Correlates and predictors of self-harm in a prospective sample of sexually assaulted adolescents

2020 ◽  
Vol 25 (4) ◽  
pp. 847-859
Author(s):  
Fatima Valencia-Agudo ◽  
Tami Kramer ◽  
Venetia Clarke ◽  
Andrea Goddard ◽  
Sophie Khadr
Keyword(s):  
Depressive Symptoms ◽  
Sexual Assault ◽  
Bivariate Analysis ◽  
Clinical Implications ◽  
Future Studies ◽  
Stress Symptoms ◽  
History Of ◽  
Self Harm ◽  
Logistic Regressions ◽  
Larger Sample

Background: Sexual assault of adolescents is associated with negative mental health outcomes, including self-harm. Little is known about correlates and predictors of self-harm after sexual assault. We hypothesized that pre-assault vulnerabilities and post-assault psychological distress would be associated with self-harm after experiencing a recent sexual assault. Methods: The sample was recruited from adolescents aged 13 to 17 years accessing sexual assault centers and it included 98 females. Longitudinal data were collected at T0 (3.9 weeks on average post-assault) and T1 (21.8 weeks on average post-assault). Bivariate analysis and hierarchical binary logistic regressions were performed. Results: The rate of self-harm was 38.1% before the assault and 37.8% after the assault ( T1). History of family dysfunction ( OR 3.60 (1.30, 10.01)), depressive symptoms at T0 ( OR 5.83 (2.35, 14.43)) or T1 ( OR 2.79 (1.20, 6.50), and posttraumatic stress symptoms at T1 ( OR 3.21 (1.36, 7.58)) predicted self-harm at T1. These effects were attenuated when adjusting for confounders, except for depressive symptoms at T0 ( OR 4.21 (1.57, 11.28)). Discussion: Clinical implications for the prevention of onset or continuation of self-harm following adolescent sexual assault are discussed. Future studies should replicate these findings in a larger sample and consider different trajectories of self-harm.

scholarly journals Depressive symptoms and neuroticism-related traits are the main factors associated with wellbeing independent of the history of lifetime depression in the UK Biobank

2021 ◽  
pp. 1-9
Author(s):  
Chiara Fabbri ◽  
Julian Mutz ◽  
Cathryn M. Lewis ◽  
Alessandro Serretti
Keyword(s):  
Depressive Symptoms ◽  
Risk Scores ◽  
Depression Symptoms ◽  
Uk Biobank ◽  
Single Episode ◽  
History Of ◽  
Physical Diseases ◽  
Self Harm ◽  
The Uk

Abstract Background Wellbeing has a fundamental role in determining life expectancy and major depressive disorder (MDD) is one of the main modulating factors of wellbeing. This study evaluated the modulators of wellbeing in individuals with lifetime recurrent MDD (RMDD), single-episode MDD (SMDD) and no MDD in the UK Biobank. Methods Scores of happiness, meaningful life and satisfaction about functioning were condensed in a functioning-wellbeing score (FWS). We evaluated depression and anxiety characteristics, neuroticism-related traits, physical diseases, lifestyle and polygenic risk scores (PRSs) of psychiatric disorders. Other than individual predictors, we estimated the cumulative contribution to FWS of each group of predictors. We tested the indirect role of neuroticism on FWS through the modulation of depression manifestations using a mediation analysis. Results We identified 47 966, 21 117 and 207 423 individuals with lifetime RMDD, SMDD and no MDD, respectively. Depression symptoms and personality showed the largest impact on FWS (variance explained ~20%), particularly self-harm, worthlessness feelings during the worst depression, chronic depression, loneliness and neuroticism. Personality played a stronger role in SMDD. Anxiety characteristics showed a higher effect in SMDD and no MDD groups. Neuroticism played indirect effects through specific depressive symptoms that modulated FWS. Physical diseases and lifestyle explained only 4–5% of FWS variance. The PRS of MDD showed the largest effect on FWS compared to other PRSs. Conclusions This was the first study to comprehensively evaluate the predictors of wellbeing in relation to the history of MDD. The identified variables are important to identify individuals at risk and promote wellbeing.

scholarly journals Care Programme Approach – documentation of past risk-related behaviour

