Exploring the relationship between pain and self-harm thoughts and behaviours in young people using network analysis

Abstract Background Self-harm thoughts and behaviours (SHTBs) are a serious public health concern in young people. Emerging research suggests that pain may be an important correlate of SHTBs in young people. However, it remains unclear whether this association is driven by the shared association with other correlates of SHTBs. This study used network analysis to delineate the relationship between SHTBs, pain and other correlates of SHTBs in a population-based sample of young people. Methods We performed secondary analyses, using data from 7977 young people aged 5–16 years who participated in the British Child and Adolescent Mental Health Survey in 2004. We used χ2 tests and network analysis to examine the complex interplay between SHTBs, pain and other correlates of SHTBs, including psychiatric disorders, childhood trauma, stressful life events, parental distress, family dysfunction, peer problems and inhibitory control deficits. Results Pain was associated with a doubled risk of SHTBs, and likewise, SHTBs were associated with a doubled risk of pain. Furthermore, network analysis showed that although pain was significantly associated with all measured correlates of SHTBs, except family dysfunction, pain was most strongly associated with SHTBs, after accounting for these measured correlates. Conclusions To the best of our knowledge, this is the first study to utilise network analysis to provide novel insights into the complex relationship between SHTBs, pain and other known correlates of SHTBs in young people. Results suggest that pain is an independent correlate of SHTBs. Future research should aim to identify underlying mechanisms.

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Behavior change techniques in mobile apps targeting self-harm in young people: a systematic review

Translational Behavioral Medicine ◽

10.1093/tbm/ibaa131 ◽

2021 ◽

Author(s):

Elena Panagiotopoulou ◽

Celeste Peiris ◽

Daniel Hayes

Keyword(s):

Young People ◽

Behavior Change ◽

Dialectical Behavior Therapy ◽

Mobile Apps ◽

Mental Healthcare ◽

Future Research ◽

Active Components ◽

Behavior Change Techniques ◽

Other Information ◽

Self Harm

Abstract Despite the high prevalence of self-harm among young people, as well as their extensive use of mobile apps for seeking support with their mental healthcare, it is unclear whether the design of mobile apps aimed at targeting self-harm is underpinned by behavior change techniques (BCTs). To systematically analyze and identify (a) what BCTs and (b) what theories are present in self-harm apps for young people in an attempt to understand their active components. Systematic searches in Apple store, followed by thorough screening, were conducted to identify free mobile apps targeting self-harm in young people. Five apps met the inclusion criteria and were used by trained researchers, who coded identified features against the BCT Taxonomy V1. Despite the majority of apps being underpinned by principles of Dialectical Behavior Therapy (DBT), no other information is available about specific theories underpinning these apps. Nineteen of the 93 BCTs were identified across the five apps. The most frequently used BCT was “Distraction” (54.2%), offering ideas for activities to distract users from self-harming. Other techniques that were used often were “Social Support (unspecified)” (27.0%) and “Behavior Substitution” (10.6%). This study provides the first analysis of BCTs present in mental health apps which are designed to target the reduction of self-harm in young people. Future research is needed to evaluate the effectiveness of the apps, as well as assess the effectiveness of the BCTs present.

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Comorbidity of self-harm and disordered eating in young people: Evidence from a UK population-based cohort

Journal of Affective Disorders ◽

10.1016/j.jad.2020.12.053 ◽

2021 ◽

Vol 282 ◽

pp. 386-390

Author(s):

Naomi Warne ◽

Jon Heron ◽

Becky Mars ◽

Paul Moran ◽

Anne Stewart ◽

...

