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1.
J Affect Disord ; 321: 320-328, 2023 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-36302491

RESUMO

BACKGROUND: People engage in nonsuicidal self-injury (NSSI) to reduce negative affect, but it is not clear why they engage in this harmful type of behavior instead of using healthier strategies. The primary goal of this study was to evaluate whether people choose NSSI to reduce negative affect because they perceive it to be less cognitively costly than other available strategies. METHOD: In experiment one, 43 adults completed a novel, relief-based effort discounting task designed to index preferences about exerting cognitive effort to achieve relief. In experiment two, 149 adults, 52 % with a history of NSSI, completed our effort discounting task. RESULTS: Our main results suggest that people will accept less relief from an aversive experience if doing so requires expending less effort, i.e. they demonstrate effort discounting in the context of decisions about relief. We also found and that effort discounting is stronger among those with a history of NSSI, but this association became nonsignificant when simultaneously accounting for other conditions associated with aberrant effort tradeoffs. LIMITATIONS: The use of a control group without NSSI or other potentially harmful relief-seeking behaviors limits our ability to draw specific conclusions about NSSI. The ecological validity of our task was limited by a modestly effective affect manipulation, and because participants made hypothetical choices. CONCLUSIONS: This study demonstrates that preferences about exerting cognitive effort may be a barrier to using healthier affect regulation strategies. Further, the preference not to exert cognitive effort, though present in NSSI, is likely not unique to NSSI. Instead, effort discounting may be a transdiagnostic mechanism promoting an array of harmful relief-seeking behaviors.


Assuntos
Comportamento Autodestrutivo , Humanos , Adulto , Comportamento Autodestrutivo/psicologia , Afeto , Nível de Saúde , Cognição
2.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 47(9): 1267-1274, 2022.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-36411711

RESUMO

Growing evidence supports an association between self-harm and aggression, and the two behaviors frequently co-occur. The co-occurrence of self-harm and aggression is termed as dual harm. Existing evidence reveals that rather than a simple co-occurrence of self-harm and aggression, dual-harm may be an independent behavior different from a sole harm behavior. Identification of characteristics and influencing factors for dual harm may help develop effective prevention strategies for the affected population. A review of the literature yields a high incidence of dual harm among the clinical and forensic populations. Individuals with dual harm engage in an earlier, more frequent, and a wider range of harmful behaviors, with the increased use of lethal methods. Common factors that affect dual harm include childhood adversities, emotional dysregulation, personality traits, mental disorders, and biological factors. A comprehensive theory to explain dual harm is still not available. Currently, two main theories for explaining mechanism of dual harm are the two-stage model of countervailing forces and the cognitive-emotional model. An in-depth exploration of characteristics, influencing factors, and theories for dual harm is of great importance for the prevention of dual harm.


Assuntos
Transtornos Mentais , Comportamento Autodestrutivo , Humanos , Criança , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/prevenção & controle , Comportamento Autodestrutivo/psicologia , Agressão/psicologia
3.
Rev Lat Am Enfermagem ; 30(spe): e3735, 2022.
Artigo em Inglês, Português, Espanhol | MEDLINE | ID: mdl-36351086

RESUMO

OBJECTIVE: to develop and validate educational material to strengthen adolescent health care on non-suicidal self-injury. METHOD: methodological research designed in three stages: (1) construction of the material based on a mixed study on needs related to the theme through social networks and an umbrella review on health care related to non-suicidal self-injury; (2) validation with 10 experts in mental health and/or self-inflicted violence selected through the Lattes Platform; (3) evaluation by the target public, with health professionals being invited, without restriction of training. Validation and evaluation data were collected by using a sociodemographic questionnaire and the Suitability Assessment of Materials for evaluation of health-related information for adults. We used descriptive statistics, content validity index, and Gwet's AC1 test. RESULTS: the material obtained good general acceptance and reliability in the validation by the experts (AC1= 0.633; p=0.0000) and in the evaluation by the target public (AC1=0.716; p=0.0000). All professionals pointed out the personal contribution and educational potential of the material. CONCLUSION: we highlight the construction of science-based educational material to strengthen the health care for adolescents with non-suicidal self-injury. KEYPOINTS: (1) Scientific data-based construction of educational material for prevention of non-suicidal self-injury (NSSI). (2) General acceptance and reliability in the validation of the material by experts. (3) Acceptance and reliability in the evaluation of the material by health professionals. (4) Dissemination of material for health education initiatives to prevent NSSI.


