Exploring the Reciprocal Relations between Nonsuicidal Self-Injury, Negative Emotions and Relationship Problems in Chinese Adolescents: A Longitudinal Cross-Lag Study

The present study explored the reciprocal relations between nonsuicidal self-injury (NSSI), negative emotions and relationship problems in a community sample of 2,435 (57.6% females) Chinese adolescents. Participants completed measures assessing 12 NSSI behaviors, three negative emotions (depression, anxiety and tension), and relationship problems at two time points over a 6-month period. A longitudinal cross-lag analysis was used to test the reciprocal relations among the studied variables. Results showed that after controlling for their initial associations, NSSI significantly predicted negative emotions over time but not vice versa, and relationship problems significantly predicted NSSI over time but not vice versa. Theoretical and clinical implications of these findings were discussed.     

Impulsivity and Nonsuicidal Self-Injury: Examining the Role of Affect Manipulation

The assessment of impulsivity is complicated by the construct’s multi-faceted nature and poor correspondence between self-report and behavioral measures. These complications extend to populations anecdotally described as impulsive, including individuals who engage in nonsuicidal self-injury (NSSI). Research suggests that self-injurers report impulsivity, primarily negative urgency. Thus, negative affect may be an important prerequisite for increased impulsive behaviors. The present laboratory study examined self-report impulsivity differences between individuals with and without a history of NSSI and if self-injurers demonstrated behavioral impulsivity when experiencing negative affect. Undergraduates with (N?=?54) and without (N?=?61) a history of NSSI participated in a two-part laboratory-based study that investigated the role of affect manipulation in impulsivity and NSSI. Participants were randomly assigned to either a negative or a neutral-relaxing mood induction. Participants completed self-report measures of impulsivity, NSSI, and negative affect. A behavioral measure of impulsivity was administered during Session 1 (prior to a mood induction task) and again during Session 2 (following a mood induction task) to determine whether affect had an effect on behavioral impulsivity task performance. Self-injurers reported higher negative urgency and lack of perseverance but did not display impulsivity on the behavioral task, even under conditions of negative affect.     

自伤青少年的冲动性

以自我报告、行为学和脑电为指标, 检验自伤青少年的冲动性。研究1, 对820名普通中学生和72名工读生进行问卷调查, 探讨自伤行为与情绪调节困难、冲动性的关系。结果表明, 冲动性能够预测自伤行为, 且预测效应量大于情绪调节困难。研究2, 采用Go/Nogo范式的ERPs实验, 检验自伤组与对照组冲动控制的行为学与脑电差异。结果表明, 自伤组Nogo正确反应的N2波幅显著高于对照组, N2潜伏期在部分电极点处高于对照组。脑电地形图显示两者的脑电差异主要体现在前额叶区。结论：自伤青少年的冲动性高于同龄普通青少年。     

Motivations for Self‐Injury,Affect, and Impulsivity: A Comparison of Individuals with Current Self‐Injury to Individuals with a History of Self‐Injury

Individuals who report nonsuicidal self‐injury (NSSI) are characterized by the tendency to act rashly while experiencing distress (negative urgency), the tendency to act without thinking, and endorsement of both social and affect regulation motives for the behavior. However, very little research has identified characteristics that distinguish current self‐injurers from those with a history of the behavior. The purpose of this study was to compare individuals with current self‐injury to a history of self‐injury on impulsivity‐related personality traits, motives for self‐injury, and distress. Among a sample of 429 undergraduates, 120 reported self‐injury. Among these 120 individuals, 33 endorsed self‐injury within the past month, with a mean frequency of 4.77 acts of NSSI. Within the self‐injury group, current self‐injurers reported higher endorsement of affect regulation motives for NSSI, and higher levels of current negative affect than individuals with a history of self‐injury. There were no differences between current and former self‐injurers on measures of impulsivity, endorsement of social motives for NSSI, or positive affect. We propose that individuals who use NSSI to regulate negative affect may be more likely to repeatedly engage in this behavior over time.     

