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      Non-suicidal Self-Injury in Clinical Practice

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          Abstract

          Background: Non-suicidal self-injury (NSSI) among adolescents is a major public health concern and a common problem in clinical practice. The aim of this study was to examine different aspects of NSSI in a high-risk adolescent sample in clinical practice in association with personality disorders, symptoms, and coping skills to enhance the understanding of NSSI and improve treatment interventions.

          Methods: In a sample of 140 adolescent inpatients treated for personality disorders, assessments were performed pre-treatment and post-treatment using a questionnaire on NSSI developed for clinical practice, the Structured Clinical Interview for DSM personality disorders, the Symptom Check List 90, and the Cognitive Emotion Regulation Questionnaire.

          Results: NSSI was common (66.4%) among the inpatient adolescents. Of those without NSSI behaviour ( n = 47), 10 (21.3%) started NSSI during treatment. NSSI was related to number of personality disorders and not to one specific. Participants who experienced NSSI ( n = 93) reported significantly more symptoms and the negative coping strategy self-blame. They scored lower on the positive coping strategies of refocusing and reappraisal.

          Conclusion: NSSI in adolescent clinical practice is common, not exclusive to borderline personality disorder and could be contagious. Reducing self-blame and enhancing positive refocusing and positive reappraisal seem important treatment targets.

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          Most cited references38

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          Prevalence of nonsuicidal self-injury in nonclinical samples: systematic review, meta-analysis and meta-regression.

          Published prevalence estimates of nonsuicidal self-injury (NSSI) among nonclinical samples are highly heterogeneous, raising concerns about their reliability and hindering attempts to explore the alleged increase in NSSI over time. Accordingly, the objectives of this study were to investigate the influence of methodological factors on heterogeneity in NSSI prevalence estimates, explore changes over time, and estimate overall international NSSI prevalence. Results showed that methodological factors contributed over half (51.6%) of the heterogeneity in prevalence estimates, and, after adjusting for these factors, NSSI prevalence did not increase over time. Overall, pooled NSSI prevalence was 17.2% among adolescents, 13.4% among young adults, and 5.5% among adults. Clearly, development of standardized methodology in NSSI research is crucial if accurate estimates are desired. © 2014 The American Association of Suicidology.
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            SCL-90: an outpatient psychiatric rating scale--preliminary report.

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              Non-suicidal self-injury among adolescents: diagnostic correlates and relation to suicide attempts.

              Non-suicidal self-injury (NSSI) is a prevalent behavioral problem, yet many fundamental aspects of NSSI remain unknown. This case series study reports on the diagnostic correlates of adolescents with a recent history of NSSI and examines the relation between NSSI and suicide attempts. Data are from clinical interviews with 89 adolescents admitted to an adolescent psychiatric inpatient unit who engaged in NSSI in the previous 12 months. Results revealed that 87.6% of adolescents engaging in NSSI met criteria for a DSM-IV Axis I diagnosis (M=3.0, S.D.=2.2, range=0 to 8 diagnoses), including externalizing (62.9%), internalizing (51.7%), and substance use (59.6%) disorders. Most adolescents assessed also met criteria for an Axis II personality disorder (67.3%). Overall, 70% of adolescents engaging in NSSI reported a lifetime suicide attempt and 55% reported multiple attempts. Characteristics of NSSI associated with making suicide attempts included a longer history of NSSI, use of a greater number of methods, and absence of physical pain during NSSI. These findings demonstrate the diagnostic heterogeneity of adolescents engaging in NSSI, highlight the significant overlap between NSSI and suicide attempts, and provide a point of departure for future research aimed at elucidating the relations between non-suicidal and suicidal self-injury.
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                Author and article information

                Contributors
                Journal
                Front Psychol
                Front Psychol
                Front. Psychol.
                Frontiers in Psychology
                Frontiers Media S.A.
                1664-1078
                07 March 2019
                2019
                : 10
                : 502
                Affiliations
                [1] 1De Jutters, Centre for Youth Mental Healthcare Haaglanden , The Hague, Netherlands
                [2] 2Curium-LUMC , Oegstgeest, Netherlands
                [3] 3Lucertis Child and Adolescent Psychiatry , Rotterdam, Netherlands
                Author notes

                Edited by: Xavier Noel, Free University of Brussels, Belgium

                Reviewed by: Daniel Stein, The Edmond and Lily Safra Children’s Hospital, Israel; Miguel E. Rentería, QIMR Berghofer Medical Research Institute, Australia

                *Correspondence: Kirsten Hauber, k.hauber@ 123456dejutters.com

                This article was submitted to Psychopathology, a section of the journal Frontiers in Psychology

                Article
                10.3389/fpsyg.2019.00502
                6424099
                30930814
                731eae16-e5b9-466d-a268-9589623fe528
                Copyright © 2019 Hauber, Boon and Vermeiren.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                History
                : 10 September 2018
                : 20 February 2019
                Page count
                Figures: 0, Tables: 3, Equations: 0, References: 54, Pages: 8, Words: 0
                Categories
                Psychology
                Original Research

                Clinical Psychology & Psychiatry
                nssi,personality disorder,adolescents,observational descriptive study,mbt

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