Mental flexibility and problem solving in adult patients who present non-suicidal self-injury

Abstract

IntroductionNon-Suicidal Self-Injury (NSSI) is considered a dysfunctional way of dealing with problem situations.ObjectiveThis study aimed to investigate the problem solving capacity in adults with NSSI compared to controls.MethodsThirty-three patients who sought treatment for NSSI (NSSI group) were compared with 33 individuals without psychiatric disorder (control group). We also investigated Axis I disorders, executive functions and problem solving capacity.ResultsIn both groups, the majority were women (77.25%) with a mean age of 30 years, and the beginning of NSSI behavior of 16 years. The most common NSSI behaviour was skin cutting, and the most common reason given for engaging in that behaviour was “to stop negative feelings”. The most common psychiatric comorbidities were major depressive disorder (60.6%). Compared to controls, the group with NSSI showed lower results in relation to problem solving capacity (P = 0.000) and mental flexibility (P = 0.007). Deficits in problem solving capacity may be a reflection of low mental flexibility of adults with NSSI. This may be a risk factor for the beginning of NSSI and the persistence of it in adulthood.ConclusionEarly identification and treatment focused on problem solving capacity during the adolescence may prevent the chronicity of NSSI.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Executive functioning in psychiatric patients with deliberate self-harm, as compared with a psychiatric and a healthy comparison group

“…Previous studies on EF and DSH have highlighted inhibition and working memory as topics of interests, although cognitive flexibility also has been explored (Drabble et al, 2014;Garreto et al, 2017;Miranda et al, 2012). The results from the present study differ from Fikke et al (2011) results, since they indicate that the domain of cognitive flexibility is primarily affected, and not working memory.…”

“…In a related study, Miranda et al (2012) found that cognitive inflexibility predicted suicidal ideation in a population of individuals with previous suicidal behavior. Also, in a comparison between patients who sought treatment for NSSI and a non-psychiatric comparison group, Garreto et al (2017) found that the NSSI-group showed significantly lower problemsolving capacity and mental flexibility.…”

Cognitive impairment and factors influencing depression in adolescents with suicidal and self-injury behaviors: a cross-sectional study

“…Studies of suicidal brains have found that the changes in brain structure and function associated with suicide are mainly in the orbitofrontal and dorsolateral parts of the PFC, which are the control systems of EF such as cognitive inhibition [ 70 ]. Studies have revealed that the EF of adolescents with NSSI—specifically flexibility and high-risk decision-making—is significantly different from that of non-NSSI adolescents [ 71 , 72 ]. Deficiencies in problem-solving capacity may indicate low mental flexibility in people with self-injury [ 71 ].…”