Differences between adolescent suicide attempters and depressed adolescents.

Most of the characteristics differentiating between adolescent attempters and nonattempters do not have discriminative power in comparing 48 adolescents who recently attempted suicide with 66 depressed adolescents. These characteristics may probably be attributed to an affective disorder that is present in most of the suicide attempters. However, suicide attempters, compared with the depressed group, live in more problematic circumstances (such as family disruption or sexual abuse) and have a cognitive style that promotes a more negative evaluation of events and situations. Their depressive symptoms are distinguished from the depressed group by withdrawal and isolation, besides maintaining a hopeless and negative expectation of the future. Furthermore, there are reasons to accept the idea that suicidal behavior is a serious alternative within their behavioral repertoire. Based on these findings, a psychological interpretation is given concerning the dynamics leading to a suicide attempt. Also, intervention strategies are discussed.     

Risk for suicide attempts among adolescents who engage in non-suicidal self-injury.

The current study examined whether common indicators of suicide risk differ between adolescents engaging in non-suicidal self-injury (NSSI) who have and have not attempted suicide in an effort to enhance clinicians' ability to evaluate risk for suicide within this group. Data were collected from 540 high school students in the Midwest who completed the RADS, RFL-A, SIQ, and SHBQ as part of a larger adolescent risk project. Results suggest that adolescents engaging in NSSI who also attempt suicide can be differentiated from adolescents who only engage in NSSI on measures of suicidal ideation, reasons for living, and depression. Clinical implications of the findings are discussed.     

Psychotherapeutic approaches to non-suicidal self-injury in adolescents

ABSTRACT: Non-suicidal self-injury (NSSI) among adolescents is gaining increasing attention in both clinical and scientific arenas. The lifetime prevalence of NSSI is estimated to vary between 7.5% to 8% for preadolescents, increasing to between 12% and 23% for adolescents. Despite the prevalence and the increasing interest in NSSI, few psychotherapeutic treatments have been designed specifically for NSSI, and no treatments have been evaluated specifically for the treatment of NSSI among adolescents. Consequently, child and adolescent clinicians are left with little evidence-based guidance for treating this challenging population. To provide some guidance, evaluations of treatments for adults with NSSI and for adolescents with related conditions, such as deliberate self-harm and borderline personality disorder, are reviewed. Clinical guidelines and resources are also discussed to assist with the gaps in the knowledge base for treatment of NSSI among adolescents.     

Cognitive traits in inpatient adolescents with and without prior suicide attempts and non-suicidal self-injury

Objective

Establishing a psychiatric diagnosis and assessing suicidal tendencies is often a challenging task particularly in the early stages of an illness. Cognitive impairments characterize different psychiatric entities, but there is no known specific cognitive deficit profile that could help the clinician in achieving the diagnostic task. This study’s aim was to establish a cognitive profile and test its ability to differentiate psychiatric inpatient subgroups, in terms of suicidal risk and diagnosis. The sample constituted of 76 consecutive admissions to the psychiatric adolescent day-care unit, who were admitted for any diagnosis. Assessment included full psychiatric interview and cognitive evaluation, using the COGNISTAT test.

Results

Of the 76 participants, 58% reported having suicidal ideation and 29% reported a prior attempted suicide. Subjects who had a prior suicide attempt had better orientation and attention scores in the COGNISTAT. Other cognitive domains did not differentiate between groups or diagnoses.

Conclusion

These preliminary results suggest a significant association between specific cognitive characteristics and suicidal behavior in adolescents. Those cognitive characteristics might prove clinically useful in the assessment of suicide risk. Further study is needed to establish this association and generalize the conclusion to different populations.     

Impulsivity and clinical symptoms among adolescents with non-suicidal self-injury with or without attempted suicide

This study examined clinical characteristics and laboratory-measured impulsive behavior of adolescents engaging in either non-suicidal self-injury with (NSSI + SA; n = 25) or without (NSSI-Only; n = 31) suicide attempts. We hypothesized that adolescent with NSSI + SI would exhibit more severe clinical symptoms and higher levels of behavioral impulsivity compared to adolescents with NSSI-Only. Adolescents were recruited from an inpatient psychiatric hospital unit and the two groups were compared on demographic characteristics, psychopathology, self-reported clinical ratings, methods of non-suicidal self-injury, and two laboratory impulsivity measures. Primary evaluations were conducted during psychiatric hospitalization, and a subset of those tested during hospitalization was retested 4–6 weeks after discharge. During hospitalization, NSSI + SA patients reported worse depression, hopelessness, and impulsivity on standard clinical measures, and demonstrated elevated impulsivity on a reward-directed laboratory measure compared to NSSI-Only patients. In the follow-up analyses, depression, hopelessness, suicidal ideation, and laboratory impulsivity were improved for both groups, but the NSSI + SA group still exhibited significantly more depressive symptoms, hopelessness, and impulsivity than the NSSI-Only group. Risk assessments for adolescents with NSSI + SA should include consideration not only of the severity of clinical symptoms but of the current level impulsivity as well.     

