disord ; 356: 13-21, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38588726

RESUMO

BACKGROUND: Mental disorders that follow traumatic experience may increase risk of suicidality, but a comprehensive approach to understand how these mental disorders mediate the association between psychological traumatic experience and suicidality should be elucidated. In this study, we attempted to provide comprehensive evidence on how depressive symptoms and neuroticism can mediate the association between psychological traumatic experiences and suicidal behaviours including suicidal ideation, suicidal planning, and suicide attempts. METHODS: We analyzed 111,931 participants from UK Biobank who had completed mental health web-based questionnaire from 2016 to 2017. "Self-harm and suicidal behaviour and ideation (SSBI) score" was calculated by the response from suicidal behaviours and self-harm questionnaires. Conducting multivariate linear regression, depressive symptoms, anxiety symptoms, and neuroticism were selected as potential mediators. We constructed a latent class mediation model estimated direct effect of psychological traumatic events on suicidality and indirect effect of psychological traumatic events mediated by depressive symptoms and neuroticism. RESULTS: Psychological traumatic events were positively associated with suicidal behaviours. Depressive symptoms and neuroticism significantly mediated the effect of psychological traumatic events on suicidality. Anxiety symptoms did not mediate the association between psychological traumatic events and suicidality. CONCLUSION: Psychological traumatic events, irrespective of life stage of occurrence, are associated with suicidality. The association between psychological traumatic events and suicidality can be partially explained by depressive symptoms and neuroticism of those who were exposed to psychological trauma.


Assuntos
Depressão , Análise de Classes Latentes , Neuroticismo , Ideação Suicida , Humanos , Masculino , Feminino , Reino Unido/epidemiologia , Pessoa de Meia-Idade , Depressão/psicologia , Depressão/epidemiologia , Idoso , Adulto , Trauma Psicológico/epidemiologia , Trauma Psicológico/psicologia , Tentativa de Suicídio/estatística & dados numéricos , Tentativa de Suicídio/psicologia , Análise de Mediação , Inquéritos e Questionários , Bancos de Espécimes Biológicos , Ansiedade/psicologia , Ansiedade/epidemiologia , Suicídio/psicologia , Suicídio/estatística & dados numéricos , Comportamento Autodestrutivo/psicologia , Comportamento Autodestrutivo/epidemiologia , Biobanco do Reino Unido
11.
BMC Public Health ; 24(1): 1035, 2024 Apr 13.
Artigo em Inglês | MEDLINE | ID: mdl-38614987

RESUMO

INTRODUCTION: Widespread concern exists in today's world regarding self-harm and interpersonal violence. This study to analyze the changes in temporal trends and spatial patterns of risk factors and burdens of self-harm and interpersonal violence using the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. METHODS: Temporal trends in self-harm and interpersonal violence were initially summarized using the estimated annual percentage change (EAPC). Data were compiled and visualized to delineate changes in disease burden and factors influencing self-harm and interpersonal violence from 1990 to 2019, stratified by gender, age and GBD region. RESULTS: In 2019, the DALY rates of self-harm were 424.7(95% UI 383.25, 466.93). Over the period from 1999 to 2019, self-harm exhibited an overall decreasing trend, with the EAPC of -1.5351 (95% CI -1.6194, -1.4507), -2.0205 (95% CI -2.166, -1.8740) and -2.0605 (95% CI -2.2089, -1.9119), respectively. In contrast, the incidence rate of interpersonal violence was significantly higher than self-harm, with a rate of 413.44 (95% UI 329.88, 502.37) per 100,000 population. Mortality and DALYs of interpersonal violence were lower than those of self-harm, at 5.22 (95% UI 4.87, 5.63) and 342.43 (95% UI 316.61, 371.55). Disease burden of self-harm and interpersonal violence varied by gender, age groups and region. Specific risk factors showed that alcohol use, high temperature and drug use were the main risk factors for self-harm, while alcohol use, intimate partner violence and high temperature were associated with interpersonal violence. Low temperature was a common protective factor for both self-harm and interpersonal violence. The burden of self-harm and interpersonal violence was attributed to different factors influences in different SDI regions. CONCLUSIONS: The study explored temporal trends and spatial distribution of the global disease burden of self-harm and interpersonal violence, emphasizing the significant impact of factors such as alcohol use, temperature, and drug use on disease burden. Further research and policy actions are needed to interpret recent changes of disease burden of self-harm and interpersonal violence, and dedicated efforts should be implemented to devise evidence-based interventions and policies to curtail risk factors and protect high-risk groups.


