Echoes of early-life stress on suicidal behavior in individuals with substance use disorder / Ecos del estrés en la vida temprana en el comportamiento suicida en personas con trastorno por uso de sustancias

Introduction: Psychoactive substances abuse is considered a problematic social factor due its likelihood to cause harmful, self-destructive behaviors to the subjects and the overall society. Stress in an individual's early life may also be a contributing factor to substance abuse as well as suicide attempts. There is a lack of studies examining these factors in people with substance-use disorder. Aim: to identify the relationship between early-life stress and suicide attempts in drug-dependent adults. Methods: This is a predictive correlational study with a cross-sectional approach. The convenience sample consisted of 105 individuals treated at an outpatient unit for addiction treatment. The participants were assessed using the Mini-international Neuropsychiatric Interview, a Childhood Trauma Questionnaire to measure the severity of the different types of early life stress; the Beck Scale for Suicide Ideation was also used. The data were analyzed using descriptive and inferential statistics through univariate and multivariate logistic regression. Results: The analyzed sample included 33 (31.4%) individuals who attempted suicide and were significantly more likely to suffer from emotional, physical, or sexual abuse than those who had never attempted suicide (p <0,05). Conclusions: Different forms of early-life stress are related to attempted suicide in people with substance-use disorder. Further studies are needed to understand the effects of early-life stress on suicide attempts in drug-dependent people.

Introducción: El abuso de sustancias psicoactivas se considera un factor social problemático cuando se producen conductas autodestructivas perjudiciales para el sujeto y la sociedad. El estrés en la vida temprana de una persona también puede ser un factor que contribuya a las situaciones de abuso de sustancias, así como a los intentos de suicidio. Hay una falta de estudios que examinen estos factores en personas con trastorno por uso de sustancias. Objetivo: Identificar la relación entre estrés en la vida temprana y los intentos de suicidio en personas adultas con trastorno por uso de sustancias. Métodos: Estudio correlacional, predictivo, transversal. La muestra de conveniencia consistió en 105 personas tratadas en una unidad ambulatoria para el tratamiento de adicciones. Las personas se evaluaron por medio de la Mini-Entrevista Neuropsiquiátrica Internacional, el Cuestionario de Trauma Infantil para medir la gravedad de los diferentes tipos de estrés en la vida temprana y la Escala de Beck para Ideación Suicida. Los datos se analizaron mediante estadística descriptiva e inferencial mediante regresión logística univariante y multivariante. Resultados: De la muestra analizada, 33 (31,4%) habían intentado suicidarse y tenían una exposición significativamente mayor al abuso emocional, físico y sexual (p<0,05) en comparación con las personas que nunca habían intentado suicidarse. Conclusiones: Diferentes formas de estrés en la vida temprana están relacionadas con el intento de suicidio en personas con trastorno por consumo de sustancias. Se necesitan más estudios para comprender los efectos del estrés en la vida temprana sobre los intentos de suicidio en una persona con dependencia.

Introdução: O uso abusivo de substâncias psicoativas é considerado um fator social problemático quando ocorrem comportamentos autodestrutivos prejudiciais ao sujeito e à sociedade. O estresse no início da vida de um indivíduo também pode ser um fator que contribui para situações de abuso de substâncias, bem como tentativas de suicídio. Há uma falta de estudos examinando esses fatores em pessoas com transtorno por uso de substâncias. Objetivo: Identificar a relação entre o estresse no início da vida e as tentativas de suicídio em adultos com transtorno de uso de substâncias. Métodos: Estudo correlacional preditivo com abordagem transversal. A amostra por conveniência foi composta por 105 indivíduos atendidos em uma unidade ambulatorial para tratamento de dependências e foi avaliada por meio do Mini-International Neuropsychiatric Interview, do Childhood Trauma Questionnaire para medir a gravidade de diferentes tipos de estresse precoce e da Escala de Beck para Ideação Suicida. Os dados foram analisados por meio de estatística descritiva e inferencial por meio de regressão logística univariada e multivariada. Resultados: Da amostra analisada, 33 (31,4%) já haviam tentado suicídio e tiveram exposição significativamente maior a abusos emocionais, físicos e sexuais (p <0,05) em comparação com os participantes que nunca tentaram suicídio. Conclusões: Diferentes formas de estresse no início da vida estão relacionadas à tentativa de suicídio em indivíduos com transtorno por uso de substâncias . Mais estudos são necessários para compreender os efeitos do estresse precoce nas tentativas de suicídio de uma pessoa com dependência.

Modelo explicativo de ansiedad generalizada y bullying como predictores de autolesiones no suicidas en adolescentes peruanos

Fundamento las autolesiones no suicidas se consideran un problema de salud pública y social durante la última década, el cual afecta en mayor medida a los adolescentes. La ansiedad generalizada y el bullying pueden ser factores desencadenantes para su desarrollo. Objetivo analizar un modelo explicativo de la ansiedad generalizada y el bullying como predictores de autolesiones no suicidas en adolescentes peruanos. Métodos estudio de diseño explicativo, transversal, con participación de 1 249 adolescentes peruanos, de edad promedio de 15 años (desviación estándar = 1,49) quienes respondieron escalas sobre ansiedad generalizada, bullying y autolesiones no suicidas. Para el análisis de datos, se aplicó la potencia estadística, la correlación y un modelo de regresión estructural basado en covarianzas para confirmar el modelo explicativo. Resultados las variables psicológicas se correlacionaron de manera positiva y estadísticamente significativa. El modelo propuesto presentó índices de ajuste adecuados (CFI = 0,94; RMSEA = 0,03 [IC del 90 %: 0,02-0,03] y SRMR = 0,04) y se evidenció que la ansiedad generalizada (β = 0,26, p = 0,001) y las dimensiones del bullying, como la agresión (β = 0,25, p = 0,001) y la victimización (β = 0,21, p = 0,003) predijeron de manera estadísticamente significativa las autolesiones no suicidas. Conclusiones los hallazgos sugieren que tanto la ansiedad generalizada como el bullying predicen las autolesiones no suicidas en adolescentes. La evidencia proporciona información útil para desarrollar y evaluar programas de prevención basados en estas variables psicológicas, con vistas a disminuir el riesgo de las autolesiones no suicidas.

