Autolesiones no suicidas en estudiantes de medicina: frecuencia y factores asociados

Introducción: la salud mental de los estudiantes de medicina ha sido ampliamente investigada, demostrando que forman parte de un grupo vulnerable al desarrollo de trastornos mentales. Objetivo: el objetivo de esta investigación fue determinar la frecuencia de NSSI y sus factores asociados en estudiantes de medicina del Paraguay. Metodología: este fue un estudio descriptivo y transversal. Se lanzó una encuesta online para evaluar depresión, ansiedad y autolesiones, se utilizaron las escalas PHQ-2, GAD-7 y SHQ, respectivamente. Resultados: recibimos respuestas de 330 estudiantes de medicina. De los participantes, el 71,2 % eran mujeres. Se identificó que el 46,4 % de los participantes padecía depresión (PHQ-2 ≥ 3) y el 37,3 % ansiedad (GAD-7 ≥10). La frecuencia de NSSI fue del 27 % (n = 89). Los principales factores asociados a NSSI fueron un diagnóstico previo de un trastorno mental (que aumentó la probabilidad de NSSI en 3,76 veces) y/o una historia de abuso físico o sexual (con un aumento de 3,75 veces). Conclusión: esta investigación encontró la presencia de NSSI en casi 3 de cada 10 de los estudiantes de medicina encuestados. Los principales factores asociados con la conducta autolesiva fueron un diagnóstico previo de un trastorno mental y/o antecedentes de abuso físico o sexual.

Introduction: the mental health of medical students has been extensively researched, showing that they are part of a group vulnerable to the development of mental disorders. Aim: the aim of this research was to determine the frequency of NSSI and its associated factors in medical students in Paraguay. Methodology: this was a descriptive and cross-sectional study. An online survey was launched to assess depression, anxiety, and self-harm, the PHQ-2, the GAD-7 and SHQ scales were used, respectively. Results: we received responses from 330 medical students. Of the participants, 71.2 % were female. 46.4% of the participants were identified as having depression (PHQ-2 ≥ 3) and 37.3 % as having anxiety (GAD-7 ≥10). The frequency of NSSI was 27 % (n = 89). The main factors associated with NSSI were a previous diagnosis of a mental disorder (which increased the likelihood of NSSI by 3.76 times) and/ or a history of physical or sexual abuse (with a 3.75-fold increase). Conclusion: this research found the presence of NSSI in almost 3 out of 10 of the medical students surveyed. The main factors associated with self-injurious behavior were a previous diagnosis of a mental disorder and/or a history of physical or sexual abuse.

Autolesión no suicida en población general: frecuencia y factores asociados en Paraguay

Introducción: La investigación sobre la autolesión no suicida permite aumentar la conciencia sobre este fenómeno, posibilita su detección temprana y la implementación de estrategias más eficaces en prevención y tratamiento. Esto conlleva a una reducción del sufrimiento individual, los costos económicos y el impacto en la sociedad en su totalidad. Objetivo: Determinar la frecuencia y factores asociados a autolesión no suicida en una muestra de población adulta de Paraguay. Metodología: Estudio descriptivo de asociación cruzada, de corte transversal y prospectivo. Una encuesta en línea fue difundida a través de redes sociales y aplicaciones de mensajería. Esta incluía preguntas sobre datos sociodemográficos y clínicos. La presencia de autolesiones se determinó a través de la versión en español de la escala Self-Harm Questionnaire. Se utilizó estadística descriptiva para todas las variables. Para buscar asociaciones se utilizó la prueba chi cuadrado. Resultados: Participaron 241 personas (media de edad=32±12 años, 74,7% mujeres). Se encontró una frecuencia de autolesiones de 24,5% (n=59). De estos, el 91,5% había tenido ideación suicida al menos una vez. Se encontró asociación entre el nivel de ingresos y la frecuencia de autolesiones (χ

Introduction: Research on non-suicidal self-injury raises awareness of this phenomenon, enabling the early detection and implementation of more effective strategies in prevention and treatment. This leads to a reduction in individual suffering, economic costs, and impact on society. Objective: To determine the frequency and associated factors of non-suicidal self-injury in a sample of the adult population of Paraguay. Methodology: This was a descriptive, cross-sectional, and prospective study. An online survey was disseminated through social networks and messaging applications. The survey included questions on sociodemographic and clinical data. The presence of self-injury was determined by using the Spanish version of the Self-Harm Questionnaire. Descriptive statistics were used for all the variables. The chi-square test was used to examine associations. Results: There were 241 participants (mean age=32±12 years, 74.7%female). A non-suicidal self-injury frequency of 24.5% (n=59) was observed. Of these, 91.5% reported suicidal ideation at least once. An association was found between income level and the frequency of non-suicidal self-injury (χ

Autolesiones no suicidas en estudiantes de medicina: frecuencia y factores asociados / Non-suicidal Self-injury in Medical Students: Frequency and Associated Factors

