Non-suicidal Self-injurious Thoughts and Behaviors Among Adolescent Inpatients

Millon, Emma M.; Alqueza, Kira L.; Kamath, Rahil A.; Marsh, Rachel; Pagliaccio, David; Blumberg, Hilary P.; Stewart, Jessica; Auerbach, Randy P.

doi:10.1007/s10578-022-01380-1

Cited by 13 publications

(15 citation statements)

References 77 publications

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“…The high-severity group reported more methods and younger age of onset than both the other classes, in addition to more strongly endorsing intrapersonal functions for their use of self-harm. In addition to the differences in ITS variables, classes significantly differed on severity of psychological distress, which is consistent with the association of psychosocial and suicide-related risk (ABS, 2022;Baiden et al, 2017;Lynskey et al, 2006;Millon et al, 2022;Victor & Klonsky, 2014). However, the lack of significant differences in terms of number of suicide attempts and baseline suicidal ideation between profiles was unexpected.…”

Section: Main Findingssupporting

confidence: 73%

Generalisability of the interpersonal theory of suicide to latent profiles of young people attending treatment in a suicide prevention service

Janackovski,

Deane,

Hains

et al. 2023

Psychol Psychother

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ObjectiveThe Interpersonal Theory of Suicide (ITS) could help identify differences in groups of suicidal adolescents and inform treatment.MethodLatent Profile Analysis (LPA) using thwarted belongingness (TB), perceived burdensomeness (PB), hopelessness, and capability was conducted on data from an at‐risk clinical sample (N = 500). The ITS prediction that changes in TB and PB are associated with changes in suicidal ideation was tested using admission and discharge data.ResultsLatent Profile Analysis identified three profiles with increasing complexity and severity on ITS factors. The profiles were labelled low‐severity (7.6% of participants), moderate‐severity (45.2%), and high‐severity (47.2%). ITS predictions were partially supported for the full sample and only for the high‐severity and moderate‐severity subgroups, whereby changes in TB were significantly associated with changes in suicidal ideation over the course of treatment. However, changes in PB were only significant in the moderate‐severity subgroup, and none of the ITS predictions were supported in the low‐severity subgroup. Additionally, effect sizes for changes in TB and PB were modest in all analyses.ConclusionsOur findings highlight the importance reducing low belongingness in youth, which is a component of all supported interventions of youth suicide prevention. However, given the modest association of changes in ITS variables had with changes in suicidal ideation, it may be fruitful to elaborate on the relative importance on types of low belongingness or include other non‐ITS variables.

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Section: Main Findingssupporting

confidence: 73%

Generalisability of the interpersonal theory of suicide to latent profiles of young people attending treatment in a suicide prevention service

Janackovski,

Deane,

Hains

et al. 2023

Psychol Psychother

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“…Thus, the clinical utility of the BADS and the ability to discriminate between MDD and PDD requires further study in non-inpatient samples. Further, the current sample was predominantly female and White, which, despite being similar to other inpatient adolescent samples (particularly those with high rates of suicidal behavior; Millon et al, 2022 ; Patel et al, 2020 ), does indicate that these findings need to be replicated in various samples with diverse demographic characteristics to determine their generalizability. These analyses were also cross-sectional, taking place during a limited hospitalization of the adolescent.…”

Section: Discussionmentioning

confidence: 49%

“…While adolescents often present with multiple contributing factors for hospitalization, the majority of inpatient adolescents report suicidal ideations and related behaviors (Alqueza et al, 2021 ; Hanssen-Bauer et al, 2011 ; Rodriguez-Quintana & Ugueto, 2021 ). In addition, among adolescents hospitalized for suicidal behavior, 50–90% meet current or lifetime criteria for a depressive diagnosis (Millon et al, 2022 ; Poyraz Fındık et al, 2022 ). Given the brief nature of hospital stays and the prevalence of depressive disorders within inpatient settings, a number of short screening tools have been developed for depressive disorders, including rating scales (e.g., Children’s Depression Inventory [CDI; Kovacs, 2015 ], Center for Epidemiological Studies-Depression Scale [CES-D; Radloff, 1977 ]) and brief interviews (e.g., clinician-administered questions briefly assessing depressive symptoms; Sharp & Lipsky, 2002 ; Young et al, 2010 ).…”

Section: Introductionmentioning

confidence: 99%

The Brief Adolescent Depression Screen: A Brief Screening Tool for Depression and Suicidal Behavior in Inpatient Adolescents

