Rates of Non-Suicidal Self-Injury: A Cross-Sectional Analysis of Exposure

Research on the social influences associated with rates of non-suicidal self-injury (NSSI) is scarce and limited to studies of contagion within inpatient and residential treatment settings. Using an archival dataset that included 1,965 college students, the current study examined whether exposure to acts of NSSI and/or suicidal behavior in others was associated with increased rates of NSSI. Results supported hypotheses in that participants who knew someone who had engaged in NSSI only, or knew someone who engaged in both NSSI and suicidal behavior were more likely to have engaged in NSSI compared to those not exposed. The findings provide preliminary, albeit indirect, evidence of the potential for social modeling to influence rates of NSSI within college students. Directions for future studies are offered.     

Non-Suicidal Self-Injury in Pediatric Bipolar Disorder: Clinical Correlates and Impact on Psychosocial Treatment Outcomes

Non-suicidal self-injury (NSSI) in childhood is not well documented, especially among youth with pediatric bipolar disorder (PBD). The current study evaluated prevalence and correlates of NSSI, and its impact on intervention response, in a randomized trial of Child- and Family-Focused Cognitive-Behavioral Therapy (CFF-CBT) versus Treatment As Usual (TAU), adjunctive to pharmacotherapy. This study included 72 children ages 7–13 (58% male) with PBD. NSSI and correlates were assessed at baseline; mood and psychiatric severity were measured longitudinally. NSSI was common: 31% endorsed NSSI behaviors; 10% reported thoughts of NSSI, in the absence of behaviors. Children engaging in NSSI reported higher depression, psychosis, suicidality, and hopelessness; lower self-esteem; and reduced family help-seeking in univariate analyses. In a multivariate logistic regression, high child depression and psychosis, and low family help-seeking, remained significantly associated with baseline NSSI. In mixed-effects regression models, presence of NSSI at baseline did not influence the response of depressive symptoms to treatment. Children who endorsed NSSI experienced steeper response trajectories for psychiatric severity, regardless of treatment group. Youth who denied NSSI showed poorer response to TAU for manic symptoms; mania trajectories in CFF-CBT were similar across youth. Thus, NSSI in PBD is common and associated with impairment. As children might engage in NSSI for different reasons, the function of NSSI should be considered in treatment. Since children without NSSI fared worse in TAU, it may be important to ensure that youth with PBD receive structured, intensive interventions. CFF-CBT was efficacious regardless of NSSI, and thus shows promise for high-risk children with PBD.     

Initial Psychometric Validation of the Non-Suicidal Self-Injury Scar Cognition Scale

Given the growing literature on the detrimental psychological consequences of NSSI, it is surprising that scarce research has focused on the permanent physical consequences of NSSI, scarring to one’s tissue (Burke et al. Psychiatry Research 228, 416–424, 2015; Lewis The Journal of Nervous and Mental Disease, 204(1), 33–35 2016). Indeed, with recent research suggesting that upwards of half of those with a history of NSSI bear scarring as a result of the behavior (Burke et al. Comprehensive Psychiatry, 65, 79–87 2016), the psychological implications of scarring are important to understand. Given preliminary literature suggesting that the vast majority of individuals who bear NSSI scars ascribe a great deal of meaning to their scarring, and that this meaning varies widely, a psychometrically sound scale is needed to comprehensively and systematically assess NSSI scar-related cognitions. The present study examined the psychometric properties of the Non-Suicidal Self-Injury Scar Cognition Scale (NSSI-SCS). A sample of 110 undergraduates with at least one scar from NSSI completed the NSSI-SCS as well as measures of concurrent and divergent validity. Exploratory Factor Analysis was conducted to determine the factor structure of the NSSI-SCS. Results indicated that a five-factor solution offered the best fit for the data. Psychometric analyses support the validity of the NSSI-SCS given evidence of concurrent validity, divergent validity, and reliability. Future research should examine the test-retest reliability of the NSSI-SCS, as well as its sensitivity to change, particularly in the context of treatment research.     

Maternal Emotion Socialization of Adolescent Girls Engaging in Non-Suicidal Self-Injury

Research on Child and Adolescent Psychopathology - Non-suicidal self injury (NSSI) is a transdiagnostic maladaptive behavior that is highly prevalent in adolescence. A greater understanding of the...     

The Mediatory Role of Maladaptive Schema Modes Between Parental Care and Non-Suicidal Self-Injury

Non-suicidal self-injury (NSSI) is being increasingly recognised as a behaviour of significant clinical importance. Yet, there remains uncertainty regarding the underlying mechanisms of NSSI. This study aimed to explore the relationship between maladaptive schema modes, parental bonding, and NSSI. Seventy psychiatric outpatients with a history of NSSI completed the Deliberate Self-Harm Inventory, Schema Mode Inventory, and Parental Bonding Inventory. Results revealed that maladaptive schema modes were significantly associated with low parental care and with an earlier age of onset, longer duration, and higher number of methods of NSSI. Maladaptive schema modes also significantly mediated the relationship between parental care and age of onset of NSSI and between parental care and duration of NSSI. Two maladaptive schema modes (namely, Punitive Parent and Angry Child) were also found to be significant mediators in this relationship. The clinical implications of this research are discussed.     