Assuntos
Violência por Parceiro Íntimo , Comportamento Autodestrutivo , Humanos , Carga Global da Doença , Comportamento Autodestrutivo/epidemiologia , Consumo de Bebidas Alcoólicas , Fatores de Risco
12.
BMJ Open ; 14(4): e069862, 2024 Apr 24.
Artigo em Inglês | MEDLINE | ID: mdl-38663920

RESUMO

BACKGROUND: Many 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 yet to be explored in this population. OBJECTIVE: This study sought to explore the acceptability and safety of a specific app (BlueIce) for university students who self-harm. METHODS: This was an exploratory, mixed methods study with 15 university students attending university well-being services with self-harming thoughts and/or behaviours. BlueIce was offered alongside the face-to-face support provided by the well-being service. Self-harming thoughts and behaviours, coping self-efficacy, and symptoms of anxiety and depression were measured before and after using BlueIce for 6 weeks. Follow-up interviews were also undertaken to explore how students perceived BlueIce in more depth. RESULTS: Following app use, there were statistically significant reductions in symptoms of anxiety (baseline M 12.47, SD 4.42; follow-up M 10, SD 4.16) t(14)=2.26, p=0.040, d=0.58 and depression (baseline M 16.5, SD 5.17, follow-up M 12.27, SD 3.66) t(13)=5.50, p<0.001, d=1.47. Qualitative findings showed participants found BlueIce to be acceptable, safe and helpful, and reported that they were more able to cope with difficult feelings and better understand their self-harm triggers following use of the app. CONCLUSION: BlueIce was an acceptable, safe and helpful source of support for university students struggling with self-harm thoughts and/or behaviours. This builds on previous findings with adolescents and suggests that BlueIce could be a particularly acceptable and helpful resource for university students.


Assuntos
Ansiedade , Depressão , Aplicativos Móveis , Comportamento Autodestrutivo , Smartphone , Estudantes , Humanos , Comportamento Autodestrutivo/psicologia , Feminino , Masculino , Estudantes/psicologia , Universidades , Adulto Jovem , Adulto , Autoeficácia , Adaptação Psicológica , Adolescente
13.
BMC Prim Care ; 25(1): 139, 2024 Apr 27.
Artigo em Inglês | MEDLINE | ID: mdl-38678191

RESUMO

BACKGROUND: The World Health Organization has called for improved surveillance of self-harm and suicide attempts worldwide to benefit suicide prevention programs. International comparisons of registrations are lacking, however, and there is a need for systematically collected, high-quality data across countries. The current study investigated healthcare professionals' perceptions of registration practices and their suggestions for ensuring high-quality registration of self-harm and suicide attempts. METHODS: Qualitative interviews (N = 20) were conducted among medical secretaries, medical doctors, nurses, and registration advisers from psychiatric and somatic emergency departments in all regions of Denmark between September 2022 and March 2023. Content analysis was performed using NVivo. RESULTS: Despite great efforts to standardize and assure the quality of registration in Denmark, almost all the healthcare professionals perceived registration practice as inconsistent and unreliable. Codes are often misclassified or unused due to insufficient time, non-standardized training, or insufficient information. The interview informants suggested that coding guidelines should be simplified and made more visible, alongside technical solutions in the electronic health record system. CONCLUSION: The study findings resulted in eight overall recommendations for clinical practice that aim at improving the registration of patients presenting with self-harm or suicide attempts. This would be expected to help improve surveillance and prevention programs.


Assuntos
Serviço Hospitalar de Emergência , Pesquisa Qualitativa , Comportamento Autodestrutivo , Tentativa de Suicídio , Humanos , Tentativa de Suicídio/estatística & dados numéricos , Tentativa de Suicídio/psicologia , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/prevenção & controle , Comportamento Autodestrutivo/psicologia , Dinamarca/epidemiologia , Masculino , Feminino , Atitude do Pessoal de Saúde , Sistema de Registros , Adulto , Pessoal de Saúde/psicologia , Entrevistas como Assunto
14.
Child Abuse Negl ; 152: 106804, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38636157