Background non-suicidal self-harm has been considered a public and social health problem during the last decade, which affects adolescents to a greater extent. Generalized anxiety and bullying can be trigger factors for its development. Objective to analyze a generalized anxiety and bullying explanatory model as non-suicidal self-harm predictors in Peruvian adolescents. Methods cross-sectional, explanatory design study, with 1,249 Peruvian adolescents, average age 15 years old (standard deviation = 1.49), who answered scales on generalized anxiety, bullying, and non-suicidal self-harm. For data analysis, statistical power, correlation, and a structural regression model based on covariances were applied to confirm the explanatory model. Results the psychological variables were positively and statistically significantly correlated. The proposed model had adequate fit indices (CFI = 0.94; RMSEA = 0.03 [90% CI: 0.02-0.03] and SRMR = 0.04) and it was evidenced that generalized anxiety (β = 0.26, p = 0.001) and bullying dimensions such as aggression (β = 0.25, p = 0.001) and victimization (β = 0.21, p = 0.003) statistically significantly predicted self-harm not suicidal. Conclusions The findings suggest that both generalized anxiety and bullying predict non suicidal self-harm in adolescents. The evidence provides useful information for developing and evaluating prevention programs based on these psychological variables, to reduce the non-suicidal self-harm risks.

Adaptação e evidências de validade do Deliberate Self-Harm Inventory - versão simplificada (DSHI-s) / Adaptation and evidence of validity of the Deliberate Self-harm Inventory - short version (DSHI-s) / Adaptación y evidencias de validez del Deliberate Self-Harm Inventory - versión simplificada (DSHI-s)

Esta pesquisa adaptou e analisou as evidências de validade da versão simplificada do Deliberate Self-Harm Inventory (DSHI-s) para o português. Participaram 160 estudantes do ensino médio. Aplicou-se um questionário sociodemográfico, o Questionário de Impulso, Autodano e Ideação Suicida na Adolescência (QIAIS-A) e a versão traduzida do DSHI-s (nomeado como Inventário de Autolesão Deliberada - reduzido - IAD-r). A análise dos dados foi conduzida por meio dos softwares SPSS e Factor. O resultado da análise fatorial exploratória indicou uma estrutura final para o IAD-r composta por 15 itens distribuídos em um fator e a escala apresentou boa consistência interna (alfa de Cronbach=0,95; ômega de McDonald=0,95). Constataram-se, também, evidências de validade convergente do IAD-r com o QIAIS-A (índice de correlação=0,775; p<0,001). Portanto, os presentes achados demonstraram evidências de validade do IAD-r, pois foram obtidas características psicométricas satisfatórias para mensuração de comportamentos autolesivos em adolescentes. (AU)

This research adapted to Portuguese and analyzed the validity evidence of the simplified version of the Deliberate Self-Harm Inventory (DSHI-s). Participants included 160 high school students. A sociodemographic questionnaire, the Questionnaire of Impulse, Self-harm and Suicidal Ideation in Adolescence (QIAIS-A), and the translated version of the DSHI-s (Deliberate Self-Injury Inventory - reduced - IAD-r) were applied. Data analysis was conducted using SPSS and Factor. The result of the Exploratory Factor Analysis indicated a final structure for the IAD-r composed of 15 items and one factor, and the scale showed good internal consistency (Cronbach's Alpha=.95; McDonald's Omega=.95). There was also evidence of convergent validity of the IAD-r with the QIAIS-A (correlation index=.775; p<.001). Therefore, the current findings allow attesting that the IAD-r showed satisfactory validity evidence for measuring self-injurious behaviors in adolescents. (AU)

Esta investigación adaptó y analizó evidencias de validez de la versión simplificada del Deliberate Self-Harm Inventory (DSHI-s) para portugués. Participaron 160 estudiantes de secundaria. Se aplicó un cuestionario sociodemográfico, el Cuestionario de Impulso, Autolesiones e Ideación Suicida en la Adolescencia (QIAIS-A) y la versión traducida del DSHI-s (denominado Inventario de Autolesiones Deliberadas - reducido - IAD-r). El análisis de los datos se realizó con el software SPSS y Factor. El resultado del Análisis Factorial Exploratorio indicó una estructura final para el IAD-r con 15 ítems distribuidos en un factor, y la escala mostró una buena consistencia interna (Alfa de Cronbach=0,95; Omega de McDonald's=0,95). También hubo evidencias de validez convergente del IAD-r con el QIAIS-A (índice de correlación=0,775; p<0,001). Por lo tanto, los presentes hallazgos demuestran evidencias de la validez del IAD-r, ya que se obtuvieron características psicométricas satisfactorias para medir conductas autolesivas en adolescentes. (AU)

Práticas aplicadas nas escolas em situações de automutilação em adolescentes: protocolo de revisão de escopo / Practices applied in schools in situations of self-mutilation among adolescents: scope review protocol