Look before you leap: the role of negative urgency in appraisals of ambiguous and unambiguous scenarios in individuals high in generalized anxiety disorder symptoms

Negative interpretation bias, the propensity to make threatening interpretations of ambiguous information, is associated with symptoms of generalized anxiety disorder (GAD). Apart from its relationship with intolerance of uncertainty (IU), little is known about what explains the presence of this cognitive bias in GAD. One factor may be negative urgency (NU), the tendency to take rash action when distressed, which is related to GAD symptoms and to cognitive biases in nonclinical populations. The aim of the present study was to examine the relationship between NU and interpretation bias in individuals high in GAD symptoms (N = 111). IU, trait anxiety, and other forms of impulsivity were examined concurrently as competing correlates of interpretation bias. Greater NU and IU were found to be unique correlates of greater threatening interpretations of ambiguous scenarios. Greater NU was also a unique correlate of greater threatening interpretations of negative and positive scenarios. No other forms of impulsivity were uniquely related to interpretation bias. The findings suggest that greater NU may have a role in the tendency for individuals high in GAD symptoms to make threatening interpretations in response to ambiguous scenarios, overtly threatening situations, and situations without indication of threat or danger. Theoretical implications of these findings are discussed.     

Non-suicidal self-injury and identity distress in Flemish adolescents: Exploring gender differences and mediational pathways

There is an increasing amount of research that examines non-suicidal self-injury (NSSI) in relation to identity formation in adolescents. However, little or no research to date has explored associations between NSSI and identity distress in specific domains. To address this shortcoming, we assessed NSSI, identity distress, anxiety, and depression using self-report questionnaires in 568 high school students. Gender differences in NSSI were found with lifetime prevalence of NSSI being twice as high in females as compared to males. Gender differences in terms of identity domains were also significant; adolescent females showed higher levels of distress in the identity domains of career goals, friendship, and group loyalties as compared to males. Adolescents engaging in NSSI showed higher distress in domains of long-term goals, friendship, sexual orientation and behavior, values and beliefs. Results indicated that it was not distress in specific domains as such but the impairment due to daily impact of identity distress that explained additional variance in lifetime prevalence of NSSI above and beyond gender, age, depression, and anxiety. We also demonstrated that gender differences in lifetime prevalence of NSSI were mediated by differences in such identity impairment. Clinical implications of these findings are discussed.     

Nonsuicidal Self‐Injury in College Students: The Role of Perfectionism and Rumination

A paucity of research exists examining personality and cognitive characteristics that may contribute to nonsuicidal self‐injury (NSSI). The purpose of the current study was to clarify the contribution of perfectionism and rumination, along with depression and anxiety, to NSSI within a sample of 170 college students. Group comparisons revealed that participants with a history of NSSI endorsed significantly more rumination and depressive and anxious symptoms then non‐NSSI controls. Results regarding perfectionism were mixed, with NSSI participants differing from controls on select aspects of perfectionism. Results suggest higher levels of depression and anxiety and a ruminative cognitive style may increase vulnerability for NSSI; however, further research is needed to clarify the contribution of perfectionism.     

Physical Activity,Exercise Motivations,Depression, and Nonsuicidal Self‐Injury in Youth

This study explored the relationship between physical activity, depression, and nonsuicidal self‐injury (NSSI) in 167 high school and undergraduate students (mean age = 17.37, range 14–25). Results indicated that NSSI frequency had a significant negative relationship with physical activity, and physical activity moderated the relationship between depressive symptoms and self‐harm. Specifically, high levels of depressive symptoms and low levels of physical activity had the greatest frequency of NSSI. Lastly, appearance‐based exercise motivations were significantly related to increased frequencies of NSSI. Overall, physical activity may possess a protective nature against NSSI, especially in individuals with depressive symptoms.     

