Self-injury is a common phenomenon among adolescents and young adults, however its prevalence in clinical population is estimated at 40-80%, especially in regard to patients during puberty. Symptoms usually appear between 12th and 14th year of age, and their average duration is approx. 2 years. According to accepted sociocultural norms self-injury can be regarded as a normal behavior. Nevertheless, the prevalence of body art phenomenon in Western culture including professional tattooing, piercing, scarification, burning tattoos and other body modification typical for tribal cultures, has forced the need to redefine the boundaries for normative behavior. Introduction of a separate nosological unit of Non-Suicidal Self Injury in the fifth edition of DSM classification proves the validity of discussion, being hold for many years, regarding classification and understanding of the underlying mechanisms of self-harm. The aim of our study was to present the current state of knowledge regarding self-harm, with an emphasis on issues devoted to their placement in newest mental disorders classifications and mechanisms responsible for their development and maintenance. Databases such as: PubMed, EBSCO (medical and psychological resources) and WEB OF SCIENCE (years 1990-2016) have been screened for the following key words: self-injury, self-harm, self-mutilation, suicide, deliberate self-harm, affect regulation, NSSI, DSH, personality disorders, suicide attempt, neurobiology self-harm, DSM-5, adolescent, adults, stress coping styles, self-mutilation - children, adolescents and adults-prevalence. The analysis indicated 110 articles and 3 textbooks. We have used the following criteria: (1) for the articles presenting the latest research on risk factors for self-harm we have used the criterion of the study group number (>30 people) and meta-analyses have been included, (2) for theories explaining the mechanisms of self-harm criterion of empirical review of the assumptions and the number of the published studies that verify the theory has been applied.
Until the end of the nineties last century personality disorders could not be diagnosed before the age of eighteen. Nevertheless, the results of studies published in the last decade have revealed that personality disorders can be observed in children and adolescents and that personality disorders diagnosed in adult patients had been present as early as in childhood. The knowledge of possible mechanisms shaping personality disorders in childhood is unsatisfactory and needs to be expanded. Developmental psychology explains the development of abnormal personality through inappropriate attachment patterns and abnormal transitions between developmental phases. Genetic and temperamental factors are also important in the aetiology of personality disorders as well as early maladaptive schemas resulting from personal experiences and interactions with others. The aim of this article is to review the current knowledge on the mechanisms shaping the development of personality and personality disorders in childhood and adolescence.
Adult personality disorders are well recognized and described in the literature. The discussion about the possibility of the presence of personality disorders in adolescents started about 20 years ago. Some authors claim the before the age of 18 it is only possible to identify precursors of future personality disorders and such a standpoint is reflected in diagnostic criteria. This is based on the assumption that personality in adolescence is still not well established. Consequently, the criterion on the persistence of symptoms for the period of time cannot be met (the persistence of symptoms of personality disorders for the period of at least two years). Other approach postulates that problems presented in adolescence should not be exclusively limited to Axis I according to DSM. The proponents of this approach claim that current diagnostic tools are not adjusted to adolescents, thus it is very difficult to measure stability and persistence of symptoms in this age group. This paper presents literature review on personality disorders in adolescence.
Cel pracyCel: ocena trafności kryterialnej oraz stabilności w czasie diagnozy zaburzeń osobowości u młodzieży oraz związków między stylem przywiązania a rozpoznaniem zaburzeń osobowości.MetodaMateriał i metoda: 50 nastolatków (46 dziewcząt oraz 4 chłopców) w wieku 15-17 lat, hospitalizowanych w oddziale psychiatrii dzieci i młodzieży, przebadano przy pomocy ustrukturyzowanego wywiadu SCID-II i Inwentarza Przywiązania do Rodziców i Rówieśników (IPPA). Powtórną ocenę wywiadem SCID-II przeprowadzono po upływie roku w grupie osób spełniających kryteria diagnostyczne dla zaburzeń osobowości w pomiarze 1WynikiWyniki: w pomiarze 1 kryteria diagnostyczne dla różnych rodzajów zaburzeń osobowości potwierdzono u 41 (82%) adolescentów (średnia liczba kryteriów =5.9). Najczęściej potwierdzano kryteria dla zaburzeń osobowości typu borderline (n=26; średnia liczba kryteriów =7.9). W pomiarze 2 przebadano 21 osób (51%), średnia ilość potwierdzonych kryteriów wyniosła =6.6. Wykazano istotny statystycznie związek pomiędzy ilością kryteriów diagnostycznych dla zaburzeń osobowości w pomiarze 1 i ilością kryteriów w pomiarze 2 (r=0.58, p<0.010). U 82% badanych nastolatków z zaburzeniami osobowości stwierdzono pozabezpieczny styl przywiązania z matką, przy czym w grupie spełniającej kryteria dla zaburzeń osobowości typu borderline dominował lękowo-unikający styl przywiązania (83%).WnioskiWnioski: Cechy zaburzeń osobowości w wieku nastoletnim, szczególnie typu borderline, są trwałe na przestrzeni roku..
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