Assuntos
Comportamento Autodestrutivo , Adulto , Adolescente , Humanos , Reprodutibilidade dos Testes , Comportamento Autodestrutivo/prevenção & controle , Comportamento Autodestrutivo/psicologia , Inquéritos e Questionários
4.
Behav Ther ; 53(6): 1219-1232, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36229118

RESUMO

Integrating across motivational models suggests that different self-damaging behaviors (SDBs) are enacted for similar reasons. However, it remains unclear whether some motives are more relevant to certain SDBs than others. To answer this question, the present study compared the salience of 8 potentially shared motives across 3 exemplar SDBs, selected to represent different points along the internalizing and externalizing spectra: binge drinking, disordered eating (binge eating, purging, fasting), and nonsuicidal self-injury (NSSI). Seven hundred and four first-year university students (73% female, Mage = 17.97) completed monthly surveys assessing their engagement in and motives for SDBs. Motives were conceptualized as either interpersonal (bonding with others, conforming with others, communicating strength, communicating distress, reducing demands) or intrapersonal (reducing negative emotions, enhancing positive emotions, punishing oneself). Multilevel models compared endorsement of each motive across SDBs. Results revealed that SDBs were motivated by similar goals, albeit to different degrees. Although some exceptions emerged, interpersonal motives were most salient to binge drinking, followed by disordered eating, and then NSSI. In contrast, intrapersonal motives were most salient to NSSI, followed by disordered eating, and then binge drinking. Motivational differences were also found within disordered eating. For example, punishing oneself was more relevant to purging and fasting than binge eating, whereas relieving negative emotions was more relevant to binge eating and purging than fasting. Similar to dimensional models that position SDBs on internalizing or externalizing spectra, the salience of motives for binge drinking and NSSI may fall on distinct spectra (i.e., interpersonal and intrapersonal, respectively), with motives for disordered eating exhibiting elements consistent with both spectra. This study supports a common motivational framework for investigating and potentially treating a variety of topographically distinct SDBs.


Assuntos
Consumo Excessivo de Bebidas Alcoólicas , Transtorno da Compulsão Alimentar , Transtornos da Alimentação e da Ingestão de Alimentos , Comportamento Autodestrutivo , Adolescente , Consumo Excessivo de Bebidas Alcoólicas/psicologia , Transtorno da Compulsão Alimentar/psicologia , Feminino , Humanos , Masculino , Motivação , Comportamento Autodestrutivo/psicologia
5.
Child Adolesc Ment Health ; 27(4): 325-327, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36250453

RESUMO

Reducing deaths by suicide in youth is an urgent public health goal and effective treatment approaches remain limited. This editorial reviews new research published in this issue of Child and Adolescent Mental health that may inform youth suicide prevention efforts, including an open trial of a new, family-focused group intervention for youth with suicidal ideation and findings showing that life problems associated with presentation to the emergency department for self-harm vary by age and gender. The need for multi-component treatments that have the flexibility to target a range of life problems/risk factors and to include families in treatment is discussed, along with the need to find a way to make such interventions scalable. Finally, this editorial addresses this issue's debate by discussing the role of mindfulness in dialectical behavior therapy for suicidal youth and the need to carefully monitor and further examine the effectiveness and safety of mindfulness with this patient population.


Assuntos
Comportamento Autodestrutivo , Suicídio , Adolescente , Criança , Humanos , Saúde Mental , Fatores de Risco , Comportamento Autodestrutivo/prevenção & controle , Comportamento Autodestrutivo/psicologia , Ideação Suicida , Suicídio/prevenção & controle , Suicídio/psicologia
6.
Trials ; 23(1): 849, 2022 Oct 05.
Artigo em Inglês | MEDLINE | ID: mdl-36199120