Introducción: la salud mental de los estudiantes de medicina ha sido ampliamente investigada, demostrando que forman parte de un grupo vulnerable al desarrollo de trastornos mentales. Objetivo: el objetivo de esta investigación fue determinar la frecuencia de NSSI y sus factores asociados en estudiantes de medicina del Paraguay. Metodología: este fue un estudio descriptivo y transversal. Se lanzó una encuesta online para evaluar depresión, ansiedad y autolesiones, se utilizaron las escalas PHQ-2, GAD-7 y SHQ, respectivamente. Resultados: recibimos respuestas de 330 estudiantes de medicina. De los participantes, el 71,2 % eran mujeres. Se identificó que el 46,4 % de los participantes padecía depresión (PHQ-2 ≥ 3) y el 37,3 % ansiedad (GAD-7 ≥10). La frecuencia de NSSI fue del 27 % (n = 89). Los principales factores asociados a NSSI fueron un diagnóstico previo de un trastorno mental (que aumentó la probabilidad de NSSI en 3,76 veces) y/o una historia de abuso físico o sexual (con un aumento de 3,75 veces). Conclusión: esta investigación encontró la presencia de NSSI en casi 3 de cada 10 de los estudiantes de medicina encuestados. Los principales factores asociados con la conducta autolesiva fueron un diagnóstico previo de un trastorno mental y/o antecedentes de abuso físico o sexual.

Introduction: the mental health of medical students has been extensively researched, showing that they are part of a group vulnerable to the development of mental disorders. Aim: the aim of this research was to determine the frequency of NSSI and its associated factors in medical students in Paraguay. Methodology: this was a descriptive and cross-sectional study. An online survey was launched to assess depression, anxiety, and self-harm, the PHQ-2, the GAD-7 and SHQ scales were used, respectively. Results: we received responses from 330 medical students. Of the participants, 71.2 % were female. 46.4% of the participants were identified as having depression (PHQ-2 ≥ 3) and 37.3 % as having anxiety (GAD-7 ≥10). The frequency of NSSI was 27 % (n = 89). The main factors associated with NSSI were a previous diagnosis of a mental disorder (which increased the likelihood of NSSI by 3.76 times) and/ or a history of physical or sexual abuse (with a 3.75-fold increase). Conclusion: this research found the presence of NSSI in almost 3 out of 10 of the medical students surveyed. The main factors associated with self-injurious behavior were a previous diagnosis of a mental disorder and/or a history of physical or sexual abuse.

Research status of non-suicidal self-injury in children and adolescents / 四川精神卫生

The purpose of this paper is to review the research status on non-suicidal self-injury （NSSI） in children and adolescents， so as to provide references for the cognition and intervention of NSSI behavior in children and adolescents. NSSI behavior is an independent risk factor for suicide， which not only poses a serious threat to the mental health of children and adolescents， but also brings a great burden on families and society. This paper focuses on the epidemiology， etiology， relationship with other psychiatric disorders， and treatment of NSSI behaviors in children and adolescents.

Establishment and verification of a diagnostic prediction model for non-suicidal self-injury behaviors in adolescents with depressive disorder / 四川精神卫生

ObjectiveTo establish a diagnostic prediction model for non-suicidal self-injury （NSSI） behaviors in adolescents with depressive disorder， in order to provide references for early identification of NSSI behaviors in them. MethodsRetrospective analysis was performed on the clinical data of adolescents with depressive disorder （n=366） who were admitted to the Pediatric Department of Shenzhen Kangning Hospital from January 1 to December 31， 2021. According to the Diagnostic criteria of Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5） diagnostic criteria for NSSI， the patients were divided into comorbid NSSI group （n=289） and non-NSSI group （n=77）. The selected adolescents were randomly divided into a training set （n=258） and a verification set （n=108） in a 7∶3 ratio. Logistic regression analysis was used to screen the independent risk factors for NSSI behaviors in adolescents with depressive disorder， which served as the basis for prediction model. Finally， the receiver operating characteristic （ROC） curve was established and the area under curve （AUC） was calculated to evaluate the discrimination in the training set and validation set. Calibration curve was applied to evaluate the calibration degree of the model. The Homser-Lemeshow （HL） test was conducted to evaluate the goodness of fit of the model. And decision curve analysis （DCA） was performed to evaluate the clinical benefit of the model. ResultsGender （β=1.734， OR=5.561， 95% CI： 2.678~11.964）， education level （β=0.864， OR=2.737， 95% CI： 1.174~4.795）， history of suicide attempts （β=0.932， OR=2.539， 95% CI： 1.253~5.144）， being an only child （β=0.745， OR=2.106， 95% CI： 1.029~4.311） and depression severity （β=0.056， OR=1.058， 95% CI： 1.025~1.092） were independent risk factors related to NSSI behaviors in adolescents with depressive disorder （P<0.05 or 0.01）. The AUC was 0.808 （95% CI： 0.746~0.870） in the training set， and was 0.722 （95% CI： 0.581~0.864） in the validation set. The prediction model showed good calibration with the HL test （P=0.561）. ConclusionGender， education level， suicide attempt history， being an only child and depression severity are independent risk factors for NSSI behaviors in adolescents with depressive disorder， furthermore， the diagnostic clinical prediction model constructed using above factors for NSSI behaviors in adolescents with depressive disorder has displayed good sensitivity and specificity.