2003 ◽  
Vol 27 (8) ◽  
pp. 298-300 ◽  
Author(s):  
Peter Dick ◽  
Tessa Durham ◽  
Mitchell Stewart ◽  
Scott Kane ◽  
Jim Duffy
Keyword(s):  
Clinical Information ◽  
Relevant Information ◽  
Risk Category ◽  
Clinical Implications ◽  
Routine Practice ◽  
Care Programme ◽  
Related Information ◽  
History Of ◽  
Self Harm ◽  
History Of Violence

Aims and MethodThe aim of the study was to assess the practicality of extracting past risk-related information from case records and to assess how this process might be cost-effectively incorporated in routine practice. Case records of 43 patients referred to the Care Programme Approach in Dundee were examined.ResultsOur study yielded relevant information – 39% of patients had a history of violence, 58% of self-harm or suicide, 58% of severe self-neglect and 72% of non-compliance with medication. However, it took an average of 5 hours to conduct a thorough review of each case because the notes were bulky and poorly organised.Clinical ImplicationsRetrospective review of conventional case records in routine practice is likely to be incomplete and misleading. Prospective recording should be practicable if used selectively, but requires a standardised approach to clinical recording and case note maintenance. The risk recording system we developed, incorporating a dated index of incidents by risk category, followed by brief summaries of each incident, provides key clinical information not available from a simple check list while not sacrificing brevity.

scholarly journals Obstetric complications and risk of schizophrenia

2001 ◽  
Vol 179 (5) ◽  
pp. 409-414 ◽  
Author(s):  
Hollie V. Thomas ◽  
Christina Dalman ◽  
Anthony S. David ◽  
Johan Gentz ◽  
Glyn Lewis ◽  
...  
Keyword(s):  
Case Control ◽  
Obstetric Complications ◽  
Early Age ◽  
Stockholm County ◽  
Maternal History ◽  
Future Studies ◽  
Increased Risk ◽  
History Of ◽  
And Control ◽  
Larger Sample

BackgroundObstetric complications have been studied frequently as possible risk factors for schizophrenia.AimsTo test the hypotheses that individual obstetric complications are most strongly associated with an increased risk of schizophrenia in males, in patients with an early age at first diagnosis and in subjects with a maternal history of psychosis.MethodCases of schizophrenia diagnosed between January 1971 and June 1994 were identified in the Stockholm County In-Patient Register. Controls were matched on age, gender, hospital of birth and parish of birth. Obstetric data were recorded blind to case–control status for 524 cases and 1043 controls.ResultsThis study did not find any large or consistent effect of gender, age at diagnosis or maternal history of psychosis on the risk of schizophrenia associated with individual complications.ConclusionsFuture studies should examine these effects using a much larger sample that includes patients with schizophrenia and control subjects whose genetic risk of schizophrenia has been assessed accurately.

scholarly journals Acute Stress Symptoms After Forcible and Substance-Involved Rapes

2019 ◽  
Vol 43 (4) ◽  
pp. 485-493
Author(s):  
Anna E. Jaffe ◽  
Christine K. Hahn ◽  
Amanda K. Gilmore
Keyword(s):  
Sexual Assault ◽  
Multivariate Regression ◽  
Acute Stress ◽  
Early Symptom ◽  
Sexual Assault Survivors ◽  
Stress Symptoms ◽  
History Of ◽  
Race Ethnicity ◽  
Acute Stress Symptoms

In the early aftermath of a sexual assault, survivors often experience symptoms of distress including reexperiencing, avoidance, and hyperarousal symptoms. However, less is known about associations between rape characteristics and the nature of early reactions. We designed the current study to examine the unique and combined associations between use of force and substances during rape on acute stress symptoms. Participants were 56 women (ages 18–58) who completed a sexual assault medical forensic exam in the emergency department within 120 hours of the rape and then completed a follow-up clinical phone screening within 30 days of the forensic exam. Follow-up assessments included characteristics of the recent rape (force, substances), history of prior sexual assault, demographics, and symptoms of acute stress. Multivariate regression analyses revealed that, after controlling for prior sexual assault, sexual orientation, and race/ethnicity, there were no significant differences on any symptom cluster by rape type. However, this study involved a small, difficult-to-reach sample and, therefore, was only powered to detect large effect sizes. We encourage more research examining potentially unique, early symptom presentations for substance-involved rapes.

scholarly journals Relationship between 5-HT function and impulsivity and aggression in male offenders with personality disorders

