Auditory Hallucinations and Self-Injurious Behavior in General Population Adolescents: Modeling Within-Person Effects in the Tokyo Teen Cohort

Abstract

Background and Hypotheses A wealth of evidence suggests that adolescent psychotic experiences (PEs), and especially auditory hallucinations (AHs), are associated with an increased risk for self-injurious behavior (SIB). However, the directionality and specificity of this association are not well understood, and there are no published studies investigating within-person effects over time. The present study aimed to test whether AHs and SIB prospectively increase reciprocal risk at the individual level during early-to-middle adolescence. Study Design Three waves (12y, 14y, and 16y) of self-reported AHs and SIB data from a large Tokyo-based adolescent birth cohort (N = 2825) were used. Random Intercept Cross-Lagged Panel Model (RI-CLPM) analysis was conducted to test the within-person prospective associations between AHs and SIB. Study Results At the within-person level, AHs were associated with subsequent SIB over the observation period (12y–14y: β = .118, P < .001; 14–16y: β = .086, P = .012). The reverse SIB->AHs relationship was non-significant at 12–14y (β = .047, P = .112) but emerged from 14y to 16y as the primary direction of influence (β = .243, P < .001). Incorporating depression as a time-varying covariate did not meaningfully alter model estimates. Conclusions A complex bi-directional pattern of relationships was observed between AHs and SIB over the measurement period, and these relationships were independent of depressive symptoms. Adolescent AHs may be both a predictor of later SIB and also a manifestation of SIB-induced psychological distress.

Examining dynamic developmental trends: the interrelationship between age-friendly environments and healthy aging in the Chinese population—evidence from China Health and Retirement Longitudinal Study, 2011–2018

“…Both the CLPM and RI-CLPM models consider covariates. However, incorporating multiple covariates would lead to a more complex model, making it challenging to interpret [ 52 ]. Hence, in this study, we included only non-time-varying control variables, including ACE, education, gender, urban–rural distribution, and regional distribution.…”

A call to action: informing research and practice in suicide prevention among individuals with psychosis

“…Many studies of psychosis and suicide in the literature are crosssectional (55)(56)(57), limiting the conclusions that can be drawn to impact the assessment of suicide risk, suicide prevention interventions, and understanding of mechanisms underlying the association between psychosis and suicide risk (55). While many studies have reported that psychosis is a risk factor for suicide (8,10), recent evidence suggests a bidirectional relationship between psychosis-like experiences and suicide thoughts and behaviors (58,59). Further longitudinal studies designed specifically to address these questions of clinical relevance are needed to inform suicide prevention practices.…”

Longitudinal relationships of psychotic-like experiences with suicidal ideation and self-harm in adolescents

“…Although PLEs have been considered a risk factor for SITBs [10,11], a recent study has proposed a suicidal drive hypothesis, which suggests that SITBs may prompt the emergence of PLEs in some individuals, as a means of externalizing the self-directed threat that arises from SITBs [17]. Three longitudinal studies, utilizing two or three waves of data (collected over 2, 4, 6 years, respectively) have investigated this hypothesis, yielding inconsistent ndings: while two studies supported a temporal association between self-injurious/suicidal behaviors and PLEs/auditory hallucinations [18,19], the other study found no such temporal link [20]. These disparate results may stem from differences in assessments, analytical techniques, and study design/length, as well as confounding factors that have been linked to both phenomena [21].…”