Disorders - Non-suicidal self-harm behaviours
Zare,
Elahe, Kaveh, Mohammad H., Karimi, Masoud, Nazari, Mahin, Seif, Mozhgan
Introduction: Nonsuicidal self-injury (NSSI) in adolescents is a growing public health concern, demanding preventive measures,
particularly among high school students. Based on social cognitive theory (SCT), self-efficacy coupled with outcome expectations, social support,
self-regulation, and behavioral intention, determine the likelihood of engaging in such a behavior. Thus, the present study was to investigate the
effect of a SCT-based educational intervention on NSSI prevention in female high school students.\rMethods: This randomized educational intervention
trial was conducted on 191 female high school students, aged 15-17 years (15.95 ± 0.59) (viz. 99 individuals in intervention group and 92 controls).
Intervention group attended five SCT-based educational intervention sessions concerning NSSI prevention. Data were then collected by three self-
administered questionnaires. The first questionnaire was to measure demographic variables and the second one, intermediate outcome measure, was
implemented to evaluate SCT constructs. The third questionnaire also measured NSSI (final outcome measure). Data were analyzed using SPSS software
v.24.\rResults: After controlling the pretest scores, the repeated-measure multivariate analysis of covariance revealed a significant time and group
interaction in multivariate (F = 154.8, p < .001) and univariate analysis, which is in favor of the effectiveness of educational intervention on
changing the mean scores of NSSI and all SCT constructs. SCT constructs explained 41% of the variance in conforming intention for NSSI prevention (p
< .001).\rConclusion: The study findings were in favor of effectiveness of an SCT-based educational intervention in intention of preventing NSSI.
Journal of Adolescence, 95(5) : 1005-
1016
- Year: 2023
- Problem: Non-suicidal self-harm behaviours
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any)
Rockstroh, F., Edinger, A., Fischer-Waldschmidt, G., Josi,
J., Brunner, R., Resch, F., Kaess, M., Cavelti, M.
Aims: In this study the long-term effects of 'The Cutting-Down Programme' (CDP), a brief
psychotherapeutic intervention for nonsuicidal self-injury (NSSI) in adolescents, compared to high-quality treatment as usual (TAU) were evaluated
two to 4 years after entry into a randomized controlled trial (RCT). Method(s): Assessments of NSSI, suicide attempts, borderline personality
disorder (BPD), depression, and quality of life took place two to 4 years (T3) after enrollment in a RCT. The evolution of NSSI, suicide attempts,
depression, and quality of life was analysed using mixedeffects models (generalized linear models, poisson-regression, and linear regression).
Ordered logistic regression was used for analysing BPD diagnoses. Data from T0 (baseline), T2 (10 months), and T3 (2- 4 years) are reported. Result
(s): Out of 74 patients, 70 (95%) returned for T3. The frequency of NSSI events alongside with suicide attempts and depression further decreased
between T2 and T3 and BPD between T0 and T3 in both groups. Quality of life remained stable. No group differences occurred during this follow-up
period. Both groups received substantial but comparable additional treatment between T2 and T3. More treatment sessions during the follow-up period
were linked to larger improvements of NSSI. Conclusion(s): The CDP was found to be as effective as TAU in promoting recovery from NSSI and comorbid
symptoms in the long run. Results suggest that treatment effects from a brief psychotherapeutic intervention may endure and even further improve
after completion of the program. However, additional treatment seems to improve chances for recovery independent from CDP versus TAU.
Early Intervention in Psychiatry, 17(Supplement
1) : 167
- Year: 2023
- Problem: Non-suicidal self-harm behaviours
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions
Meza, J. I., Zullo, L., Vargas, S. M., Ougrin, D., Asarnow, J. R.
BACKGROUND: Adopting a common elements approach, this
practitioner review aims to highlight specific treatment elements that are common to interventions with demonstrated benefits in randomized
controlled trials (RCTs) for reducing suicide attempts and self-harm in youth. Identification of common treatment elements among effective
interventions offers a key strategy for clarifying the most robust features of effective interventions and improving our ability to implement
effective treatment and decrease the lag between scientific advances and clinical care.\rMETHODS: A systematic search of RCTs evaluating
interventions targeting suicide/self-harm in youth (ages 12-18) yielded a total of 18 RCTs assessing 16 different manualized interventions. An open
coding process was used to identify common elements present within each intervention trial. Twenty-seven common elements were identified and
classified into format, process, and content categories. All trials were coded for the inclusion of these common elements by two independent raters.