Effect of knowledge of a friend's non-suicidal self-injury behavior on self injury and suicide behaviors of adolescents / 中华行为医学与脑科学杂志

Objective:To explore the relationship between knowledge of a friend's non-suicidal self-injury (NSSI) behavior and self injury and suicide behaviors of adolescents.Methods:From January 2020 to January 2021, totally 1 683 students from a middle school in Xiamen were randomly selected by cluster sampling.The suicide items of the self-injurious thoughts and behaviors interview(SITBT) were used to assess whether students were aware of their friends' self injurious history and their self injurious behaviors.The suicide items of the mini international neuropsychiatric interview for children and adolescents (MINI-KID) were used to assess students' suicide ideation and behavior.The data were statistically analyzed by SPSS 21.0 software.Logistic regression model was used to analyze the relationship between knowledge of a friend's NSSI and adolescents' own self-reported NSSI and suicidal behaviors.Results:A total of 1 683 junior and senior high school students completed the survey, including 412 (24.4%) who knew their friend's NSSI history and 1 271 (75.6%) who did not know their friend's NSSI history.There were statistically significant differences between the adolescents known and unknown friends' NSSI histories in terms of age, gender, whether they were left-behind children, mental disorders, their own NSSI, suicide attempts, and suicidal ideation (all P<0.05). Knowledge of a friend's NSSI behavior had positive predictive effect on adolescents' own NSSI behavior ( β=0.558, OR=2.01, 95% CI=1.58-3.88), suicidal ideation( β=0.238, OR=3.03, 95% CI=2.08-5.55), and suicide attempts ( β=0.233, OR=2.88, 95% CI=1.55-5.45) (all P<0.05). Conclusion:Knowledge of a friend's NSSI behavior may have an impact on adolescents' own self-injury and suicidal behavior.

Childhood trauma and non-suicidal self-injury in college students: chain mediating effects of rejection sensitivity and experiential avoidance / 中华行为医学与脑科学杂志

Objective:To explore the effect of childhood trauma on non-suicidal self-injury and the chain mediating effect of rejection sensitivity and experiential avoidance.Methods:From June 2021 to April 2022, totally 1 130 college students were investigated with childhood trauma questionnaire-short form(CTQ-SF), the tendency to expect rejection scale, acceptance and action questionnaire-2nd edition(AAQ-Ⅱ) and Ottwa self-injury inventory(OSI). SPSS 25.0 and Mplus 8.0 software were used for descriptive analysis, Spearman correlation analysis, structural equation model construction and Bootstrap mediation effect test.Results:Correlation analysis showed that childhood trauma (34.64±8.25), rejection sensitivity (58.02±9.54), experiential avoidance (23.90±7.96) and non-suicidal self-injury (0(0, 1)) were all significantly positively correlated with each other( r=0.163-0.532, all P<0.01). Structural equation model showed that empirical avoidance played a partial mediating effect between childhood trauma and non-suicidal self-injury in college students, with an effect size of 0.045(95% CI=0.013-0.084). Rejection sensitivity and experiential avoidance played a chain mediating effect between childhood trauma and non-suicidal self-injury in college students, with an effect size of 0.017(95% CI=0.005-0.035). Conclusion:Childhood trauma can directly predict non-suicidal self-injury in college students, and it can also indirectly predict non-suicidal self-injury through the partial mediation effect of experiential avoidance and the chain mediation effect of rejection sensitivity and experiential avoidance.

Analysis of characteristics of non-suicidal self-injury in 120 adolescents / 上海预防医学

ObjectiveTo explore the characteristics of adolescent non-suicidal self-injury （NSSI） behavior， and to enable clinicians to further understand adolescents with NSSI behavior， so as to make better clinical diagnosis and intervention. MethodsFrom July 2022 to June 2023， 120 adolescent patients with NSSI behavior were selected from the outpatient department of our hospital by convenience sampling， and the general demographic data were collected by self-made general situation questionnaire. The characteristics and motivation of NSSI among adolescents with NSSI were analyzed by using the NSSI questionnaire and Ottawa self-injury inventory （OSI）. ResultsThe average age of the first NSSI in the adolescents was 12.90±1.233， and the most common was 13 years old. The most common site of NSSI was the lower arm or wrist （58.33%）， followed by the hand （27.5%）. The most commonly used NSSI was "intentionally cutting oneself" （68.33%）； The most common motivation for NSSI is emotional regulation. ConclusionThere are significant differences in gender among adolescents with NSSI behavior. The age of first NSSI is concentrated， and the highest incidence is in the 11‒14 years old. The common way of self-injury is cutting. NSSI is usually associated with the intention to relieve suffering and is characterized by high frequency， using variety of methods， and low mortality. Adolescents with NSSI often choose to implement NSSI with emotion regulation as the main function， including external emotion regulation and internal emotion regulation.