RESUMO

BACKGROUND: Men who present to the emergency department (ED) with self-harm are at high risk of dying by suicide, with 2.7% of men dying in the year following their presentation, more than double the rate for women (1.2%). Despite this, care received after an ED visit is highly variable and many are not assessed for psychological needs. Furthermore, the limited psychological care that is available is often not covered by provincial health insurance. Even when referrals for follow-up care are made, engagement rates are low. Previous recommendations to improve engagement include written discharge plans, caring contacts, and focused interventions targeting middle-aged men at elevated risk of dying by suicide. Blended care, the incorporation of technology into traditional care, has also been proposed as a method to increase engagement in and clinical benefits from psychotherapy. This project aims to determine whether the delivery of an evidence based treatment (problem-solving therapy (PST)) is enhanced by the addition of a custom smartphone application (BEACON) compared to usual care. Due to the impact of the COVID-19 pandemic on site participation and the planned implementation, we have made several changes to the study design, primary outcome, and implementation. METHOD: We originally proposed a cohort study nested within a larger cluster randomized trial wherein intervention sites would deliver the blended care, and control sites, whose personnel were not aware of their participation, would continue delivering usual care. The cohort study evaluated participant level outcomes as previously described by Hatcher et al. (2020). Due to pandemic-related constraints, our number of participating sites dropped to five potential sites which left the cohort study underpowered. As such, we changed the study design to a multi-site, individual randomized controlled trial (RCT) among the five remaining sites. Participants will be randomized to six sessions of therapy (PST) alone, or to the therapy plus BEACON, and followed up for 6 months. Our primary outcome was changed to evaluate feasibility and acceptability with the aim of designing a definitive RCT. Study implementation was reimagined to allow for completely virtual/online conduct to comply with local COVID-19 and institutional restrictions on in-person activities. CONCLUSION: This updated protocol will provide strong results for the planning of a definitive RCT of the blended care intervention in the future, addressing areas of difficulty and concern prior to its implementation. We will evaluate the feasibility of the study intervention, assess recruitment and retention of participants, and address challenges with implementing the protocol. Lastly, we will evaluate the appropriateness of our primary outcome measure and accurately determine a sample size for a definitive RCT. TRIAL REGISTRATION: ClinicalTrials.gov, NCT03473535 . Registered on March 22, 2018.


Assuntos
COVID-19 , Comportamento Autodestrutivo , COVID-19/terapia , Estudos de Coortes , Serviço Hospitalar de Emergência , Estudos de Viabilidade , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Ontário , Psicoterapia , Ensaios Clínicos Controlados Aleatórios como Assunto , Comportamento Autodestrutivo/diagnóstico , Comportamento Autodestrutivo/psicologia , Comportamento Autodestrutivo/terapia , Smartphone
7.
Artigo em Inglês | MEDLINE | ID: mdl-36231200

RESUMO

Non-suicidal self-injury (NSSI) can be defined as the deliberate destruction of body tissues to generate harm. College students have a higher incidence of NSSI. With the deepening of research on college students' NSSI, the connection between their self-consistency congruence and NSSI has drawn the attention of many scholars. The current study examined the association between self-concordance and NSSI, the mediating function of negative emotions, and the moderating role of gender. We surveyed 1020 college students from three universities in Jiangxi Province using a self-concordant scale, a NSSI questionnaire, and a negative emotion questionnaire. The results showed that self-concordance was negatively correlated with NSSI. There is an obvious negative connection between self-consistency congruence and negative emotions. There was a significant positive correlation between negative emotions and the NSSI scores. Negative emotions could mediate the association between self-consistency congruence and NSSI. Compared to males, females' self-concordant effects on negative emotions are easier to moderate.


Assuntos
Comportamento Autodestrutivo , Emoções , Feminino , Humanos , Masculino , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/psicologia , Estudantes/psicologia , Inquéritos e Questionários , Universidades
8.
Sci Rep ; 12(1): 17238, 2022 Oct 14.
Artigo em Inglês | MEDLINE | ID: mdl-36241902

