Seeking help for non-suicidal self-injury: A social network analysis approach

Individuals who self-injure have consistently reported less perceived social support; yet, little is actually known about the support they seek out from others specifically for non-suicidal self-injury. The goal of this study was to explore characteristics of support networks of those who self-injure. Twenty-three percent reported not seeking support for self-injury, while the remaining reported smaller social networks than typical. Most participants sought help infrequently, and when they did, found supporters to be only moderately helpful. Network characteristics were found to relate to self-injury behavior and patterns emerged regarding supporters in the networks. Implications for advocacy and education are provided.     

Do hotter temperatures increase the incidence of self-harm hospitalisations?

A relationship between air temperature and the incidence of suicide has been established in a number of previous studies. Interestingly, the relationship between geographical variation in temperature and suicide incidence has generally been found to be negative, while the relationship between temporal variation in temperature and suicide incidence has generally been found to be positive. It is less clear, however, how temperature relates to the incidence of self-harm. This topic is of particular importance given the presence of ongoing global warming. This study investigated the relationship between temperature and the incidence of self-harm resulting in hospitalisation in New Zealand. Self-harm hospitalisations by date and district for 1993–2009 were obtained from the Ministry of Health. Meteorological data was obtained from NIWA. Generalised linear mixed models were used to estimate the effects of three different components of variation in temperature: geographical, seasonal and irregular. Irregular (random) daily variation in temperature had a modest positive relationship with the incidence of acts of self-harm resulting in hospitalisation, with about 0.7% extra incidents for every 1 °C increase in temperature. However, there was no strong evidence for a positive effect of either seasonal or geographical variation in temperature. We conclude that temperature does appear to bear some relation to the incidence of self-harm, with irregular daily variation in temperature having a positive effect. However, inconsistencies in the effects of different components of variation in temperature make it challenging to accurately predict how global warming will influence the incidence of self-harm.     

Mixture Modeling of Nonsuicidal Self-Injury and Binge Eating: Behaviors and Motives

Nonsuicidal self-injury (NSSI) and binge eating frequently co-occur. These behaviors are often used to alleviate distress. Previous studies examining this co-occurrence have used a variable-centered approach. The current study used a person-centered approach (mixture modeling) to examine how individuals cluster in groups based on their past-month NSSI, past-month objective and subjective binge episodes (OBEs and SBEs, respectively), and endorsement of coping motives for NSSI and eating in two large samples of emerging adults. Validators included self-report measures of emotion regulation, impulsivity, and negative affect. In Study 1, additional validators included lifetime history of mental health treatment and suicide attempts. In Study 2, additional validators included child abuse history. In both Study 1 and Study 2, a three-class solution provided the most interpretable fit with classes characterized as (a) low psychopathology; (b) the presence of OBEs and NSSI, and endorsement of NSSI coping motives; and (c) the presence of SBEs and NSSI, and endorsement of high levels of NSSI coping motives. In both studies, eating motives were equivalent in Classes 2 and 3, but NSSI motives were most strongly endorsed by Class 3. In Study 1, Class 2 endorsed higher rates of lifetime suicide attempts than Class 3. In Study 2, both Class 2 and Class 3 endorsed higher rates of child abuse than Class 1, although they did not differ from each other. The class structure and validator analysis were consistent across samples and measures. Results suggest that binge eating and NSSI tend to cluster together in otherwise healthy emerging adults.     

Further evidence of renewal in automatically maintained behavior

Renewal is a relapse phenomenon that refers to the recurrence of a previously reduced behavior following a change in stimulus conditions. Muething et al. (2022) examined the phenomenology of renewal among individuals with automatically maintained challenging behavior treated at an outpatient clinic. We replicated their findings by retrospectively examining renewal across various topographies of automatically maintained behavior treated at an inpatient hospital, and we extended their work by also examining differences across subtypes of automatically maintained self-injurious behavior. The prevalence of renewal was comparable to that observed by Muething et al., supporting the notion that automatically maintained challenging behavior is susceptible to relapse phenomena. Furthermore, renewal was twice as likely to occur for individuals with Subtype 2 versus Subtype 1 self-injurious behavior, providing additional evidence of behavioral differentiation between subtypes. Our findings suggest that even after apparent stability in treatment, practitioners should remain vigilant for the recurrence of automatically maintained behavior during generalization.     

The effect of rumination on recall of emotional words: comparison of dysphoric individuals with and without a history of nonsuicidal self-injury

ABSTRACT

Prior research and theory has suggested that rumination plays a role in nonsuicidal self-injury (NSSI), and rumination increases recall of negative autobiographical information in dysphoric individuals. Across two studies, we investigated whether rumination (versus distraction) differentially influences the recall of emotional words among dysphoric persons with and without a history of NSSI. Participants encoded unpleasant, neutral, and pleasant words and then were randomly assigned to either focus on the meaning and consequences of their emotions (i.e. rumination) or unrelated thoughts (i.e. distraction) before they were asked to recall encoded words. Across the two studies, we did not find a significant effect of rumination on memory for emotional words among dysphoric people with (Studies 1 and 2) or without a history of NSSI (Study 1). We did find that people were more likely to remember neutral words as opposed to unpleasant or pleasant words across studies, regardless of rumination condition. Together, results from these two well-powered studies provide fairly compelling evidence that rumination after encoding has little to no effect on recall for emotional words in people elevated on symptoms of depression or with NSSI history. These findings can be used to refine theories of rumination and NSSI.     