Psychological experiences in adolescents with non-suicidal self-injury behavior： a qualitative Meta-synthesis / 四川精神卫生

BackgroundNon-suicidal self-injury （NSSI） is a serious global public health issue and an important risk factor for suicide attempts and completed suicide. The incidence of NSSI among adolescents in China is 27.4%. Therefore， it is critical to address NSSI and prevent its progression into more severe mental health conditions. ObjectiveTo systematically evaluate the psychological experiences and needs of adolescents with NSSI behavior， so as to provide references for formulating targeted intervention strategies for this demographic. MethodsA computer search was conducted across a total of eleven databases， including Cochrane Library， Embase， PubMed， PsycINFO， Web of Science， CINAHL， Medline， CNKI， Wanfang， VIP and CBM， to gather qualitative research on the psychological experiences and needs of adolescents with NSSI behavior. The search extended from the establishment of these databases up to March， 2023. The Australian Joanna Briggs Institute （JBI） qualitative research quality evaluation tools were used to evaluate the included literature， and a Meta-synthesis method was used to integrate the results. ResultsA total of 11 studies were included， yielding 46 research findings. Similar findings were consolidated into 10 new categories， ultimately resulting in 5 synthesized outcomes， including interpersonal conflict， academic pressure and self-reflective struggles， self-injurious behaviors intertwined with inner emotions， the power of love to overcome helplessness， and adjustment and seeking positive coping strategies. ConclusionAdolescents often have experienced negative life events before NSSI behaviors， with notable conflicts in interpersonal relationships， academic pressures and family education. Following NSSI behavior， they undergo various psychological experiences， such as transient feelings of relief， dependence and guilt. In addition， they crave guidance and assistance from professionals to cope with negative emotions.［Funded by Social Psychological Service and Crisis Intervention in 2022 （number， LZXL-202213）］

Effect of mentalization-based family therapy on depressive symptoms and non-suicidal self-injury behavior in adolescents with major depressive disorder / 四川精神卫生

BackgroundThe major depressive disorder has high prevalence among adolescents， and non-suicidal self-injury （NSSI） behaviors frequently occur among patients， therefore， major depressive disorder in adolescents has become the researching focus. ObjectiveTo explore the effect of mentalization-based family therapy （MBFT） on depressive symptoms and NSSI behavior in adolescents with major depressive disorder， and to provide references for the rehabilitation of major depressive disorder in adolescents. MethodsA total of 90 adolescent patients with major depression disorder who met the diagnostic criteria of International Classification of Diseases， 10th edition （ICD-10） for depressive disorders and attended Wuhan Mental Health Center from January to December 2022 were selected， and were assigned into study group （n=44） and control group （n=46） using random number table method. All participants received routine intervention， based on this， study group added a 60-minute MBFT intervention once a week for 8 weeks. Before the intervention and at the end of 1st， 2nd，4th and 8th week，the two groups were assessed using Hamilton Depression Scale-24 item （HAMD-24）， General Self-Efficacy Scale （GSES）， Pittsburgh Sleep Quality Index （PSQI） and Ottawa Self-injury Inventory （OSI）. ResultsThe repeated measures analysis of variance reported a statistical main effect of time， main effect of group， and interaction effect between time and group at the baseline and the end of 1st， 2nd， 4th and 8th week of treatment in HAMD-24 score （F=69.621， 15.428， 29.623， P˂0.05）， OSI score （F=176.642， 37.682， 21.873， P˂0.05）， GSES score （F=215.236， 57.421， 27.857， P˂0.05） and PSQI score （F=268.541， 61.863， 33.867， P˂0.05）. Individual effect analysis discovered a statistical difference between study group and control group at the end of 2nd， 4th and 8th week of treatment in HAMD-24 score （t=5.567， 8.645， 6.233， P˂0.01）， OSI score （t=3.675， 11.817， 9.632， P˂0.01）， GSES score （t=23.462， 31.709， 12.750， P˂0.01） and PSQI score （t=9.664， 22.457， 9.333， P˂0.01）. ConclusionMBFT may improve depressive symptoms， NSSI behavior， sleep quality and self-efficacy in adolescents with major depressive disorder. ［Funded by 2022 Natural Science Foundation Project of Hubei Province （number， 2022CFB483）］

Advances in the electrophysiological research on neurocognitive function in adolescents with non-suicidal self-injury / 中国当代儿科杂志

Non-suicidal self-injury (NSSI) is becoming increasingly common in adolescents and seriously affects their physical and mental health, and it is also a major risk factor for suicide among adolescents. NSSI has now become a public health issue of general concern; however, the identification of cognitive dysfunction in NSSI is still based on neuropsychological cognitive assessment and subjective questionnaire assessment, with a lack of objective evaluation indicators. As a method for studying the cognitive neural mechanism of NSSI, electroencephalography is a reliable tool for finding objective biomarkers of NSSI. This article reviews the recent research on electrophysiology associated with cognitive dysfunction in adolescents with NSSI.