Vaughan

Kemp

Robertson

et al. 2023

Child Youth Care Forum

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Background In clinical settings, there is significant need for brief, easily-administered assessment tools for adolescent depression that can be used by mental health clinicians from a variety of training backgrounds. Existing depression screening tools do not assess for duration and consistency of symptoms, two key indicators of pathological depression. Objective The Brief Adolescent Depression Screen (BADS) was developed to screen for major and persistent depressive disorders in adolescents in order to meet the assessment needs in an inpatient setting, and the validity of this tool was tested. Method The current study used a sample of 396 inpatient adolescents to assess the screening utility of the BADS for detecting whether the adolescent meets criteria for a depressive diagnosis according to a well-validated semi-structured interview, as well as detecting a positive history of suicidal behavior. Further, the screening utility of this measure was compared to the utility of an established depression rating scale. Results Analyses first determined the duration of depressive symptoms on the BADS that optimally screened for the presence of Major Depressive Disorder and Persistent Depressive Disorder. Findings indicated that, using these optimal screening cut-offs, the BADS showed a strong screening utility, resulting in a sensitivity and specificity for identifying full depressive diagnoses and a positive history of suicidal behavior with similar or greater accuracy than an established rating scale. Conclusions These findings provide initial evidence to suggest that the BADS may be a helpful screening tool for adolescent depressive disorders in inpatient settings.

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“…Another study [ 13 ] showed that co-morbid anxiety disorders are important risk factors for the development of NSSI behaviors in patients with depressive disorders, and their NSSI behaviors occur more frequently, and the risk of NSSI behaviors in depressive disorders with co-morbid anxiety disorders is three times higher than in those without co-morbid anxiety disorders. Many studies [ 22 – 25 ] around the world have also confirmed that anxiety, depression and NSSI are closely related. Finally, regarding the interrelationship between negative life events and NSSI, previous studies [ 26 – 29 ] have shown that negative life events are a risk factor for NSSI.…”

Section: Introductionmentioning

confidence: 91%

The relationship between negative life events and non-suicidal self-injury (NSSI) among Chinese junior high school students: the mediating role of emotions

et al. 2022

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Background Adolescent non-suicidal self-injury (NSSI) is common and adolescence is the most common period of first self-injury, and the occurrence of NSSI is influenced by negative life events and emotional symptoms. The mediating role of emotional symptoms in the interaction between negative life events and NSSI has not been carefully investigated yet. Methods For middle school students in three schools in a Chinese province, the Adolescents Self-Harm Scale was used to investigate NSSI, the Adolescent Self-Rating Life Events Check List was used to investigate adolescent negative life events, and the Self-Rating Anxiety Scale and Self-Rating Depression Scale were used to assess their emotional symptoms. After the description of general data and the test for differences between groups, the relationship between negative life events, emotional symptoms and NSSI was analyzed using Pearson correlation analysis. Structural equation modeling was used to analyze the mediating role of emotions in negative life events and NSSI. Results A total of 2376 junior high school students completed this survey, which revealed an annual NSSI prevalence of 37.1% (n = 881) and a higher prevalence of NSSI among girls and rural adolescents. Among adolescents who developed NSSI, 67.4% (N = 594) used multiple means of self-injury. The most common means of self-injury was hair pulling (51.0%), and the most common NSSI purpose and external factors/events were venting bad emotions or feelings (57.5%) and poor academic performance (44.9%), respectively. Negative life events, emotional symptoms and NSSI were positively associated (P < 0.05). Structural equation modeling with negative life events, emotional symptoms and NSSI as variables showed that the model-fit index matched the data well, with RMSEA = 0.073, AGFI = 0.945, GFI = 0.980, CFI = 0.985, NFI = 0.982, TLI = 0.968, IFI = 0.985, and negative life events, emotional symptoms (anxiety, depression) and NSSI all had direct effects with standardized path coefficients of 0.16, 0.19, and 0.23, respectively, with negative life events playing an indirect role in NSSI through emotional symptoms and emotional symptoms playing an incomplete mediating role in negative life events and NSSI. Conclusion The prevalence of NSSI was higher among Chinese junior high school students. Both negative life events and emotional symptoms were direct risk factors for NSSI. In addition, negative life events were also indirect risk factors for NSSI, and emotional symptoms played an incomplete mediating role in the relationship between the effects of negative life events and NSSI. This indicates that the combination of reducing the frequency of negative life events while maintaining individual emotional stability during adolescent development can effectively reduce the prevalence of NSSI in adolescents.

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Non-suicidal Self-injurious Thoughts and Behaviors Among Adolescent Inpatients

Cited by 13 publications

References 77 publications

Generalisability of the interpersonal theory of suicide to latent profiles of young people attending treatment in a suicide prevention service

Generalisability of the interpersonal theory of suicide to latent profiles of young people attending treatment in a suicide prevention service

The Brief Adolescent Depression Screen: A Brief Screening Tool for Depression and Suicidal Behavior in Inpatient Adolescents

The relationship between negative life events and non-suicidal self-injury (NSSI) among Chinese junior high school students: the mediating role of emotions

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