OBJETIVO: Identificar as práticas aplicadas nas escolas em situações de autolesão não suicida em adolescentes. MÉTODO: A estratégia de busca será aplicada no Medical Literature Analysis and Retrieval System Online (MEDLINE/PubMed), Excerpta Medica Database (EMBASE/Elsevier); Cumulated Index in Nursing and Allied Health Literature (CINAHL/Ebsco); Scopus/Elsevier, Cochrane Library; Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) via Biblioteca Virtual em Saúde (BVS), Base de Dados de Enfermagem (BDENF); PsycINFO; Education Resources Information Center (ERIC); Web of Science Core Collection, Scientific Electronic Library Online (SCIELO), e na literatura cinzenta. Serão considerados artigos de pesquisas primárias, quantitativos e/ou qualitativos, sem limitações quanto à data da publicação e idioma. Os resultados serão inseridos no EndNote v.X9 e duplicatas serão removidas. O Rayyan QCRI20 será utilizado na seleção dos estudos. Esta será feita por dois revisores independentes de forma cega. Discordâncias serão resolvidas por consenso ou terceiro revisor. Será utilizado o diagrama de fluxo Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Os dados serão extraídos usando a ferramenta de extração na abordagem scoping review do Joanna Briggs Institute (JBI).

OBJECTIVE: Identify practices applied in schools in situations of non-suicidal self-injury in adolescents. METHOD: The search strategy will be applied in Medical Literature Analysis and Retrieval System Online (MEDLINE/PubMed), Excerpta Medica Database (EMBASE/Elsevier); Cumulated Index in Nursing and Allied Health Literature (CINAHL/Ebsco); Scopus/Elsevier, Cochrane Library; Latin America and the Caribbean Health Sciences Literature (LILACS) by Virtual Health Library (VHL), Nursing Database (BDENF); PsycINFO; Education Resources Information Center (ERIC); Web of Science Core Collection, Scientific Electronic Library Online (SCIELO), and gray literature. Primary, quantitative and/or qualitative research articles will be considered without restriction regarding publication date and language. Results will be entered into EndNote X9, and duplicates will be removed. The Rayyan QCRI20 will be used in the selection of studies. This will be done by two independent reviewers blindly. Disagreements will be resolved by consensus or a third reviewer. The Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) flowchart will be used. Data will be extracted using the extraction tool in the JBI scoping review approach.

Research progress on the self-injury behavior in children with autism spectrum disorder / 中华实用儿科临床杂志

Self-injury behavior (SIB) is a common problem behavior of children with autism spectrum disorder (ASD), which is characterized by a series of harmful reactions made by themselves causing tissue and physical damages.It seriously affects the physical and mental health in children.An early identification of SIB in children with ASD is helpful to relieve symptoms and improve the prognosis.Aiming to enrich the understanding of SIB in children with ASD and to promote early detection and intervention, this article reviews and summarizes the research on clinical characteristics, influencing factors, evaluation, detection and intervention methods of SIB in children with ASD in recent years.

A machine learning-based predictive model of nonsuicidal self-injurious behavior among college students in Guizhou Province / 中国学校卫生

Objective@#To explore the effectiveness of machine learning algorithms in predicting non-suicidal self-injury (NSSI) behavior among college students, and to analyze the influencing factors of NSSI behavior, thus providing a reference for promoting psychological well-being.@*Methods@#In December 2022, a stratified random cluster sampling method was used to select 835 college students from a university in Guizhou Province, China. The Adolescent Self-injury Scale, Family Function Assessment Scale, and Emotion Regulation Self-efficacy Scale were used to evaluate the participants. Demographic characteristics, family factors, and emotional factors were taken as independent variables, while the dependent variable was whether college students exhibited NSSI behavior. Machine learning algorithms, including Logistic regression, support vector machine (SVM), decision trees, algorithm gradient boosting trees, random forests, and AdaBoost, were used to construct predictive models.@*Results@#The detection rate of NSSI behavior among the college students was 23.23% (194 individuals). The NSSI behavior group scored higher than the non-NSSI behavior group in total family function, emotional communication, egoism, and family rules ( t=3.02, 3.35 , 2.23,2.87, P <0.05). On the other hand, the non-NSSI behavior group scored higher than the NSSI behavior group in total emotion regulation selfefficacy, managing negative emotion self-efficacy, and expressing positive emotion self-efficacy ( t=-5.04, -5.48 , -2.43, P <0.05). The recall rates of random forests, SVM, Logistic regression, decision trees, algorithm gradient boosting trees, and AdaBoost were 84.3% , 90.6%, 73.4%, 87.5%, 95.3%, 89.0%, respectively. The F1 scores were 84.4%, 92.1%, 71.2 %, 79.4%, 91.7%, 89.1% , respectively. The respective precision rates were 84.4%, 93.5%, 69.1%, 72.7%, 88.4%, 89.1 %. The AUC scores were 0.845, 0.922, 0.706, 0.776, 0.915, and 0.891, respectively.@*Conclusion@#Compared to the algorithm gradient boosting tree, random forest, Logistic regression, and AdaBoost models, the SVM model has a better predictive effect on whether college students in Guizhou Province exhibits NSSI behavior. It is recommended to use an appropriate model to identify students at risk of NSSI behavior as early as possible and provide psychological crisis interventions to promote their mental health.