Deliberate self-harm and sexual abuse in adolescence

Helping a young person to render repeated self-injury redundant as a solution to problems connected with having been sexually abused requires a containing context which both supports autonomic healing in the patient and provides an experiential model for the restoration of relationship with adults as a safe (non-abusive) activity. In this paper a case study is presented and some treatment issues for individual psychotherapeutic work are addressed. These include ensuring that the power balance between patient and therapist is acknowledged by emphasizing the patient's self-determination, recognizing patterns of re-enactment within sessions, and addressing here-and-now behaviour and its link with the original trauma. This paper also examines the changing function of self-injurious behaviour and how it can be perceived as addictive after the establishment of a proper alliance between patient and therapist. the circular logic involved in avoiding identification with the abuse-perpetrator by way of self-injury is explored. the therapeutic relationship as an alternative to this is discussed.     

The Experiences of Self-Injury Amongst Adolescents and Young Adults within a South African Context

The aim of the study was to explore the experiences of self-injury among adolescents and young adults within the South African context. The participants were twelve university students who had self-injured in their adolescence (females = 92%). The data were collected through interviews, personal writings and collages and analysed using phenomenological data analysis. The findings indicate that self-injury is a strategy used to alleviate intense intrapersonal and interpersonal distress. To understand the complexity of self-injury, an integrative theoretical approach, encompassing a developmental and biopsychosocial perspective was used.     

Relationship among gender-related stress,resilience factors,and mental health in a Midwestern U.S. transgender and gender-nonconforming population

Background: Transgender and gender-nonconforming individuals experience more discrimination than their cisgender peers, and this discrimination can be associated with poorer mental health. This study used the gender minority stress model as a framework to examine the relationship among gender-related stressors and resilience factors and mental health outcomes. The study particularly aimed to increase knowledge of the gender-nonconforming population.

Methods: A community sample of 83 individuals that identify as a gender different than the sex assigned to them at birth completed an online survey. Depression and anxiety were assessed using the Center for Epidemiological Studies Depression Scale (CES-D) and Beck Anxiety Inventory (BAI), respectively. The Gender Minority Stress and Resilience measure was used to assess distal and proximal stressors and resilience factors.

Results: The median CES-D and BAI scores were 16 and 13, respectively. Forty percent had a history of non-suicidal self-injury (NSSI), 75% had experienced suicidal ideation, and 45% had attempted suicide. Proximal stress was found to be a positive predictor of depressive symptoms. Resilience was a weak negative predictor of anxiety symptoms. Distal stress was a positive predictor of suicide attempts, and resilience factors and hormone use were marginal negative predictors of suicide attempt. Trans women were significantly less likely to have engaged in NSSI, but had a significantly higher proximal stress score than trans men and gender-nonconforming individuals.

Conclusion: Our study found high rates of mental health problems in the trans and gender-nonconforming sample. Our findings in part support the gender minority stress model, with gender-related stress predicting certain mental health problems and resilience being a negative predictor. Overall, gender-nonconforming individuals have had similar experiences and mental health findings as transgender individuals.     

Prospective prediction of nonsuicidal self-injury: a 1-year longitudinal study in young adults

Nonsuicidal self-injury (NSSI) has become a significant public health problem. Although numerous studies have examined cross-sectional psychological correlates of NSSI, there has been little research examining predictors of NSSI over time. The present study examined cross-sectional and longitudinal correlates of NSSI in 81 young adult self-injurers (M age = 19, 74.1% female, 51.9% Caucasian), 51 of whom were followed up 1 year later. At baseline, participants completed self-report measures of NSSI, Axis-I disorders, borderline personality disorder (BPD), and impulsivity, as well as an implicit measure of NSSI attitudes and identity. One year later, participants completed a Timeline Followback Method whereby they indicated their engagement in NSSI over the previous 12 months. Analyses replicated many known cross-sectional correlates of NSSI, including symptoms of several Axis-I disorders and BPD. However, many of these same variables failed to predict the course of NSSI over the 1-year follow-up. The only variables to prospectively predict NSSI were past NSSI (i.e., frequency, methods, and recency of NSSI), participants’ behavioral forecast of their engagement in future NSSI, and BPD features. Findings suggest that many cross-sectional correlates of NSSI may not be useful for predicting subsequent NSSI. Instead, NSSI severity and BPD features appear to best predict continued engagement in NSSI.     

Adolescents' deliberate self-harm, interpersonal stress, and the moderating effects of self-regulation: a two-wave longitudinal analysis

The predictive effects of peer victimization and harsh parenting on deliberate self-harm were examined. As derived from the experiential avoidance model, the study also tested whether these links were moderated by individual self-regulation approaches. Data were collected at two points in time from 880 junior high school students (mean age = 13.72) in Sweden. Analyses using structural equation modeling revealed that Peer Victimization was predictive of self-harm. Although Harsh Parenting was not predictive of self-harm, this link was moderated by adolescents' gender. No moderating effect of self-regulation was revealed. The study concludes that the high prevalence of deliberate self-harm recently found in community samples of adolescents cannot be prevented without attending to environmental psychosocial factors.