RCTs were also classified into those where trial results supported improvements in suicide/self-harm behavior (n = 11 supported trials) and those
without supported evidence (n = 7 unsupported trials).\rRESULTS: Compared with unsupported trials, the 11 supported trials shared the following
elements: (a) inclusion of therapy for both the youth and family/caregivers; (b) an emphasis on relationship-building and the therapeutic alliance;
(c) utilization of an individualized case conceptualization to guide treatment; (d) provided skills training (e.g. emotion regulation skills) to both
youth and their parents/caregivers; and (e) lethal means restriction counseling as part of self-harm monitoring and safety planning.\rCONCLUSIONS:
This review highlights key treatment elements associated with efficacy that community practitioners can incorporate in their treatments for youth
presenting with suicide/self-harm behaviors.
Journal of Child Psychology & Psychiatry & Allied
Disciplines, 06 : 06
- Year: 2023
- Problem: Non-suicidal self-harm behaviours, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any)
Liljedahl, S. I., Hellner, C., Pettersson,
A., Ghaderi, A.
Both self-harm and suicidal behaviors have been targeted
through school-based prevention programs, many of which have been developed in the United States. The aims of this systematic review were to assess
effects of school-based prevention programs on suicide and self-harm and to evaluate whether they are fit to the exporting culture. The review
followed Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Our inclusion criteria, structured according to
population/problem, intervention, control/comparison, outome, were: children and youth up to 19 years of age, school-based programs at universal,
selective or indicated levels compared with teaching as usual or with other programs, and outcomes of suicide or self-harm measured at least 10 weeks
after intervention. Studies without a control group or using non-behavioral outcomes were excluded. A comprehensive and systematic literature search
was conducted from the 1990s to March 2022. Risk for bias was assessed with checklists adapted from the Cochrane Risk of Bias (ROB) tool. A total of
1,801 abstracts were retrieved. Five studies fulfilled our inclusion criteria, but one had high risk for bias. Confidence in the evidence for effect
was assessed with Grading of Recommendations Assessment, Development and Evaluation (GRADE). Studies included in this review were evaluated with
respect to applicability in the context of international export. Only two school-based programs demonstrated efficacy in preventing suicidal
behaviors. Although implementation of evidence-based interventions is a crucial next step, further replication with simultaneous attention to
dissemination and implementation issues are called for. Funding and registration: conducted on assignment by the Swedish government. The protocol is
available at the SBU website in Swedish.
Scandinavian Journal of
Psychology, 27 : 27
- Year: 2023
- Problem: Non-suicidal self-harm behaviours, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any)
Dobias, Mallory L., Chen, Sharon, Fox, Kathryn R., Schleider, Jessica L.
Rates of self-injurious thoughts and
behaviors (SITBs) increase sharply across adolescence and remain high in young adulthood. Across 50 years of research, existing interventions for
SITBs remain ineffective and inaccessible for many young people in particular need of mental healthcare. Briefer intervention options may increase
access to care. However, many traditional interventions for SITBs take 6 months or more to complete-making it difficult for providers to target SITBs
under real-world time constraints. The present review (1) identifies and (2) summarizes evaluations of brief psychosocial interventions for SITBs in
young people, ages 10-24 years. We conducted searches for randomized and quasi-experimental trials conducted in the past 50 years that evaluated
effects of \"brief interventions\" (i.e., not exceeding 240 min, or four 60-min sessions in total length) on SITBs in young people. Twenty-six
articles were identified for inclusion, yielding a total of 23 brief interventions. Across all trials, results are mixed; only six interventions
reported any positive intervention effect on at least one SITB outcome, and only one intervention was identified as \"probably efficacious\" per
standard criteria for evidence-based status. While brief interventions for SITBs exist, future research must determine if, how, and when these
interventions should be disseminated. (PsycInfo Database Record (c) 2023 APA, all rights reserved)
Clinical child and family psychology review, 26(2) : 482-
568
- Year: 2023
- Problem: Non-suicidal self-harm behaviours, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Other service delivery and improvement
interventions
Zhang, Y., Huang, K., Cong, H., Wang, M.