RESUMO

This study analyzed the factors influencing adolescents' non-suicidal self-injury (NSSI) behavior and their interrelationships, and established a total influencing factor model. Through a literature analysis and semi-structured interviews with 87 adolescents and 27 experts in Guangxi Province, China, 13 influencing factors were identified from six aspects: physiological factors, cognitive factors, emotional factors, social support factors, social environment, and NSSI behavior. A system of factors influencing adolescents' NSSI behavior and a model of the factors influencing the comprehensive antagonism multilevel explanatory structure were obtained using a combination of Decision-Making Trial and Evaluation Laboratory technique and Total Adversarial Interpretive Structural Model. In descending order, NSSI, emotional state, self-efficacy, and self-cognition influenced adolescents' NSSI behavior. Social environment, exercise, and recreation had a greater impact on other factors, while NSSI, emotional regulation ability, and emotional state were greatly affected by other factors. Emotion regulation ability, self-cognition, self-efficacy, family support, school support, social support, and sleep were found to be the core factors influencing NSSI behavior of adolescents. These factors could be used to directly intervene in adolescent NSSI behavior. Timely treatment of adolescents' negative emotional states is directly conducive to preventing NSSI behavior and alleviating its severity.


Assuntos
Comportamento do Adolescente , Comportamento Autodestrutivo , Adolescente , Comportamento do Adolescente/psicologia , China , Emoções , Humanos , Comportamento Autodestrutivo/psicologia , Ideação Suicida
9.
Brain Behav ; 12(11): e2771, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36168882

RESUMO

OBJECTIVE: This study was performed to explore the effect of childhood trauma on nonsuicidal self-injury (NSSI) in adolescents with bipolar II (BD II) depression. METHODS: Based on the diagnostic criteria of the DSM-5 and structured interviews to assess the presence or absence of NSSI, 184 adolescent patients with BD II depression were divided into the NSSI (n = 112) and non-NSSI (n = 72) groups. The Adolescent Nonsuicidal Self-Injury Assessment Questionnaire (ANSAQ), Childhood Trauma Questionnaire-Short Form (CTQ-SF), Toronto Alexithymia Scale (TAS-20), Hamilton Depression Scale (HAMD), and Hamilton Anxiety Scale (HAMA) were used to assess the subjects. RESULT: The CTQ-SF, HAMD, HAMA, and TAS-20 scores were significantly higher in the NSSI group than in the non-NSSI group (p < .01). Logistic regression analysis showed emotional abuse (p = .028, OR = 1.14, 95% CI = 1.01-1.28) and age of onset (p = .009) as risk factors for NSSI. Adolescents with onset age 12-13 years (OR = 6.30, 95% CI = 1.72-23.10) and 14-15 years (OR = 2.24, 95% CI = 1.04-4.84) had a higher risk of self-injury relative to adolescents aged 16-18 years. CONCLUSION: Childhood trauma and alexithymia were important influencing factors in adolescent patients with BD II depression. Emotional abuse and age of onset as risk factors for NSSI, and difficulties in emotion recognition were positively associated with the patients' NSSI.


Assuntos
Experiências Adversas da Infância , Transtorno Bipolar , Comportamento Autodestrutivo , Humanos , Adolescente , Transtorno Bipolar/psicologia , Depressão/epidemiologia , Depressão/psicologia , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/psicologia , Sintomas Afetivos/epidemiologia , Sintomas Afetivos/psicologia
10.
J Affect Disord ; 319: 490-496, 2022 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-36162670

RESUMO

BACKGROUND: Psychiatric disorders are common among individuals treated for deliberate self-harm (DSH) in general hospitals. However, few large-scale studies have explicitly addressed psychiatric disorders among adult DSH patients. AIM: To examine the presence of psychiatric disorders among adults presenting to general hospitals following DSH, and further to establish clinical and sociodemographic determinants of being diagnosed with a psychiatric disorder in this patient population. METHOD: Data from several national registers were interlinked to identify all individuals aged 18 and older presenting to general hospital for DSH during the period 2008-2018. Logistic regression was used to examine the association between psychiatric disorders (ICD-10) and clinical and sociodemographic characteristics of the DSH patients. RESULTS: Altogether 39,534 subjects with 63,622 episodes of DSH were included in the study with a gender ratio (F:M) of 1.48. The majority were unmarried and had low income and education. Psychiatric disorders were present in 58.5 % of all episodes and in 54.3 % of the index episodes. Affective disorders displayed the highest prevalence (18.3 %), followed by alcohol use disorder (16.4 %). Personality disorders were highly prevalent among young females with multiple DSH episodes. Middle-aged individuals had the highest prevalence of psychiatric disorders. Presence of psychiatric disorders was significantly associated with DSH repetition. LIMITATIONS: Data was restricted to variables available in the registers. CONCLUSIONS: Psychiatric disorders were common among DSH patients in the present cohort, but distributed differently between the genders. DSH repetition and middle-age was associated with being diagnosed with a psychiatric disorder.


