The Nature of Self-Injurious Behaviours Prevalent Among the Youth.

Mapping Intimacies ◽

10.21203/rs.3.rs-58717/v1 ◽

2020 ◽

Author(s):

Ritika Singh ◽

Sabeen Rizvi

Keyword(s):

Positive Reinforcement ◽

Negative Reinforcement ◽

Borderline Personality ◽

Assessment Tools ◽

Clinical Disorder ◽

Factors Associated ◽

Dsm 5 ◽

Self Injury ◽

High Prevalence ◽

Qualitative Measure

Abstract Background Self-injurious thoughts and behaviours (SITBs) include a spectrum of self-harming behaviours that an individual may choose to engage in - one such behaviour is labelled as Non-Suicidal Self-Injury (NSSI). The current study was carried out to assess the epidemiological factors associated with NSSI, regarded as a clinical disorder included under the Conditions for Further Study in the DSM-5, and to explore its association with borderline personality traits. Additionally, it also aimed at assessing the reasons why individuals indulge in SITBs. Methods Inclusion criteria for the participants were age 18–24 (in years) and provision of written informed consent to participate in the research. The Alexian Brothers Assessment of Self-Injury, McLean Screening Instrument for Borderline Personality Disorder, and Self-Injurious Thoughts Behaviours Interview were used as the clinical assessment tools. The data was analysed using descriptive statistics (mean and SD), along with a qualitative measure to explore the themes associated with SITBs. Results Participants included 123 (female − 72.35%) young adults (age in years: M = 21.26, SD = 3.67), selected with purposive sampling. 51.21% (female n = 51; age in years: M = 21.03, SD = 1.55) of the total participants endorsed NSSI behaviour, and among them, 39.68% reported having suicidal ideation at least once in their lifetime. Further, the study revealed that participants who endorsed SITBs scored high on MSI-BPD, suggesting an association between the two. 22.22% met the diagnostic criteria of NSSI Disorder under DSM-5. Engagement in SITBs was found to be motivated by automatic negative and positive reinforcement, social negative reinforcement, and self-punishment. Lastly, cognitive appraisal of circumstances acts as a primary precipitant to SITBs. This study draws attention on the alarming ubiquity of SITBs and the similar factors associated with it in many countries of the world. Conclusions The study reiterates emphasis on the notion that adolescents are incredibly vulnerable to adapting harmful mechanisms to cope with their struggles. The research indicates high prevalence rates of different forms of SITBs in the general population and the risk at which self-harming individuals operate.

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Functional assessment of restrictive eating: A three-study transdiagnostic investigation

10.31234/osf.io/q2ezw ◽

2020 ◽

Author(s):

Shirley B Wang ◽

Kathryn Fox ◽

Chelsea Evanna Boccagno ◽

D.Phil. Jill Miranda Hooley ◽

Patrick Mair ◽

...

Keyword(s):

Binge Eating ◽

Functional Assessment ◽

Positive Reinforcement ◽

Negative Reinforcement ◽

Social Functions ◽

Restrictive Eating ◽

Self Injury ◽

Three Samples ◽

Problematic Behaviors ◽

Function Models

Restrictive eating is common across the lifespan and eating disorder (ED) severity levels, and associated with negative psychological outcomes. Little is known about functional processes that maintain restriction. Here, we extend research on four-function models (identifying automatic negative, automatic positive, social negative, and social positive reinforcement functions) that have previously been applied to nonsuicidal self-injury (NSSI), binge eating, and purging to restricting. We assessed restrictive eating functions in three samples: transdiagnostic adolescents (Study 1: N=457), transdiagnostic adults (Study 2: N=145), and adults with acute or weight-restored anorexia nervosa (Study 3: N=38). Study 1 indicated the four-function model was a good fit for restricting (RMSEA=0.06, TLI=0.88). This factor structure replicated across Studies 2 (CFI=0.97, RMSEA=0.07, TLI=0.97, SRMR=0.09) and 3 (CFI=0.99, RMSEA=0.06, TLI=0.99, SRMR=0.14). Unlike NSSI, binge eating, and purging, which have been found to primarily serve automatic negative reinforcement functions, all three present studies found automatic positive reinforcement was most highly endorsed (by up to 85% of participants). In Studies 1 and 3, automatic functions were associated with poorer emotion regulation (ps<.05). In Study 1, social functions were associated with less social support (ps<.001). Across studies, automatic functions were associated with greater restriction ps<.05). Functions varied slightly by ED diagnosis. Across ED presentation, severity, and developmental stage, restrictive eating may be largely maintained by automatic positive reinforcement, with some variability across presentations. Continued examination of restrictive eating functions will establish processes that maintain restriction, allowing more precise treatment targeting for these problematic behaviors.