Relationship between depressive mood and non-suicidal self-injury in middle school students： the mediating role of impulsivity / 四川精神卫生

BackgroundNon-suicidal self-injury （NSSI） behavior poses a significant risk to the psychosomatic health of middle school students. However， the intrinsic mechanisms underlying the risk factors associated with NSSI behavior remain unclear. ObjectiveTo explore the relationship and underlying mechanism between depressive mood， impulsivity， and NSSI behavior in middle school students， and provide valuable insights for the prevention and intervention of NSSI behavior in this population. MethodsIn March 2021， 1 161 middle school students were recruited by cluster random sampling. They were assessed using Adolescent Non-Suicidal Self-Injury Assessment Questionnaire （ANSAQ）， Center for Epidemiologic Studies Depression Scale （CES-D）， and Barratt Impulsivity Scale （BIS-II）. Spearman's correlation analysis was used to examine the correlation between depressive mood， impulsivity and NSSI behavior in middle school students. Moreover， the Process mediation effect analysis was adopted to test the mediating role of impulsivity between depressive mood and NSSI behavior. ResultsTotal of 122 people（10.51%） with NSSI behavior were detected. CES-D score was positively correlated with the total score of BIS-II and scores of all dimensions （r=0.340~0.556， P<0.01）， and also were positively correlated with the total score of ANSAQ and scores of all dimensions （r=0.437~0.540， P<0.01）. Additionally， the total score and dimension scores of BIS-II were positively correlated with the total score and dimension scores of ANSAQ （r=0.157~0.437， P<0.01）. Impulsivity played a partial mediating role between depressive mood and NSSI behavior ［indirect effect=0.035 （95% CI： 0.004~0.067， P<0.01）， indirect effect accounted for 5.81% of the total effect］. ConclusionDepressive mood in middle school students has both a direct and indirect influence on NSSI behavior， partially mediated by impulsivity. Consequently， impulsivity plays a partial mediating role between depressive mood and NSSI behavior.［Funded by Humanities and Social Sciences Research Science Institute of Chongqing Municipal Education Commission （number， 23KSZ017）］

#automutilação: a expressão simbólica da autolesão não suicida / #automutilação: a expressão simbólica da autolesão não suicida / #automutilación: la expresión simbólica de la autolesión no suicida

A autolesão não suicida (ALNS) é um fenômeno de relevância crescente com altas taxas de prevalência em adolescentes e jovens adultos. Como método, foi realizada etnografia virtual em comunidade de autolesão no Facebook de modo a ampliar a compreensão dos aspectos simbólicos relacionados à prática. Em fevereiro de 2021, 133 publicações foram coletadas e divididas em três categorias de análise: autolesão, sofrimento e religião. A autolesão é compreendida como similar ao comportamento compulsivo por meio do qual praticantes buscam uma experiência de transcendência ainda que às custas de dor. Assemelha-se a uma dependência comportamental. O sofrimento descrito aponta processos depressivos e se caracteriza por solidão, dificuldade de expressão de sentimentos e necessidade de manutenção de uma persona funcional no cotidiano. Assim, a comunidade emerge como meio de expressão dos aspectos relegados à sombra no mundo offline.

Non-suicidal self-injury (NSSI) is a phenomenon of increasing relevance, with high prevalence rates in adolescents and young adults. NSSI is one of the main risk factors for future. The method of virtual ethnography was carried out in a self-injury community on Facebook in order to broaden the understanding of the symbolic aspects related to the practice. In February 2021, 133 publications were collected and divided into three categories of analysis: self-injury, suffering and religion. Self-injury was understood as a compulsive behavior through which practitioners seek an experience of transcendence at the expense of pain. It resembles an addict behavior. The suffering described refers to depressive processes and is characterized by loneliness, difficulty in expressing feelings and the need to maintain a functional persona in everyday life. Therefore, the group emerges as a means of expressing aspects relegated to the shadows in the offline world.

