scholarly journals An Analysis of Nonsuicidal Self-Injury Among Children and Adolescents in Inpatient Psychiatric Hospitals and Units in Pennsylvania

2020 ◽  
pp. 30-41
Author(s):  
Elizabeth Kukielka
Keyword(s):  
Eating Disorders ◽  
Patient Safety ◽  
Children And Adolescents ◽  
Psychiatric Hospitals ◽  
Adolescent And Young Adult ◽  
Patient Specific ◽  
Psychiatric Setting ◽  
Self Injury ◽  
Self Harm ◽  
Nonsuicidal Self Injury

Nonsuicidal self-injury (NSSI) is defined as the direct, deliberate destruction of one’s own body tissue to inflict harm or pain without an underlying suicidal intent. NSSI may include such behaviors as cutting, scratching, biting, hitting, and head banging, and excludes suicidal gestures, accidental injuries, indirect self-harm behaviors (e.g., eating disorders or drug abuse), and socially accepted forms of body modification (e.g., piercing or tattooing). NSSI typically begins in adolescents around 13 or 14 years of age, and lifetime prevalence in the adolescent and young adult population is estimated to be 15% to 20%. Although NSSI does not always progress to or predict future suicidal behaviors, there is believed to be a link between the two, which makes this an important patient safety concern. NSSI has been observed in both the community and the clinical setting, although rates of NSSI are higher within the psychiatric population. NSSI may present as a symptom of numerous psychiatric conditions, including anxiety disorders; mood disorders; substance abuse; eating disorders; and personality disorders, such as borderline personality disorder (BPD).5 Although clinicians once considered NSSI primarily in the context of BPD, NSSI was added as a distinct condition in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) in 2013. In 2019, analysts at the Patient Safety Authority (PSA) conducted and published a study of events submitted to the Pennsylvania Patient Safety Reporting System (PA-PSRS) involving patient self-harm in the nonpsychiatric setting.8 However, an analysis of events in PA-PSRS involving selfharm, and more specifically NSSI, in the psychiatric setting had yet to be undertaken. In this study, we conducted an indepth review and analysis of patient safety events involving NSSI among children and adolescents in the inpatient psychiatric setting that took place in 2019. The purpose of this study was to examine patient-specific factors, such as age and gender, as well as other contributing circumstances, such as interpersonal interactions, that may precipitate NSSI in this patient population.

Latent Class Analysis of Nonsuicidal Self-Injury Among Justice-Involved Juveniles: Association With Motivational and Emotional Aspects of Self-Harm Behavior

2021 ◽  
pp. 009385482199841
Author(s):  
Melinda Reinhardt ◽  
Zsolt Horváth ◽  
Boglárka Drubina ◽  
Gyöngyi Kökönyei ◽  
Kenneth G. Rice
Keyword(s):  
Latent Class Analysis ◽  
Latent Class ◽  
Juvenile Detention ◽  
Class Analysis ◽  
Detention Centers ◽  
Self Injury ◽  
Class 1 ◽  
Emotional Aspects ◽  
Self Harm ◽  
Nonsuicidal Self Injury

Significantly higher rates of nonsuicidal self-injury (NSSI) have been discovered among justice-involved juveniles. Our study aimed to discriminate homogeneous subgroups of justice-involved youth with different self-harm behavior characteristics based on latent class analysis. A total of 244 adolescents (92.6% boys; Mage = 16.99, SD = 1.28) in Hungarian juvenile detention centers completed measures of NSSI and dissociation. High-NSSI (Class 1; 9%), moderate-NSSI (Class 2; 42.6%), and low-NSSI (Class 3; 48.4%) profiles were detected relating to different forms of NSSI. Multiple comparisons showed that girls were members of Class 1 and 2 at higher rates and these subgroups showed significantly higher dissociation proportions than Class 3. Our findings pointed out diversity in self-harm profiles with different characteristics in terms of methods and severity of self-harm, experienced emotions, and other emotion regulation tendencies among justice-involved adolescents. These results suggest sophisticated treatment approaches to match variations in severity and presentation.

