Disorders - Non-suicidal self-harm behaviours
Dobias, M. L., Schleider, J. L., Jans, L., Fox, K. R.
Background:
Across 50 years of research, existing interventions for self-injurious thoughts and behaviors (SITBs) in adolescents have remained largely
ineffective and inaccessible. Single-session interventions, interventions designed to last one session, may be a low-cost and timely resource for
adolescents engaging in SITBs who may not otherwise receive treatment. Method(s): 565 adolescents (Mage = 14.95 years) endorsing recent
engagement in non-suicidal self-injury (NSSI) were randomized to receive a 30-min, web-based, single-session intervention-\"Project SAVE\"-or an
active, attention-matched control program. Proximal outcomes were measured at baseline and immediately post-intervention. Long-term outcomes were
measured at baseline and 3-month follow-up. Result(s): Adolescents rated Project SAVE as acceptable; 80% of participants randomized to SAVE completed
the intervention. Between-group effects were non-significant for pre-registered outcomes: post-intervention likelihood of future NSSI; 3-month
frequencies of NSSI and suicidal ideation at follow-up. Relative to control-group participants, SAVE participants reported short-term improvements in
two exploratory outcomes: self-hatred (d = -.35, p<.001) and desire to stop future NSSI (d =.25, p =.003). Conclusion(s): Project SAVE is an
acceptable resource for adolescents engaging in SITBs-with short-term effects on clinically-relevant outcomes. Future research may evaluate SAVE as
an easy-to-access, short-term coping resource for youth engaging in SITBs. Clinical Trials.gov identifier: NCT04498143. Copyright © 2021 Elsevier
Ltd
Behaviour Research and Therapy, 147 (no
pagination) :
- Year: 2021
- Problem: Non-suicidal self-harm behaviours
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Supportive
therapy, Other Psychological Interventions, Technology, interventions delivered using technology (e.g. online, SMS)
Boege, I.
Non-suicidal-self-injury (NSSI) in adolescents needing inpatient
treatment is a serious health risk behaviour. NSSI-specific treatment programs for inpatients hardly exist. \"Cut the Cut\" (CTC) is a new treatment
program in intervals, addressing this problem. Aim of this pilot-study was to evaluate acceptability and feasibility of CTC. 23 female inpatients (12
CTC, 11 control, aged 15-17; mean=16.80, SD.70) engaging in NSSI were evaluated for service user satisfaction, frequency, and severity of NSSI at T1
(admission), T2 (discharge after interval 1, CTC-group) and T3 (discharge). A qualitative interview was performed at T3. Significant improvement in
NSSI-frequency was given (T1-T3: CTC p=0.010; control p=0.038). Severity of NSSI reduced slightly (mild NSSI: CTC p=0.022, control p=0.087; severe
NSSI: CTC p=0.111, control p=0.066). Satisfaction of parents (T3 mean 28.38) and adolescents (T3 mean 26.11) in CTC was rated high. CTC is a feasible
treatment option for inpatients engaging in NSSI. Further studies over time are needed.Trial registration Number DRKS00016762, 05.03.2019,
retrospectively registered.
Child psychiatry and human
development., 03 :
- Year: 2021
- Problem: Non-suicidal self-harm behaviours
- Type: Controlled clinical trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Psychological Interventions
(any), Other Psychological Interventions, Other complementary & alternative
interventions
Fox, K. R.
Self-injurious thoughts and behaviors (SITBs) are major public health concerns impacting a wide range of individuals and communities.