A qualitative study of experiences of non suicidal self injury in adolescents with depression / 中国学校卫生

Objective@#To understand the real experience and feelings of self injurious cutting in adolescents with depression, to provide guidance for clinical targeted interventions.@*Methods@#During November 2021 to May 2022, 19 adolescent patients with depression who had cut themselves as the type of non suicidal self injury were recruited from a tertiary first class psychiatric hospital in Chengdu, Sichuan Province. All the participants were interviewed in a semi structured manner, which used the interpretative phenomenological analysis to analyze the transcription data.@*Results@#The experience and feelings of non suicidal self injury in adolescent with depression could be summarized into five themes: self injury thoughts that arise under external interference; self injurious behavior in a thousand thoughts; painful but a happy experience of self injury; cutting as the most frequently selected form of non suicidal self injury; decreases in self injurious behavior reduced when they feel love and responsibility.@*Conclusion@#Non suicidal self injury of adolescent patients with depression are affected by various factors. Clinicians should provide targeted clinical care according to the characteristics of patients, as well as the no suicide contract, alternative skills of non suicidal self injury behaviors, and a multi dimensional social support platform with the families of patients.

Association of sleep quality, depressive symptoms with non suicidal self injury among rural middle school students / 中国学校卫生

Objective@#To investigate the association of sleep quality, depressive symptoms and their interaction with non suicidal self injury (NSSI) among rural middle school students, so as to provide a reference for early prevention and control of NSSI among rural middle school students.@*Methods@#A multi stage cluster sampling method was used to randomly select four rural middle schools in Xuzhou, Jiangsu Province. A total of 1 723 middle school students were investigated according to the principle of grade stratification and class random selection. Paper questionnaires (including demographic factors, Non Suicidal Self Injury Short Scale, Pittsburgh Sleep Quality Index, Patient Health Questionnare-9) were used to conduct the questionnaire survey. Logistic regression model was used to analyze the association of sleep quality, depressive symptoms and their interaction with NSSI among rural middle school students.@*Results@#Totally 30.5% of middle school students had NSSI. Univariate results showed that girls (33.0%) had a higher incidence of NSSI than boys(27.3%), and those with sleep disorders and depressive symptoms had a higher incidence of NSSI, which was 46.8%, 43.6%. The results of multivariate Logistic regression showed that the risk of NSSI in students with sleep disorder was 1.80 times that in those without sleep disorder( OR 95%CI=1.42-2.28, P <0.01). The risk of NSSI in students with depressive symptoms was 3.32 times higher than that in those without depressive symptoms( OR 95%CI=2.60-4.24, P <0.01). The interaction results showed that there was additive interaction between sleep disturbance and depressive symptoms on the occurrence of NSSI behavior in rural middle school students, and the relative excess risk, attributable proportion and synergy index were 1.80, 0.30 and 1.57, respectively.@*Conclusion@#Sleep disorder and depressive symptoms are risk factors for NSSI among rural middle school students, and there is additive interaction between them.

Violência autoprovocada em adultos no Espírito Santo entre 2011-2018: análises em relação aos casos notificados / Self-harm violence in adults in Espírito Santo between 2011-2018: Analyses in relation to reported cases / Violencia autoinflingida de adultos en Espírito Santo entre 2011-2018: análisis en relación a casos informados

Objetivo: identificar a proporção de violência autoprovocada em adultos em relação aos casos notificados no Espírito Santo no período de 2011-2018 e sua associação com características individuais e do evento. Métodos: estudo transversal, realizado com dados dos casos notificados de violência do Sistema de Informação de Agravos de Notificação (SINAN) do Espírito Santo, entre 2011 e 2018. A população de interesse foi de indivíduos na faixa etária de 20 a 59 anos. O desfecho foi violência autoprovocada. Características individuais e do evento foram as variáveis independentes. Realizou-se análise bivariada e multivariada apresentadas em razão de prevalência bruta e ajustada. Resultados: a proporção de violência autoprovocada notificada foi de 29,6% no período estudado. Considerando o montante de casos de violência notificados, foram verificadas associações de violência autoprovocada com sexo feminino, ter idade 20 a 29 anos, apresentar maior escolaridade, deficiência ou transtorno mental, residência como local de ocorrência, suspeita de uso de álcool e ausência de história de ocorrência anterior. Conclusão: as variáveis relacionadas ao indivíduo e ao ambiente da ocorrência estão associadas a violência autoprovocada, indicando um perfil específico para estes casos de violência em relação ao conjunto das notificações.

Objective: identify the proportion of self-inflicted violence in adults in relation to reported cases in Espírito Santo in the period 2011-2018 and its association with individual and event characteristics. Methods: cross-sectional study, conducted with data from reported cases of violence from the Brazilian Information System for Notifiable Diseases (SINAN) of Espírito Santo, between 2011 and 2018. The population of interest was individuals in the aged between 20 and 59 years. The outcome variable was self-inflicted violence. The individual and event characteristics were the independent variables. Bivariate and multivariate analysis were performed and presented in relation to the crude and adjusted prevalence ratio. Results: the proportion of self-inflicted violence reported was 29.6% in the period studied. Considering the number of reported cases of violence, associations of self-inflicted violence were verified with the female gender, age range of 20 to 29 years, higher education, disability or mental disorder, residence as place of occurrence, suspected alcohol use, and no history of previous event occurrence. Conclusion: the variables related to the individual and the environment of the occurrence are associated with self-inflicted violence, indicating a specific profile for these cases of violence in relation to the set of notifications