青少年非自杀性自伤的神经生物学机制

本文目的是对近年来青少年非自杀性自伤(NSSI)的神经生物学机制的相关研究进行归纳汇总,并探讨青少年NSSI相关研究现状。NSSI在青少年中多发,是自杀的独立危险因素,严重影响青少年的身心健康,已成为普遍关注的公共卫生问题。本文总结青少年的NSSI研究现状及其神经生物学机制,以期为青少年NSSI的临床干预提供参考。     

儿童青少年非自杀性自伤的研究现状

本文目的是对儿童青少年非自杀性自伤（NSSI）的研究现状进行综述,为儿童青少年NSSI行为的认识与干预提供参考。NSSI行为是自杀的独立危险因素,不仅严重威胁到儿童青少年的身心健康,而且也给其家庭及社会带来了极大的负担。本文将对儿童青少年NSSI行为的流行病学、病因学、与其他精神疾病之间的关系以及治疗进行阐述。     

青少年非自杀性自伤行为动机的研究进展

阿尔茨海默病（AD）属于慢性神经退行性疾病,是引起老年痴呆的主要病因。AD 发病机 制复杂,临床预后极差。长链非编码 RNAs（lncRNAs）是一类不能编码蛋白,通过转录及转录后水平调 节基因的表达,参与了癌症、神经系统、心血管系统以及衰老等病理生理过程。lncRNAs 与 AD 的发生 发展相关在 1992 年首次提出之后,不同 lncRNAs 在 AD 中的作用受到广泛关注。现对近年来 lncRNAs 与 AD 的相关研究进行概述,以期为 AD 的防治提供新思路。     

Longitudinal development of pain sensitivity in adolescent non-suicidal self-injury

Nonsuicidal self-injury (NSSI) is associated with reduced pain sensitivity (PS). Existing theories posit that altered PS is a risk factor for NSSI. Cross-sectional data suggest that PS normalizes in those terminating self-injury. However, previously no study addressed the longitudinal course of PS in patients engaging in NSSI. We addressed changes in PS and clinical symptomatology in adolescents with NSSI (n = 18) and matched controls (n = 19) over one year. Despite significant clinical improvements, PS did not change in the NSSI group but decreased in controls. Greater NSSI reduction was associated with increased pain tolerance. Findings are discussed in the light of current theories on PS in NSSI.     

青少年非自杀性自伤行为动机的研究进展

青少年是发生非自杀性自伤行为的高发群体。相关研究显示，青少年发生非自杀性自伤 行为的动机对自伤行为有很大影响。现从调节情绪、影响人际和自我强化三方面对青少年发生自伤行 为的动机进行综述，希望能对青少年自伤行为的干预和治疗提供参考。     

The role of parental psychopathology and personality in adolescent non-suicidal self-injury

Adolescent non-suicidal self-injury (NSSI), a significant risk factor for suicidal behavior, is strongly associated with adolescent psychopathology and personality traits, particularly those characterized by poor self-regulation. Some parental psychopathology and personality traits have also been identified as risk factors for adolescent NSSI, but specific parental characteristics and mechanisms involved in this association have not been systematically examined. The current study comprehensively investigated the contribution of parental psychopathology and personality to adolescent NSSI using data from the baseline wave of the Adolescent Development of Emotion and Personality Traits (ADEPT) study of 550 adolescent girls (mean age = 14.39 years, SD = 0.63) and their biological parents. We first investigated whether parental lifetime psychiatric diagnoses, and personality and clinical (rumination, self-criticism, emotional reliance) traits were associated with adolescent NSSI. We also tested whether adolescent history of psychiatric illness, personality, and clinical traits mediated the associations between parental characteristics and adolescent NSSI. Parental substance use disorder, adult-ADHD symptoms, self-criticism, and lower agreeableness and conscientiousness were associated with offspring's NSSI. These associations were mediated through adolescent characteristics. In contrast, parental mood and anxiety disorders and neuroticism were unrelated to adolescent NSSI. The results suggest that parental traits and disorders characterized by self-regulatory difficulties and lack of support constitute risk factors for self-injury in adolescent girls, acting via adolescent traits. This demonstrates that parental influences play a significant role in the etiology of adolescent NSSI.     