RESUMO

BACKGROUND: Repetitive non-suicidal self-injury (R-NSSI) in adolescence represents a significant risk factor for suicide. Although exposure to family stress is robustly associated with the risk of non-suicidal self-injury (NSSI), studies have not examined the potential mechanisms linking different forms of family stress and R-NSSI. OBJECTIVE: This study examined how unique dimensions of family stress (threat and deprivation) relate to R-NSSI via interactions between impulsivity and emotion dysregulation. PARTICIPANTS AND SETTING: The current sample included 3801 middle-school adolescents (42.2 % girls, Mage = 13.21 years). METHODS: We conducted a two-wave study with 6-month intervals. Participants completed self-report measures assessing family stress, impulsivity, emotion dysregulation, and NSSI. RESULTS: Moderate mediation analyses showed that threat was indirectly associated with NSSI frequency through the interaction of impulsivity and emotion dysregulation in the R-NSSI group and indirectly through impulsivity in the occasional NSSI (O-NSSI) group. Deprivation did not predict subsequent NSSI frequency in either group. CONCLUSIONS: These findings lend empirical support to dimensional models of adversity and suggest that adolescents who experience threat-related family stress may have greater impulsivity and are more likely to report R-NSSI in the context of emotion dysregulation.


Assuntos
Regulação Emocional , Comportamento Impulsivo , Comportamento Autodestrutivo , Estresse Psicológico , Humanos , Adolescente , Feminino , Masculino , Comportamento Autodestrutivo/psicologia , Estresse Psicológico/psicologia , Fatores de Risco , Autorrelato , Família/psicologia , Criança , Comportamento do Adolescente/psicologia
15.
J Affect Disord ; 356: 528-534, 2024 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-38657761

RESUMO

BACKGROUND: Hospital-treated self-harm is a strong predictor of suicide and hospital contacts may include missed opportunities for suicide prevention. We conducted a data linkage study to identify factors associated with suicide in people treated in hospital for self-harm in Victoria, Australia. METHOD: We undertook a cohort study following 14,307 people treated in hospital for an episode of self-harm (i.e., either admitted or non-admitted ED presentations) over the period 2011 and 2012 and used data from the Victorian Suicide Register to identify suicides within 5 years. We estimated unadjusted hazard ratios (HRs) for suicide using survival analysis for each exposure variable and then computed adjusted HRs using a multivariate model that included all exposure variables. RESULTS: Among females, the risk of suicide was higher in those aged 50-74 years (HR 1.78; Cl: 1.02, 3.10), residing in areas of least disadvantage (HR 2.58; Cl: 1.21, 5.50), who used hanging as a method of self-harm (HR 5.17; Cl: 1.86, 14.35) and with organic disorders (HR 6.71; Cl: 2.61, 17.23) or disorders of adult personality and behaviour (HR 2.10; Cl: 1.03, 4.27). In males, the risk of suicide was higher in those who used motor vehicle exhaust gas (MVEG) as a method of self-harm (HR 3.48; Cl: 1.73, 7.01), and with disorders due to psychoactive substance abuse (HR 1.75; Cl: 1.14, 2.67). CONCLUSION: Although all patients should be routinely assessed for risk and needs following hospital-treated self-harm including appropriate follow-up care, people who use MVEG or hanging as methods of self-harm are obvious candidates for close follow-up.


Assuntos
Comportamento Autodestrutivo , Suicídio , Humanos , Feminino , Masculino , Pessoa de Meia-Idade , Comportamento Autodestrutivo/epidemiologia , Adulto , Idoso , Suicídio/estatística & dados numéricos , Estudos de Coortes , Vitória/epidemiologia , Adulto Jovem , Adolescente , Fatores de Risco , Hospitalização/estatística & dados numéricos , Sistema de Registros , Fatores Sexuais , Modelos de Riscos Proporcionais , Armazenamento e Recuperação da Informação , Fatores Etários
16.
Psicol. conduct ; 32(1): 125-143, Abr 1, 2024. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-232225

RESUMO

El objetivo de esta investigación fue describir el efecto de la depresión, la desesperanza y la impulsividad sobre la orientación al suicidio y el papel de la impulsividad como mediador de la orientación suicida en universitarios con antecedentes de conductas autolesivas. Participaron 1.645 jóvenes entre los 18 y 29 años, de dos ciudades colombianas. Se seleccionaron 218 jóvenes (M= 21,00; DT= 2,99) que informaron de al menos un intento de suicidio en el último año, quienes contestaron el “Inventario de orientación suicida”, la “Escala de desesperanza de Beck”, el “Inventario de depresión de Beck” y la “Escala de impulsividad de Barratt”. La depresión, la desesperanza y la impulsividad explicaron el 63% de la variación de la orientación al suicidio (R2= 0,635; IC 95% [0,555; 0,713]; p= 0,001). La impulsividad medió con depresión en aquellos casos en los que la orientación suicida era alta, cuyos efectos totales, directos e indirectos, fueron estadísticamente significativos (p< 0,001). La impulsividad desempeña un papel mediador entre la depresión y la desesperanza en la predicción de la orientación suicida.(AU)