The effects of behavioral inhibition/approach system as predictors of Internet addiction in adolescents

This study aimed to determine how the Behavioral Inhibition System (BIS) and the Behavioral Approach System (BAS) affect Internet addiction in adolescents. Two hundred and eleven high school students participated in this study and completed the Young’s Internet Addiction Test (IAT), BIS/BAS scales, and several self-administered questionnaires about depression, anxiety, and impulsivity. Hierarchical regressions showed that BIS and BAS × BIS emerged as significant predictors of IAT; however, only BAS-fun seeking subscale predicted IAT among BAS related subscales. In further analyses, the BAS-fun seeking subscale was mediated by impulsivity and anxiety, and BIS was mediated by anxiety and depression. The current findings imply that BIS and BAS interdependently influence vulnerability to Internet addiction through both shared (anxiety) and different (depression and impulsivity, respectively) pathways.     

青少年自伤网络展示的动机及其影响

自我伤害行为是一种复杂且危险的心理病理行为,它会给个体的身心带来不同程度的损害。自伤是在多种因素的共同作用下产生,且在青少年中发生率最高。随着互联网的普遍使用,网络已经成为青少年生活中不可或缺的部分,近年来研究者开始关注到青少年的自伤网络展示行为。研究显示,许多自伤青少年会在网络上展示自己的自伤行为;个体一般是在多种动机的作用下对自己的自伤行为或经历进行展示;这些展示的内容既可能会让更多的人模仿或强化自伤,也可能会为自伤者提供社会支持,有助于他们减少自伤行为。     

Psychiatric and Self‐Injury Profiles of Adolescent Suicide Attempters versus Adolescents Engaged in Nonsuicidal Self‐Injury

To better delineate the unique correlates of self‐injurious behaviors (SIB), psychiatric profiles of mutually exclusive groups of adolescents who made a suicide attempt (SA) versus those engaged in nonsuicidal self‐injury (NSSI) were examined. Contrary to hypotheses, the NSSI group endorsed earlier onsets of SIB and suicidal ideation (SI), as well as higher rates of depression and anxiety compared with their SA counterparts. Future work is warranted to understand the role of SI, including duration of SI and anxiety in the development of NSSI, and to identify risk and resiliency factors useful in predicting an adolescent's SIB status.     

The associations between non-suicidal self-injury and borderline personality disorder features among Chinese adolescents

This study examined the relative importance of four major BPD features, that is, affective instability, disturbed interpersonal relationship, unstable sense of self, and behavioral impulsivity, in explaining the presence, initiation, repetition, and discontinuation of non-suicidal self-injury (NSSI) among a 2-year follow-up sample of 4,782 (68.5% girls) Hong Kong Chinese secondary school students. Affective instability, disturbed interpersonal relationship and behavioral impulsivity were significantly associated with the presence of NSSI both concurrently and longitudinally. These three BPD features were also related to the future initiation of NSSI. On the other hand, only behavioral impulsivity made a significant contribution to the repetition of NSSI. Additionally, a lower level of affective instability was also associated with quitting NSSI. We discussed some possible mechanisms underlying the effects of different BPD features on different developmental stages of NSSI.     

Non-Suicidal Self-Injury Among Male Adjudicated Adolescents: Psychosocial Concerns,Coping Responses,Diagnoses, and Functions

Non-suicidal self-injury (NSSI) refers to self-inflicted physical injury without suicidal intent. NSSI is particularly common in forensic settings and associated with several psychosocial concerns, coping responses, diagnoses, and functions, but little information is available regarding NSSI in adjudicated male adolescents. The present study examined the frequency and types of NSSI among adjudicated male adolescents (n?=?103) and assessed the relationships between NSSI history, psychosocial concerns, coping responses, diagnoses, and functions within this population. Approximately two-thirds (66%) reported NSSI history. Participants with NSSI history reported poorer social adaptation and greater alienation and boredom, aggression, and emotional lability than controls. Youth with high-frequency NSSI were also more likely to utilize emotional discharge as an unhealthy coping response than controls. In addition, participants with high-frequency NSSI were more likely than controls to meet criteria for a mood or anxiety disorder. Function of NSSI primarily surrounded anxiety reduction/affect regulation, punishment, dissociation reduction, and social/sensation-seeking. NSSI appears to be prevalent among male adjudicated youths, and the findings suggest that the relationship between NSSI history, psychosocial concerns, coping responses, and functions is nuanced and could inform more calibrated assessment and treatment strategies.     