青少年非自杀性自伤心理干预的研究进展

青少年非自杀性自伤（NSSI）是全球重大公共卫生事件之一，对其进行有效干预具有重要意义。本文对青少年常见NSSI特定和非特定性的心理干预进行综述，以期提高医护人员对NSSI的重视，为后续研究选择合适的干预方式提供借鉴。     

青少年非自杀性自伤行为与反刍思维相关性的研究进展

非自杀性自伤（NSSI）是自杀意念和自杀行为的重要预测因素，其在全球青少年中的患病率呈逐渐上升趋势，成为青少年常见的公共卫生问题之一。反刍思维作为一种认知过程和情绪调节策略，与NSSI密切相关，高水平的反刍思维易诱发NSSI。本文从青少年NSSI和反刍思维的相关理论、反刍思维对青少年产生的影响及相关干预措施进行综述，旨在为早期发现青少年NSSI并进行针对性的干预提供方向。     

Cognitive characteristics of adolescent suicide attempters

The present study examined the relationship among psychiatric diagnosis, depression, attributional style, and hopelessness among 69 adolescent suicide attempters and 40 psychiatrically hospitalized adolescent controls. Contrary to predictions, the suicide attempters were more likely than the nonsuicidal group to attribute good events to global causes. No differences in attributional style were found across the depressed versus nondepressed subjects. However, there was a modest relationship between depression and attributional style. Results suggest that maladaptive cognitive characteristics are present in adolescent clinical samples but may be less specific to suicide attempters than is often suggested.     

Two subtypes of adolescent suicide attempters

An empirical classification of 203 adolescent suicide attempters (mean age 17.3) was achieved using multiple correspondence analysis. The characteristics upon which the classification is based concern sociodemographic as well as psychological variables. Two groups are identified: the first is predominantly characterized by recent problematic behaviors, whereas the second group is primarily characterized by problematic circumstances. Analyzing related variables, the first group seems to have special clinical and preventive interest, because of its high risk for recidivism. The second group seems to have a satisfactory level of functioning.     

家庭环境因素与青少年非自杀性自伤的研究进展

非自杀性自伤（NSSI）对个体身心健康有深远影响,特别是在青少年这一高发人群中,现已成为严重的公共卫生问题。许多研究表明,家庭环境因素在青少年NSSI的发生与发展中起着重要的作用。现对家庭环境因素与青少年NSSI进行综述,为NSSI的预防和家庭干预提供依据。     

Altered psychobiological reactivity but no impairment of emotion recognition following stress in adolescents with non-suicidal self-injury

Impairments in both stress regulation and emotion recognition have been associated with borderline personality disorder (BPD) and non-suicidal self-injury (NSSI). Although it has been proposed that emotion recognition deficits particularly emerge during stress, this hypothesis has not been fully investigated. Adolescents with and without NSSI performed emotion recognition tasks before and after the employment of the Trier Social Stress Test (TSST). The psychobiological stress response was captured with psychological self-reports (affect, stress and dissociation), physiological recordings (heart rate, HR, and heart rate variability, HRV) and endocrinological sampling of saliva (cortisol and alpha-amylase). Mixed-linear models were applied to analyze stress-induced changes in emotion recognition performance and respective stress response measures. The TSST elicited altered psychobiological stress responses in adolescents with NSSI: A more pronounced decrease in positive affect, a more pronounced increase in negative affect, a less pronounced increase in HR, a less pronounced decrease in HRV and a more pronounced increase in alpha-amylase throughout the stress induction than adolescents without NSSI. Stress responses (dissociation, negative affect, cortisol and HR) differed as a function of BPD severity on a continuum, illustrating greater reactivity on self-reports but decreased biological responsiveness in those with greater BPD severity. Stress induction had similar effects on emotion recognition in adolescents with and without NSSI. Recognition sensitivity and recognition speed equally increased, in the absence of any differences in recognition accuracy. In contrast to prominent propositions, psychosocial stress does not appear to account for impaired emotion recognition across the BPD spectrum.

     

Body image as a mediator of non-suicidal self-injury in adolescents

Attitudes towards the body have been largely overlooked as a potential risk factor for adolescent non-suicidal self-injury (NSSI) despite theorizing that a negative body image may play a critical role in the development of this behavior. The current study used structural equation modeling to evaluate the fit of a theoretical model specifying body image as a mediator between negative affect and NSSI in a combined clinical and non-clinical sample of 284 adolescents. The data supported the model, accounted for 21.6% of the variance in NSSI, and body image significantly mediated the relationship between negative affect and NSSI. These findings provide essential preliminary evidence that body image may represent a necessary but not sufficient risk factor for NSSI in adolescents and that treatment for NSSI should consider targeting body-related pathology in addition to emotion regulation. The findings also support including body image within developing etiological models of NSSI.