Mum, Dad! Is the hospital my home? The psychological and psychiatric consequences of parental neglect – a description of 2 cases

Abstract The issue of parental neglect is a constantly topical one. Neglect is not only the lack of satisfying basic needs, but also the lack of ensuring a sense of security, belonging, and insufficient physical, emotional or verbal closeness with the child. Poor parental care, lack of a sense of closeness and availability of the parent, along with other environmental factors (e.g. addictions, diseases and mental disorders in the family) result in abnormal formation of the child’s personality, and can also be associated with depression, anxiety, self-harm or suicide attempts. The aim of the study was to present the clinical cases of two teenage patients (AA. – 13 years old, BB. – 16 years old) staying in the I Department of Psychiatry, Psychotherapy and Early Intervention in Lublin (Department for Children and Youth), whose mental health problems were caused by a constant neglect on the part of parents. Case reports: The patients came from dysfunctional families in which members showed a tendency to addiction (alcohol) and were emotionally and physically absent from the lives of the girls. Due to considerable upbringing problems, girls were hospitalized many times, both in paediatric wards and in psychiatric wards for children and adolescents, with various medical diagnoses. Conclusions: The presented cases of two patients indicate a potential cause-and-effect relationship between parental neglect, coexisting environmental factors (addictions of family members) and abnormal formation of the child’s personality, self-harm or suicide attempts. In such family systems, it is extremely important, apart from a court-appointed family guardian, to introduce a family assistant to provide emotional or advisory support.

Download Full-text

″Time does not heal all wounds″: Sexual victimisation is associated with depression, anxiety and PTSD in old age

10.1101/2021.06.05.21258397 ◽

2021 ◽

Author(s):

Anne Nobels ◽

Gilbert M.D. Lemmens ◽

Lisa Thibau ◽

Marie Beaulieu ◽

Christophe Vandeviver ◽

...

Keyword(s):

Mental Health ◽

Older Adults ◽

Health Care ◽

Old Age ◽

Suicide Attempts ◽

Mental Health Problems ◽

Later Life ◽

Health Impact ◽

The Past ◽

Self Harm

Background Sexual violence (SV) has an important impact on mental health. Childhood sexual abuse is linked to internalising disorders in later life. In older adults, SV occurs more often than previously believed. Moreover, health care workers lack the skills to address SV in later life. Studies researching the mental health impact of lifetime SV, i.e. SV during childhood, adulthood and old age, are lacking. Methods Between July 2019 and March 2020, 513 older adults living in Belgium participated in structured face-to-face-interviews. Selection occurred via a cluster random probability sampling with a random walk finding approach. Depression, anxiety and posttraumatic stress syndrome (PTSD) were measured using validated scales. Participants were asked about suicide attempts and self-harm during their lifetime and in the past 12-months. SV was measured using behaviourally specific questions based on a broad SV definition. Results Rates for depression, anxiety and PTSD were 27%, 26% and 6% respectively, 2% had attempted suicide, 1% reported self-harm in the past 12-months. Over 44% experienced lifetime SV, 8% in the past 12-months. Lifetime SV was linked to depression (p =.001), anxiety (p =.001), and PTSD in participants with a chronic illness/disability (p = .002) or no/lower education (p <.001). We found no link between lifetime SV and suicide attempts or self-harm in the past 12-months. Conclusions Lifetime SV is linked to mental health problems in late life. Tailored mental health care for older SV victims is necessary. Therefore, capacity building of professionals, and development of clinical guidelines and care procedures are important.

Download Full-text

Engaging families in the management of adolescent self-harm

Evidence-Based Mental Health ◽

10.1136/eb-2017-102791 ◽

2018 ◽

Vol 21 (1) ◽

pp. 16-22 ◽

Cited By ~ 4

Author(s):

Shilpa Aggarwal ◽

George Patton

Keyword(s):