Keyword(s):

Young People ◽

Disordered Eating ◽

Population Based ◽

Self Harm

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Effectiveness, Acceptability, and Feasibility of Digital Health Interventions for LGBTIQ+ Young People: Systematic Review

Journal of Medical Internet Research ◽

10.2196/20158 ◽

2020 ◽

Vol 22 (12) ◽

pp. e20158

Author(s):

Dylan Gilbey ◽

Helen Morgan ◽

Ashleigh Lin ◽

Yael Perry

Keyword(s):

Young People ◽

Sexual Health ◽

Digital Health ◽

Health Interventions ◽

Health Concern ◽

Sufficient Evidence ◽

Future Research ◽

Evidence Based ◽

Bisexual Men ◽

Targeted Interventions

Background Young people (aged 12-25 years) with diverse sexuality, gender, or bodily characteristics, such as those who identify as lesbian, gay, bisexual, transgender, intersex, or queer (LGBTIQ+), are at substantially greater risk of a range of mental, physical, and sexual health difficulties compared with their peers. Digital health interventions have been identified as a potential way to reduce these health disparities. Objective This review aims to summarize the characteristics of existing evidence-based digital health interventions for LGBTIQ+ young people and to describe the evidence for their effectiveness, acceptability, and feasibility. Methods A systematic literature search was conducted using internet databases and gray literature sources, and the results were screened for inclusion. The included studies were synthesized qualitatively. Results The search identified 38 studies of 24 unique interventions seeking to address mental, physical, or sexual health–related concerns in LGBTIQ+ young people. Substantially more evidence-based interventions existed for gay and bisexual men than for any other population group, and there were more interventions related to risk reduction of sexually transmitted infections than to any other health concern. There was some evidence for the effectiveness, feasibility, and acceptability of these interventions overall; however, the quality of evidence is often lacking. Conclusions There is sufficient evidence to suggest that targeted digital health interventions are an important focus for future research aimed at addressing health difficulties in LGBTIQ+ young people. Additional digital health interventions are needed for a wider range of health difficulties, particularly in terms of mental and physical health concerns, as well as more targeted interventions for same gender–attracted women, trans and gender-diverse people, and people with intersex variations. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42020128164; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=128164

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Poisoning substances taken by young people: a population-based cohort study

British Journal of General Practice ◽

10.3399/bjgp18x698897 ◽

2018 ◽

Vol 68 (675) ◽

pp. e703-e710 ◽

Cited By ~ 6

Author(s):

Edward G Tyrrell ◽

Denise Kendrick ◽

Kapil Sayal ◽

Elizabeth Orton

Keyword(s):

Cohort Study ◽

Young People ◽

Population Based ◽

Incidence Rates ◽

Practice Research ◽

Mortality Data ◽

Clinical Practice Research Datalink ◽

Self Harm ◽

Harm Prevention ◽

Rate Ratios

BackgroundGlobally, poisonings account for most medically-attended self-harm. Recent data on poisoning substances are lacking, but are needed to inform self-harm prevention.AimTo assess poisoning substance patterns and trends among 10–24-year-olds across EnglandDesign and settingOpen cohort study of 1 736 527 young people, using linked Clinical Practice Research Datalink, Hospital Episode Statistics, and Office for National Statistics mortality data, from 1998 to 2014.MethodPoisoning substances were identified by ICD-10 or Read Codes. Incidence rates and adjusted incidence rate ratios (aIRR) were calculated for poisoning substances by age, sex, index of multiple deprivation, and calendar year.ResultsIn total, 40 333 poisoning episodes were identified, with 57.8% specifying the substances involved. The most common substances were paracetamol (39.8%), alcohol (32.7%), non-steroidal anti-inflammatory drugs (NSAIDs) (11.6%), antidepressants (10.2%), and opioids (7.6%). Poisoning rates were highest at ages 16–18 years for females and 19–24 years for males. Opioid poisonings increased fivefold from 1998–2014 (females: aIRR 5.30, 95% confidence interval (CI) = 4.08 to 6.89; males: aIRR 5.11, 95% CI = 3.37 to 7.76), antidepressant poisonings three-to fourfold (females: aIRR 3.91, 95% CI = 3.18 to 4.80, males: aIRR 2.70, 95% CI = 2.04 to 3.58), aspirin/NSAID poisonings threefold (females: aIRR 2.84, 95% CI = 2.40 to 3.36, males: aIRR 2.76, 95% CI = 2.05 to 3.72) and paracetamol poisonings threefold in females (aIRR 2.87, 95% CI = 2.58 to 3.20). Across all substances poisoning incidence was higher in more disadvantaged groups, with the strongest gradient for opioid poisonings among males (aIRR 3.46, 95% CI = 2.24 to 5.36).ConclusionIt is important that GPs raise awareness with families of the substances young people use to self-harm, especially the common use of over-the-counter medications. Quantities of medication prescribed to young people at risk of self-harm and their families should be limited, particularly analgesics and antidepressants.