2001 ◽  
Vol 178 (4) ◽  
pp. 352-359 ◽  
Author(s):  
M. Dolan ◽  
I. M. Anderson ◽  
J. F. W. Deakin
Keyword(s):  
Personality Disorders ◽  
Borderline Personality ◽  
Plasma Testosterone ◽  
Future Studies ◽  
Borderline Personality Disorders ◽  
Male Offenders ◽  
History Of ◽  
Self Harm ◽  
Prolactin Response ◽  
Special Hospital

BackgroundReduced serotonergic (5-HT) function and elevated testosterone have been reported in aggressive populations.AimsTo investigate relationships between impulsivity, aggression, 5-HT function and testosterone in male offenders with personality disorders.MethodSixty male offenders with DSM–III–R personality disorders and 27 healthy staff controls were assessed using the Special Hospital Assessment of Personality and Socialisation (SHAPS), impulsivity and aggression ratings, d-fenfluramine challenge and plasma hormone concentrations.ResultsThe SHAPS non-psychopaths and those with schizoid personality disorders had enhanced 5-HT function (prolactin response to d-fenfluramine). Reduced 5-HT function was found in offenders with DSM–III–R borderline personality disorders and those with a history of repeated self-harm or alcohol misuse. The 5-HT function was inversely correlated more strongly with impulsivity than with aggression. Plasma testosterone correlated positively with aggressive acts. The SHAPS primary psychopaths had lower initial cortisol and higher testosterone concentrations than controls.ConclusionsFuture studies are needed to investigate regional brain 5-HT function.

scholarly journals Predictors of deliberate self-harm among adolescents: Answers from a cross-sectional study on India

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Debashree Sinha ◽  
Shobhit Srivastava ◽  
Prem Shankar Mishra ◽  
Pradeep Kumar
Keyword(s):  
Depressive Symptoms ◽  
Internet Access ◽  
Outcome Variable ◽  
Bivariate Analysis ◽  
Binary Logistic Regression Analysis ◽  
Adolescent Boys ◽  
Cross Sectional ◽  
Deliberate Self Harm ◽  
Self Harm ◽  
Parental Abuse

Abstract Background Although existing research supports the correlation of hereditary and psychological factors with an adolescent’s deliberate self-harm, there is a dearth of research that focus on their socio-economic characteristics. This paper intends to identity the potential risk factors that influence an adolescent’s deliberate self-harm. Methods Data for this study was obtained from Understanding the Lives of Adolescents and Young Adults (UDAYA) study conducted in 2015–16 with sample of 5,969 adolescent boys and 9,419 girls aged 10–19 years. The outcome variable was deliberate self-harm among adolescents. The explanatory variables added in the study were age, current schooling status, working status, media exposure, access to internet, parental abuse, involvement in fights, substance use, depressive symptoms, caste, religion, wealth index, residence and states. Bivariate analysis along with binary logistic regression analysis was done to fulfill the study objectives. Results About 4.5% and 3.2% of adolescent boys and girls, respectively had deliberate self-harm. The odds of deliberate self-harm were 50 per cent more likely among adolescent girls who had internet access [OR 1.50; CI 1.05–2.16]. The likelihood of deliberate self-harm was 49 per cent and 61 per cent significantly more likely among adolescent boys [OR 1.49; CI 1.11–2.0] and girls [OR 1.61; CI 1.27–2.04] who experienced parental physical abuse respectively. With reference to minimal/mild depressive symptoms, adolescents who had moderate [boys-OR 2.10; CI 1.29–3.4 and girls-OR 2.50; CI 1.774–3.59] or moderately high/severe [boys-OR 4.58; CI 2.88–7.29 and girls-OR 4.18; CI 3.1–5.63] depressive symptoms had significantly higher odds of deliberate self-harm. Conclusions Internet access, parental abuse, involvement in fights, and depressive symptoms emerged as significant predictors of deliberate self-harm among adolescent boys and girls. Results suggest that an early identification of the predictors and intervention might prevent deliberate self-harm among adolescents. Since parents play a major role in the lives and development of adolescents, it is highly recommended that they initiate open and supportive communication with their children.

scholarly journals Exposure to and experience of self-harm and self-harm related content: An exploratory network analysis