scholarly journals Temporal trends in annual incidence rates for psychiatric disorders and self-harm among children and adolescents in the UK, 2003–2018

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lukasz Cybulski ◽  
Darren M. Ashcroft ◽  
Matthew J. Carr ◽  
Shruti Garg ◽  
Carolyn A. Chew-Graham ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Young People ◽  
Anxiety Disorders ◽  
Children And Adolescents ◽  
Autism Spectrum ◽  
Incidence Rates ◽  
Annual Incidence ◽  
Health Crisis ◽  
Self Harm ◽  
The Uk

Abstract Background There has been growing concern in the UK over recent years that a perceived mental health crisis is affecting children and adolescents, although published epidemiological evidence is limited. Methods Two population-based UK primary care cohorts were delineated in the Aurum and GOLD datasets of the Clinical Practice Research Datalink (CPRD). We included data from 9,133,246 individuals aged 1–20 who contributed 117,682,651 person-years of observation time. Sex- and age-stratified annual incidence rates were estimated for attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) (age groups: 1–5, 6–9, 10–12, 13–16, 17–19), depression, anxiety disorders (6–9, 10–12, 13–16, 17–19), eating disorders and self-harm (10–12, 13–16, 17–19) during 2003–2018. We fitted negative binomial regressions to estimate incidence rate ratios (IRRs) to examine change in incidence between the first (2003) and final year (2018) year of observation and to examine sex-specific incidence. Results The results indicated that the overall incidence has increased substantially in both boys and girls in between 2003 and 2018 for anxiety disorders (IRR 3.51 95% CI 3.18–3.89), depression (2.37; 2.03–2.77), ASD (2.36; 1.72–3.26), ADHD (2.3; 1.73–3.25), and self-harm (2.25; 1.82–2.79). The incidence for eating disorders also increased (IRR 1.3 95% CI 1.06–1.61), but less sharply. The incidence of anxiety disorders, depression, self-harm and eating disorders was in absolute terms higher in girls, whereas the opposite was true for the incidence of ADHD and ASD, which were higher among boys. The largest relative increases in incidence were observed for neurodevelopmental disorders, particularly among girls diagnosed with ADHD or ASD. However, in absolute terms, the incidence was much higher for depression and anxiety disorders. Conclusion The number of young people seeking help for psychological distress appears to have increased in recent years. Changes to diagnostic criteria, reduced stigma, and increased awareness may partly explain our results, but we cannot rule out true increases in incidence occurring in the population. Whatever the explanation, the marked rise in demand for healthcare services means that it may be more challenging for affected young people to promptly access the care and support that they need.

scholarly journals Testing an equifinality model of nonsuicidal self-injury among early adolescent girls

2014 ◽  
Vol 26 (3) ◽  
pp. 851-862 ◽  
Author(s):  
Kate Keenan ◽  
Alison E. Hipwell ◽  
Stephanie D. Stepp ◽  
Kristen Wroblewski
Keyword(s):  
Relational Aggression ◽  
Adolescent Girls ◽  
Emotion Dysregulation ◽  
Community Sample ◽  
Environmental Stressors ◽  
Risk Scores ◽  
Self Injury ◽  
Risk Indices ◽  
Self Harm ◽  
Nonsuicidal Self Injury

AbstractNonsuicidal self-injury (NSSI) is a common behavior among females that has been shown to confer risk for continued self-injury and suicidal attempts. NSSI can be viewed conceptually as behavior that is pathognomonic with aggression and/or depression. Empirical research on concurrent correlates supports this concept: numerous and diverse factors are shown to be significantly associated with self-harm, including depression, emotion dysregulation, impulsivity, and aggression and other conduct problems, as well as environmental stressors such as bullying, harsh parenting, and negative life events. In the present study, we test hypotheses regarding developmental precursors (measured from ages 8 to 12 years) to NSSI in young adolescent girls (ages 13–14 years), specifically whether aggression, depression, and environmental stressors distinguish girls with and without self-harm, and whether there is evidence for multiple developmental pathways to NSSI. Data were derived from the longitudinal Pittsburgh Girls Study. In this community sample of girls, the prevalence of NSSI at ages 13 or 14 years of age was 6.0%. Initial levels in dimensions measured within the depression, aggression, and environmental stressor domains accounted for variance in NSSI in early adolescence. Changes over time in relational aggression and assertiveness were also significantly associated with risk for NSSI. To a large extent, adolescent NSSI was predicted by psychological deficits and stress exposure that began early in childhood. Risk indices were calculated using the 85th or 15th percentile. Close to 80% of girls who engaged in NSSI during adolescence were identified by at least one risk domain in childhood. A sizable proportion of adolescent girls who later engaged in NSSI had childhood risk scores in all three domains; the remaining girls with adolescent NSSI were relatively evenly distributed across the other risk domain profiles. The observation that multiple pathways to NSSI exist suggests that deficits underlying the behavior may vary and require different modes of prevention.