Effect Size ◽

Suicide Attempts ◽

Mental Health Problems ◽

Controlled Trial ◽

Stepped Care ◽

Behaviour Therapy ◽

Duration Of Treatment ◽

Family Interventions ◽

Self Harm ◽

Randomised Controlled

Adolescent self-harm is an emerging public health challenge. It is associated with later psychiatric and substance use disorders, unemployment and suicide. Family interventions have been effective in a range of adolescent mental health problems and for that reason were reviewed for their effectiveness in the management of adolescent self-harm. The search identified 10 randomised and 2 non-randomised controlled trial conducted in the high-income countries. For the most part the evidence is of low quality. The interventions were classified as brief single session, intermediate-level and intensive family interventions depending on the intensity and duration of treatment. Brief interventions did not reduce adolescent self-harm. Intermediate interventions such as the Resourceful Adolescent Parent Programme, Safe Alternatives for Teens and Youth Programme and attachment-based family treatment were effective in reducing suicidal behaviour (effect size 0.72), suicide attempts (P=0.01) and suicidal ideations (effect size 0.95), respectively in the short-term with an absence of long-term follow-up data. Intensive adolescent interventions such as dialectical behaviour therapy and mentalisation-based therapy reduced suicidal ideation (effect size 0.89) and self-harm (56% vs 83%, P=0.01), respectively. The persistence of effects beyond the intervention end point is not known in many interventions. Early involvement of the family, an evaluation of the risks at the end of an acute crisis episode and a stepped-care model taking into account level of suicide risk and resources available to an adolescent and her/his family are likely to promote better outcomes in adolescents who self-harm.

Download Full-text

Interpreting neuropsychological impairment among adolescent inhalant users: two case reports

Acta Neuropsychiatrica ◽

10.1111/j.1601-5215.2007.00236.x ◽

2008 ◽

Vol 20 (1) ◽

pp. 41-43 ◽

Cited By ~ 7

Author(s):

Michael J. Takagi ◽

Dan I. Lubman ◽

Murat Yücel

Keyword(s):

Mental Health ◽

Cognitive Deficits ◽

Mental Health Problems ◽

Case Reports ◽

Case Manager ◽

Intellectual Ability ◽

Neuropsychological Impairment ◽

Future Research ◽

Dysfunctional Families

Objective:To illustrate the need to carefully consider mental health, psychosocial and motivational factors when investigating cognitive and intellectual impairment among chronic inhalant users.Methods:Two adolescent chronic inhalant users with similar psychosocial disadvantages (eg unstable and dysfunctional families, state-based care, school absenteeism and forensic issues) and histories of comorbid drug use and mental health problems were assessed using a battery of paper and pencil and computerised neuropsychological tests.Results:Contrary to the expectations of her case manager, one participant performed within the normal range for her age in all domains of intellectual ability, while the other participant, in line with the expectations of her case manger, showed marked cognitive deficits and intellectual disability.Conclusions:The typically complex presentation of chronic inhalant users (ie disadvantaged psychosocial backgrounds, comorbid psychopathology and poor motivation/engagement) is rarely considered when investigating associated cognitive and intellectual functioning. Future research should more carefully consider the role of such factors, given the evidence suggesting that they can considerably alter (accentuate or diminish) the association between inhalant abuse and neuropsychological impairment.

Download Full-text

Examining the Mental Health Presentations of Treatment-Seeking Transgender and Gender Nonconforming (TGNC) Youth

Child Psychiatry & Human Development ◽

10.1007/s10578-021-01289-1 ◽

2021 ◽

Author(s):

Shannon L. Stewart ◽

Jocelyn N. Van Dyke ◽

Jeffrey W. Poss

Keyword(s):

Mental Health ◽

Emotional Abuse ◽

Suicide Attempts ◽

Mental Health Problems ◽

Family Relationship ◽

Treatment Seeking ◽

Gender Nonconforming ◽

Supportive Family ◽

Self Harm ◽

And Gender

AbstractRecent research suggests that transgender and/or gender nonconforming (TGNC) youth present with heightened levels of mental health problems compared to peers. This study seeks to examine the mental health needs of a large sample of treatment-seeking TGNC youth by comparing them to cisgender males and females. Participants were 94,804 children and youth ages 4–18 years (M = 12.1, SD = 3.72) who completed the interRAI Child and Youth Mental Health Instrument (ChYMH) or Screener (ChYMH-S) at participating mental health agencies in the Ontario, Canada. Overall, the mental health presentations of TGNC youth were similar to cisgender females but at higher acuity levels. TGNC youth showed significantly higher levels of anxiety, depression, social disengagement, positive symptoms, risk of suicide/self-harm, and were more likely to report experiencing emotional abuse, past suicide attempts, and a less strong, supportive family relationship than cisgender females and males. Clinical implications of these findings are discussed.