Despite major efforts to develop and refine treatments to reduce SITBs, the efficacy of SITB interventions remains unclear. To provide a
comprehensive summary of SITB treatment efficacy, we conducted a meta-analysis of published randomized controlled trials (RCTs) that have attempted
to reduce SITBs. A total of 591 published articles from 1,125 unique RCTs with 3,458 effect sizes from the past 50 years were included. The random-
effects meta-analysis yielded surprising findings: The overall intervention effects were small across all SITB outcomes; despite a near-exponential
increase in the number of RCTs across five decades, intervention efficacy has not improved; all SITB interventions produced similarly small effects,
and no intervention appeared significantly and consistently stronger than others; the overall small intervention effects were largely maintained at
follow-up assessments; efficacy was similar across age groups, though effects were slightly weaker for child/adolescent populations and few studies
focused on older adults; and major sample and study characteristics (e.g., control group type, treatment target, sample size, intervention length)
did not consistently moderate treatment efficacy. This meta-analysis suggests that fundamental changes are needed to facilitate progress in SITB
intervention efficacy. In particular, powerful interventions target the necessary causes of pathology, but little is known about SITB causes (vs.
SITB correlates and risk factors). The field would accordingly benefit from the prioritization of research that aims to identify and target common
necessary causes of SITBs. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
Psychological bulletin, 146(12) : 1117-1145
- Year: 2020
- 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)
Baetens, Imke, Decruy, Christine, Vatandoost, Shokoufeh, Vanderhaegen, Birgit, Kiekens, Glenn
Non-suicidal self-injury (NSSI) is prevalent in adolescence and is associated with increased risk for a variety
of subsequent negative mental health outcomes, necessitating an evidence-based preventive approach. This pilot study examines the potential
iatrogenic effects and feasibility of an evidence-based school program for the prevention of NSSI. Differences are examined between a general in-
classroom prevention program (Happyles) and this program combined with a 1-h in-classroom psychoeducation module on NSSI (HappylesPLUS) in terms of
primary (e.g., delay in NSSI onset and decrease in NSSI frequency, urges, probability of future engagement) and secondary outcomes (e.g.,
psychological distress, emotion regulation, help-seeking, and stigma) using a mixed-method design. A total of 651 secundary school pupils (Mage =
12.85 years; 49.8% female versus 50.2% male) were assigned to the Happyles program and HappylesPLUS. Participants filled out validated self-report
questionnaires pre (T0) and post (T1, 6 weeks after T0) the school prevention program, including the Youth Outcome Questionnaire (YOQ), the Brief
Non-Suicidal Self-Injury Assessment Test (BNSSI-AT), the Difficulties in Emotion Regulation Scale (DERS), the Attitudes Toward Seeking Professional
Psychological Help Scale-Short Form (ATSPPH-SF), and the Peer Mental Health Stigmatization Scale (PMHSS). Qualitative semi-structured interviews (at
T2,6 weeks after T1) were conducted with participants with and without a history of NSSI. Overall, results show no iatrogenic effects of the NSSI-
focused psychoeducation module. In terms of our primary outcome, both groups reported a reduced likelihood of future NSSI engagement from T0 to T1.
Regarding secondary outcome measures, we also observed increased emotional awareness in both groups. The qualitative data suggest that the addition
of the NSSI-specific module to the Happyles program may have direct benefits to some students with lived experience, such as increased help-seeking
behavior for NSSI. Findings of this pilot study show that incorporating NSSI-specific modules into evidence-based school prevention programs is
feasible and does not lead to iatrogenic effects. Future work is needed to evaluate the potential (longer-term) benefits of incorporating NSSI-
focused modules to evidence-based mental health programs in the prevention of NSSI. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
Frontiers in Psychiatry Vol 11 2020, ArtID
437, 11 :
- Year: 2020
- Problem: Non-suicidal self-harm behaviours
- Type: Randomised controlled trials
-
Stage: Universal prevention
-
Treatment and intervention: Psychological Interventions
(any), Psychoeducation
Argento, A.
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.
HIGHLIGHTS The 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, : 1-15
- Year: 2020
- Problem: Non-suicidal self-harm behaviours
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Psychological Interventions
(any), Other Psychological Interventions, Mindfulness based
therapy
Kennedy, G. A., Jean-Forney, K., Pinner, D., Martinez, K. M., Buchman-Schmitt, J. M., Keel, P. K.