青少年自我伤害行为的潜在转变分析:一项纵向研究

研究采用潜在转变分析探究了青少年自我伤害行为的发展。对3600名青少年进行为期18个月的追踪,对其自我伤害行为进行了三次测量。通过纵向数据分析识别出过渡组这一以往研究未发现的群体,该组被试仅出现程度较轻的自我伤害行为,且占总体的比例随时间快速下降。通过转变矩阵解释了过渡组和高发组的不稳定性是自我伤害行为发生率降低的原因,并发现冲动性、负向情绪等个体易感因素比家庭等人际因素对自我伤害行为存在更为显著的预测作用。在性别差异上,女生比男生更容易产生自我伤害行为,也更容易受到各方面因素的影响。最后,文章针对青少年自我伤害行为的预防和控制工作提出了建议。     

Co-occurrence of non-suicidal self-injury and impulsivity in extreme weight conditions

The aims of the present study were to determine the prevalence of non-suicidal self-injury (NSSI) in different eating disorder (ED) groups and morbid obesity, and to investigate whether NSSI in different ED/obesity groups co-occur with impulsivity. We assessed 535 individuals (365 ED and 170 obese patients) by means of a single item assessing lifetime NSSI and the Barratt Impulsivity Scale, which measures different dimensions of impulsivity. The results showed that 19.1% of the ED patients engaged in at least one act of NSSI during their life-time. NSSI was more prevalent in Bulimia Nervosa, Binge Eating Disorder, Eating Disorder Not Otherwise Specified compared to Anorexia Nervosa, Restrictive type and morbid obesity. Finally, ED/obese patients who engaged in NSSI scored significantly higher on the attentional, motor and non-planning subscales than patients without NSSI. The implications of these findings for the treatment of NSSI in binge/purging ED patients are discussed.     

Non-Suicidal Self-Injury Among Ethnically and Racially Diverse Emerging Adults: Do Factors Unique to the Minority Experience Matter?

This study investigated clinically-significant non-suicidal self-injury (NSSI), defined as five or more lifetime episodes of NSSI, among racially and ethnically diverse emerging adults with a focus on factors unique to the minority experience. Seven hundred and nine emerging adults at an urban university, 85 % of whom were non-White, completed questionnaires assessing NSSI, racism, ethnic identity, Borderline Personality Disorder (BPD) characteristics such as impulsive behavior, emotion and interpersonal dysregulation and identity disturbance, suicidal behavior, and current depression and anxiety symptoms. Overall, 13 % of the sample reported a history of clinically-significant NSSI. Asian and White emerging adults reported significantly higher rates of NSSI than Hispanics and Blacks. Logistic regression analyses revealed positive relationships between BPD characteristics and NSSI and current anxiety and NSSI, which were not attenuated by increased ethnic identification. Experience with racism did not predict NSSI in the multivariate model. These findings are discussed as they pertain to current understanding and prevention of NSSI among racial and ethnic minority emerging adults.     

Cognitive and Social Factors Associated with NSSI and Suicide Attempts in Psychiatrically Hospitalized Adolescents

Although non-suicidal self-injury (NSSI) and suicide attempts (SA) frequently co-occur among youth, there is increasing evidence that both the risk factors and the phenomenology of the behaviors are distinct. This study examined how individuals who engage in NSSI only, individuals who attempt suicide only, and those who have histories of both NSSI and at least one suicide attempt may differ in terms of cognitions and perceived social support. Participants were 185 adolescents (78.1 % female) between the ages of 13 and 18 recruited from a psychiatric inpatient facility in the northeastern United States. One hundred forty-eight teens were identified with a history of self-injurious behavior and divided into three groups: NSSI only (n?=?45), SA only (n?=?24) or both NSSI and SA (NSSI+SA; n?=?79). Analyses showed that the NSSI+SA group exhibited more cognitive errors, negative self-statements, and negative views of self, world, and future, as well as less perceived familial support than either the NSSI or SA only groups. There were no differences between groups on perceived support from teachers or peers. No significant demographic or diagnostic differences were found between the NSSI and SA groups. Limitations and clinical implications of the current research are discussed.     