Background: The
depression of college students requires psychological intervention based on clinical drug treatment. Group psychological counseling is an effective
psychological intervention. This study aims to explore the effect of group psychological counseling on negative emotions and Nonsuicidal Self-injury
(NSSI) behaviors of college students with depression. Subjects and methods: A total of 84 students with depression by screening diagnosis at Qingdao
University in March 2018 were divided into the control group (n=42) and the intervention group (n=42). Students in the control group only received
drug therapy, whereas the intervention group underwent group psychological counseling intervention based on drug therapy. A comparison between
depression, self-injury behaviors, and sense of life purpose of the two groups before and after the intervention was performed. Result(s): The post-
test Self-Rating Depression Scale (SDS) standard score of students in both groups was significantly lower than the pre-test SDS standard score
(P<0.05). The SDS standard scores of the post-test and the trace test in the intervention group were significantly lower than those in the control
group (P<0.05). Compared with the pre-test value, the total scores in the Meaning in Life Questionnaire (MLQ) of the post-test in both groups
significantly increased. The intervention group received significantly higher scores in the MLQ of the post-test and trace test compared with the
control group (P<0.05). Both groups also received significantly higher scores in the post-test in the Quality System Audit (QSA) compared with the
pre-test (P<0.05). The intervention group also received higher scores on the post-test and trace test in some dimensions in the QSA compared with
those of the control group (P<0.05). Conclusion(s): Group psychological counseling intervention for college students with depression can alleviate
their depressive symptoms, improve their sense of life meaning, reduce the risk of suicide, and control their NSSI behaviors. Copyright © 2022
Medicinska Naklada Zagreb. All rights reserved.
Psychiatria Danubina, 34
(2) : 229-235
- Year: 2022
- Problem: Depressive Disorders, Non-suicidal self-harm behaviours, Suicide or self-harm behaviours (excluding non-suicidal self-harm), Suicide or self-harm with comorbid mental disorder
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Antidepressants
(any), Psychological Interventions
(any), Other Psychological Interventions
Vandechali, A. R., Hassanzadeh, R., Abbasi, G.
Background: Adolescence is a part of human life during which people face a set of transformational obstacles and challenges.
Objective(s): This study aimed to determine the effectiveness of positive therapy on self-harm thoughts and psychological well-being in students with
dissolved romantic relationships. Method(s): This quasi-experimental study was conducted based on a pretest-posttest control group design and
follow-up. The statistical population (n=587) consisted of patients referring to the counseling centers in Sari city, Iran, among which 30 students
with dissolved romantic relationships were selected based on the inclusion and exclusion criteria. Participants completed the Self-Harm Inventory and
the Ryff's Psychological Well-Being Scale in three stages, namely pre-test, post-test, and follow-up. The experimental group received 8 sessions of
positive psychotherapy, whereas the control group received no intervention. Data were analyzed in SPSS.22 software using the repeated measures
analysis method. Result(s): In the experimental group, the mean of self-harm thoughts decreased from 18.53+/-1.95 in the pre-test to 8.00+/-1.64 in
the post-test. Moreover, in the experimental group, the mean of psychological well-being increased from 43.60+/-12.45 in the pre-test to 97.13+/-8.14
in the post-test. However, in the control group, the means of psychological well-being were obtained at 40.80+/-11.26 in the pre-test and 40.80+/-
11.30 in the post-test, which was not different. Conclusion(s): The results of the study showed that positive psychotherapy reduced self-harm and
suicidal thoughts and increased psychological well-being in students with dissolved romantic relationships. Copyright © 2022, Razavi International
Journal of Medicine.
Razavi International Journal of Medicine, 10(2) : 102-
108
- Year: 2022
- Problem: Non-suicidal self-harm behaviours
- Type: Randomised controlled trials
-
Stage: At risk (indicated or selected prevention)
-
Treatment and intervention: Psychological Interventions
(any), Positive
psychology
Harris, L. M., Huang, X., Funsch, K. M., Fox, K. R., Ribeiro, J. D.