Objective: Research suggests that weight suppression (WS) is linked to non-suicidal self-injury (NSSI) and that drive for thinness and
depression may explain this association. We conducted a proof-of-concept study using a randomized control trial design to determine if improving body
esteem and reducing depressive symptoms reduced NSSI in individuals with WS. Method(s): Weight suppressed participants (N = 60) who engaged in NSSI
were recruited from the community and randomly assigned to an on-line intervention or control condition. The on-line intervention was adapted from a
cognitive-dissonance intervention originally designed to reduce thin-ideal internalization in females to an intervention to reduce internalization of
unhealthy body ideals in both genders. Participants' weight/shape concerns, depressive symptoms, and NSSI were assessed at pre- and post-
intervention, or at baseline and 2-week follow-up for controls. Result(s): Compared to controls, participants in the treatment condition reported
greater decreases in likelihood of future NSSI [Cohen's d (95% CI) = -0.38 (-0.90-0.15)], weight/shape concerns [-1.19 (-1.75 to -0.62)], depressive
symptoms [-1.00 (-1.56 to -0.45)], and significant improvements in appearance [1.27 (0.70-1.84)] and weight esteem [1.38 (0.80-1.96)]. Discussion(s):
Future work could test this intervention in a larger trial with an active alternative treatment condition. Copyright © 2019 Wiley Periodicals,
Inc.
International Journal of Eating
Disorders, 52(2) : 206-210
- Year: 2019
- Problem: Depressive Disorders, Non-suicidal self-harm behaviours
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder), At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive dissonance
therapy, Technology, interventions delivered using technology (e.g. online, SMS)
Maugeri, A., Fava, G., Fioriello, F., Perrotti, G., Pacifici, S., Terrinoni, A.
SCOPO DEL LAVORO: Non-suicidal self-injury (NSSI) is a clinical condition defined as the
intentional, self-inflicted damage to the surface of the body without suicidal intent, which is not socially sanctioned (Nock, 2009; Favazza). This
disorder involves about 12-35% of the adolescent community. Several findings show that the psychopathological dimension more related to NSSI concerns
personality functioning. Regarding therapeutic approach, studies about the effectiveness of psychotherapeutic treatment are reported in literature;
on the other hand poor evidence about psychopharmacological treatment is available, although some psychiatric drugs, frequently prescribed as off-
label, are currently used in clinical practice. The goal of our study is to assess the outcome of self-harming adolescents treated with atypical
antipsychotic drug (aripiprazole or quetiapine), or in add-on with mood stabilizer (lithium), and to identify possible different degrees of
effectiveness between drugs. MATERIALI E METODI: 43 adolescent patients between 13 and 18 years have been enrolled in the study. They were assessed
for NSSI disorder as they were treated with off-label psychiatric drugs. Patients with Intellectual disability, Autism spectrum disorders or
Psychotic disorders have been excluded from the sample. In order to investigate the NSSI, the partecipants were administered the study measures
including the Repetitive Non Suicidal Self Injury Questionary (R-NSSIQ) to evaluate the repetitiveness of self-injuring acts, and Deliberate Self-
Harm Inventory (DSHI) to assess their severity according to the scoring in the Clinician-Rated Severity of Non Suicidal Self-Injury. Afterwards, all
patients enrolled have been treated pharmacologically with one atypical antipsychotic drug (aripiprazole or quetiapine), or in add-on with lithium.
At the 6-month follow-up all patients were administered a DSHI re-test to assess possible changes in the severity degree of their self-injuring
behavior. RISULTATI: Patients in the sample received a diagnosis of Unipolar or Bipolar mood disorder, Post-traumatic stress disorder and Borderline
personality features. At the first assessment, most of the sample examined showed a severe degree of self-injuring behavior (level 4 according to
CRS). Patients who had a lower level of severity of self-injurious conduct, treated with antipsychotic monotherapy, showed a better response to
pharmacological treatment, resulting in a reduction of the CRS severity level. Patients with a severe initial clinical condition (CRS level 4), who
required surgical treatment or used more than one self-injuring method, treated with pharmacological polytherapy, showed a worse outcome.
