Impulsivity and clinical symptoms among adolescents with non-suicidal self-injury with or without attempted suicide

Abstract

This study examined clinical characteristics and laboratory-measured impulsive behavior of adolescents engaging in either non-suicidal self-injury with (NSSI+SA; n = 25) or without (NSSIOnly; n = 31) suicide attempts. We hypothesized that adolescent with NSSI+SI would exhibit more severe clinical symptoms and higher levels of behavioral impulsivity compared to adolescents with NSSI-Only. Adolescents were recruited from an inpatient psychiatric hospital unit and the two groups were compared on demographic characteristics, psychopathology, selfreported clinical ratings, methods of non-suicidal self-injury, and two laboratory impulsivity measures. Primary evaluations were conducted during psychiatric hospitalization, and a subset of those tested during hospitalization was retested 4-6 weeks after discharge. During hospitalization, NSSI+SA patients reported worse depression, hopelessness, and impulsivity on standard clinical measures, and demonstrated elevated impulsivity on a reward-directed laboratory measure compared to NSSI-Only patients. In the preliminary follow-up analyses, depression, hopelessness, suicidal ideation, and laboratory impulsivity were improved for both groups, but the NSSI+SA group still exhibited significantly more depressive symptoms, hopelessness, and impulsivity than the NSSI-Only group. Risk assessments for adolescents with NSSI+SA should include consideration not only of the severity of clinical symptoms but of the current level impulsivity as well.

Non-Suicidal Self-Injury in Swedish Adolescents : Prevalence, Characteristics, Functions and Associations With Childhood Adversities

“…More depressive symptoms (Dougherty et al, 2009;Jacobson et al, 2008;Muenhlenkamp & Gutierrez, 2007;Taliaferro, Muehlenkamp, Borowsky, McMorris, & Kugler, 2012), hopelessness (Dougherty et al, 2009;Taliaferro et al, 2012), suicidal ideation (Brausch & Gutierrez, 2010;Dougherty et al, 2009;Muehlenkamp & Gutierrez, 2007) and history of physical abuse (Asarnow et al, 2011;Taliaferro et al, 2012) were found in the NSSI+SA group compared to the NSSI group in both community and clinical and samples. In addition, fewer reasons for living (Muehlenkamp & Gutierrez, 2007) and less parental support (Brausch & Gutierrez, 2010) have also been reported by individuals with NSSI+SA in community samples.…”

O desempenho executivo em pacientes que apresentam automutilação

“…O início da automutilação geralmente acontece na adolescência, entre os 11 e 15 anos e pode permanecer por décadas (Favazza, 1998;LayeGindhu;Sohonest-Reichll, 2005;Klonsky, 2007b, Dougherty et al, 2009Kerr;Muehlenkamp, 2010;Catledge et al, 2012;Swannell et al, 2014).…”

“…A impulsividade tem sido considerada como um importante componente para se compreender a automutilação (Simeon et al, 1992;Herpertz et al, 1995;Herpertz et al, 1997;Dougherty et al, 2009). O termo impulsividade, como característica, traço ou definição de um tipo de personalidade, tem sido utilizado para abordar os aspectos impulsivos de alguns transtornos.…”

“…No entanto, na presente amostra, a média de idade do início do comportamento foi mais tardia (16 anos) que as descritas na literatura (11 e 15 anos) (Favazza, 1998;Laye-Gindhu;Sohonest-Reichll, 2005;Klonsky, 2007b, Dougherty et al, 2009Kerr;Muehlenkamp, 2010;Catledge et al, 2012;Swannell et al, 2014 Os comportamentos mais comuns de automutilação foram: cortes na pele (85%), padrão consistente com os estudos já publicados que citam a ocorrência deste tipo de lesão entre 70% a 85% da amostra (Briere;Gil, 1998;Whitlock et al, 2006;Klonsky, 2011;In-Albon et al, 2013;Rodav et al, 2014;Whitlock et al, 2014 (Selby et al, 2012), caracterizada por altas taxas de transtornos, como depressão e ansiedade. Contudo, neste estudo, as prevalências encontradas (100% da amostra apresentou comorbidades psiquiátrica) são superiores às relatadas anteriormente (87,6%) (Klonsky et al, 2003;.…”

Le suicide de la personne âgée : existe-t-il des spécificités liées à l’âge ?

“…Ce résultat a été répliqué depuis chez des adolescents (Dougherty et al, 2009 ;Mathias et al, 2011) Il a aussi été mis en évidence une prise de décision désavantageu-se chez le sujet âgé suicidant (Clark et al, 2011, Dombrovski et al, 2011b, suggérant que les anomalies de prise de décision peuvent être un facteur cognitif de vulnérabilité suicidaire à tout âge.…”