La autolesión no suicida (ALNS) es un fenómeno de creciente relevancia con altas tasas de prevalencia en adolescentes y adultos jóvenes. Como método, se realizó una etnografía virtual en una comunidad de autolesiones en Facebook con el fin de ampliar la comprensión de los aspectos simbólicos relacionados con la práctica. En febrero de 2021 se recopilaron 133 publicaciones y se dividieron em tres categorías de análisis: autolesiones, sufrimiento y religión. Se entiende que la autolesión es similar al comportamiento compulsivo por el cual los practicantes buscan una experiencia de trascendencia incluso a expensas del dolor. Se asemeja a una adicción conductual. El sufrimiento descrito apunta a procesos depresivos y se caracteriza por la soledad, la dificultad para expresar los sentimientos y la necesidad de mantener una personalidad funcional en la vida cotidiana. Así, la comunidad surge como medio de expresión de aspectos relegados a la sombra en el mundo offline.

Revision of the non-suicidal self-injury behavior scale for adolescents with mental disorder / 中南大学学报(医学版)

OBJECTIVES@#Adolescents are at high risk of non-suicidal self-injury (NSSI). Currently, there is no clinical assessment tool for adolescent NSSI behaviors measurement with global consistency. The Ottawa Self-injury Inventory (OSI) is considered as a relatively comprehensive assessment tool for NSSI, but the questionnaire is discussed with excessive content and timecostly, which may affect the reliability of the measurement results for adolescent.Thus, this study, based on OSI, aims to revise the assessment tool for adolescent with NSSI that is suitable for both clinically and scientifically, referring to the diagnostic criteria for NSSI in the 5th Diagnostic and Statistical Manual of Mental Disorder (DSM-5).@*METHODS@#This study was led by the Second Xiangya Hospital of Central South University and collaborated with 6 mental health service institutions in China from August to December 2020. Adolescent aged from 12 to 24 years old who had self-injury behavior and met the DSM-5 diagnostic criteria for NSSI were continuously recruited in the psychiatric outpatient department or ward. After clinical diagnosis by an experienced attending psychiatrist or above, the general information and OSI were collected by questionnaires. SPSS 24.0 and AMOS structural equation model statistical softwares were used to conduct item analysis and exploratory factor analysis on the obtained data to complete the revision of the scale. Cronbach's alpha coefficient, split-half reliability, test-retest reliability, and content validity and structure validity were performed to analyze the reliability and validity and confirmatory factor analysis was carried out to test the structure validity for the revised scale.@*RESULTS@#A total of 234 adolescent with NSSI were enrolled, including 33 (14.1%) males and 201 (85.9%) females with the mean age of (16.2±2.6) years old. The most common clinical diagnoses were depression disorder (57.4%), bipolar disorder (20.9%), adolescent mood disorder (17.1%), etc. Nine items (item 2, 7, 11, 13, 23, 24, 10, 17, 18) in the functional scale of OSI were deleted according to extreme grouping method, correlation analysis, and principal component analysis in exploratory factor analysis. The revised functional scale for NSSI consisted of 15 items. The reliability analysis showed that the Cronbach's alpha coefficients of NSSI thought and behavior frequency, addiction characteristics, and function scales were 0.799, 0.798, and 0.835, respectively, and the split-half coefficients were 0.714, 0.727, and 0.852, respectively. The test-retest coefficients of the latter 2 scales were 0.466 and 0.560, respectively. The correlation coefficient between sub-items and total scores in each part of the scale showed good content validity. The exploratory factor analysis showed that a component was extracted from the frequency of thoughts and behaviors of NSSI, one component was extracted from the addictive characteristics, and three components were extracted from the functional part. The three functional subscales were social influence, external emotion regulation, and internal emotion regulation. The factor load of each item was >0.400.@*CONCLUSIONS@#The revised Chinese version OSI targeted the adolescent patients with mental disorders has relatively ideal reliability and validity. The scale shows high stability, dependability, and a reasonable degree of fit. It is a suitable assessment tool for clinical and scientific research on adolescent with NSSI.

Association between non-suicidal self-injury behavior and impulsivity in adolescent patients with depressive disorder in the first hospitalization / 四川精神卫生