CONCLUSIONI: No significant differences were found between Aripiprazole and Quetiapine. The association lithium + antipsychotic led to a switch to a
lower CRS level in the 75% of patients. This result is suggestive of a variability of severity of NSSI, depending on emotional lability. According to
these results, additional studies are needed to improve current knowledge about the pharmacological treatment of NSSI and to develop an evidence-
based treatment protocol for these patients.
Journal of Psychopathology, 25 (Supplement 2) : 65-66
- Year: 2019
- Problem: Non-suicidal self-harm behaviours
- Type: Controlled clinical trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Atypical Antipsychotics (second
generation), Lithium
Glenn, C. R., Esposito, E. C., Porter, A. C., Robinson, D. J.
The current review
provides an evidence base update of psychosocial treatments for self-injurious thoughts and behaviors (SITBs) in youth. A systematic search was
conducted of 2 major scientific databases (PsycInfo and PubMed) and ClinicalTrials.gov for relevant randomized controlled trials (RCTs) published
prior to June 2018. The search identified 26 RCTs examining interventions for SITBs in youth: 17 were included in the 2015 review and 9 trials were
new to this update. The biggest change since the prior review was the evaluation of Dialectical Behavior Therapy for adolescents (DBT-A) as the first
Level 1: Well-established intervention for reducing deliberate self-harm (composite of nonsuicidal and suicidal self-injury) and suicide ideation in
youth and Level 2: Probably efficacious for reducing nonsuicidal self-injury and suicide attempts. Five other interventions were rated as Level 2:
Probably efficacious for reducing SITBs in youth, with the new addition of Integrated Family Therapy. This evidence base update indicates that there
are a few promising treatments for reducing SITBs in youth. Efficacious interventions typically include a significant family or parent training
component as well as skills training (e.g., emotion regulation skills). Aside from DBT-A, few treatments have been examined in more than one RCT.
Given that replication by independent research groups is needed to evaluate an intervention as Well-established, future research should focus on
replicating the five promising interventions currently evaluated as Probably efficacious. In addition, an important future direction is to develop
brief efficacious interventions that may be scalable to reach large numbers of youth. (PsycINFO Database Record (c) 2019 APA, all rights
reserved)
Journal of Clinical Child and Adolescent Psychology, 48(3) : 357-
392
- Year: 2019
- Problem: Non-suicidal self-harm behaviours, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other service delivery and improvement
interventions
Kennedy, G. A., Jean-Forney, K., Pinner, D., Martinez, K. M., Buchman-Schmitt, J. M., Keel, P.
K.
Objective: Research suggests that weight suppression (WS) is linked to non-suicidal self-injury (NSSI) and that drive for thinness and
depression may explain this association. We conducted a proof-of-concept study using a randomized control trial design to determine if improving body
esteem and reducing depressive symptoms reduced NSSI in individuals with WS. Method(s): Weight suppressed participants (N = 60) who engaged in NSSI
were recruited from the community and randomly assigned to an on-line intervention or control condition. The on-line intervention was adapted from a
cognitive-dissonance intervention originally designed to reduce thin-ideal internalization in females to an intervention to reduce internalization of
unhealthy body ideals in both genders. Participants' weight/shape concerns, depressive symptoms, and NSSI were assessed at pre- and post-
intervention, or at baseline and 2-week follow-up for controls. Result(s): Compared to controls, participants in the treatment condition reported
greater decreases in likelihood of future NSSI [Cohen's d (95% CI) = -0.38 (-0.90-0.15)], weight/shape concerns [-1.19 (-1.75 to -0.62)], depressive
symptoms [-1.00 (-1.56 to -0.45)], and significant improvements in appearance [1.27 (0.70-1.84)] and weight esteem [1.38 (0.80-1.96)]. Discussion(s):
Future work could test this intervention in a larger trial with an active alternative treatment condition. Copyright © 2019 Wiley Periodicals,
Inc.
