Hypothalamic-pituitary-adrenal axis dysregulation in depressed adolescents with non-suicidal self-injury

Klimes‐Dougan, Bonnie; Begnel, Erin; Almy, Brandon; Thai, Michelle; Schreiner, Melinda Westlund; Cullen, Kathryn R.

doi:10.1016/j.psyneuen.2018.11.004

Cited by 61 publications

(56 citation statements)

References 41 publications

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“…One of the outcomes of chronic stress exposure is a reduced capability of the HPA axis to respond to acute stressors (Herman et al, 2016), thus providing an explanation for the blunted plasma cortisol concentrations to the acute stress of blood sampling in our monkeys with SIB. These findings of a blunted stress response to an acute stressor are also congruent with an emerging literature in humans with NSSI (Kaess et al, 2012; Klimes‐Dougan et al, 2019).…”

Section: Comprehensive Plansupporting

confidence: 87%

Self‐Injurious behavior in rhesus macaques: Issues and challenges

Novak

2020

American J Primatol

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Some monkeys housed in research facilities develop abnormal behavior ranging from stereotypic to the more serious condition of self-injurious behavior (SIB).We initially sought to understand how and why monkeys engaged in SIB and more importantly why only a small percentage of laboratory monkeys, with seemingly similar housing and background, developed this disorder. Of particular importance was the recognition that different pathways might lead to SIB and that strong individual differences would affect the manifestation of this disorder and the response to treatment. We developed a comprehensive plan to identify effective treatment and prevention strategies. We started with characterizing the disorder in terms of prevalence and types of environments in which it was found. We then conducted observations on a cohort of SIB and control monkeys to identify conditions associated with SIB (e.g., disordered sleep) as well as clinical disease states and congenital defects that could be precipitating factors.We examined the environmental events that triggered episodes of SIB in monkeys with the disorder and evaluated three models that might explain the reinforcement contingencies associated with SIB, including tension reduction, self-stimulation, and social communication. Possible treatments for SIB such as environmental enrichment, social housing, and pharmacotherapy were tested by our group and others. To date, no single treatment has been found to abolish SIB, and each of these treatments is impacted by individual differences. To develop possible prevention strategies, we examined colony management and health records to find risk factors for SIB. These risk factors generalized to other facilities, and considerable effort was expended by all behavioral managers at these facilities to reduce early life stress exposure, to minimize the length of individual cage housing by emphasizing pair housing, and to reduce the possible stressfulness of various veterinary/medical procedures by implementing positive reinforcement training.

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Section: Comprehensive Plansupporting

confidence: 87%

Self‐Injurious behavior in rhesus macaques: Issues and challenges

Novak

2020

American J Primatol

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“…Another recent study also demonstrated reduced amygdala-medial prefrontal cortex (mPFC) resting-state functional connectivity (RSFC) in adolescents with NSSI (Santamarina-Perez et al, 2019). Neuroendocrine studies have previously reported a blunted pattern of cortisol response to experimental stressors in adolescents with NSSI (Kaess et al, 2012;Plener et al, 2017), a finding that was also noted in a considerably larger sample of adolescents diagnosed with major depressive disorder comparing those engaging or not engaging in NSSI (Klimes-Dougan et al, 2019). Furthermore, these studies have yielded some suggestions of divergence in systems among adolescents with NSSI, manifesting as physiological blunting despite self-reported high levels of stress.…”

Section: Introductionmentioning

confidence: 77%

Multimodal assessment of sustained threat in adolescents with nonsuicidal self-injury