Assuntos
Transtornos Mentais , Comportamento Autodestrutivo , Adulto , Pessoa de Meia-Idade , Humanos , Feminino , Masculino , Hospitais Gerais , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/psicologia , Transtornos Mentais/psicologia , Transtornos da Personalidade/epidemiologia , Transtornos da Personalidade/complicações , Transtornos do Humor/epidemiologia , Fatores de Risco
11.
Medicine (Baltimore) ; 101(37): e30694, 2022 Sep 16.
Artigo em Inglês | MEDLINE | ID: mdl-36123847

RESUMO

Although many concerns have been raised on increased self-harm or suicide attempts since the emergence of the coronavirus disease 2019 (COVID-19) pandemic, the numbers of studies reported no consistent increase. This study aimed to analyze the data on the request for emergency medical service (EMS) in Daegu Metropolitan City in Korea to investigate the effects of the COVID-19 pandemic on the incidence and types of suicidal patients. Data of 4480 cases requesting EMS related to self-harm or suicide 1 year before and after the COVID-19 pandemic were retrospectively comparatively analyzed (February 19, 2019-February 18, 2021). The number of EMS requests for self-harm and suicide increased after the pandemic compared to that before the pandemic (daily mean request 5.83 [±2.597] vs 6.43 [±2.918]). In particular, the number of female patients increased per day on average (2.61 [±1.717] vs 3.17 [±1.893]). With respect to the reasons for the request, committed self-harm and attempts to commit self-harm increased, whereas the presumption against suicide decreased. With respect to consciousness levels, the number of alert patients increased, whereas the number of transport cases decreased. For the method of the attempt, hanging and carbon monoxide/gas poisoning decreased, whereas jumping from a height and drowning increased. The number of patients with psychiatric history and those with other chronic illnesses increased. In multivariate regression analysis, women (OR 1.227, 95% CI = 1.072-1.405, P = .003), patients with psychiatric diseases (OR 1.223, 95% CI = 1.031-1.450, P = .021), patients with other chronic illnesses (OR 1.510, 95% CI = 1.127-2.023, P = .006), and CO or gas poisoning (not attempted) (OR 1.349, 95% CI = 1.038-1.753, P = .025) showed statistically significant differences. Among the request for EMS, requests for committed self-harm and attempts to commit suicide increased. Medical support and measures for mental health and emergency medical systems should be established for female patients and patients with psychiatric or other chronic diseases.


Assuntos
COVID-19 , Intoxicação por Gás , Comportamento Autodestrutivo , COVID-19/epidemiologia , Monóxido de Carbono , Feminino , Intoxicação por Gás/epidemiologia , Hospitais , Humanos , Registros Médicos , Pandemias , Estudos Retrospectivos , Fatores de Risco , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/psicologia
12.
Child Abuse Negl ; 133: 105870, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36084408

RESUMO

BACKGROUND: Child maltreatment is a risk factor for a range of mental disorders later in life, including dangerous self-harm and suicide attempts. A better understanding of the mechanisms underlying this association can inform prevention and intervention. OBJECTIVE: To investigate personality functioning as a potential mediator of the association of childhood abuse and neglect and self-harm and suicide attempts in the general population. PARTICIPANTS AND SETTING: Data were drawn from a representative German population sample (N = 2510). METHODS: Participants filled out the Childhood Trauma Questionnaire (CTQ), OPD Structure Questionnaire (OPD-SQS), and items of the Self-Injurious Thoughts and Behaviors Interview (SITBI). In structural equation models, we operationalized impaired personality functioning as the mediator between childhood abuse and neglect and self-harm. RESULTS: Individuals with a history of self-harm (combining suicide attempts, N = 47, and non-suicidal self-injury, N = 83) reported more childhood abuse and neglect (d = 1.39, p < .001) and greater impairments in personality functioning (d = 1.64, p < .001) than the rest of the population. The indirect effect via personality functioning accounted for 48.8 % of the total effect of childhood abuse and neglect on self-harm. In more differentiated analyses, emotional abuse showed the strongest association with self-harm. Only physical and sexual abuse had direct effects. CONCLUSIONS: The results specify the relationship between child maltreatment and self-harm by demonstrating that it is partly mediated by basic functions of personality assessed using a dimensional measure. These abilities constitute modifiable risk factors that can be addressed by psychotherapy.