International Journal of Eating
Disorders, 52(2) : 206-210
- Year: 2019
- Problem: Depressive Disorders, Non-suicidal self-harm behaviours
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder), At risk (indicated or selected prevention)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Cognitive dissonance
therapy, Technology, interventions delivered using technology (e.g. online, SMS)
Maugeri, A., Fava, G., Fioriello, F., Perrotti, G., Pacifici, S., Terrinoni, A.
SCOPO DEL LAVORO: Non-suicidal self-injury (NSSI) is a clinical condition defined as the
intentional, self-inflicted damage to the surface of the body without suicidal intent, which is not socially sanctioned (Nock, 2009; Favazza). This
disorder involves about 12-35% of the adolescent community. Several findings show that the psychopathological dimension more related to NSSI concerns
personality functioning. Regarding therapeutic approach, studies about the effectiveness of psychotherapeutic treatment are reported in literature;
on the other hand poor evidence about psychopharmacological treatment is available, although some psychiatric drugs, frequently prescribed as off-
label, are currently used in clinical practice. The goal of our study is to assess the outcome of self-harming adolescents treated with atypical
antipsychotic drug (aripiprazole or quetiapine), or in add-on with mood stabilizer (lithium), and to identify possible different degrees of
effectiveness between drugs. MATERIALI E METODI: 43 adolescent patients between 13 and 18 years have been enrolled in the study. They were assessed
for NSSI disorder as they were treated with off-label psychiatric drugs. Patients with Intellectual disability, Autism spectrum disorders or
Psychotic disorders have been excluded from the sample. In order to investigate the NSSI, the partecipants were administered the study measures
including the Repetitive Non Suicidal Self Injury Questionary (R-NSSIQ) to evaluate the repetitiveness of self-injuring acts, and Deliberate Self-
Harm Inventory (DSHI) to assess their severity according to the scoring in the Clinician-Rated Severity of Non Suicidal Self-Injury. Afterwards, all
patients enrolled have been treated pharmacologically with one atypical antipsychotic drug (aripiprazole or quetiapine), or in add-on with lithium.
At the 6-month follow-up all patients were administered a DSHI re-test to assess possible changes in the severity degree of their self-injuring
behavior. RISULTATI: Patients in the sample received a diagnosis of Unipolar or Bipolar mood disorder, Post-traumatic stress disorder and Borderline
personality features. At the first assessment, most of the sample examined showed a severe degree of self-injuring behavior (level 4 according to
CRS). Patients who had a lower level of severity of self-injurious conduct, treated with antipsychotic monotherapy, showed a better response to
pharmacological treatment, resulting in a reduction of the CRS severity level. Patients with a severe initial clinical condition (CRS level 4), who
required surgical treatment or used more than one self-injuring method, treated with pharmacological polytherapy, showed a worse outcome.
CONCLUSIONI: No significant differences were found between Aripiprazole and Quetiapine. The association lithium + antipsychotic led to a switch to a
lower CRS level in the 75% of patients. This result is suggestive of a variability of severity of NSSI, depending on emotional lability. According to
these results, additional studies are needed to improve current knowledge about the pharmacological treatment of NSSI and to develop an evidence-
based treatment protocol for these patients.
Journal of Psychopathology, 25 (Supplement 2) : 65-66
- Year: 2019
- Problem: Non-suicidal self-harm behaviours
- Type: Controlled clinical trials
-
Stage: Disorder established (diagnosed disorder)
-
Treatment and intervention: Biological Interventions
(any), Atypical Antipsychotics (second
generation), Lithium
Glenn, C. R., Esposito, E. C., Porter, A. C., Robinson, D.
J.
The current review
provides an evidence base update of psychosocial treatments for self-injurious thoughts and behaviors (SITBs) in youth. A systematic search was
conducted of 2 major scientific databases (PsycInfo and PubMed) and ClinicalTrials.gov for relevant randomized controlled trials (RCTs) published
prior to June 2018. The search identified 26 RCTs examining interventions for SITBs in youth: 17 were included in the 2015 review and 9 trials were
new to this update. The biggest change since the prior review was the evaluation of Dialectical Behavior Therapy for adolescents (DBT-A) as the first
Level 1: Well-established intervention for reducing deliberate self-harm (composite of nonsuicidal and suicidal self-injury) and suicide ideation in
youth and Level 2: Probably efficacious for reducing nonsuicidal self-injury and suicide attempts. Five other interventions were rated as Level 2:
Probably efficacious for reducing SITBs in youth, with the new addition of Integrated Family Therapy. This evidence base update indicates that there
are a few promising treatments for reducing SITBs in youth. Efficacious interventions typically include a significant family or parent training
component as well as skills training (e.g., emotion regulation skills). Aside from DBT-A, few treatments have been examined in more than one RCT.