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Proposed Diagnostic Criteria for theDSM-5of Nonsuicidal Self-Injury in Female Adolescents: Diagnostic and Clinical Correlates

Psychiatry Journal ◽

10.1155/2013/159208 ◽

2013 ◽

Vol 2013 ◽

pp. 1-12 ◽

Cited By ~ 61

Author(s):

Tina In-Albon ◽

Claudia Ruf ◽

Marc Schmid

Keyword(s):

Major Depression ◽

Diagnostic Criteria ◽

Borderline Personality ◽

Female Adolescents ◽

Clinical Correlates ◽

Dsm 5 ◽

Self Injury ◽

High Comorbidity ◽

Nssi Disorder ◽

Nonsuicidal Self Injury

Nonsuicidal self-injury (NSSI) is included as conditions for further study in theDSM-5. Therefore, it is necessary to investigate the proposed diagnostic criteria and the diagnostic and clinical correlates for the validity of a diagnostic entity. The authors investigated the characteristics of NSSI disorder and the proposed diagnostic criteria. A sample of 73 female inpatient adolescents and 37 nonclinical adolescents (aged 13 to 19 years) was recruited. Patients were classified into 4 groups (adolescents with NSSI disorder, adolescents with NSSI without impairment/distress, clinical controls without NSSI, and nonclinical controls). Adolescents were compared on self-reported psychopathology and diagnostic cooccurrences. Results indicate that adolescents with NSSI disorder have a higher level of impairment than adolescents with other mental disorders without NSSI. Most common comorbid diagnoses were major depression, social phobia, and PTSD. There was some overlap of adolescents with NSSI disorder and suicidal behaviour and borderline personality disorder, but there were also important differences. Results further suggest that the proposedDSM-5diagnostic criteria for NSSI are useful and necessary. In conclusion, NSSI is a highly impairing disorder characterized by high comorbidity with various disorders, providing further evidence that NSSI should be a distinct diagnostic entity.

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Nonsuicidal Self-Injury and Suicide: Differences Between Those With and Without Borderline Personality Disorder

Journal of Personality Disorders ◽

10.1521/pedi_2018_32_385 ◽

2020 ◽

Vol 34 (1) ◽

pp. 131-144 ◽

Cited By ~ 1

Author(s):

Alina Z. Levine ◽

Rawya Aljabari ◽

Kristy Dalrymple ◽

Mark Zimmerman

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Suicidal Behavior ◽

Suicide Attempts ◽

Behavior Disorder ◽

Borderline Personality ◽

Skin Picking ◽

Dsm 5 ◽

Self Injury ◽

Nonsuicidal Self Injury

Nonsuicidal self-injury (NSSI) is associated with borderline personality disorder (BPD), but it also occurs in nonclinical samples (Briere & Gil, 1998), inflicting serious harm and serving as a precursor to suicide attempts (Klonsky, May, & Glenn, 2013). Therefore, the DSM-5 proposed a nonsuicidal self-injury disorder (NSSID) and suicidal behavior disorder. Because this addition requires reconciliation with current BPD criteria, the authors' study evaluated type and frequency of NSSI and suicide attempts in 3,795 outpatients. Both were found in those without BPD, although the behaviors increased when some symptoms and full criteria for BPD were met. Wound/skin picking, scratching, and hitting were most common. Cutting was the fifth most common self-injury for those with BPD and the eighth most common for those without the disorder. Therefore, increased clinical attention is warranted for such self-injury, which may go unnoticed but indicate significant distress. Findings suggest that NSSID/suicidal behavior disorder may account for self-injury outside of BPD.

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Self-harm - an overview of the tools used to assess non-suicidal self-harming behaviors

Current Problems of Psychiatry ◽

10.1515/cpp-2017-0027 ◽

2017 ◽

Vol 18 (4) ◽

pp. 342-359

Author(s):

Ewelina Drzał-Fiałkiewcz ◽

Agata Makarewicz ◽

Mateusz Walczak ◽

Aleksandra Walczak ◽

Małgorzta Futyma-Jędrzejewska ◽

...