ObjectiveTo explore the characteristics of impulsivity in adolescent depressive disorder patients with non-suicidal self-injury （NSSI） behavior， analyze the relationship between NSSI behavior and impulsivity， so as to identify patients with NSSI behavior and provide targeted intervention at early stages. MethodsA total of 53 adolescent patients with depressive disorder who were hospitalized for the first hospitalization in Shenzhen Kangning Hospital were enrolled， diagnosed using Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5）. Thereafter， the adolescents were divided into NSSI group （n=30） and non-NSSI group （n=23）. Hamilton Depression Scale-17 item （HAMD-17）， Adolescents Self-Harm Scale and Barratt Impulsivity Scale （BIS-11） were used to evaluate the severity of depression， NSSI and impulsivity. ResultsCompared with the non-NSSI group， the NSSI group scored higher on HAMD-17 ［（25.50±4.10） vs. （21.43±4.64）， t=3.379， P<0.01］， motor impulsiveness of BIS-11 ［（51.67±15.95） vs. （38.70±14.90）， t=3.018， P<0.01］， cognitive impulsiveness ［（52.75±13.22） vs. （43.37±18.40）， t=2.161， P<0.05］， non-planning impulsiveness ［（68.00±15.32） vs. （50.76±21.35）， t=3.424， P<0.01］ and BIS-11 ［（57.42±11.08） vs. （44.27±14.83）， t=3.695， P<0.01］. Within NSSI group， the score of Adolescents Self-Harm Scale was positively correlated with the score of motor impulsiveness in BIS-11 （r=0.691， P<0.01）. Binary Logistic regression analysis showed that HAMD-17 score （β=0.172， OR=1.187， 95% CI： 1.007~1.400） and non-planning impulsiveness of BIS-11 （β=0.044， OR=1.045， 95% CI： 1.002~1.091） were associated with NSSI in adolescent patients with depressive disorder （P<0.05）. ConclusionThe severity of depressive symptoms and non-planning impulsiveness may be risk factors for NSSI behavior in adolescent patients with depressive disorder.

Epidemiological characteristics and influencing factors of non-suicidal self-injury behaviors among middle school students in Jiangmen / 四川精神卫生

ObjectiveTo investigate epidemiological characteristics and influencing factors of non-suicidal self-injury （NSSI） behaviors among middle school students in Jiangmen. MethodsA total of 1 220 middle school students in Jiangmen were selected for the study through stratified random sampling from November to December 2020. The self-compiled general demographic questionnaire， Coping Style Scale for Middle School Students， Olweus Bully/Victim Questionnaire （BVQ）， Social Support Scale for Adolescents， and Center for Epidemiologic Studies-Depression Scale （CES-D） were used for the assessment. Then binary Logistic regression analysis was performed to screen the factors influencing NSSI behaviors in students. ResultsA total of 204 middle school students （16.72%） were found to be engaged in NSSI behaviors， of whom 67 were male and 137 were female. There were statistically significant differences between the NSSI group and the non-NSSI group in terms of gender， school period， lodging， peer relationship and academic performance （χ2=22.162， 7.247， 6.541， 45.787， 25.097， P<0.05 or 0.01）. Compared with the non-NSSI group， the NSSI group scored higher on CES-D （t=-14.240） and BVQ （t=-5.952）， lower on Social Support Scale for Adolescents （t=9.238）. Within the Coping Style Scale for Middle School Students， NSSI group had lower problem-focused coping score （t=7.148） and higher emotion-focused coping score （t=-7.038） than those of non-NSSI group. The detection rates of school bullying， verbal and relational bullying were higher in NSSI group compared with non-NSSI group （χ2=34.215， 29.785，16.465）. The differences were statistically significant （P<0.01）. Binary Logistic regression showed that depression （OR=1.090， P<0.01） and school bullying （OR=1.492， P<0.05） entered into the regression model. ConclusionThe situation of NSSI behaviors of middle school students in Jiangmen is serious， and depression and school bullying are risk factors affecting NSSI behaviors in students.

Prevalence of non-suicidal self-injury behavior among Chinese adolescents with depression： a Meta-analysis / 四川精神卫生

ObjectiveTo analyze the prevalence rate of non-suicidal self-injury （NSSI） behavior in Chinese adolescents with depression， so as to provide references for the intervention of NSSI behavior in adolescents with depression. MethodsThe literature databases such as CNKI， VIP， Wanfang， China Biology Medicine Disc， PubMed， Web of Science， Cochrane Library and Embase were searched via computer for the cross-sectional studies related to the prevalence of NSSI behavior in adolescents with depression published from inception to February， 2020. Then the eligibility assessment， data extraction and assessment of methodological quality were performed independently by two reviewers， and the Meta-analysis was performed by using RevMan 5.4. ResultsA total of 2 238 adolescents in 10 studies were included. Meta-analysis yielded that the prevalence rate of NSSI behavior in Chinese adolescents with depression was 51% （95% CI： 43%~59%）. Subgroup analysis of NSSI behavior in adolescents with depression implied that the prevalence rate was 36% （95% CI： 22%~50%） in female adolescents， which was higher than 18% （95% CI： 12%~24%） in male adolescents. The prevalence rate of NSSI behavior was 57% （95% CI： 38%~77%） in depression adolescents with suicidal ideation， which was higher than 4% （95% CI： 0~8%） in those without suicidal ideation. The prevalence rate of NSSI behavior was 54% （95% CI： 41%~67%） in depression adolescents diagnosed with Diagnostic and Statistical Manual of Mental Disorders， fifth edition （DSM-5）， which was higher than 46% （95% CI： 40%~51%） in those diagnosed with the International Classification of Diseases， tenth edition （ICD-10）. The prevalence rate of NSSI behavior was 52% （95% CI： 41%~63%） in depression adolescents in the literatures with quality score of 7， which was close to 50% （95% CI： 44%~55%） in depression adolescents in the literatures with quality score of 6. The comparison of above subgroups all had statistical differences （P<0.05 or 0.01）. ConclusionChinese adolescents with depression suffer a high prevalence rate of NSSI behavior， with higher prevalence in females than in males， and in those with suicidal ideation than in those without suicidal ideation.