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Violent Video Games and Attitudes Towards Victims of Crime

International Journal of Cyber Behavior Psychology and Learning ◽

10.4018/ijcbpl.2013070101 ◽

2013 ◽

Vol 3 (3) ◽

pp. 1-16 ◽

Cited By ~ 1

Author(s):

Lavinia McLean ◽

Mark D. Griffiths

Keyword(s):

Video Games ◽

Young People ◽

Video Game ◽

Future Research ◽

Relevant Research ◽

Violent Video Games ◽

Violent Video Game ◽

Positive Attitudes ◽

Victims Of Crime ◽

The Relationship

Previous research has indicated that playing violent video games may be associated with an increase in acceptance of violence and positive attitudes towards perpetrators of crime. This study is the first to investigate the relationship between playing violent video games and attitudes towards victims of crime. A total of 206 young people (aged 12-24 years) completed measures of attitudes towards victims and violent video game exposure. The results suggest that exposure to violent video games is associated with less concern being reported for victims of crime. Young people who play more violent video games reported less concern for general victims and for culpable victims, and these effects cannot be explained by gender or age differences. The results are discussed in relation to relevant research in the area, along with recommendations for future research.

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Inflammatory bowel disease is associated with higher dementia risk: a nationwide longitudinal study

Gut ◽

10.1136/gutjnl-2020-320789 ◽

2020 ◽

Vol 70 (1) ◽

pp. 85-91 ◽

Cited By ~ 8

Author(s):

Bing Zhang ◽

Hohui E Wang ◽

Ya-Mei Bai ◽

Shih-Jen Tsai ◽

Tung-Ping Su ◽

...

Keyword(s):

Neurodegenerative Disorder ◽

Disease Risk ◽

Subsequent Development ◽

Population Based ◽

Future Research ◽

Research Database ◽

Dementia Risk ◽

The Central Nervous System ◽

Inflammatory Bowel ◽

The Relationship

ObjectiveIncreasing evidence supports reciprocal communication between the enteric and the central nervous system in disease, termed the ‘gut–brain axis’. Recent findings suggest a connection between IBD and development of Parkinson’s disease. The role of IBD in dementia, another insidious neurodegenerative disorder, has not been explored.DesignUsing the Taiwanese National Health Insurance Research Database, we performed comparative analysis of 1742 patients with IBD ≥45 years old against 17 420 controls to assess dementia risk following IBD diagnosis. Controls were matched on bases of sex, access to healthcare, income and dementia-related comorbidities. All individuals were followed for dementia diagnosis for up to 16 years. Subanalyses included the relationship between sex, ulcerative colitis (UC) and Crohn’s disease (CD), and dementia risk.ResultsOverall incidence of dementia among patients with IBD was significantly elevated (5.5% vs 1.4% among controls). Patients with IBD were diagnosed with dementia at 76.24 years old on average, compared with 83.45 among controls. The HR of developing dementia among patients with IBD was 2.54 (95% CI 1.91 to 3.37). Among dementia types, the risk of developing Alzheimer’s dementia demonstrated the greatest increase. Dementia risk did not differ between sex differences nor UC versus CD.ConclusionThis population-based cohort study demonstrates significant association between IBD and subsequent development of dementia. Dementia was diagnosed at an earlier age among patients with IBD, and disease risk appeared to increase with IBD chronicity. These findings highlight the need for future research to elucidate the relationship between IBD and dementia.

