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Background The purpose of this study is to examine the prevalence and correlates of non-suicidal self-injury (NSSI) among children and adolescents diagnosed with bipolar disorder (BP). Methods Four hundred-thirty two youth with a diagnosis of BP and their parents, including 193 children and 239 adolescents, completed a diagnostic interview and instruments to assess youth clinical and illness history, youth comorbidity, parental mood disorder, and psychosocial functioning. Results Approximately 22% of children and 22% of adolescents reported NSSI during the course of their most recent mood episode. In a multivariate model controlling for global impairment, among children, a BPI or BPII diagnosis (versus BPNOS), psychosis, separation anxiety disorder, and greater severity of depressive symptoms were found to be associated with NSSI. Among adolescents, a mixed episode, a suicide attempt, greater severity of depressive symptoms, and poor psychosocial functioning were found to be associated with NSSI. Neither the presence of a youth comorbid disruptive behavior disorder nor a parental mood disorder was associated with NSSI. Limitations The primary limitations of this study include the use of a cross-sectional study design, lack of a control group, and limited generalizability of study results to non-clinical and ethnically diverse samples. Conclusions NSSI is not uncommon among youth with BP, particularly those who present with BPI or BPII, psychosis, a mixed episode, suicidal behavior, severe depressive symptoms, separation anxiety, and/or poor psychosocial functioning. However, the relative importance of these factors in relation to NSSI may vary with age. Treatments for BP that are developmentally sensitive, examine the function of NSSI for each youth, and teach adaptive skills to address emotional and social needs, may prove to be most successful.

Hopelessness is a known risk factor for a number of negative outcomes including suicide attempts and deaths. However, little is known about how hopelessness may develop. The goal of this study was to examine the impact of verbal victimization on changes in children’s levels of hopelessness. Participants were four hundred forty-eight 4th and 5th grade children who were assessed twice, six months apart. As hypothesized, reports of verbal victimization occurring during the follow-up period predicted residual change in children’s levels of hopelessness. This relation was maintained even after statistically controlling for children’s depressive symptoms. Together, these findings suggest that verbal victimization is associated with a greater risk for developing hopelessness in elementary school children, an effect that appears at least partially independent of concurrent depressive symptoms.

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