A chain mediating model of rumination and depression between non-suicidal self-injury and suicidal ideation in adolescents with depressive disorder / 中华行为医学与脑科学杂志

Objective:To explore the effects of non-suicidal self-injury on suicidal ideation in adolescents with depressive disorder, and the mediating role of rumination and depression between them.Methods:A sample of 397 depressive disorder adolescents were recruited to complete the adolescent non-suicidal self-injury behaviour questionnaire, ruminative responses scale (RRS), self-rating depression scale (SDS), and Beck scale for suicide ideation-Chinese version(BSI-CV). All data processing and analysis were performed using SPSS 23.0.The mediating effect was tested by correlation analysis and Bootstrap analysis.Results:The non-suicidal self-injury score was (29.192±11.281), the rumination score was (65.036±12.284), the depression score was (75.770±11.278), and the suicidal ideation score was (40.681±11.626). Non-suicidal self-injury was significantly and positively correlated with suicidal ideation( r=0.403, P<0.01), rumination and depression( r=0.332, 0.470, both P<0.01). Rumination was significantly and positively correlated with depression and suicidal ideation( r=0.549, 0.181, both P<0.05). Depression was significantly and positively correlated with suicidal ideation( r=0.313, P<0.01). The direct effect value of non-suicidal self-injury on suicidal ideation was 0.341(95% CI=0.238-0.444), the indirect effect of non-suicidal self-injury on suicidal ideation through two pathways, the separate mediating effect value of depression was 0.057(95% CI=0.077-0.114), and the chain mediating effect value of rumination and depression was 0.026(95% CI=0.004-0.057). Conclusion:Non-suicidal self-injury can directly affect suicidal ideation of depressive disorder adolescents and indirectly through rumination and depression.

The relationship between non-suicidal self-injury and implicit attitude / 中华行为医学与脑科学杂志

Non-suicidal self-injury(NSSI) is defined as deliberate " destruction to body issue without conscious suicidal intent" and which is not culturally and socially sanctioned.The evaluation of NSSI mainly includes explicit measurement and implicit measurement.In recent years, implicit measurement has received wide attention from scholars, among which the implicit association task(IAT), as a tool to measure the relative attitude towards objects in individuals' implicit cognition and to prevent the interference of consciousness, which is an effective method to evaluate NSSI.On the basis of introducing the background of implicit attitude, this paper summarized the research progress of implicit attitude in distinguishing and predicting NSSI from behavioral and neuroimaging perspectives.Firstly, compared with the group without NSSI history, the NSSI group had a more recognized implicit attitude towards NSSI, which was correlated with the frequency and severity of NSSI.Secondly, compared with other known traditional predictors, whether implicit attitude is a better predictor of subsequent behavior of NSSI remains controversial.Finally, there are not many studies on the biological basis of implicit attitude towards NSSI in NSSI populations.Preliminary results suggest that the activation of salience networks and the reduction of gray matter volume in some brain regions (such as the dorsal striatum) may be related to implicit attitude in NSSI populations.To sum up, measuring implicit attitudes towards NSSI is useful for screening and predicting people at risk for NSSI, especially when individuals have false reports or low self-awareness.In addition, this paper also put out some shortcomings for future research and clinical intervention.

Trend analysis of Cite Space-based research on non-suicidal self-injury / 中国实用护理杂志

Objective:To summarize the hotspots and developmental status of non-suicidal self-injury research by clustering and co-occurrence to the literature on non-suicidal self-injury on the basis of Cite Space, and in order to provide references for future research and intervention.Methods:Non-suicidal self-injury literature included in the Web of science core collection from January 1975 to August 2020 was searched, and the included literature was visualized and analyzed using Cite Space 5.5.R2 knowledge mapping software.Results:A total of 974 articles were retrieved, and the number of articles published showed an increasing trend year by year, mostly in developed countries. The country with the highest cumulative number of articles was the United States, with a total of 412 articles, and the first organization was Katholieke Univ Leuven, with a total of 42 articles. Key words co-occurrence and clustering showed that the current research focus was on adolescents, suicidal behavior, dialectical behavior therapy, and borderline personality disorder. The most cited literature was by Muehlenkamp.Conclusions:Non-suicidal self-injury research has developed rapidly in recent years. At present, non-suicidal self-injury population, related intervention measures, screening and evaluation tools, Meta-analysis and risk factor analysis are its research frontiers and hot spots.