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Cause and effect in studies on unemployment, mental health and suicide: a meta-analytic and conceptual review

Psychological Medicine ◽

10.1017/s0033291713001621 ◽

2013 ◽

Vol 44 (5) ◽

pp. 909-917 ◽

Cited By ~ 80

Author(s):

A. Milner ◽

A. Page ◽

A. D. LaMontagne

Keyword(s):

Mental Health ◽

Meta Analysis ◽

Population Based ◽

Future Research ◽

Temporal Relationships ◽

Causal Assumptions ◽

Confounder Adjustment ◽

Past Experiences ◽

Study Designs ◽

The Relationship

BackgroundThere are ongoing questions about whether unemployment has causal effects on suicide as this relationship may be confounded by past experiences of mental illness. The present review quantified the effects of adjustment for mental health on the relationship between unemployment and suicide. Findings were used to develop and interpret likely causal models of unemployment, mental health and suicide.MethodA random-effects meta-analysis was conducted on five population-based cohort studies where temporal relationships could be clearly ascertained.ResultsResults of the meta-analysis showed that unemployment was associated with a significantly higher relative risk (RR) of suicide before adjustment for prior mental health [RR 1.58, 95% confidence interval (CI) 1.33–1.83]. After controlling for mental health, the RR of suicide following unemployment was reduced by approximately 37% (RR 1.15, 95% CI 1.00–1.30). Greater exposure to unemployment was associated with higher RR of suicide, and the pooled RR was higher for males than for females.ConclusionsPlausible interpretations of likely pathways between unemployment and suicide are complex and difficult to validate given the poor delineation of associations over time and analytic rationale for confounder adjustment evident in the revised literature. Future research would be strengthened by explicit articulation of temporal relationships and causal assumptions. This would be complemented by longitudinal study designs suitable to assess potential confounders, mediators and effect modifiers influencing the relationship between unemployment and suicide.

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A Systematic Review of Amenable Resilience Factors that Moderate and/or Mediate the Relationship between Childhood Adversity and Mental Health in Young People

10.31219/osf.io/bkyax ◽

2017 ◽

Author(s):

Jessica Fritz ◽

Anne de Graaff ◽

Helen Caisley ◽

Anne-Laura Van Harmelen ◽

Paul O. Wilkinson

Keyword(s):

Mental Health ◽

Social Support ◽

Systematic Review ◽

Young People ◽

Empirical Support ◽

Childhood Adversity ◽

Future Research ◽

Increased Risk ◽

Resilience Factors ◽

The Relationship

THIS IS A PRE-PRINT OF AN ARTICLE PUBLISHED IN "FRONTIERS IN PSYCHIATRY - SPECIAL ISSUE: RESILIENCE, LIFE EVENTS, TRAJECTORIES AND THE BRAIN (9: 230)". THE FINAL AUTHENTICATED VERSION IS AVAILABLE ONLINE AT: https://doi.org/10.3389/fpsyt.2018.00230Background: Up to half of Western children and adolescents experience at least one type of childhood adversity. Individuals with a history of childhood adversity have an increased risk of psychopathology. Resilience enhancing factors reduce the risk of psychopathology following childhood adversity. A comprehensive overview of empirically supported resilience factors is critically important for interventions aimed to increase resilience in young people. Moreover, such an overview may aid the development of novel resilience theories. Therefore, we conducted the first systematic review of social, emotional, cognitive and/ or behavioural resilience factors after childhood adversity.Methods: We systematically searched Web of Science, PsycINFO and Scopus (e.g. including MEDLINE) for English, Dutch and German literature. We included cohort studies that examined whether a resilience factor was a moderator and/ or a mediator for the relationship between childhood adversity and psychopathology in young people (mean age 13-24). Therefore, studies were included if the resilience factor was assessed prior to psychopathology, and childhood adversity was assessed no later than the resilience factor. Study data extraction was based on the STROBE report and study quality was assessed with an adapted version of Downs and Black’s scale. The preregistered protocol can be found at: http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42016051978.Results: The search identified 1969 studies, of which 22 were included (eight nationalities, study sample n range: 59-6780). We found empirical support for 13 of 25 individual-level (e.g. high self-esteem, low rumination), six of 12 family-level (e.g. high family cohesion, high parental involvement), and one of five community-level resilience factors (i.e. high social support), to benefit mental health in young people exposed to childhood adversity. Single versus multiple resilience factor models supported the notion that resilience factors should not be studied in isolation, and that interrelations between resilience factors should be taken into account when predicting psychopathology after childhood adversity.Conclusions: Interventions that improve individual, family, and/ or social support resilience factors may reduce the risk of psychopathology following childhood adversity. Future research should scrutinize whether resilience factors function as a complex interrelated system that benefits mental health resilience after childhood adversity.