Self-Cutting and Suicidal Ideation among Adolescents: Gender Differences in the Causes and Correlates of Self-Injury

In recent years, non-suicidal self-injury (NSSI) among adolescents has been identified as alarmingly common place. Some studies have suggested that more than one in eight adolescents have engaged in self-cutting or other self-injuring behaviors. Even more of a concern is that self-injury often foreshadows suicide or suicide attempts. With self-cutting common in middle and high schools, understanding the antecedents and correlates of such behavior may help counselors and others public health officials identify troubled students and initiate preventative measures. This study utilizes data from 2,639 high school students from the Delaware Youth Risk Behavior Survey to investigate the gender differences in NSSI and suicidal ideation. Overall, 13% reported engaging in NSSI within the past year, with females reporting significantly higher rates (17%) of NSSI than males (9%). Results indicate that there are significant gender differences in NSSI and suicidal thoughts based upon previous victimization experiences, reported substance use, depression, health behaviors, and sexual orientation.     

Body Regard as a Moderator of the Relation between Emotion Dysregulation and Nonsuicidal Self‐Injury

Despite research documenting a strong association between emotion dysregulation and nonsuicidal self‐injury (NSSI), the moderators of this association have received little attention. Thus, it remains unclear why some individuals with heightened emotion dysregulation engage in NSSI and others do not. Body regard (i.e., how one perceives, experiences, and cares for the body) may be one such moderator, explaining the risk for NSSI among some individuals with emotion dysregulation. The current study used structural equation modeling within a sample of 398 undergraduates (26% reporting NSSI, mean frequency = 25.16, SD = 40.5) to test the interactive effect of emotion dysregulation and body regard on NSSI frequency when controlling for negative affect and borderline personality disorder symptoms. The interaction model provided a strong fit to the data and showed that emotion regulation was associated with NSSI only when low levels of body regard were present. Results suggest that body regard may be important to understanding who engages in NSSI within the context of emotion dysregulation. Possible mechanisms underlying the interaction between body regard and emotion dysregulation are discussed along with treatment and prevention implications.     

The Initial Efficacy of Stand-Alone DBT Skills Training for Treating Impulsivity Among Individuals With Alcohol and Other Substance Use Disorders

Impulsivity is considered a core feature of substance use disorders (SUDs), including personological (i.e., negative urgency, positive urgency, lack of premeditation) and neuropsychological (i.e., cognitive and motor disinhibition, impulsive choice) dimensions. Dialectical Behavior Therapy Skills Training (DBT-ST) as a stand-alone treatment is an effective intervention for alcohol use disorder (AUD) and other SUDs. However, there are no studies that have investigated changes in impulsivity levels during a DBT-ST program, especially testing the therapeutic effects of DBT skills. Twenty-nine patients with AUD and other SUDs were admitted to a 3-month DBT-ST program. Self-report (i.e., UPPS-P) and computerized neuropsychological (i.e., Attentional Network test; Go/No-Go task; Iowa Gambling Task) measures of impulsivity were administered at the beginning and end of the DBT-ST. Distress tolerance (DTS), mindfulness (MAAS, FFMQ) and emotion regulation (DERS) were also assessed pre- and post-intervention. The study included two age- and gender-matched control groups: (a) untreated patients with SUDs (N = 29); (b) healthy controls (HCs) (N = 29). Twenty-four (82.7%) patients concluded the DBT-ST program. Emotion-based forms of impulsivity significantly improved during the program. At the end of treatment, impulsivity levels were significantly lower than those of untreated patients with SUDs and they were not significantly different from HCs. Cognitive disinhibition significantly decreased during the treatment. The improvement in impulsivity was explained by pre- posttreatment changes in distress tolerance, mindfulness and emotion regulation. Motor disinhibition did not improve during the treatment. These findings supported the initial efficacy of the DBT-ST program for addressing different features of impulsivity among individuals with AUD and other SUDs. Future follow-up studies should demonstrate the role of impulsivity domains in long-term relapse prevention.