Nonsuicidal Self-Injury (NSSI), or the deliberate damage of bodily tissue without suicidal intent, is a prevalent issue in young people. Relative to those who have never self-injured, young people with either recent (i.e., past-year) or distal (i.e., lifetime, but not in the past year) histories of NSSI demonstrate difficulties with emotion regulation, the process of modulating emotional responses. Emotion regulation difficulties are a risk factor for other forms of Self-Damaging Behaviours (SDBs), including binge drinking, substance use, and binge eating, which are more prevalent among individuals with a history of NSSI. Prominent theoretical models of NSSI and other SDBs posit that these behaviours may share a common function of altering negative mood states, explaining their frequent co-occurrence. The present study hypothesized that first-year university students with distal, recent, or no history of NSSI a) would differ in their rates of SDB engagement over seven months, and b) would differ in their strength of association between changes in stress and concurrent SDB engagement. Further, the present study hypothesized that emotional dysregulation would moderate the association between stress and SDB engagement. Multilevel modelling with longitudinal data from two cohorts of first-year undergraduates (N=540) revealed that students with either distal or recent NSSI histories were more likely to engage in substance use than their peers who had never self-injured, but did not report a greater frequency of binge eating or binge drinking. Regardless of NSSI history, substance use was unrelated to within-person changes in stress or emotional dysregulation. Higher-than-usual stress was associated with increased frequency of binge eating and binge drinking, but this association was unrelated to NSSI history or emotional dysregulation. Results suggest that elevated risk for substance use may persist even after NSSI has stopped, while other forms of SDBs (i.e., binge drinking and binge eating) were not predicted by NSSI history. Further, results suggest that some SDBs (i.e., binge drinking and binge eating) are enacted more frequently during periods of stress, but that this pattern is not unique to those with a history of NSSI or those who struggle to regulate their emotions. Consistent with person-centred models of NSSI recovery, these results suggest that vulnerability to some SDBs may persist even after NSSI has stopped. Future research should further examine the mechanisms underlying the complex association between NSSI and SDBs. / Graduate

The participant was a 52 year-old woman, diagnosed with a profound intellectual disability, who engaged in high rates of severe self-injurious behaviors (SIB) predominantly in the forms of head banging and head hitting. A series of analyses and interventions was implemented to establish appropriate toileting behavior in the natural environment. Treatment consisted of conjugate reinforcement for optimal toilet positioning with the absence of SIB, episodic positive reinforcement of eliminating in the toilet, and programed generalization across environments and staff. Results showed the maintenance of optimal toilet positioning, decrease in SIB (under 1 instance per min), and appropriate eliminating in 96.3% of all available sessions. Direct support staff were trained to implement the program with 100% fidelity.

The present study examined presence of sexual assault history and perfectionism (viz., positive strivings & evaluative concerns) as predictors of self-destructive behaviors (viz., NSSI & suicidal behaviors) in a sample of 287 women college students. Results obtained from conducting a series of hierarchical regression analyses indicated several notable patterns. Sexual assault history was a consistent predictor of both NSSI and suicidal behaviors. Moreover, the inclusion of perfectionism was also found to consistently predict additional unique variance in NSSI and suicidal behaviors, even after accounting for sexual assault history. These patterns remained largely unchanged even after accounting for shared variance between NSSI and suicidal behaviors. Within the perfectionism set, evaluative concerns emerged as the most consistent unique predictor of both indices of self-destructive behavior. Finally, we did not find evidence for a significant Positive Strivings × Evaluative Concerns interaction effect in our analyses. Overall, our findings indicate that beyond the presence of sexual assault history, perfectionism remains an important predictor of self-destructive behaviors in women college students.

No description available.

Non-suicidal self-injury (NSSI), defined as the deliberate damaging or destruction of body tissue without intent to die, are common behaviors amongst youth. Although prior work has shown heightened response to negative outcomes and dampened response to positive outcomes across multiple methods, including behavioral and physiological measures, little is known about the neural processes involved in NSSI. This study examined associations between NSSI engagement and responsivity to rewards and losses in youth with and without a lifetime engagement in NSSI. We employed a task-based functional magnetic resonance imaging (fMRI) study to examine differences between regions of interest (ROIs; ventral and dorsal striatum [VS, DS], anterior cingulate cortex [ACC], orbitofrontal cortex [OFC], ventrolateral and ventromedial prefrontal cortex [vlPFC; vmPFC], and insula) and whole-brain connectivity (utilizing bilateral DS, mPFC, and insula seed ROIs) in youth with and without NSSI. We used two reward tasks, in order to examine differences between groups across domains of reward (i.e., monetary and social). Additionally, we examined the specificity of the associations by controlling for dimensional levels of related psychopathology (i.e., aggression and depression). Results from the current study found that NSSI was associated with decreased activation following monetary gains in all ROIs. Further, these differences remained significant when controlling for comorbid psychopathology, including symptoms of aggression and depression. Finally, exploratory connectivity analyses found that NSSI was associated with differential connectivity between regions including the DS, vmPFC, insula, parietal operculum cortex, supramarginal gyrus, cerebellum, and central opercular cortex. Weakened connectivity between these regions could suggest deficits in inhibitory control of emotions in individuals with NSSI, as well as dysfunction in pain processing in individuals with NSSI, whereby these individuals experience pain as more salient or rewarding than individuals without NSSI. Although results did not support our hypotheses, findings suggest disrupted reward processes in youth with NSSI, contributing to our understanding of the role that reward processes may play in NSSI, in the engagement and reinforcement of these behaviors. We also conducted an extensive systematic review of the studies indexing neural structure and function in NSSI, summarizing the literature on the neurobiological correlates of several psychological processes implicated in NSSI engagement, including emotion processes, pain processes, executive processes, social processes, and reward processes. Results of the review highlighted the neural regions most consistently associated with NSSI, including the amygdala, insula, frontal, prefrontal, and orbitofrontal cortices, and the anterior cingulate, dorsal striatum, and ventral striatum. Additionally, data showed that NSSI is associated with greater emotional responses in negative situations, poorer down-regulation of negative emotions, and poorer inhibitory control over impulsive behaviors. Overall, findings suggest that NSSI is associated with maladaptive coping, and that this down-regulation of negative emotion resulting from NSSI may be experienced as rewarding and may serve to reinforce engagement in these behaviors. Finally, this review highlighted the importance of standardizing the methods of indexing neural structure and function in NSSI, specifically in terms of how NSSI is categorized, which comorbid disorders are examined, and how neuroimaging data are collected and analyzed, so that research in this area is comparable and reproducible. / Psychology