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Interpersonal Violence Around Pregnancy Experienced by Rural and Urban Canadian Women: Correlates and Selected Health Outcomes

Journal of Interpersonal Violence ◽

10.1177/08862605211043576 ◽

2021 ◽

pp. 088626052110435

Author(s):

Yingying Su ◽

Carl D’Arcy

Keyword(s):

High Risk ◽

Rural Women ◽

Interpersonal Violence ◽

Stressful Life Events ◽

Population Based ◽

Health Concern ◽

Global Public Health ◽

Physical And Mental Health ◽

Increased Risk ◽

Rural Mothers

Interpersonal violence around pregnancy is of increasing global public health concern affecting both women themselves and their children. The primary aim of this study is to explore and identify potential correlates of such violence and to examine maternal and birth outcomes subsequent to that violence in a nationally representative sample of urban and rural women in Canada. The data are from the Maternity Experiences Survey (MES), a Canadian population-based postcensus survey administered to 6,421 Canadian mothers in 2006. Survey participants were 15 years and older and had given birth to a singleton and continued to live with their infant at the time of the survey. The survey response rate was 78%. Multivariable logistic regression analyses were used in the analysis with adjustments made for confounding variables. The study findings indicated that living in an urban environment was associated with an increased risk of interpersonal violence experience around the time of pregnancy ( OR = 1.31, 95% CI: 1.03-1.66). In addition, being aboriginal, young, unmarried, economically disadvantaged, a nonimmigrant, and having more than four pregnancies, as well as cigarette smoking, alcohol drinking and drug use before the pregnancy were correlated with interpersonal violence around pregnancy. Maternal interpersonal violence experiences were also associated with postnatal depression and stressful life events among both urban and rural mothers. However, maternal interpersonal violence experiences were only associated with preterm birth among rural mothers but not among urban mothers. The present study highlights the need to implement effective interventions for women experiencing interpersonal violence around pregnancy due to its potential impact on maternal and newborn’s physical and mental health. Screening and intervention should be targeted high-risk women particularly those who are indigenous, young, unmarried, nonimmigrants, of lower socioeconomic status, and manifesting high risk health behaviors.

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Sleep and pain

10.1093/oso/9780198778240.003.0017 ◽

2018 ◽

Author(s):

Nicole K. Y. Tang ◽

Esther F. Afolalu ◽

Fatanah Ramlee

Keyword(s):

Public Health ◽

Primary Care ◽

Population Level ◽

Population Based ◽

Future Research ◽

Long Term Conditions ◽

Treatment Development ◽

The Individual ◽

The Relationship

Pain and sleeplessness are two of the commonest reasons for primary care appointments. The prevalence of each problem alone is high, and to add to the complexity, pain and insomnia frequently co-occur, with pain interrupting sleep and pain being further aggravated following a poor night’s sleep. Sleep and pain management are increasingly recognized as important to public health. In particular, insomnia and chronic pain are long-term conditions that actively contribute to morbidity, disability, economic burden to society, and suffering to the individual and immediate family. This chapter examines the interrelationship between the two at the population level. Specifically, evidence from population-based studies regarding the co-occurrence and temporal link of pain and sleep is reviewed, with moderators and mediators of the relationship highlighted. Possible directions for future research and treatment development are also outlined.

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