Objetivo: identificar la proporción de violencia autoinflingida de adultos en relación a casos informados en Espírito Santo en período 2011-2018 y su asociación con características individuales y del evento. Métodos: estudio transversal, realizado sobre datos de los casos informados de violencia del Sistema de Información de Enfermedades de Notificación Obligatoria (SINAN, acorde sigla en portugués) de Espírito Santo, entre 2011 y 2018. La población de interés corresponde a individuos en faja etaria de 20 a 59 años. El desenlace refiere a violencia autoinflingida. Las características individuales y del evento fueron las variables independientes. Se realizó análisis bivariado y multivariado, expresados en razón de prevalencia bruta y ajustada. Resultados: la proporción de violencia autoinflingida informada fue del 29,6% en el período estudiado. Considerando la cantidad de casos de violencia notificados, fueron verificadas asociaciones de violencia autoinflingida con sexo femenino, edad de 20 a 29 años, tener mayor escolarización, deficiencia o trastorno mental, domicilio como lugar de ocurrencia, sospecha de abuso de alcohol y ausencia de historial de ocurrencia previa. Conclusión: las variables relacionadas al individuo y al ámbito de ocurrencia están asociadas a violencia autoinflingida, indicando un perfil específico para estos casos de violencia en relación al conjunto de notificaciones.

Association between incidence of injuries and health related behavior among middle school students in five provinces in China / 中国学校卫生

Objective@#To explore the association between incidence of injuries and health related behavior among middle school students in China, to provide evidence for injury prevention.@*Methods@#A questionnaire survey was conducted among 1 067 students who were selected from Zhejiang, Guangdong, Jiangxi, Sichuan and Guizhou provinces by using stratified random cluster sampling method. Chi square test and multiple Logistic regression analyses were used to analyze incidence of injuries and health related behavior.@*Results@#The prevalence of self injury among middle school students in five provinces was 11.0%, the prevalence of intentional injury was 13.2%. Multiple Logistic regression analyses showed that attempting smoking, not eating breakfast every day, having a low mood more than 2 weeks in the past 6 months were positively correlated with self injury ( OR=3.02, 2.04, 4.30, P ＜0.01) after adjusting for region, and the smoking attempt behavior was positively correlated with intentional injury ( OR=2.03, P ＜0.05) after adjusting for region, urban and rural, residence condition, weekly allowance condition.@*Conclusion@#Smoking attempt behavior could be viewed as a shared predictor for both self injury and intentional injury behavior among middle school students, smoking control intervention should be carried out actively among students.

Correlation analysis between non suicidal self injury behavior and depressive symptoms in adolescents / 中国学校卫生

Objective@#To explore the correlation between non suicidal self injury(NSSI) behaviors and depressive symptoms in adolescents and to provide a theoretical basis for improvement of adolescent physical and mental health.@*Methods@#A total of 8 102 adolescents aged 12-17 years were selected by random cluster sampling method in Shanghai, Urumqi, Changsha and Kunming, using the Center for Epidemiologic Studies Depression Scale (CES-D) and the Adolescent Non Suicidal Self Injurious Behavior Assessment Questionnaire. Depressive symptoms and the occurrence of NSSI behaviors were assessed. The relationship between NSSI behaviors and depressive symptoms was analyzed using Chi square test, one way analysis and Logistic regression analysis.@*Results@#The overall detection rate of NSSI in adolescents, 24.6%, with a significantly lower detection rate in boys (23.1%) than in girls (26.2%) ( χ 2=10.97, P <0.05), and 24.7%, 24.6% in the middle school and high school segments, respectively, but the difference was not statistically significant ( χ 2=0.01, P >0.05). The overall detection rate of adolescent depressive symptoms was 49.7 % in the group with NSSI and 17.7% in the group without NSSI, with statistically significant differences ( χ 2=808.80, P < 0.01 ). The detection rates of adolescent depressive symptoms in the group with NSSI (male:44.0%, female:54.7%, middle school:49.6%, high school:49.8%) and the group without NSSI (male:14.2%, female:21.4%, middle school:14.3%, high school: 21.0 %) were statistically significant by sex and age groups ( χ 2=385.58, 412.44, 520.60, 313.78, P ＜0.01). Logistic regression models, after adjusting for gender and age, the risk for depressive symptoms was 2.65 times (95% CI =2.27-3.09) and 7.28 times (95% CI = 6.34- 8.37) more frequently in adolescents with episodic self injurious behavior and frequent self injurious behavior, respectively, compared to those without self injurious behavior. The association between NSSI status and depressive symptoms did not show sex differences ( P >0.05).@*Conclusion@#Adolescent NSSI behavior is positively associated with depressive symptoms, the attention should be paid to adolescent physical and mental health to reduce the occurrence of NSSI.

Progress in the pathogenesis and treatment of non suicidal self injury in adolescents / 中国学校卫生

Abstract@#Non suicide self injury is highly common in adolescents, which is seriously threatening their physical and mental health. It is an important predictor of future suicide, and has become a focus of global public health concern. At present, the research on adolescent non suicidal self injury is still in its infancy, and its formation process is complex. The pathogenesis is not completely clear, and the relevant treatment studies are relatively few. The paper expounds the pathogenesis and treatment of the nonsuicidal adolescent NSSI from the perspectives of genetics, neurobiology, neuroimage and social psychology, aiming to provide a theoretical basis for adolescent NSSI prevention and intervention.