Prevalence and Function of Non-Suicidal Self-Injury (NSSI) in a Community Sample of Adolescents, Using Suggested DSM-5 Criteria for a Potential NSSI Disorder

Previous prevalence rates of non-suicidal self-injury (NSSI) in adolescents have varied considerably. In the present cross-sectional study, prevalence rates, characteristics and functions of NSSI were assessed in a large randomized community sample consisting of 3,060 (50.5 % female) Swedish adolescents aged 15–17 years. The suggested criteria for NSSI disorder in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition, (DSM-5) were used to assess prevalence rates with the aim of arriving at a more precise estimate. Out of the whole sample, 1,088 (35.6 %) adolescents (56.2 % female) reported at least one episode of NSSI during the last year, of which 205 (6.7 %) met suggested DSM-5 criteria for a potential NSSI disorder diagnosis. The NSSI disorder diagnosis was significantly more common in girls (11.1 % vs. 2.3 %, χ ² (1, N?=?3046) = 94.08, p?<?0.001, cOR?=?5.43, 95 % CI [3.73, 7.90]). The NSSI disorder group consisted of significantly more smokers and drug users compared to adolescents with NSSI that did not meet DSM-5 criteria for NSSI disorder, and also differed concerning demographic variables. A confirmatory factor analysis (CFA) was conducted on reported functions of NSSI, with the aim of validating Nock and Prinstein’s (Journal of Consulting and Clinical Psychology 72:885–890, 2004, Journal of Abnormal Psychology 114:140–146, 2005) four-factor model on a Swedish community sample, resulting in a close to acceptable fit. A two-factor model (social and automatic reinforcement) resulted in a slightly better fit. The most frequently reported factors were positive and negative automatic reinforcement. A majority of functions were significantly more often reported by girls than boys. The implications of the suggested DSM-5 criteria and reported functions are discussed.     

Painfully bored: the role of negative urgency and history of Non-Suicidal Self-Injury in Self-Administering painful stimuli

Motivation and Emotion - The current study aims to examine the causal effect of boredom on non-suicidal self-injury (NSSI), expanding prior experimental research by including an anger induction to...     

Non-Suicidal Self-Injury in Adolescents: Addressing the Function and the Family From the Perspective of Systemic Family Therapies

Non-suicidal self-injury (NSSI) in adolescence has been increasing steadily over the past several decades. Mental health professionals frequently address NSSI solely within an individual context. Behaviorally focused therapy is the norm for treating NSSI in adolescents, but existence of the behavior as a larger manifestation of structural family problems is missing from this modality of therapy. Although short-term outcomes display a reduction or cessation of NSSI, long-term efficacy is still not proven for behaviorally focused therapies. Addressing the function of NSSI in a family context will help shift the perspective of clinicians from behavioral, individual therapy to structural family therapy.     

Non-Suicidal Self-Injury and Adolescents Attachment with Peers and Mother: The Mediating Role of Identity Synthesis and Confusion

Non-suicidal self-injury (NSSI) is highly prevalent in adolescents. Secure attachment with family and peers can reduce vulnerability to NSSI and can optimize the outcomes of developmental challenges such as identity formation. Problems experienced in these developmental processes and contexts can increase vulnerability to NSSI. Hence, the present study examined associations between attachment with mother and peers, identity formation, and NSSI, using self-report questionnaires in 528 high school students (Mean age = 15.0 years, SD = 1.84, 11–19 years, 50.4 % females). The lifetime prevalence of NSSI was found to be 14.2 %. Mediation analyses indicated that peer trust had a significant negative indirect effect on NSSI via identity synthesis and confusion. The positive association between peer alienation and NSSI was partially mediated by a lack of identity synthesis. Further, the pathways from maternal trust and alienation to NSSI were fully mediated by both identity confusion and synthesis. Clinical implications and suggestions for future research are discussed.     

创伤后应激障碍诊治的思考

创伤后应激障碍随着人类灾害事故的频发升级,已引起了世界范围内的高度关注和研究.本文就思考缘起、疾病发病态势、疾病临床表现、其生物学变化及疾病预后所引发的思考启示、提醒当前要加强公众教育,并从中体悟疾病所映射的医学、物理学、心理学、社会学、宗教、哲学方面的涵义做一探索.     

The Ecology of Self-Injury: A Multivariate Approach

ABSTRACT: In an ecological study of the distribution of self-injury in London, Canada, the authors found that self-injury occurred more frequently in the central areas of the city. Multivariate analysis revealed that living arrangements, such as high density of housing and single-person households, are closely associated with inflated rates on self-injury. Low socio-economic status is also related to self-injury but neither family status nor mobility are significant predictors. Ecological relationships such as these suggest directions for future research on individuals and may also be of direct use to planners who wish to locate treatment services advantageously.     