Download Full-text

Self-Harm, Suicidal Behaviours, and Cyberbullying in Children and Young People: Systematic Review (Preprint)

10.2196/preprints.9044 ◽

2017 ◽

Author(s):

Ann John ◽

Alexander Charles Glendenning ◽

Amanda Marchant ◽

Paul Montgomery ◽

Anne Stewart ◽

...

Keyword(s):

Suicidal Ideation ◽

Young People ◽

Suicide Attempts ◽

Mental Health Problems ◽

Current Evidence ◽

Suicidal Behaviors ◽

Traditional Bullying ◽

Children And Young People ◽

Self Harm ◽

Meta Analyses

BACKGROUND Given the concerns about bullying via electronic communication in children and young people and its possible contribution to self-harm, we have reviewed the evidence for associations between cyberbullying involvement and self-harm or suicidal behaviors (such as suicidal ideation, suicide plans, and suicide attempts) in children and young people. OBJECTIVE The aim of this study was to systematically review the current evidence examining the association between cyberbullying involvement as victim or perpetrator and self-harm and suicidal behaviors in children and young people (younger than 25 years), and where possible, to meta-analyze data on the associations. METHODS An electronic literature search was conducted for all studies published between January 1, 1996, and February 3, 2017, across sources, including MEDLINE, Cochrane, and PsycINFO. Articles were included if the study examined any association between cyberbullying involvement and self-harm or suicidal behaviors and reported empirical data in a sample aged under 25 years. Quality of included papers was assessed and data were extracted. Meta-analyses of data were conducted. RESULTS A total of 33 eligible articles from 26 independent studies were included, covering a population of 156,384 children and young people. A total of 25 articles (20 independent studies, n=115,056) identified associations (negative influences) between cybervictimization and self-harm or suicidal behaviors or between perpetrating cyberbullying and suicidal behaviors. Three additional studies, in which the cyberbullying, self-harm, or suicidal behaviors measures had been combined with other measures (such as traditional bullying and mental health problems), also showed negative influences (n=44,526). A total of 5 studies showed no significant associations (n=5646). Meta-analyses, producing odds ratios (ORs) as a summary measure of effect size (eg, ratio of the odds of cyber victims who have experienced SH vs nonvictims who have experienced SH), showed that, compared with nonvictims, those who have experienced cybervictimization were OR 2.35 (95% CI 1.65-3.34) times as likely to self-harm, OR 2.10 (95% CI 1.73-2.55) times as likely to exhibit suicidal behaviors, OR 2.57 (95% CI 1.69-3.90) times more likely to attempt suicide, and OR 2.15 (95% CI 1.70-2.71) times more likely to have suicidal thoughts. Cyberbullying perpetrators were OR 1.21 (95% CI 1.02-1.44) times more likely to exhibit suicidal behaviors and OR 1.23 (95% CI 1.10-1.37) times more likely to experience suicidal ideation than nonperpetrators. CONCLUSIONS Victims of cyberbullying are at a greater risk than nonvictims of both self-harm and suicidal behaviors. To a lesser extent, perpetrators of cyberbullying are at risk of suicidal behaviors and suicidal ideation when compared with nonperpetrators. Policy makers and schools should prioritize the inclusion of cyberbullying involvement in programs to prevent traditional bullying. Type of cyberbullying involvement, frequency, and gender should be assessed in future studies.