The aim of this research was to describe the effect of depression,hopelessness, and impulsivity on orientation to suicide and the role of impulsivityas a mediator of suicidal orientation in university students with a history of self-injury behaviors. 1645 young people between 18 and 29 years old participated,from two Colombian cities. 218 young people were selected (M= 21.00; SD= 2.99)who reported at least one suicide attempt in the last year, who answered the“Suicidal Orientation Inventory”, the “Beck Hopelessness Scale”, the “BeckDepression Inventory” and the “Barratt Impulsivity Scale”. Depression,hopelessness, and impulsivity explained 63% of the variation in suicidal orientation (R 2 = .635, IC 95% [.555, .713], p= .001). Impulsivity mediated with depression inthose cases in which suicidal orientation was high, whose total, direct and indirecteffects were statistically significant (p< .001). Impulsivity plays a mediating rolebetween depression and hopelessness in predicting suicidal orientation.K EY WORDS : depression, hopelessness, impulsivity, suicidality, college youth.(AU)


Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto Jovem , Comportamento do Adolescente , Suicídio , Depressão , Comportamento Autodestrutivo , Comportamento Impulsivo , Psicologia do Adolescente , Saúde Mental , Psicologia
17.
Behav Ther ; 55(3): 469-484, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38670662

RESUMO

Although the literature suggests trait-like differences in affective and cognitive vulnerabilities between individuals with and without a history of nonsuicidal self-injury (NSSI), little is known about how these dispositional differences are experienced in the natural environment. The present study compares the intensity, inertia, interaction, and variability of affective (negative and positive affect) and cognitive states (rumination, self-criticism) in the everyday lives of individuals who do and do not engage in NSSI. Using experience sampling methodology (ESM), 60 emerging adults (ages = 18-22 years) with and without past-year NSSI (equally distributed) completed eight questionnaires per day for 12 days (in total, 96 questionnaires per participant), resulting in 4,587 assessments (median compliance = 83.3%; IQR = 71.9-91.7). In a dynamic structural equation modeling framework, dynamic parameters (i.e., mean intensity, carryover effects, spillover effects, and within-person variability) were evaluated using multilevel vector autoregressive models. Emerging adults who engage in NSSI experience higher intensity and greater variability of negative affect, rumination, and self-criticism, whereas those who do not engage in NSSI experience higher intensity and lower variability of positive affect. In addition, past-year NSSI predicted stronger affective-cognitive interactions over time, with stronger spillover effects of negative and positive affect on subsequent rumination and self-criticism in individuals who engage in NSSI. Depressive symptoms and trait levels of emotion dysregulation and self-criticism partially negated these differences. Our findings provide evidence that emerging adults who self-injure experience more negative affective-cognitive states in daily life and point to the potential relevance of boosting positive emotions to buffer negative cognitions.


Assuntos
Afeto , Cognição , Comportamento Autodestrutivo , Humanos , Comportamento Autodestrutivo/psicologia , Masculino , Feminino , Adulto Jovem , Adolescente , Inquéritos e Questionários , Avaliação Momentânea Ecológica , Autoavaliação (Psicologia) , Ruminação Cognitiva , Adulto , Autoimagem
18.
J Youth Adolesc ; 53(6): 1301-1322, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38564099

RESUMO

Suicide remains the second most common cause of death in young people aged 10-24 years and is a growing concern globally. The literature reports a vast number of factors that can predispose an adolescent to suicidality at an individual, relational, community, or societal level. There is limited high-level research identifying and understanding these risk and protective factors of adolescent suicidality. The present study used an umbrella review and meta-analysis to synthesize evidence from the review literature in the past 20 years on risk and protective factors of self-harm and suicidality (behavior and ideation) in adolescents. The umbrella review included 33 quantitative reviews with 1149 individual studies on suicidality and self-harm. Based on the data synthesis, it compared the public health impact of exposure on the population of the identified exposure. Bullying victimization was the most attributed environmental exposure for suicidality. The other identified significant school and individual factors were sleeping disturbance, school absenteeism, and exposure to antidepressants. Several significant vulnerable young populations were identified with significantly higher prevalence of suicidality, including lesbian, gay, bisexual, transgender, queer (or questioning) youth and those with mental health disorders, problem behaviors, previous suicidality, self-harm, and gender (female). A person-centered approach emphasizing connectedness and bully-free school environments should be a priority focus for schools, health professionals, and public health policymakers.