Keyword(s):

Young People ◽

Psychiatric Disorders ◽

Key Words ◽

Assessment Tools ◽

Self Assessment ◽

Dsm 5 ◽

Self Injury ◽

Self Mutilation ◽

Self Harm ◽

Assessment Scales

AbstractIntroduction: Non-Suicidal Self-Injury (NSSI) is the deliberate injury to one’s own body intended to cause mental or physical harm to oneself. In view of the growing scale of the NSSI, especially among young people without identifying any other psychiatric disorders, the disorder was included in both DSM-5 and ICD10 as independent diagnostic entity. Many etiopathogenetic hypotheses and research tools assessing various aspects of NSSI have been developed.The aim of the work is to present and discuss the most commonly used scales for NSSI assessment.Method: A review of available literature was made using the databases Medline / PubMed, using the key words: “self injury”, “self-mutilation”, “non-suicidal,”, “NSSI”, “self-harm” and time descriptors: 2005-2017Results: Available tools were divided into three groups: I- scale of self-assessment made by the patient, II- assessment made by the clinician, and III- auxiliary scale.Conclusions: None of the available scales covers the complexity of the NSSI phenomenon. For the overall NSSI assessment, several NSSI assessment tools are suggested, taking into account both self-assessment scales and clinical evaluation.

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Comorbidity Between Non-suicidal Self-Injury Disorder and Borderline Personality Disorder in Adolescents: A Graphical Network Approach

Frontiers in Psychiatry ◽

10.3389/fpsyt.2020.580922 ◽

2020 ◽

Vol 11 ◽

Author(s):

Tinne Buelens ◽

Giulio Costantini ◽

Koen Luyckx ◽

Laurence Claes

Keyword(s):

Borderline Personality Disorder ◽

Personality Disorder ◽

Separation Anxiety ◽

Borderline Personality ◽

Small Male ◽

Dsm 5 ◽

Self Injury ◽

Symptom Level ◽

First Time ◽

Nssi Disorder

In 2013, DSM-5 urged for further research on non-suicidal self-injury (NSSI) and defined NSSI disorder (NSSI-D) for the first time separate from borderline personality disorder (BPD). However, research on the comorbidity between NSSI-D and BPD symptoms is still scarce, especially in adolescent populations. The current study selected 347 adolescents who engaged at least once in NSSI (78.4% girls, Mage = 15.05) and investigated prevalence, comorbidity, gender differences, and bridge symptoms of NSSI-D and BPD. Network analysis allowed us to visualize the comorbidity structure of NSSI-D and BPD on a symptom-level and revealed which bridge symptoms connected both disorders. Our results supported NSSI-D as significantly distinct from, yet closely related to, BPD in adolescents. Even though girls were more likely to meet the NSSI-D criteria, our findings suggested that the manner in which NSSI-D and BPD symptoms were interconnected, did not differ between girls and boys. Furthermore, loneliness, impulsivity, separation anxiety, frequent thinking about NSSI, and negative affect prior to NSSI were detected as prominent bridge symptoms between NSSI-D and BPD. These bridge symptoms could provide useful targets for early intervention in and prevention of the development of comorbidity between NSSI-D and BPD. Although the current study was limited by a small male sample, these findings do provide novel insights in the complex comorbidity between NSSI-D and BPD symptoms in adolescence.

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Self-Injurious Behavior vs. Nonsuicidal Self-Injury

Crisis ◽

10.1027/0227-5910/a000127 ◽

2012 ◽

Vol 33 (2) ◽

pp. 106-112 ◽

Cited By ~ 3

Author(s):

Christopher M. Bloom ◽

Shareen Holly ◽

Adam M. P. Miller

Keyword(s):

Positive Reinforcement ◽

Empirical Investigation ◽

High Stress ◽

Animal Research ◽

Stress Conditions ◽

Human Populations ◽

Pharmacological Interventions ◽

Self Injury ◽

Cns Stimulant ◽

Nonsuicidal Self Injury

Background: Historically, the field of self-injury has distinguished between the behaviors exhibited among individuals with a developmental disability (self-injurious behaviors; SIB) and those present within a normative population (nonsuicidal self-injury; NSSI),which typically result as a response to perceived stress. More recently, however, conclusions about NSSI have been drawn from lines of animal research aimed at examining the neurobiological mechanisms of SIB. Despite some functional similarity between SIB and NSSI, no empirical investigation has provided precedent for the application of SIB-targeted animal research as justification for pharmacological interventions in populations demonstrating NSSI. Aims: The present study examined this question directly, by simulating an animal model of SIB in rodents injected with pemoline and systematically manipulating stress conditions in order to monitor rates of self-injury. Methods: Sham controls and experimental animals injected with pemoline (200 mg/kg) were assigned to either a low stress (discriminated positive reinforcement) or high stress (discriminated avoidance) group and compared on the dependent measures of self-inflicted injury prevalence and severity. Results: The manipulation of stress conditions did not impact the rate of self-injury demonstrated by the rats. The results do not support a model of stress-induced SIB in rodents. Conclusions: Current findings provide evidence for caution in the development of pharmacotherapies of NSSI in human populations based on CNS stimulant models. Theoretical implications are discussed with respect to antecedent factors such as preinjury arousal level and environmental stress.

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