Effects of dialectical behavior therapy on cognitive emotion regulation in adolescents with non suicidal self injury behaivor / 中国学校卫生

Objective@#To explore the effect of dialectical behavior therapy (DBT) on cognitive emotion regulation in adolescents with non suicidal self injury (NSSI), so as to provide reference for improving the cognitive and emotional well being of NSSI adolescents.@*Methods@#A total of 166 adolescents with non suicidal self injury who were hospitalized in the Department of Child and Adolescent Psychiatry of the Second Affiliated Hospital of Xinxiang Medical University from March 2021 to March 2023, were selected by the convenient sampling method. According to the random number table method, participants were divided into the experimental group and the control group, with 83 cases in each group. The control group was given routine nursing, while the experimental group was given dialectical behavior therapy on the basis of routine nursing. The 8 week intervention was conducted once a week, with 45- 60 minutes each time. The control group and the experimental group were evaluated with Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD) and Cognitive Emotion Regulation Questionnaire (CERQ) before and after the intervention. Statistical analysis was conducted using t test and χ 2 test.@*Results@#Before the intervention, there was no significant difference in the scores of each scale include HAMA, HAMD and CERQ between the experimental group and control group ( P >0.05). The scores of HAMD (13.58±3.24, 33.02±7.59), HAMA (12.41±2.51, 24.25±7.14), adaptive adjustment strategy score (69.20± 11.97 , 60.51±7.29) and nonadaptive adjustment strategy scores (37.43±7.87, 47.87±5.20) of CERQ, significantly changed after 8 weeks of intervention ( t=-21.46, -14.25, 5.57, -10.08, P <0.01).@*Conclusions@#Dialectical behavior therapy can improve the anxiety, depression and cognitive emotion regulation of adolescents with NSST. Active intervention should be taken to regulate the emotions of adolescent with NSSI and reduce the occurrence of NSSI.

Association of anxiety, insomnia, and family cohesion with Internet addiction and non suicidal self injury behavior in junior and senior school students / 中国学校卫生

Objective@#To explore the mediating effect of anxiety, insomnia, and family cohesion between Internet addiction and non suicidal self injury (NSSI) behavior among junior and senior school students, so as to develop interventions to promote adolescent mental health.@*Methods@#A total of 3 026 junior and senior school students from Yixing, Jiangsu Province, China, were selected by stratified cluster sampling from December 2022 to February 2023, and were administered the Ottawa Self injury Inventory (OSI), Depression, Anxiety and Stress Scale-21 (DASS-21), Family Environment Scale-Chinese Version (FES-CV), Insomnia Severity Index (ISI), and Chinese Internet Addiction Scale Revised (CIAS-R). A mediating effect model was constructed to analyze the mediating effect of anxiety, insomnia, and family cohesion on Internet addiction and NSSI.@*Results@#Internet addiction ( r = 0.24), insomnia ( r =0.28), and anxiety ( r =0.27) were positively correlated with NSSI, while the latter was negatively correlated with family cohesion ( r =-0.23) ( P <0.01). The mediating effect model was well fitted ( CFI=0.999, TLI=0.978, RMSEA = 0.030 ). Anxiety (mediation effect value:0.12, 95% CI =0.08-0.18) and family cohesion (mediation effect value:0.08, 95% CI = 0.03 -0.13) had a separate mediating effect. A chain meditating effect was found in the case of anxiety and insomnia (mediation effect value:0.14, 95% CI =0.10-0.20), family cohesion and anxiety (mediation effect value:0.05, 95% CI =0.03-0.07), family cohesion and insomnia (mediation effect value:0.05, 95% CI =0.03-0.07), and family cohesion, anxiety, and insomnia (mediation effect value:0.06, 95% CI =0.04-0.08). The mediating effect accounted for 14.9%, 10.1%, 17.5%, 6.0%, 5.6%, and 7.1%, respectively.@*Conclusions@#Anxiety, insomnia, and family cohesion partially mediate Internet addiction and NSSI. Schools and families should pay attention to Internet addiction among junior and senior school students and develop appropriate interventions to promote adolescent mental health, so as to reduce the prevalence of NSSI.

Association of peer bullying, life satisfaction with self harm among junior high school students / 中国学校卫生

Objective@#To explore the association between adolescent peer bullying, life satisfaction and self-harm, so as to provide intervention support for the prevention of adolescent self-harm behaviors.@*Methods@#In October 2022, 5 724 junior high school students from Xuancheng, Hefei, Huaibei in Anhui Province were selected by multistage stratified random cluster sampling, and a self-administered adolescent mental health behavior questionnaire was used to conduct the survey.@*Results@#The detection rate of peer bullying among adolescents was 30.0%, and the detection rates of the five self-harm behaviors including highly lethal self-harm, less lethal self-harm with visible tissue damage, self-harm without visible tissue damage, self-harm with latency damage, and psychological self-harm were 10.2%, 25.8%, 35.5%, 20.8% and 28.2%, respectively. Logistic regression model results showed a positive association between exposure to peer bullying and the five self-harmful behaviors ( OR =2.52-3.21, P <0.01), and a negative association between life satisfaction and the five self-harmful behaviors ( OR =0.19-0.33, P <0.01). Adolescent life satisfaction had a moderating effect between exposure to peer bullying and highly lethal self-harm, less lethal self-harm with visible tissue damage, self-harm without visible tissue damage, and self-harm with latency damage ( OR=1.53, 1.42, 1.30, 1.39, P <0.05), and no moderating effect between exposure to peer bullying and psychological self-harm ( P >0.05).@*Conclusion@#Peer bullying among adolescents may increase the risk of self-harm behavior. Improvement of life satisfaction can effectively mitigate the negative effects of peer bullying on adolescent self-harm.

