Parent-child interactions, peripheral serotonin, and self-inflicted injury in adolescents.

Abstract

Self-inflicted injury in adolescence indicates significant emotional and psychological suffering. Although data on the etiology of self-injury are limited, current theories suggest that the emotional lability observed among self-injuring adolescents results from complex interactions between individual biological vulnerabilities and environmental risk. For example, deficiencies in serotonergic functioning, in conjunction with certain family interaction patterns, may contribute to the development of emotional lability and risk for self-injury. The authors explored the relation between peripheral serotonin levels and mother-child interaction patterns among typical (n = 21) and self-injuring (n = 20) adolescents. Findings revealed higher levels of negative affect and lower levels of both positive affect and cohesiveness among families of self-injuring participants. Peripheral serotonin was also correlated with the expression of positive affect within dyads. Furthermore, adolescents' serotonin levels interacted with negativity and conflict within dyads to explain 64% of the variance in self-injury. These findings underscore the importance of considering both biological and environmental risk factors in understanding and treating self-injuring adolescents. Keywordsself-injury; adolescent; serotonin; family; discussion Adolescent self-inflicted injury (SII), including suicide attempts and nonsuicidal self-harm, represents a significant public health concern. In addition to the emotional toll on adolescents and their families, adolescent SII costs the United States healthcare system over $150 million per year in inpatient hospitalization costs alone (Olfson, Gameroff, Marcus, Greenberg, & Despite being a leading cause of death among youths, suicide is a low base-rate phenomenon. Epidemiological data suggest that 1.6/100,000 youths ages 10-14 and 9.7/100,000 youths ages 14-19 die by suicide each year (U.S. Public Health Service, 1999). Although nonfatal selfinjury is more common than completed suicide, with as many as 8.8% of teens reporting a "suicide attempt" (Grunbaum et al., 2002), accurately predicting suicide and self-injury on the basis of known risk factors is currently not possible. Given the significance of this public health concern, specifying etiological factors that could improve our understanding of and our ability to prevent SII should become a national priority.Despite the urgency in furthering our understanding of SII, current data are quite limited. In all likelihood, future studies will identify etiological pathways to SII through detailed analyses of both biological vulnerabilities and environmental risk factors, as well as Biology × Environment interactions. Indeed, research suggests that many psychopathological outcomes are influenced by the interaction of biological and environmental influences (Kendler, Prescott, Myers, & Neale, 2003). Thus, etiological models of SII must address the complex interrelations among dynamic biological, psychological, and social systems. Although longitudi...

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