Despite
increased numbers of children and adolescents seeking and receiving mental health treatment, rates of self-injurious thoughts and behaviors (SITBs)
in youth are rising. In the hopes of aiding ongoing efforts to alleviate the burden of SITBs in this vulnerable population, the present study
summarizes current knowledge on the efficacy of SITB interventions in children and adolescents. We conducted a meta-analysis of randomized controlled
trials (RCTs) assessing treatment effects on SITBs in child and adolescent populations. A total of 112 articles comprising 558 effect sizes were
included in analyses. Nearly all interventions produced nonsignificant reductions in SITBs. For binary SITB outcomes, a nonsignificant treatment
effect was detected, with an RR of 1.06 (95% CIs [0.99, 1.14]). For continuous SITB outcomes, analyses also yielded a nonsignificant treatment effect
(g = - 0.04 [- 0.12, 0.05]). These patterns were largely consistent across SITB outcomes, regardless of intervention type, treatment components,
sample and study characteristics, and publication year. Our findings highlight opportunities for improving SITB intervention development and
implementation in child and adolescent populations. The most efficacious interventions are likely to directly target the causes of SITBs; therefore,
future research is needed to identify the causal processes underlying the onset and maintenance of SITBs in youth.
Scientific reports, 12(1) : 12313
- Year: 2022
- Problem: Non-suicidal self-harm behaviours, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: Universal prevention, At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Complementary & Alternative
Interventions (CAM), Service Delivery & Improvement, Psychological Interventions
(any)
Eggart, V., Cordier,
S., Hasan, A., Wagner, E.
Non-suicidal self-injury (NSSI) in children and adolescents is
a frequent phenomenon. NSSI at any time is a significant predictor of future NSSI but also, and more importantly, for suicide attempts. Less evidence
is available for the impact, or more specifically, the therapeutic effect of psychotropic drugs on the emergence of NSSI in this population. The
phenomenon is clinically highly relevant since adolescent psychiatric inpatients are often affected by NSSI and most of them are treated with
psychotropic drugs. While previous reviews on NSSI comprised suicidal self-injury (SSI), this review aims at elucidating the potential impact of
psychotropic drugs on the emergence of specifically NSSI in children and adolescents. Systematic searches of articles indexed electronically in
PubMed, Embase and PsycInfo were conducted (PROSPERO CRD42020209505). Studies included in the quantitative synthesis were evaluated using the SIGN
level of evidence rating. Meta-analyses were performed using RevMan (Version 5.4). 2227 records were identified through database searches. Two
additional records were identified manually. In total, seven studies were included in qualitative and four studies in quantitative analyses. In a
meta-analysis, selective serotonin reuptake inhibitors (SSRIs) were compared vs. control medication (placebo or serotonin-norepinephrine reuptake
inhibitor) and here, no statistically significant difference between the groups could be observed regarding the frequency of NSSI events (Risk Ratio
(RR) = 1.07, 95% confidence interval (CI) 0.60-1.91, p = 0.82, I2 = 12%). Evidence regarding the association of SSRI use and NSSI among
children and adolescents is sparse and the impact of psychotropic drugs in general on NSSI rates in this population should be addressed in future
clinical and observational studies. Copyright © 2022, The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.
European Archives of Psychiatry and Clinical Neuroscience, 272(8) : 1559-
1568
- Year: 2022
- Problem: Non-suicidal self-harm behaviours
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Selective serotonin reuptake inhibitors (SSRIs), Antidepressants
(any)
Calvo, N., Garcia-Gonzalez, S., Perez-Galbarro, C., Regales-Peco, C., Lugo-Marin, J., Ramos-Quiroga, J. A., Ferrer, M.
Non-suicidal self-injury (NSSI) is a clinically significant behavior with high relevance and prevalence, especially affecting
approximately 17-18% of the adolescent population worldwide. The aim of this study is to perform a systematic review to evaluate the effectiveness of
the available Specific Psychotherapeutic Interventions (SPI) focused on the reduction of NSSI behaviors. A systematic review was performed analyzing
PsychINFO, MEDLINE, Web of Science, PubMed and Cochrane CentralRegister of Controlled Trials to identify studies of interest from January 2010 to
December 2020. According to PRISMA guidelines, only 13 studies were included in the review. Six SPI were found to specifically and significantly
reduce NSSI in adolescents: Developmental Group Psychotherapy (DGP), Therapeutic Assessment (TA), Cutting Down Program (CDP), Emotional Regulation
Individual Therapy for Adolescents (ERITA), Treatment for Self-Injurious Behaviors (T-SIB) and Intensive Contextual Treatment (ICT). Furthermore,
relevant improvements in anxiety and depression symptoms were observed. The results of this review demonstrate the effectiveness of these
interventions, mainly the CPD and T-SIB, which are the only SPI that have been studied using Randomized Controlled Trial (RCT). Considering the
clinical relevance and associated functional impairment of NSSI, more research is needed to replicate the results and to increase knowledge about
SPIs. Copyright © 2022 Elsevier B.V. and ECNP
, 58 : 86-
98
- Year: 2022
- Problem: Non-suicidal self-harm behaviours
- Type: Systematic reviews
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any)
Argento, A., Simundic, A., Mettler, J., Mills, D. J., Heath, N. L.