Effects of repetitive transcranial magnetic stimulation combined with paroxetine hydrochloride on executive function in depressed adolescents with non-suicidal self-injury / 中国基层医药

Objective:To investigate the effects of repetitive transcranial magnetic stimulation combined with paroxetine hydrochloride on executive function in depressed adolescents with non-suicidal self-injury.Methods:The clinical data of 120 depressed adolescents with depressive disorders who were admitted to The Second Hospital of Jinhua from August 2021 to July 2022 were retrospectively analyzed. They were randomly assigned to undergo treatment either with paroxetine hydrochloride (control group, n = 60) or repetitive transcranial magnetic stimulation combined with paroxetine hydrochloride (observation group, n = 60). All patients were treated for 2 months. Hamilton Depression Rating Scale-24 (HAMD-24) score, Non-suicidal Self-injury Behavior and Function Scale for Adolescents (ANSSIQ) score, executive function, brain-derived neurotrophic factor, 5-hydroxytryptamine, and clinical efficacy were determined in each group. Results:After treatment, the Hamilton Depression Rating Scale-24 score in the observation group was significantly lower than that in the control group [(15.85 ± 1.08) points) vs. (18.72±1.21) points, t = 13.71, P < 0.001). After treatment, the number of self-injury attacks, number of self-injury impulsions, and the intensity of self-injury thought within 2 weeks in the observation group were significantly lower than those in the control group ( t = 3.42, 3.03, 1.92, all P < 0.05). The scores of the Trail Making Test, Stroop Word test, Stroop Color test, and Stroop Color-Word Interference Test were significantly higher in the observation group than those in the control group ( t = 2.66, 3.33, 3.97, 4.64, all P < 0.01). Brain-derived neurotrophic factor and 5-hydroxytryptamine levels in the observation group were (11.45 ± 1.79) μg/L and (136.68 ± 11.90) μg/L, respectively, which were significantly higher than (9.06±2.21) μg/L and (124.82 ± 10.34) μg/L in the control group ( t = 6.51, 5.83, both P < 0.001). The total response rate in the observation group was significantly higher than that in the control group (91.7% vs. 78.3%, Z = 2.73, P = 0.006). Conclusion:Repetitive transcranial magnetic stimulation combined with paroxetine hydrochloride is highly effective on depressive disorders in adolescents with non-suicidal self-injury. The combined therapy can reduce symptoms, improve executive function and cognitive function, and optimize serological indicators, and thereby deserves the clinical promotion.

Social cognition and suicide-related behaviors in depression: a cross-sectional, exploratory study

Objective: To explore the association between social cognition and previous suicide attempts and non-suicidal self-injurious behavior in adults with unipolar depressive disorders. Methods: Seventy-two patients undergoing outpatient treatment for unipolar depression were enrolled in this cross-sectional study. Theory of mind was assessed using the Hinting Task and the Revised Reading the Mind in the Eyes Test. Empathy was evaluated using the Interpersonal Reactivity Index. Lifetime suicide attempts and non-suicidal self-injurious behavior were assessed using the Columbia Suicide Risk Rating Scale. Participants with and without these suicide-related outcomes were compared in terms of social cognition. Results: Patients with previous suicide attempts performed worse on the Reading the Mind in the Eyes Test (p = 0.017). Patients with a history of non-suicidal self-injurious behavior were younger (p = 0.005), had a younger age at first depressive episode (p = 0.017), and scored higher on personal distress in the Interpersonal Reactivity Index (p = 0.027). Only personal distress remained independently associated with non-suicidal self-injurious behavior in multivariable analysis (p = 0.038). Conclusion: Among patients with depression, those with previous suicide attempts or non-suicidal self-injurious behavior showed worse social cognition. These results encourage future research on social cognition deficits as clinical markers of suicide-related behaviors and as targets for interventions.

Autolesiones deliberadas y consumo de sustancias psicoactivas en adolescentes escolarizados de Colombia 2016 / Deliberate self-harm and psychoactive substance use in colombian school adolescents

BACKGROUND: Deliberate self-harm and the consumption of psy- choactive substances are important public health problems among adolescents. AIM: To determine the association of deliberate self-harm with the consumption of psychoactive substances, in school adolescents in Colombia. MATERIAL AND METHODS: A survey about deliberate self harm and psychoactive substance use during the last 12 months was answered by 80 018 adolescents aged between 12 and 18 years. RESULTS: The prevalence of deliberate self-harm in the last 12 months was 14.1%. The use of psychoactive drugs was associated with deliberate self-harm. The greatest association was observed with the use of non-prescription tranquilizers (Odds ratio 4.05 95% confidence intervals 3.42-4.81). CONCLUSIONS: We observed an association between deliberate self-harm and the consumption of different psychoactive substances.

Prevalência e fatores associados ao comportamento suicida e à tentativa de suicídio identificados no acolhimento em ambulatórios de saúde mental / Prevalence and factors associated with suicidal behavior and suicide attempt identified in patient embracement in the mental health outpatient care services

Objetivo: analisar a prevalência e os fatores associados ao comportamento suicida e a tentativa de suicídio identificados em acolhimentos em ambulatórios de saúde mental. Métodos: estudo transversal, de análise documental, que teve como fonte as fichas de acolhimento de adultos atendidos em ambulatórios de saúde mental de Cuiabá, Mato Grosso, Brasil, entre fevereiro de 2016 a junho de 2018. Foram calculadas frequências simples e percentuais para descrição das variáveis e odds ratio bruto e ajustado para sexo e idade, por meio de modelo de regressão logística. Resultados: foram analisados os registros de 1.780 acolhimentos. A prevalência de comportamento suicida foi de 7,8% e de tentativa de suicídio 4,8%. Fatores associados para cada fenômeno foram identificados. Conclusão: sexo feminino, transtorno mental e uso de substância psicoativa foram associados tanto ao comportamento suicida como a tentativa de suicídio. Essas características podem direcionar ações de qualificação ao acolhimento nestes serviços especializados.