Assuntos
Maus-Tratos Infantis , Comportamento Autodestrutivo , Criança , Maus-Tratos Infantis/psicologia , Humanos , Personalidade , Transtornos da Personalidade , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/psicologia , Tentativa de Suicídio/psicologia
13.
Evid Based Ment Health ; 25(4): 148-155, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36162975

RESUMO

QUESTION: Effective prevention of suicide requires a comprehensive understanding of risk factors. STUDY SELECTION AND ANALYSIS: Five databases were systematically searched to identify psychological autopsy studies (published up to February 2022) that reported on risk factors for suicide mortality among adults in the general population. Effect sizes were pooled as odds ratios (ORs) using random-effects models for each risk factor examined in at least three independent samples. FINDINGS: A total of 37 case-control studies from 23 countries were included, providing data on 40 risk factors in 5633 cases and 7101 controls. The magnitude of effect sizes varied substantially both between and within risk factor domains. Clinical factors had the strongest associations with suicide, including any mental disorder (OR=13.1, 95% CI 9.9 to 17.4) and a history of self-harm (OR=10.1, 95% CI 6.6 to 15.6). By comparison, effect sizes were smaller for other domains relating to sociodemographic status, family history, and adverse life events (OR range 2-5). CONCLUSIONS: A wide range of predisposing and precipitating factors are associated with suicide among adults in the general population, but with clear differences in their relative strength. PROSPERO REGISTRATION NUMBER: CRD42021232878.


Assuntos
Transtornos Mentais , Comportamento Autodestrutivo , Suicídio , Adulto , Humanos , Autopsia , Suicídio/prevenção & controle , Comportamento Autodestrutivo/psicologia , Fatores de Risco , Transtornos Mentais/epidemiologia
14.
J Affect Disord ; 318: 238-245, 2022 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-36055531

RESUMO

BACKGROUND: We examined disparities in sociodemographic and clinical characteristics and in problems preceding self-harm across levels of socio-economic deprivation (SED) in persons who presented to hospital for self-harm. METHOD: 108,092 presentations to hospitals (by 57,306 individuals) following self-harm in the Multicentre Study of Self-harm in England (1/1/2000-31/12/2016). Information on area-level SED was based on the English Index of Multiple Deprivation. Information about patients' characteristics and problems was obtained from self-harm monitoring systems in the hospitals. We assessed the association of SED with the characteristics of interest using descriptive statistics. RESULTS: Overall, 45 % of the presentations were by individuals from areas ranked nationally as most deprived, while 13 % of episodes were by individuals from the least deprived areas. Males and non-white ethnic groups were over-represented in the most deprived SED stratum. Previous self-harm was more prevalent in the two most deprived groups. Relationships difficulties with partners and other family members were reported more commonly by individuals from less socio-economically deprived areas, as were problems pertaining to finances and employment or studies. Problems in relationships with friends were more prevalent in the most deprived group relative to other groups. LIMITATIONS: Information about problems which preceded self-harm was available only for patients who received psychosocial assessment. CONCLUSIONS: Patients vary considerably across area-level SED strata in terms of gender, ethnicity, and the problems which preceded their self-harm. These findings emphasise the need to use an individualised approach to patients in understanding the unique circumstances which contribute to their self-harm and their specific care needs.