2020 ◽  
Author(s):  
Olivia J Kirtley ◽  
Ian Hussey ◽  
Lisa Marzano
Keyword(s):  
Network Models ◽  
Information Criterion ◽  
Future Research ◽  
Cross Sectional ◽  
Online Study ◽  
Graphical Lasso ◽  
Temporal Relationships ◽  
History Of ◽  
Self Harm ◽  
Larger Sample

Exposure to the self-harm behaviour of others plays a role in individuals’ own self-harm thoughts and behaviours, but there has been little consideration of the broader range of mediums through which exposure to self-harm related content may occur. N = 477 participants completed an online study, including questions regarding lifetime history of self-harm thoughts and behaviours and the frequency with which they had been exposed to self-harm via various mediums. Gaussian Markov random field network models were estimated using graphical LASSO and extended Bayesian information criterion. Bootstrapping revealed that exposure mediums with a direct connection to self-harm thoughts and behaviours were the internet (rrp = .34, 95% CI [.26, .42]) and in-passing ‘miscellaneous’ exposure (rrp = .14, 95% CI [.00, .23]). However, stability of the network centrality was low (expected influence stability = 0.52). The node with the greatest increase in expected influence within the network was miscellaneous “in-passing” exposure. In-passing exposure is an understudied exposure medium. Our results may suggest new types of exposure mediums for future research. Data were cross-sectional, so temporal relationships between exposure and behaviour could not be determined. Low stability of the networks suggests that future similar studies would benefit from larger sample sizes.

Re-Evaluation of the Evidence on the Prognostic Importance of Schizophrenic and Affective Symptoms

1987 ◽  
Vol 21 (4) ◽  
pp. 424-427 ◽  
Author(s):  
Helen Herrman
Keyword(s):  
Depressive Symptoms ◽  
Major Influence ◽  
Mortality And Morbidity ◽  
Affective Expression ◽  
Chronic Disability ◽  
Affective Symptoms ◽  
Increased Risk ◽  
Contrary View ◽  
History Of ◽  
Self Harm

An earlier literature noted consistently that depressive symptoms appear to bode well for outcome in schizophrenia and related disorders. Although this view is psychodynamically plausible, most of the studies suggesting it have substantial shortcomings. In particular, most studies have been confounded by the effects of variations in duration and history of disorder, which have a major influence on both affective expression and outcome. A contrary view is that depressive symptoms in patients with schizophrenia and related disorders suggest an increased risk of self-harm and social dysfunction, just as these symptoms do in individuals with other disorders. The substantial risks of mortality and morbidity from self-harm, the link between suicide and depression, and the high prevalence of depressive symptoms in the acute and chronic stages of the disorder have all been documented in people diagnosed as having schizophrenia. Social influences are well known to be crucial to the course and outcome of schizophrenia. The expectations of others and patients' own attitudes to their illness are also known to influence outcome. Despite this, there is no longitudinal study of first admission patients to allow us to examine the possible intervening or other role of depression in the development of chronic disability.

Borderline Personality Symptomatology and History of Domestic Violence Among Women in an Internal Medicine Setting

2007 ◽  
Vol 22 (1) ◽  
pp. 120-126 ◽  
Author(s):  
Randy A. Sansone ◽  
Anne Reddington ◽  
Karen Sky ◽  
Michael W. Wiederman
Keyword(s):  
Domestic Violence ◽  
Violence Against Women ◽  
Borderline Personality ◽  
The Self ◽  
Clinical Implications ◽  
History Of ◽  
Primary Care Patients ◽  
Self Harm ◽  
Cutoff Scores ◽  
The Relationship

In this study of primary care patients, we examined the relationship between a history of domestic violence (measured with the Severity of Violence Against Women Scale [SVAWS]) and borderline personality (measured with the Self-Harm Inventory [SHI] and the Personality Diagnostic Questionnaire-4 [PDQ-4]). We elected borderline personality for examination because several diagnostic criteria sets describe relationship features suggestive of partner abuse. In this study, both measures of borderline personality were highly related to each other (r = .73, p < .001) as well as to the SVAWS (r = .70, p < .001, for the SHI; r = .73, p < .001, for the PDQ-4). Using diagnostic cutoff scores on the measures for borderline personality, 64.0% of those with histories of domestic violence scored in the positive range on either or both measures, while only 11.1% of nonabused women did. We discuss the clinical implications of these findings.

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