Objective: Analyze the prevalence and factors associated with suicidal behavior and suicide attempt identified in patient embracement in the mental health outpatient care services. Methods: cross-sectional study with a document analysis using the information provided in the admission forms of adults treated in a patient embracement in the outpatient mental health care service in Cuiabá, Mato Grosso, Brazil, between February 2016 and June 2018. Simple frequencies and percentages were calculated for the description of variables, and crude and adjusted odds ratios for sex and age using logistic regression models. Results: The records of 1,780 embracement were analyzed. The prevalence of suicidal behavior was 7.8% and attempted suicide was 4.8%. Associated factors were identified for each phenomenon. Conclusion: female patients, with a mental disorder, and using psychoactive substances were associated with both suicidal behavior and suicide attempts. These characteristics can support the development of actions for patient embracement in these specialized services.

Psicodiagnóstico intervencionista en la adolescencia y Test de Apercepción Temática Infantil con Figuras Humanas: aportes a la clínica de la adolescencia / Psicodiagnóstico interventivo e o Teste de Apercepção Temática Infantil com Figuras Humanas: contribuições à clínica da adolescência / Interventive psychodiagnosis and the Children's Apperception Test with Human Figures: contributions to the clinic of adolescence

INTRODUCCIÓN: El Psicodiagnóstico interventivo, basado en las Consultas Terapéuticas propuestas por Winnicott, involucra, desde la primera sesión, intervenciones clínicas. Dado su empleo en diferentes contextos y poblaciones, instrumentos proyectivos como el Test de Apercepción Temática Infantil con Figuras Humanas son utilizados con la finalidad de explorar y comprender el mundo vivencial, y aspectos relevantes de la personalidad de niños y adolescentes, apoyando el trabajo clínico con adolescentes. OBJETIVO: Introducir, por medio del análisis del Psicodiagnóstico interventivo con la ayuda del CAT-H, la ilustración clínica de una adolescente con comportamiento de autolesión no suicida. MÉTODO: Se trata de un estudio clínico-teórico, con delineamiento de estudio de caso. Los datos fueron analizados a partir de la libre inspección del material y a la luz del abordaje psicoanalítico winnicottiana. RESULTADOS: Se evidenció el principal conflicto interno experimentado por el participante: sumisión frente al deseo de hacer lo que es propio de la época, así como la autoimagen vulnerable y el empleo de mecanismos de defensa primitivos dada la intensa sensación de impotencia. CONCLUSIÓN: El material clínico descrito presenta el uso del test más allá de su posibilidad diagnóstica, en calidad de mediador terapéutico, colaborando para la profundización en la queja y ofreciendo una experiencia de acogida y reflexión a la paciente, de manera similar la oferta del juego del garabato de Winnicott, es decir estableciendo contacto el campo emocional.

INTRODUÇÃO: O psicodiagnóstico interventivo, baseado nas Consultas Terapêuticas propostas por Winnicott, envolve, desde a primeira sessão, intervenções clínicas. Devido ao seu emprego em diferentes contextos e populações, instrumentos projetivos como o Teste de Apercepção Infantil com Figuras Humanas são utilizados para explorar e compreender o mundo vivencial, e aspectos relevantes da personalidade do público infanto-juvenil, subsidiando a atuação clínica com adolescentes. OBJETIVO: Apresentar a análise do psico diagnóstico interventivo com o auxílio do teste por meio da ilustração clínica de um adolescente com comportamento de autolesão não suicida. MÉTODO: Trata-se de um estudo teórico-clínico, com delineamento de estudo de caso. Os dados foram analisados a partir da livre inspeção do material e à luz da abordagem psicanalítica winnicottiana. RESULTADOS: Evidenciou-se o principal conflito interno vivenciado pelo participante: submissão versus desejo de fazer o que é próprio para a idade, assim como autoimagem vulnerável e emprego de mecanismos primitivos de defesa diante do intenso sentimento de desamparo. CONCLUSÃO: O material clínico descrito apresenta a utilização do teste além de sua possibilidade diagnóstica, como mediador terapêutico, colaborando para aprofundar a queixa e oferecendo uma experiência de acolhimento e reflexão ao paciente, à semelhança da proposta do jogo de rabiscos de Winnicott, ou seja, estabelecendo contato com o campo emocional.

INTRODUCTION: The interventive psychodiagnosis, based on the Therapeutic Consultations proposed by Winnicott, involves, from the first session, clinical interventions. Given its use in different contexts and populations, projective instruments such as the Children's Apperception Test with Human Figures are used in order to explore and understand the living world, and relevant aspects of the personality of children and adolescents, supporting clinical work with adolescents. OBJECTIVE: To present the analysis of the interventive psychodiagnosis with the help of the test through the clinical illustration of an adolescent with non-suicidal self-injury behavior. METHOD: This is a clinical-theoretical study, with a case study design. Data were analyzed from the free inspection of the material and in the light of the Winnicottian psychoanalytic approach. RESULTS: The main internal conflict experienced by the participant was evidenced: submission versus the desire to do what is proper for the age, as well as vulnerable self-image and employment of primitive defense mechanisms given the intense feeling of helplessness. CONCLUSION: The clinical material described presents the use of the test in addition to its diagnostic possibility, as a therapeutic mediator, collaborating to deepen the complaint and offering an experience of welcoming and reflection to the patient, similarly to the proposal of Winnicott's scribble game, which is, establishing contact with the emotional field.