Associations of impulsivity, hyperactivity, and inattention with nonsuicidal self-injury and suicidal behavior: longitudinal cohort study following children at risk for neurodevelopmental disorders into mid-adolescence

Abstract

Background The knowledge of how the separate Attention-Deficit/Hyperactivity Disorder (ADHD) subdimensions (impulsivity, hyperactivity, and inattention) are associated with nonsuicidal self-injury (NSSI) and suicidal behavior (SB) is limited. The objective of this study was to investigate the associations of childhood ADHD subdimensions with NSSI and SB in children at risk of neurodevelopmental disorders (NDDs; including ADHD). Methods The sample (N = 391) included twin pairs where at least one twin screened positive for at least one NDD or common comorbidity at age 9 or 12. Data on ADHD subdimensions was collected through a telephone interview with a caregiver/legal guardian at age 9 or 12, and data on NSSI and SB was collected through an in-person clinical assessment at age 15. The associations between the ADHD subdimensions and NSSI or SB were tested in three different models: (1) univariable, (2) together with the other ADHD subdimensions, and (3) in a confounder-adjusted model including other NDD symptoms in addition to ADHD subdimensions, for NSSI and SB separately. Results A total of 32 (8.2%) adolescents reported life-time engagement of NSSI, and 18 (4.6%) SB. Childhood impulsivity was associated with SB and childhood inattention with NSSI, in all models. Hyperactivity was not meaningfully associated with any of the outcomes. Conclusion Impulsivity and inattention, but not hyperactivity, may be of particular importance in understanding SB and NSSI. Brief screening for impulsivity and inattention in childhood could facilitate detection of children vulnerable to NSSI and SB and indicate valuable information for preventive and intervention strategies.

Understanding Comorbidity Between Non-Suicidal Self-Injury and Depressive Symptoms in a Clinical Sample of Adolescents: A Network Analysis

“…This is consistent with the discovery that inattention was associated with NSSI in childhood and adolescence. 48 Concentration difficulties are present in many mental disorders, such as anxiety disorder 49 and eating disorder, 50 which are commonly comorbid with NSSI. 51 , 52 In our study, concentration was assessed by one of the items on the PHQ-9 (Trouble concentrating on things, such as reading the newspaper or watching television), which was more subjective.…”

Association between age, gender, and oral traumatic ulcerative lesions: a retrospective study

“…The percentage affecting the gingiva was only 4.60%. Mounting evidence indicates that children and adolescents with attention deficit and hyperactivity disorder (ADHD) or subsyndromal ADHD have a significantly increased risk of self-inflicted injury [ 23 – 25 ]. A previous study also found that self-mutilation of the oral cavity is very common in mentally retarded children [ 26 ].…”

Impaired behavioral inhibitory control of self-injury cues between adolescents with depression with self-injury behavior and those without during a two-choice oddball task: an event-related potential study

“…Even in the last month, highly behavioral impulsivity was less likely to make deliberate attempts ( 46 ). However, another longitudinal cohort study of children at risk for neurodevelopmental disorders in mid-adolescence suggested that impulsivity and inattention may be particularly important in understanding the onset of NSSI and suicidal behaviors ( 54 ). Specifically, adolescents are in the developmental stage of self-cognitive ability whose self-reported results vary significantly.…”