scholarly journals Global Lifetime and 12-Month Prevalence of Suicidal Behavior, Deliberate Self-Harm and Non-Suicidal Self-Injury in Children and Adolescents between 1989 and 2018: A Meta-Analysis

2019 ◽  
Vol 16 (22) ◽  
pp. 4581 ◽  
Author(s):  
Kim-San Lim ◽  
Celine H. Wong ◽  
Roger S. McIntyre ◽  
Jiayun Wang ◽  
Zhisong Zhang ◽  
...  
Keyword(s):  
Suicidal Ideation ◽  
Children And Adolescents ◽  
Suicidal Behavior ◽  
School Attendance ◽  
Meta Analysis ◽  
Full Time ◽  
Deliberate Self Harm ◽  
Self Injury ◽  
Subgroup Analyses ◽  
Self Harm

Objective: This meta-analysis aimed to estimate the global lifetime and 12-month prevalence of suicidal behavior, deliberate self-harm and non-suicidal self-injury in children and adolescents. Methods: A systematic search for relevant articles published between 1989 to 2018 was performed in multiple electronic databases. The aggregate 12-month and lifetime prevalence of suicidal behavior, deliberate self-harm, and non-suicidal self-injury were calculated based on the random-effects model. Subgroup analyses were performed to compare the prevalence according to school attendance and geographical regions. Results: A total of 686,672 children and adolescents were included. The aggregate lifetime and 12-month prevalence of suicide attempts was 6% (95% CI: 4.7–7.7%) and 4.5% (95% CI: 3.4–5.9%) respectively. The aggregate lifetime and 12-month prevalence of suicidal plan was 9.9% (95% CI: 5.5–17%) and 7.5% (95% CI: 4.5–12.1%) respectively. The aggregate lifetime and 12-month prevalence of suicidal ideation was 18% (95% CI: 14.2–22.7%) and 14.2% (95% CI: 11.6–17.3%) respectively. The aggregate lifetime and 12-month prevalence of non-suicidal self-injury was 22.1% (95% CI: 16.9–28.4%) and 19.5% (95% CI: 13.3–27.6%) respectively. The aggregate lifetime and 12-month prevalence of deliberate self-harm was 13.7% (95% CI: 11.0–17.0%) and 14.2% (95% CI: 10.1–19.5%) respectively. Subgroup analyses showed that full-time school attendance, non-Western countries, low and middle-income countries, and geographical locations might contribute to the higher aggregate prevalence of suicidal behaviors, deliberate self-harm, and non-suicidal self-injury. Conclusions: This meta-analysis found that non-suicidal self-injury, suicidal ideation, and deliberate self-harm were the three most common suicidal and self-harm behaviors in children and adolescents.

Interoceptive Deficits, Nonsuicidal Self-Injury, and Suicide Attempts Among Women with Eating Disorders

2017 ◽  
Vol 48 (4) ◽  
pp. 438-448 ◽  
Author(s):  
Dorian R. Dodd ◽  
April R. Smith ◽  
Lauren N. Forrest ◽  
Tracy K. Witte ◽  
Lindsay Bodell ◽  
...  
Keyword(s):  
Eating Disorders ◽  
Suicide Attempts ◽  
Self Injury ◽  
Nonsuicidal Self Injury
Sign in / Sign up

Export Citation Format

Share Document