Assuntos
Comportamento Autodestrutivo , Emprego , Inglaterra/epidemiologia , Hospitais , Humanos , Masculino , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/psicologia
15.
J Affect Disord ; 318: 191-195, 2022 12 01.
Artigo em Inglês | MEDLINE | ID: mdl-36057292

RESUMO

BACKGROUND: Nonsuicidal self-injury (NSSI) is a prevalent health problem among adolescents and commonly associated with psychological stressors such as childhood maltreatment and comorbid psychiatric disorders (e.g., depression). There is evidence that alterations of immunological markers may occur in the context of both environmental stress and psychopathological development. METHOD: Here, we investigated differences in plasma/serum leukocytes, cortisol, c-reactive protein and interleukin-6 in a large sample of female adolescents with NSSI (n = 155) and healthy controls (HC, n = 42). Further, we assessed correlations between inflammatory markers, depression severity and the severity of childhood maltreatment. RESULTS: The absolute number of leukocytes and the leukocyte/cortisol ratio (adjusted for body mass index and smoking) were significantly higher in NSSI as compared to HC, whereas interleukin-6 and CRP levels did not differ significantly between groups. Childhood maltreatment scores were significantly correlated with the leukocyte/cortisol ratio and depression severity was significantly correlated with both, absolute leukocyte numbers and the leukocyte/cortisol ratio. CONCLUSIONS: Our results suggest that an immune activation can be detected in female adolescents with NSSI. Depression and childhood maltreatment, which are commonly reported in NSSI, may potentially underlie immune activation and partially explain group differences.


Assuntos
Maus-Tratos Infantis , Comportamento Autodestrutivo , Adolescente , Proteína C-Reativa , Criança , Maus-Tratos Infantis/psicologia , Feminino , Humanos , Hidrocortisona/metabolismo , Interleucina-6 , Comportamento Autodestrutivo/psicologia
16.
J Psychiatr Res ; 155: 338-346, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36179414

RESUMO

The functions of nonsuicidal self-injury (NSSI) consist of social and emotional aspects (Social influence, Sensation seeking, Internal and External emotion regulation). Previous studies have indicated that dysfunction in reward-related brain structures especially the striatum might drive this habitual behavior. However, no studies to date have investigated the associations between striatum and different functions for adolescents engaging in NSSI behaviors. Here, we recruited 35 depressed adolescents with recent NSSI behaviors and 36 healthy controls and acquired structural brain images, depressive symptoms, social, academic and family environments assessments, in addition to NSSI functions in patients only. Subcortical volumes and cortical thickness were estimated with FreeSurfer. Mixed linear regressions were performed to examine associations between striatal structures (caudate, putamen, nucleus accumbens, pallidum) and NSSI functions, with age, sex, total intracranial volume, hemisphere and depression severity included as covariates. Effect of environmental factors and potential associations with cortical thickness and other subcortical volumes were also tested. We found that, among the four functions, external emotional regulation represented the main function for NSSI engagement. Increased external emotion regulation was significantly associated with smaller putamen volume. No environmental factors biased the association with putamen. No associations with other cortical or subcortical regions were observed. Our findings suggested that smaller putamen might be a biomarker of NSSI engagement for depressed adolescents when they regulated frustrated or angry emotions. The results have potentially clinical implications in early identification and brain intervention of NSSI in youth.


Assuntos
Comportamento do Adolescente , Regulação Emocional , Comportamento Autodestrutivo , Adolescente , Comportamento do Adolescente/fisiologia , Emoções/fisiologia , Humanos , Putamen/diagnóstico por imagem , Comportamento Autodestrutivo/psicologia
17.
Psychiatr Danub ; 34(Suppl 8): 140-143, 2022 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-36170718

RESUMO

The sudden and unexpected spread of the COVID 19 pandemic forced the political and health institutions of many countries to adopt drastic measures to contain the contagion, forcing millions of people into isolation and loneliness since 2020. For this reason, health organizations were committed from the beginning to develop all strategies available to support the mental health of the community and to reduce the risks of a rising suicide rate. Although an apparent "protective" role of emergency interventions on suicidal behavior was confirmed during the first months of forced isolation of the population, in the following months a close correlation was highlighted between pandemic period, rising of psychological and psychiatric disorders, and suicidal ideation. The increased suicide rate in Trentino in the first half of 2022 was not unexpected.Beyond the possible increase in suicide rates, a sustained and chronic increase in suicidal risk, suicidal ideation and in self harm could be confirmed in the future. The implementation of successful strategies for reducing suicidal deaths is a public health issue and will lay on the availability of local prevention projects, on their effort to better understand suicide and suicidal behaviors during outbreak, in order to develop the general capacity to early identify risk situation, and to enhance the effectiveness of prevention plans.