Download Full-text

Cyberbullying involvement and mental health problems among late adolescents

Cyberpsychology Journal of Psychosocial Research on Cyberspace ◽

10.5817/cp2020-1-5 ◽

2020 ◽

Vol 14 (1) ◽

Cited By ~ 1

Author(s):

Sara Skilbred-Fjeld ◽

Silje Endresen Reme ◽

Svein Mossige

Keyword(s):

Antisocial Behavior ◽

Suicide Attempts ◽

Mental Health Problems ◽

Psychological Characteristics ◽

Anxiety And Depression ◽

Late Adolescents ◽

Vulnerability Factors ◽

Psychological Variables ◽

Self Harm ◽

Anxiety Depression

Exposure to cyberbullying is associated with psychological distress like depressive symptoms, self-injurious behavior and suicidal thoughts. Cyberbullying is thus a major challenge for public health. This study examines the prevalence of cyberbullying and explores the psychological characteristics of adolescents who have experienced cyberbullying. The sample consisted of 4531 Norwegian graduates in high school, age 18–21. The following psychological characteristics were investigated: self-harm, suicide attempts, antisocial behavior, anxiety and depression. Three mutually exclusive groups of cyberbullying were compared: 1) cybervictims, 2) cyberbullies and 3) cyberbully-victims. Participants involved in cyberbullying were further compared to those not involved. The prevalence of cyberbullying in this study was 5 %. There were no significant differences between cyberbullies, cybervictims and cyberbully-victims on any of the psychological variables, except for fewer reported suicide attempts in cyberbullies compared to cybervictims and cyberbully-victims. Late adolescents involved in cyberbullying did however report significantly more anxiety, depression, self-harm, suicide attempts and antisocial behavior, compared to those not involved. Thus, late adolescents involved in cyberbullying struggle more with psychological problems than non-involved adolescents. Increased knowledge about the characteristics of cyberbullies, cybervictims and cyberbully-victims could contribute to better detection and earlier identification of those involved in cyberbullying. This knowledge can further help understand more of the potential psychological vulnerability factors and consequences of cyberbullying, which could be used to optimize preventive measures and treatment.

Download Full-text

Adolescents’ self-mutilation - Relationship with dependent behaviour

Swiss Journal of Psychology ◽

10.1024/1421-0185.62.4.241 ◽

2003 ◽

Vol 62 (4) ◽

pp. 241-249 ◽

Cited By ~ 8

Author(s):

M. Bolognini ◽

B. Plancherel ◽

J. Laget ◽

P. Stéphan ◽

O. Halfon

Keyword(s):

Suicide Attempts ◽

Clinical Sample ◽

Control Sample ◽

Clinical Population ◽

Control Group ◽

Clinical Group ◽

Self Mutilation ◽

Self Harm ◽

Partial Overlap ◽

The Relationship

The aim of this study, which was carried out in the French-speacking part of Switzerland, was to examine the relationship between suicide attempts and self-mutilation by adolescents and young adults. The population, aged 14-25 years (N = 308), included a clinical sample of dependent subjects (drug abuse and eating disorders) compared to a control sample. On the basis of the Mini Neuropsychiatric Interview ( Sheehan et al., 1998 ), DSM-IV criteria were used for the inclusion of the clinical population. The results concerning the occurrence of suicide attempts as well as on self-mutilation confirm most of the hypotheses postulated: suicidal attempts and self-mutilation were more common in the clinical group compared to the control group, and there was a correlation between suicide attempts and self-mutilation. However, there was only a partial overlap, attesting that suicide and self-harm might correspond to two different types of behaviour.

Download Full-text

Attachment Organization in Suicide Prevention Research

Crisis ◽

10.1027/0227-5910/a000231 ◽

2014 ◽

Vol 35 (1) ◽

pp. 60-66 ◽

Cited By ~ 10

Author(s):

Amanda Venta ◽

Carla Sharp

Keyword(s):