Given that replication by independent research groups is needed to evaluate an intervention as Well-established, future research should focus on
replicating the five promising interventions currently evaluated as Probably efficacious. In addition, an important future direction is to develop
brief efficacious interventions that may be scalable to reach large numbers of youth. (PsycINFO Database Record (c) 2019 APA, all rights
reserved)
Journal of Clinical Child and Adolescent Psychology, 48(3) : 357-
392
- Year: 2019
- Problem: Non-suicidal self-harm behaviours, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Systematic reviews
-
Stage: At risk (indicated or selected prevention), Disorder established (diagnosed disorder)
-
Treatment and intervention: Service Delivery & Improvement, Psychological Interventions
(any), Other service delivery and improvement
interventions
Hooley, J.
M., Fox, K. R., Wang, S. B., Kwashie, A. N. D.
Background: Nonsuicidal self-injury (NSSI), which involves self-damaging
behavior (e.g., cutting) causes tissue damage and places people at elevated risk for future suicidal behaviors. Yet few specific treatments for NSSI
currently exist. Extreme self-criticism is implicated in the development and maintenance of NSSI. We conducted a randomized controlled trial to
evaluate Autobiographical Self-Enhancement Training (ASET), a novel, cognitive intervention for NSSI focused on reducing self-criticism and enhancing
positive self-worth. We also examined whether Expressive Writing (EW) was a helpful treatment for NSSI. Method(s): Participants (N = 144) who had
engaged in NSSI at least twice in the past month were recruited online and then randomly assigned via Qualtrics to receive the ASET intervention (N =
49), the EW intervention (N = 49), or Daily Journaling [JNL; N = 46]), an active comparison condition. Treatments were designed as month-long daily
diaries. Participants in ASET wrote about something that made them feel good about themselves that day, participants in EW described something that
had been on their mind that day, and participants in JNL reported on the events of the day in a factually descriptive manner without emotional
content. Result(s): Intent-to-treat analyses revealed that, regardless of treatment group, participants showed significant reductions in self-
criticism, NSSI episodes, depression, and suicide ideation from baseline to the end of active treatment. Relative to the JNL group, the ASET group
reported significantly less self-criticism at post-treatment; this was not maintained at follow-up. There was also a trend toward ASET being
associated with less suicide ideation at the end of treatment compared to EW. This difference was significant at the 3-month follow-up. Unexpectedly,
the JNL group reported significantly less suicide ideation than the EW group at post-treatment; this was maintained at 3-month follow-up. No
significant treatment effects were detected for suicide plans, suicidal behaviors, desire to discontinue NSSI, or likelihood of future NSSI.
Conclusion(s): Self-criticism is an important treatment target in NSSI, but changing self-criticism in people with an established history of NSSI
presents challenges. Nonetheless, all approaches provided benefits. This study also established the feasibility of inexpensive and easily
disseminated treatments for NSSI. Copyright © 2018 The Author(s).
BMC Psychiatry, 18 (1) (no
pagination)(264) :
- Year: 2018
- Problem: Non-suicidal self-harm behaviours, Suicide or self-harm behaviours (excluding non-suicidal self-harm)
- Type: Randomised controlled trials
-
Stage: Disorder established (diagnosed disorder), At risk (indicated or selected prevention)
-
Treatment and intervention: Complementary & Alternative
Interventions (CAM), Service Delivery & Improvement, Creative expression: music, dance, drama, art, Technology, interventions delivered using technology (e.g. online, SMS)