Relationship among self‐injury, experiential avoidance, cognitive fusion, anxiety, and depression in Chinese adolescent patients with nonsuicidal self‐injury

Hu, Zhizhong; Yu, Haiqing; Zou, Jingzhi; Zhang, Yanyan; Lu, Zihang; Hu, Maorong

doi:10.1002/brb3.2419

Cited by 38 publications

(22 citation statements)

References 42 publications

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“…The results showed that the NSSI group had significantly higher scores in childhood trauma, alexithymia, depression, and anxiety than the non-NSSI group. Several studies have also found a strong association between NSSI and childhood trauma, alexithymia, depression, and anxiety (Groschwitz et al, 2015;Hu et al, 2021;Norman & Borrill, 2015;Thomassin et al, 2016).…”

Section: Discussionmentioning

confidence: 99%

Effects of childhood trauma on nonsuicidal self‐injury in adolescent patients with bipolar II depression

Zhang

et al. 2022

Brain and Behavior

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Objective: This study was performed to explore the effect of childhood trauma on nonsuicidal self-injury (NSSI) in adolescents with bipolar II (BD II) depression. Methods:Based on the diagnostic criteria of the DSM-5 and structured interviews to assess the presence or absence of NSSI, 184 adolescent patients with BD II depression were divided into the NSSI (n = 112) and non-NSSI (n = 72) groups. The Adolescent Nonsuicidal Self-Injury Assessment Questionnaire (ANSAQ), Childhood Trauma Questionnaire-Short Form (CTQ-SF), Toronto Alexithymia Scale (TAS-20), Hamilton Depression Scale (HAMD), and Hamilton Anxiety Scale (HAMA) were used to assess the subjects. Result:The CTQ-SF, HAMD, HAMA, and TAS-20 scores were significantly higher in the NSSI group than in the non-NSSI group (p < .01). Logistic regression analysis showed emotional abuse (p = .028, OR = 1.14, 95% CI = 1.01-1.28) and age of onset (p = .009) as risk factors for NSSI. Adolescents with onset age 12-13 years (OR = 6.30, 95% CI = 1.72-23.10) and 14-15 years (OR = 2.24, 95% CI = 1.04-4.84) had a higher risk of self-injury relative to adolescents aged 16-18 years. Conclusion:Childhood trauma and alexithymia were important influencing factors in adolescent patients with BD II depression. Emotional abuse and age of onset as risk factors for NSSI, and difficulties in emotion recognition were positively associated with the patients' NSSI.

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Section: Discussionmentioning

confidence: 99%

Effects of childhood trauma on nonsuicidal self‐injury in adolescent patients with bipolar II depression

Zhang

et al. 2022

Brain and Behavior

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“…Our results are also consistent with the theory of acceptance commitment therapy. 44 The theory suggests that anxiety and NSSI may be rooted in psychological inflexibility, such as experiential avoidance and cognitive integration. Individuals attribute cognitive fusion to some of their own mistakes, and their behavior is limited by their own negative emotions; experiential avoidance implies that individuals achieve escape from negative emotions and negative events through NSSI.…”

Section: Discussionmentioning

confidence: 99%

The Relationship Between Negative Life Events and Nonsuicidal Self-Injury Among Chinese Adolescents: A Moderated-Mediation Model

Zhang¹,

Suo²,

Zhang³

et al. 2022

NDT

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Objective This study aimed to investigate whether anxiety mediates the relationship between negative life events and nonsuicidal self-injury (NSSI) in adolescents and whether this mediating role is moderated through social support. Methods The model consisted of an anonymous questionnaire survey of 506 Chinese adolescents (253 boys and 253 girls, mean age 15.11 years (SD = 1.83, range 11–18 years)). Self-designed questionnaires were used to collect demographic data. The frequency of NSSI, state anxiety, and social support degree of adolescents was assessed by the Adolescent Life Events Scale, the Chinese version of the Beck Anxiety Inventory, and the social support scale, respectively. Results Negative life events were significantly and positively correlated with anxiety and the frequency of NSSI, and anxiety was significantly and positively correlated with the frequency of NSSI. The positive association between negative life events and the frequency of NSSI among adolescents was mediated by anxiety after controlling for demographic variables. Furthermore, this mediated relationship was moderated by social support. Conclusion Anxiety was a potential mechanism linking negative life events to NSSI in adolescents and low social support important risk factor for amplifying this indirect effect. Our findings provide an empirical basis for reducing NSSI in adolescents.

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“…The total scores range from 7 to 49, with the higher scores indicating greater psychological inflexibility. CFQ-F was used to measure cognitive fusion using a 9-items self-reported questionnaire with a 7-point scale ( 32 ). The total scores range from 9 to 63, with the higher scores indicating higher psychological inflexibility.…”

Section: Methodsmentioning

confidence: 99%

The Influence of Self-Esteem and Psychological Flexibility on Medical College Students' Mental Health: A Cross-Sectional Study

et al. 2022

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BackgroundMental health problems has become a major public health issue among medical students. Self-esteem and psychological flexibility were important associated factors for mental health, but their relations have not been discussed in medical students. The present study aimed to assess the status of mental health problems among medical students and identified whether psychological flexibility had a mediating role in the effects of self-esteem on the top three most common psychological symptoms.MethodsA total of 810 undergraduate students from 18 classes comprised in the sample. Nine dimensions of psychological symptoms was assessed by the Symptom Checklist-90-revised (SCL-90-R). Self-esteem was measured by the Self-esteem Scale (SES) and psychological flexibility was evaluated by the Acceptance and Action Questionnaire 2nd Edition (AAQ-II) and Cognitive Fusion Questionnaire (CFQ-F). Univariate analysis and logistic regression analysis were used to determine the relationship among the top three common psychological symptoms, self-esteem, psychological flexibility, and participants' characteristics. The mediating effect of psychological flexibility between self-esteem and psychological symptoms was detected by bootstrap method.Results57.8% of the medical undergraduate students reported positive at least one of the nine psychological symptom dimensions assessed by the SCL-90-R and 13.8% of students had moderate or more severe symptoms. The symptoms of obsessive-compulsiveness, interpersonal sensitivity, and depression were the three most common psychological symptoms among the medical students. Meanwhile, self-esteem and psychological flexibility were negatively associated to the symptoms of obsessive-compulsiveness, interpersonal sensitivity, and depression. And, almost 50% effects of self-esteem on these three symptoms in medical students exert indirect effects through psychological flexibility.ConclusionsPsychological distress was quite common in the Chinese medical students. The three most common psychological symptoms were successively obsessive-compulsiveness, interpersonal sensitivity, and depression. Low self-esteem and psychological inflexibility might be the risk factors for these top three symptoms, and psychological flexibility might play a mediating role in the effects of self-esteem on these psychological symptoms.

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Relationship among self‐injury, experiential avoidance, cognitive fusion, anxiety, and depression in Chinese adolescent patients with nonsuicidal self‐injury

Cited by 38 publications

References 42 publications

Effects of childhood trauma on nonsuicidal self‐injury in adolescent patients with bipolar II depression

Effects of childhood trauma on nonsuicidal self‐injury in adolescent patients with bipolar II depression

The Relationship Between Negative Life Events and Nonsuicidal Self-Injury Among Chinese Adolescents: A Moderated-Mediation Model

The Influence of Self-Esteem and Psychological Flexibility on Medical College Students' Mental Health: A Cross-Sectional Study

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