Risk Factors ◽

Suicidal Ideation ◽

Suicide Attempt ◽

Interpersonal Relationships ◽

Suicide Ideation ◽

Suicide Attempts ◽

Critical Role ◽

Self Report ◽

Future Research ◽

Self Harm

Background: Identifying risk factors for suicide-related thoughts and behaviors (SRTB) is essential among adolescents in whom SRTB remain a leading cause of death. Although many risk factors have already been identified, influential theories now suggest that the domain of interpersonal relationships may play a critical role in the emergence of SRTB. Because attachment has long been seen as the foundation of interpersonal functioning, we suggest that attachment insecurity warrants attention as a risk factor for SRTB. Aims: This study sought to explore relations between attachment organization and suicidal ideation, suicide attempts, and self-harm in an inpatient adolescent sample, controlling for demographic and psychopathological covariates. Method: We recruited 194 adolescents from an inpatient unit and assigned them to one of four attachment groups (secure, preoccupied, dismissing, or disorganized attachment). Interview and self-report measures were used to create four variables reflecting the presence or absence of suicidal ideation in the last year, single lifetime suicide attempt, multiple lifetime suicide attempts, and lifetime self-harm. Results: Chi-square and regression analyses did not reveal significant relations between attachment organization and SRTB, although findings did confirm previously established relations between psychopathology and SRTB, such that internalizing disorder was associated with increased self-harm, suicide ideation, and suicide attempt and externalizing disorder was associated with increased self-harm. Conclusion: The severity of this sample and methodological differences from previous studies may explain the nonsignificant findings. Nonsignificant findings may indicate that the relation between attachment organization and SRTB is moderated by other factors that should be explored in future research.

Download Full-text

Identifying Suicide Typologies Among Trauma-Exposed Veterans

Crisis ◽

10.1027/0227-5910/a000637 ◽

2020 ◽

Vol 41 (4) ◽

pp. 288-295 ◽

Cited By ~ 1

Author(s):

Nadia Bounoua ◽

Jasmeet P. Hayes ◽

Naomi Sadeh

Keyword(s):

Latent Profile Analysis ◽

Suicide Attempts ◽

Clinical Symptoms ◽

Profile Analysis ◽

Risky Behaviors ◽

Self Report ◽

Cross Sectional ◽

Research Priority ◽

Self Harm ◽

And Behaviors

Abstract. Background: Suicide among veterans has increased in recent years, making the identification of those at greatest risk for self-injurious behavior a high research priority. Aims: We investigated whether affective impulsivity and risky behaviors distinguished typologies of self-injurious thoughts and behaviors in a sample of trauma-exposed veterans. Method: A total of 95 trauma-exposed veterans (ages 21–55; 87% men) completed self-report measures of self-injurious thoughts and behaviors, impulsivity, and clinical symptoms. Results: A latent profile analysis produced three classes that differed in suicidal ideation, suicide attempts and nonsuicidal self-injury (NSSI): A low class that reported little to no self-injurious thoughts or behaviors; a self-injurious thoughts (ST) class that endorsed high levels of ideation but no self-harm behaviors; and a self-injurious thoughts and behaviors (STaB) class that reported ideation, suicide attempts and NSSI. Membership in the STaB class was associated with greater affective impulsivity, disinhibition, and distress/arousal than the other two classes. Limitations: Limitations include an overrepresentation of males in our sample, the cross-sectional nature of the data, and reliance on self-report measures. Conclusion: Findings point to affective impulsivity and risky behaviors as important characteristics of veterans who engage in self-injurious behaviors.

Download Full-text

Disorders of Impulse Control and Self-Harm

The Oxford Handbook of Clinical Psychology ◽

10.1093/oxfordhb/9780195366884.013.0023 ◽

2010 ◽

pp. 504-530 ◽

Cited By ~ 1

Author(s):

Matthew K. Nock ◽

Christine B. Cha ◽

Halina J. Dour

Keyword(s):

Environmental Factors ◽

Psychological Factors ◽

Impulse Control ◽

Clinical Presentation ◽

Evidence Based ◽

Comprehensive Review ◽

Assessment And Treatment ◽

Self Harm ◽

Clinical Problems ◽

Control Spectrum

Disorders of impulse-control and self-harm are dangerous clinical problems that often present significant challenges for scientists and clinicians. In this chapter, we provide a comprehensive review of each disorder on the impulse-control spectrum. We begin by describing the clinical presentation and epidemiology of each disorder. Next, we discuss what is currently known about the etiology of these disorders, summarizing recent research on genetic/neurobiological factors, environmental factors, and psychological factors that appear to influence these disorders. The assessment and treatment of disorders of impulse-control and self-harm is complicated by the relatively low base-rate of these disorders, as well as by their dangerous and sensitive nature. Nevertheless, several evidence-based approaches to assessment and treatment have been developed and also are reviewed here. We conclude with recommendations for future scientific and clinical efforts aimed at better understanding, predicting, and preventing disorders of impulse-control and self-harm.

Download Full-text