et al. 2021

Self Cite

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Nonsuicidal self-injury (NSSI) is a common but poorly understood phenomenon in adolescents. This study examined the Sustained Threat domain in female adolescents with a continuum of NSSI severity (N = 142). Across NSSI lifetime frequency and NSSI severity groups (No + Mild NSSI, Moderate NSSI, Severe NSSI), we examined physiological, self-reported and observed stress during the Trier Social Stress Test; amygdala volume; amygdala responses to threat stimuli; and resting-state functional connectivity (RSFC) between amygdala and medial prefrontal cortex (mPFC). Severe NSSI showed a blunted pattern of cortisol response, despite elevated reported and observed stress during TSST. Severe NSSI showed lower amygdala–mPFC RSFC; follow-up analyses suggested that this was more pronounced in those with a history of suicide attempt for both moderate and severe NSSI. Moderate NSSI showed elevated right amygdala activation to threat; multiple regressions showed that, when considered together with low amygdala–mPFC RSFC, higher right but lower left amygdala activation predicted NSSI severity. Patterns of interrelationships among Sustained Threat measures varied substantially across NSSI severity groups, and further by suicide attempt history. Study limitations include the cross-sectional design, missing data, and sampling biases. Our findings highlight the value of multilevel approaches in understanding the complexity of neurobiological mechanisms in adolescent NSSI.

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“…In the context of inadequate emotional support and stressful life events, adolescent might response in an ineffective manner such as NSSI (Nock, 2009). As a supporting case in point, a study showed that adolescents with repeated NSSI were not able to effectively cope with psychosocial stress (Klimes-Dougan et al, 2019). In addition, mother's overprotection is related to children's unhealthy self-conscious emotions, which has been associated with the presence of NSSI and frequent NSSI (Spitzen et al, 2020).…”

Section: Discussionmentioning

confidence: 99%

Association between parenting and non-suicidal self-injury among adolescents in Yunnan, China: a cross-sectional survey

Liu

Xiao

Ran

et al. 2020

PeerJ

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Background Non-suicidal self-injury (NSSI) among adolescents is prevalent and its rate has increased in recent years worldwide. Previous studies had investigated the association between parenting and childhood NSSI, but little is known about the relationship between parental rearing and repetition and severity of NSSI. The aim of this study was to investigate associations of parenting with NSSI and its repetition and severity in a representative adolescent sample from southwestern China. Methods In this cross-sectional study, a sample of 2,705 adolescents (F/M: 1,245/1,460; mean age: 13.4 ± 2.2 years) was recruited from 14 randomly selected schools in Lincang municipality, Yunnan province, China. A self-report questionnaire was used to collect data. The Adolescent Non-Suicidal Self-Injury Function Assessment Scale and the short Chinese Egna Minnen av Barndoms Uppfostran (s-EMBU-C) were used to evaluate NSSI behaviors and parenting style, respectively. Univariate and multivariate logistic regression models were adopted to examine association between parenting and NSSI. Results Overall lifetime prevalence of NSSI was 47.1% (95% CI [36.2–58.0]), with self-cutting being the most common form (23.5% (95% CI [19.3–27.7])), followed by hitting hard objects (23.4% (95% CI [20.2–26.7])) and pulling hairs (20.9% (95% CI [18.8–22.6])). In multiple logistic regression analyses, NSSI was positively associated with high level of father’s rejection (OR: 1.32 (95% CI [1.01–1.72])), high level of mother’s rejection (OR: 1.76 (95% CI [1.46–2.13])), low level of mother’s emotional warmth (OR: 1.42 (95% CI [1.15–1.75])), and high level of mother’s overprotection (OR: 1.74 (95% CI [1.49–2.03])), repeated NSSI was positively associated with low level of father’s emotional warmth (OR: 1.39 (95% CI [1.10–1.75])) and high level of mother’s overprotection (OR: 1.79 (95% CI [1.33–2.41])), and severe NSSI was positively associated with low level of father’s emotional warmth (OR: 1.64 (95% CI [1.11–2.43])) and high level of mother’s rejection (OR: 2.16 (95% CI [1.71–2.71])). Conclusion NSSI is common among adolescents in southwestern China. Negative parenting styles are associated with NSSI, repeated NSSI, and severe NSSI. The development of intervention measures for preventing or reducing NSSI among Chinese adolescents in school settings should consider parenting styles.

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Hypothalamic-pituitary-adrenal axis dysregulation in depressed adolescents with non-suicidal self-injury

Cited by 61 publications

References 41 publications

Self‐Injurious behavior in rhesus macaques: Issues and challenges

Self‐Injurious behavior in rhesus macaques: Issues and challenges

Multimodal assessment of sustained threat in adolescents with nonsuicidal self-injury

Association between parenting and non-suicidal self-injury among adolescents in Yunnan, China: a cross-sectional survey

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