Gender Issues in the Diagnosis of Mental Disorder

No abstract available for this article.     

Assessment and Diagnosis of Conduct Disorder

Assessment and diagnosis of mental disorders has become standard practice in the counseling profession. In this article, the authors examine problems and solutions associated with accurate assessment and diagnosis of conduct disorder. Problems of conduct disorder assessment and diagnosis include (a) client deceitfulness, (b) parent and teacher misinformation, (c) counselor countertransference, (d) diagnostic comorbidity, and (e) confounding cultural and situational circumstances. Counselors seeking to accurately diagnose conduct disorder should adhere to basic assessment principles; use multi-method, multi-rater, multi-setting approaches; closely review differential explanations and diagnoses; and regularly obtain peer consultation.     

Post Traumatic Stress Disorder: A Diagnosis for Youth from Violent, Impoverished Communities

We examine the historical development and use of the diagnosis of post-traumatic stress disorder that has been primarily applied to war veterans. We explore how study of this population and refinement of this diagnosis were influenced by changing paradigms and the emergence of new theory. From this context, we then explore similarities and differences between the symptoms, stressors, and social supports of war veterans with those of youth living in violent, impoverished communities. Based upon this analysis, we conclude with implications for researchers, education, mental health, and social service policy-makers and service providers.     

Attention Deficit Hyperactivity Disorder in Adults: Implications for Theories of Diagnosis

The diagnosis of attention deficit hyperactivity disorder (ADHD) in adults has been a source of controversy, with some prominent researchers questioning its very existence and others suggesting it is an urgent clinical problem. This article reviews five domains of data addressing the validity of adult ADHD: clinical correlates, family history, treatment response, laboratory studies, and long-term outcome. It then shows how the debate over adult ADHD reflects a clash of theoretical paradigms and concludes by suggesting ways in which psychological science can collect the data needed to clarify the validity of adult ADHD.     

Reconsidering the effectiveness of temporary release: A systematic review

This article offers a systematic review of the ‘what works’ literature on temporary release, particularly as concerns home leave and work release programs. Against the ‘nothing works’ proposition, the findings suggest that both home leave and work release schemes can be effective in reducing recidivism rates, while work release may also enhance post-release employment prospects. The final section discusses the directions future evaluative research should take, with special reference to the need for drawing the link between the procedural and outcome dimensions of temporary release.     

Accuracy of Reported Community Diagnosis of Autism Spectrum Disorder

To compare community diagnoses of Autism Spectrum Disorder (ASD) reported by parents to consensus diagnoses made using standardized tools plus clinical observation. 87 participants (85% male, average age 7.4 years), with reported community diagnosis of ASD were evaluated using the Autism Diagnostic Observation Schedule) (ADOS-2), Differential Ability Scale (DAS-II), and Vineland Adaptive Behavior Scales (VABS-II). Detailed developmental and medical history was obtained from all participants. Diagnosis was based on clinical consensus of at least two expert clinicians, using test results, clinical observations, and parent report. 23% of participants with a reported community diagnosis of ASD were classified as non-spectrum based on our consensus diagnosis. ASD and non-spectrum participants did not differ on age at evaluation and age of first community diagnosis. Non-verbal IQ scores and Adaptive Behavior Composite scores were significantly higher in the non-spectrum group compared to the ASD group (104.5?±?21.7 vs. 80.1?±?21.6, p?<?.01; 71.1?±?15 versus 79.5?±?17.6, p?<?.05, respectively). Participants enrolled with community diagnosis of PDD-NOS were significantly more likely to be classified as non-spectrum on the study consensus diagnosis than Participants with Autism or Asperger (36% versus 9.5%, Odds Ratio?=?5.4, p?<?.05). This study shows suboptimal agreement between community diagnoses of ASD and consensus diagnosis using standardized instruments. These findings are based on limited data, and should be further studied, taking into consideration the influence of DSM 5 diagnostic criteria on ASD prevalence.     

Reconsidering the Value of Equality

Some people believe that the equality of people's well-being makes an outcome better, other things being constant. Call this Telic Egalitarianism. In this paper I will propose a new interpretation of Telic Egalitarianism, and compare it with the interpretation that is proposed by Derek Parfit 1995 Parfit, Derek. 1995. Equality or Priority? University of Kansas: Lindley Lecture. Reprinted in Clayton and Williams [2000: 81–125] [Google Scholar] and widely accepted by many philosophers. I will argue that my proposed interpretation is more plausible than Parfit's. One of the virtues in my interpretation is that it shows his Levelling Down Objection does not undermine Telic Egalitarianism. I also believe that my interpretation better explains the important similarity and difference between Telic Egalitarianism and his proposed Priority View.