The Association of Nonsuicidal Self-Injury with Quality of Life and Mental Disorders in Clinical Adolescents—A Network Approach

Abstract

Although earlier research has highlighted that psychiatric disorders significantly impair patients’ quality of life (QoL), few studies have examined the relationship between nonsuicidal self-injury (NSSI) and QoL. Our aim was to investigate whether QoL mediates the mental disorder–NSSI relationship, and to study the QoL ratings agreement of self and parents in a clinical population of adolescents. We involved 202 adolescents from Vadaskert Child Psychiatric Hospital and Outpatient Clinic, Budapest, aged 13–18 years. All participants completed the Deliberate Self-Harm Inventory, Inventar zur Erfassung der Lebensqualität bei Kindern und Jugendlichen, and the Mini International Neuropsychiatric Interview Kid. To map the interrelationship between the NSSI, mental disorders, and QoL dimensions, Mixed Graphical Models were estimated. Adolescents with a history of NSSI rated their QoL to be significantly lower than adolescents without NSSI. Self and parents’ QoL ratings are closer in the NSSI sample than in the no-NSSI sample. Among all QoL dimensions, only family problems had a direct significant association with NSSI engagement. Our results highlight that, contrary to our hypothesis, the presence of mental disorders mediates the relationship between most QoL dimensions and the occurrence of NSSI. Our results draw attention to the potential causal effect of environmental factors (e.g., peer problems) on mental disorders that, in turn, result in NSSI. The present paper highlights the importance of network modelling in clinical research.

A Person-Centered Approach to Adolescent Nonsuicidal Self-Injury: Predictors and Correlates in a Community Sample

“…NSSI behaviors can also occur in different psychiatric syndromes, primarily in mood, personality, anxiety, and substance use disorders (Nitkowski & Petermann, 2011 ). In parallel, life satisfaction and global well-being are patently lower in NSSI samples (Gyori et al, 2021b ). A low level of subjective well-being is itself a risk factor for unhealthy emotion regulation (Verzeletti et al, 2016 ) and psychopathology (Grant et al, 2013 ).…”

Development of a General Health Score Based on 12 Objective Metabolic and Lifestyle Items: The Lifestyle and Well-Being Index

“…It is clear how daily habits influence biological pathways for health, some of which are related to the immune system or inflammatory markers and promote healthy cellular activity; however, the impact of health perception on health is less studied and yet highly relevant [ 5 ]. Clear examples of its importance for health and longevity include: health and well-being have been linked to self-harm attitudes in the adolescence [ 6 ]; detrimental lifestyles such as poor sleep [ 7 , 8 ] and unhealthy eating habits [ 9 ] negatively impact HRQoL through various underlying mechanisms; and, compared to participants with no impairment, those reporting deteriorated self-perceived health (SPH) saw a RR for mortality of 1.99 (95% CI: 1.64 to 2.42) [ 10 ]. Some researchers stress that in some instances, these effects are of significant magnitude and thus cannot be omitted from future research [ 8 , 11 ].…”

The importance of recognizing worthlessness for suicide prevention in adolescents with Attention-deficit/hyperactivity disorder

“…In sum, our previous study, among others, revealed a triple-pathway model between attentive-disruptive disorders and suicidality: the association between the two variables were mediated by affective, psychotic, and anxiety disorders ( 5 , 8 , 9 , 21 ). Our first aim was to confirm these findings on a different sample.…”

“…According to the previous research of our group, Balazs et al ( 8 ) described that the symptoms of ADHD are associated with an increased risk for non-suicidal self-injury among adolescents, and affective and psychotic disorders and suicide mediated this relationship. Another study of our research group also found with a network approach that mood disorders, psychotic disorders and anxiety disorders mediated the path between attention/disruptive disorders and suicidality ( 21 ). Moreover, anxiety had the strongest association with ADHD ( 21 ).…”

“…Another study of our research group also found with a network approach that mood disorders, psychotic disorders and anxiety disorders mediated the path between attention/disruptive disorders and suicidality ( 21 ). Moreover, anxiety had the strongest association with ADHD ( 21 ). Furthermore, Taylor et al ( 22 ) found that the ADHD symptom severity and suicidal thought and planning was significantly mediated by anxiety.…”