Current theoretical frameworks posit that engagement in non-suicidal self-injury (NSSI) is due to an inability to regulate one's
emotions. In turn, mindfulness-based interventions have been shown to enhance emotion regulatory processes in those who engage in NSSI. OBJECTIVE(S):
The purpose of the present study was to determine whether a brief mindfulness activity was differentially effective at increasing state mindfulness
and decreasing stress following a stress induction task in university students with versus without a history of NSSI engagement. METHOD(S): The
sample consisted of two groups of participants who identified as women: participants with a history of NSSI engagement (NSSI; n=57; Mage=20.09,
SD=2.05) and participants without (no-NSSI; n=87; Mage=20.22, SD=1.94). All participants were asked to complete pre-intervention measures of state
mindfulness and stress and were randomly assigned to either a mindfulness activity (body scan) or control task condition. Following the completion of
their respective activities, a Stroop stress induction task was conducted and participants completed post-intervention measures of state mindfulness
and stress. RESULT(S): Two 3-way mixed ANOVAs (Time X NSSI status X Condition) were conducted and revealed significant time by condition interactions
for both state mindfulness, Wilk's LAMBDA = .93, F(1, 140) = 10.70, p = .001, etap2 = .07, and stress, Wilk's LAMBDA = .97, F(1, 140) = 4.21, p =
.04, etap2 = .03. As such, both groups (NSSI/no-NSSI) demonstrated similar increases in state mindfulness and decreases in stress in response to the
brief mindfulness activity following the stress induction. Implications for future research and practice will be discussed.HIGHLIGHTSThe brief
mindfulness activity effectively increased state mindfulness.The brief mindfulness activity effectively decreased stress.Benefits were experienced
similarly among both groups (NSSI/no-NSSI).
Archives of suicide research : official journal of the International
Academy for Suicide Research, 26(2) : 871-885
- Year: 2022
- Problem: Non-suicidal self-harm behaviours
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Mindfulness based
therapy
Ramsey, W. A.
Background: The Benefits and
Barriers Model proposes both benefits and barriers associated with nonsuicidal self-injury (NSSI) and that a negative association with the self plays
a key role in the initial selection of and acute motivation for NSSI. The current investigation builds upon previous findings by assessing the added
benefit of targeting self-criticism in the treatment of NSSI. Method(s): Sample included 40 participants (30 females; Mage = 14.92)
enrolled in dialectical behavior therapy for adolescents within a partial hospitalization program. All study participants received dialectical
behavior therapy for adolescents, and those randomized to the experimental condition received an additional brief cognitive intervention developed to
decrease self-criticism. Result(s): There was no evidence of an indirect effect of targeting self-criticism upon NSSI at post-treatment via post-
treatment self-criticism (b = -0.98, p =.543); however, there was evidence of a significant interaction between treatment condition and self-
criticism at pretreatment in the prediction of NSSI at post-treatment (b = 0.33, p =.030). Analyses of simple slopes indicated the conditional direct
effect of targeting self-criticism varied as a function of patient's level of self-criticism at the onset of treatment, such that individuals -1 SD
below the mean (b = -5.76, p =.037) and at average pretreatment levels of self-criticism (b = -4.09, p =.042), but not + 1 SD above the mean (b = -
2.42, p =.056), experienced fewer incidents of NSSI at post-treatment. Conclusion(s): The results of this investigation support the added benefit of
targeting self-criticism in the treatment of NSSI for adolescents. Copyright © 2021 Association for Child and Adolescent Mental Health
Child and Adolescent Mental
Health., :
- Year: 2021
- Problem: Non-suicidal self-harm behaviours, Suicide or self-harm with comorbid mental disorder
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Dialectical behavioural therapy
(DBT), Other Psychological Interventions