Assuntos
COVID-19 , Comportamento Autodestrutivo , Suicídio , Depressão/psicologia , Humanos , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/psicologia , Ideação Suicida , Suicídio/prevenção & controle , Suicídio/psicologia
18.
Artigo em Russo | MEDLINE | ID: mdl-36168690

RESUMO

This review addresses the prevalence and mutual influence of non-suicidal self-injurious behavior (NSSI) and eating disorders (ED). The data on the role of demographic, social, biological and psychological variables in the formation of ED and NSSI comorbidity is presented. The authors analyze the influence of NSSI on the course of ED, as well as prognostic values of their combination. The problems of the choice of therapeutic tactics are also highlighted.


Assuntos
Transtornos da Alimentação e da Ingestão de Alimentos , Comportamento Autodestrutivo , Comorbidade , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Humanos , Prevalência , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/psicologia , Ideação Suicida
19.
Behav Cogn Psychother ; 50(6): 620-628, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-35924301

RESUMO

BACKGROUND: Body-focused repetitive behaviours (BFRBs) such as skin picking and hair pulling are frequent but under-diagnosed and under-treated psychological conditions. As of now, most studies use symptom-specific BFRB scales. However, a transdiagnostic scale is needed in view of the high co-morbidity of different BFRBs. AIMS: We aimed to assess the reliability as well as concurrent and divergent validity of a newly developed transdiagnostic BFRB scale. METHOD: For the first time, we administered the 8-item Generic BFRB Scale (GBS-8) as well as the Repetitive Body Focused Behavior Scale (RBFBS), modified for adults, in 279 individuals with BFRBs. The GBS-8 builds upon the Skin Picking Scale-Revised (SPS-R), but has been adapted to capture different BFRBs concurrently. A total of 170 participants (61%) were re-assessed after 6 weeks to determine the test-retest reliability of the scale. RESULTS: Similar to the SPS-R, factor analysis yielded two dimensions termed symptom severity and impairment. The test-retest reliability of the scale was satisfactory (r = .72, p<.001). Concurrent validity (r = .74) with the RBFBS was good (correlational indexes for concurrent validity were significantly higher than that for discriminant validity). DISCUSSION: The GBS-8 appears to be a reliable and valid global measure of BFRBs. We recommend usage of the scale in combination with specific BFRB scales to facilitate comparability across studies on obsessive-compulsive spectrum disorders.


Assuntos
Transtorno Obsessivo-Compulsivo , Comportamento Autodestrutivo , Tricotilomania , Adulto , Comorbidade , Humanos , Transtorno Obsessivo-Compulsivo/psicologia , Reprodutibilidade dos Testes , Comportamento Autodestrutivo/psicologia , Tricotilomania/psicologia
20.
Psychiatry Res ; 317: 114810, 2022 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-36029569

RESUMO

Clinicians assessing suicidal patients in emergency departments (EDs) must decide whether to admit the person to a psychiatric ward with voluntary or compulsory hospitalization or to discharge him/her as an outpatient. This cross-sectional study aimed to identify independent predictors of this decision among a large sample of self-harm (SH) patients. It used data from all patients admitted to four Swiss EDs between 2016 and 2019. Socio-demographic, clinical, and suicidal process-related characteristics data were evaluated against the decision for voluntary or compulsory hospitalization using t-tests, Chi-Square tests and logistic multiple regression. 2142 episodes from 1832 unique patients were evaluated. Independent predictors of decision to hospitalize included: male gender, advanced age, hospital location, depression and personality disorders, substance use, a difficult socio-economic condition, a clear intent to die, and a serious suicide attempt. Significant variables that emerged as independent predictors of compulsory hospitalization were hospital location, not having anxiety and personality disorders, being retired, having a clear intent to die, and making a serious suicide attempt. Hospital EDs had different rates of compulsory psychiatric admission. However, the decision to admit a patient for hospitalization, either voluntary or compulsory, was mainly based on clinical factors.


Assuntos
Alta do Paciente , Comportamento Autodestrutivo , Humanos , Feminino , Masculino , Estudos Transversais , Comportamento Autodestrutivo/epidemiologia , Comportamento Autodestrutivo/terapia , Comportamento Autodestrutivo/psicologia , Tentativa de Suicídio/psicologia , Ideação Suicida , Hospitalização
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