Assuntos
Bullying , Comportamento Autodestrutivo , Ideação Suicida , Humanos , Adolescente , Comportamento Autodestrutivo/psicologia , Comportamento Autodestrutivo/epidemiologia , Fatores de Risco , Bullying/psicologia , Bullying/estatística & dados numéricos , Fatores de Proteção , Suicídio/psicologia , Suicídio/estatística & dados numéricos , Masculino , Comportamento do Adolescente/psicologia , Feminino
19.
BMC Psychol ; 12(1): 234, 2024 Apr 25.
Artigo em Inglês | MEDLINE | ID: mdl-38664781

RESUMO

BACKGROUND: Non-suicidal self-injury seriously harm the physical and mental health of adolescents. The aim of the current study was to explore the relationship between non-suicide self-injury, depression, and childhood trauma from the perspective of symptoms in adolescents. METHODS: A cross-sectional survey was conducted in four junior high middle schools and collected 2640 valid questionnaires. There were 1329 male students and 1311 female students. The age of the participants ranged from 11 to 17 years old, with a mean age of 13.3 (± 0.94) years. Non-suicidal self-injury (NSSI), depressive symptoms, and childhood trauma were assessed using the Adolescent Self-Harm Scale, the Childhood Depression Scale, and the Childhood Trauma Questionnaire, respectively. A network analysis was performed. RESULTS: In the network, NSSI, depressive symptoms, and childhood trauma were closely related. Negative self-esteem in the depressive symptoms and emotional abuse in childhood were the most central nodes. Negative self-esteem and negative mood were directly connected to NSSI, other nodes of depressive symptoms appeared to be indirectly connected to NSSI through these two nodes. Emotional abuse was the only node in childhood trauma categories directly connected to NSSI. Nodes of other categories of childhood trauma (physical neglect, physical abuse, emotional neglect, and sexual abuse) were indirectly connected to NSSI through emotional abuse. CONCLUSIONS: NSSI, depression, and childhood trauma of teenagers were closely related. Individuals who have suffered emotional abuse in childhood were more likely to have depressive symptoms and NSSI. Improving negative self-esteem and negative emotions and reducing emotional abuse may be beneficial in alleviating depression and reducing NSSI in adolescents.


Assuntos
Experiências Adversas da Infância , Depressão , Comportamento Autodestrutivo , Humanos , Adolescente , Comportamento Autodestrutivo/psicologia , Comportamento Autodestrutivo/epidemiologia , Masculino , Feminino , Depressão/psicologia , Depressão/epidemiologia , Criança , Estudos Transversais , Experiências Adversas da Infância/estatística & dados numéricos , Experiências Adversas da Infância/psicologia , Autoimagem , Maus-Tratos Infantis/psicologia , Maus-Tratos Infantis/estatística & dados numéricos , Inquéritos e Questionários
20.
BMC Public Health ; 24(1): 1059, 2024 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-38627716

RESUMO

BACKGROUND: Prevalence of self-harm In England is rising, however contact with statutory services remains relatively low. There is growing recognition of the potential role voluntary, community and social enterprise sector (VCSE) organisations have in the provision of self-harm support. We aimed to explore individuals' experiences of using these services and the barriers and facilitators to accessing support. METHODS: Qualitative, online interviews with 23 adults (18+) who have accessed support from VCSE organisations for self-harm in the Yorkshire and the Humber region were undertaken. Interviews were audio recorded and transcribed verbatim. Thematic analysis was undertaken using NVivo software. RESULTS: Participants described how a lack of service flexibility and the perception that their individual needs were not being heard often made them less likely to engage with both statutory and VCSE organisations. The complexity of care pathways made it difficult for them to access appropriate support when required, as did a lack of awareness of the types of support available. Participants described how engagement was improved by services that fostered a sense of community. The delivery of peer support played a key role in creating this sense of belonging. Education and workplace settings were also viewed as key sources of support for individuals, with a lack of mental health literacy acting as a barrier to access in these environments. CONCLUSIONS: VCSE organisations can play a crucial role in the provision of support for self-harm, however, pathways into these services remain complex and links between statutory and non-statutory services need to be strengthened. The provision of peer support is viewed as a crucial component of effective support in VCSE organisations. Further supervision and training should be offered to those providing peer support to ensure that their own mental health is protected.


Assuntos
Saúde Mental , Comportamento Autodestrutivo , Adulto , Humanos , Retroalimentação , Pesquisa Qualitativa , Inglaterra/epidemiologia , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/prevenção & controle , Comportamento Autodestrutivo/psicologia
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