Bakgrund: Psykisk ohälsa är ett stort folkhälsoproblem i världen och i Sverige. I många fall är det sjuksköterskor inom akutsjukvården som erbjuder den inledande vården för personer med självskadebeteende. Både sjuksköterskor och patienter upplever att akutsjukvården är bristfällig och att akutsjukvårdsmiljön är dåligt anpassad för patientgruppen. Syfte: Syftet var att beskriva sjuksköterskors erfarenheter av att möta personer med självskadebeteenden inom akutsjukvården. Metod: En litteraturstudie genomfördes med en induktiv ansats. Resultat: Tio vetenskapliga resultatartiklar användes i studien. Tre huvudkategorier identifierades: känslor, brister inom vården, kompetensbrist. Sjuksköterskor som arbetar inom akutsjukvården känner att de inte har tillräcklig utbildning, vana och erfarenhet för att vårda personer med självskadebeteende. Konklusion: Träning, utbildning och praktiska strategier krävs för att personer med självskadebeteende ska bemötas med medkänsla, respekt och värdighet inom vården. / Background: Mental illness is a big public health problem in the world and in Sweden. In many cases it’s the emergency nurses who provides the initial care for persons with self-harm behavior. Both nurses and patients experience deficiency in the emergency care and that the emergency care environment isn’t suited for this type of care. Aim: The aim was to describe nurses´ experiences of encountering persons with self-harming behavior within the emergency care. Method: A literature study was conducted with an inductive approach. Result: Ten scientific result articles were used in the study. Three main categories were identified: emotions, deficiency in healthcare, lack of competence. Nurses who are working in the emergency care feels that they don’t have enough education, practice and experience to be able to provide the best care for persons with self-harm behavior. Conclusion: Training, education and practical strategies are required for persons with self-harming behavior to be treated with compassion, respect and dignity.

No description available.

Nonsuicidal self-injury (NSSI; i.e., the deliberate destruction of one’s own bodily tissue without suicidal intent and for reasons not socially sanctioned) is prevalent and associated with clinically serious consequences. There is a need for evidence-based, stand-alone treatments for this behavior as it presents across the full range of psychiatric disorders. Developing time-efficient and cost-effective interventions for NSSI has proven difficult given that the core components of treatment remain largely unknown. The aim of this study was to examine the specific effects on NSSI of mindful emotion awareness training and cognitive reappraisal, two transdiagnostic treatment strategies that directly address the functional processes that often maintain self-injury (i.e., relief or escape from aversive thoughts or feelings). Using a counterbalanced, combined series (multiple baseline and phase change) single-case experimental design, the unique and combined impact of these two four-week interventions was evaluated among diagnostically heterogeneous, self-injuring adults (N = 10; mean age = 21.3, range = 18 to 30 years). Hypotheses were that each intervention would produce clinically meaningful reductions in NSSI; adding the alternative intervention would have additive benefit for those who did not respond to the initial intervention alone; and reductions in NSSI would be maintained over a four-week follow-up phase. Results showed that 8 of 10 participants demonstrated clinically meaningful reductions in NSSI by the follow-up phase; six participants responded to one intervention alone, whereas adding the alternative intervention was associated with additive benefit for two participants. Group-based analyses indicated a statistically significant effect of study phase on NSSI (p < .001), with fewer NSSI urges and acts occurring after the interventions were introduced. The interventions were also associated with moderate to large reductions in anxiety (d = 0.89 – 1.09), depression (d = 0.79 – 1.09), and interference caused by symptoms (d = 0.61), and with improvements in skills-based mechanisms: mindful emotion awareness (d = 1.44) and reappraisal (d = 1.30). The results suggest that increasing mindful emotion awareness and cognitive reappraisal may be two key therapeutic strategies for reducing NSSI. Transdiagnostic, emotion-focused interventions delivered in time-limited formats can serve as practical yet powerful treatment approaches, especially for lower-risk self-injuring individuals.

No description available.

No description available.