Pain perception and nonsuicidal self-injury: A laboratory investigation.

People who engage in self-injurious behaviors such as cutting and burning may have altered pain perception. Using a community sample, we examined group differences in pain threshold and pain endurance between participants who self-injured and control participants who were exposed to pressure pain applied to the finger. Participants who self-injured had higher pain thresholds (time to report pain) and endured pain for longer than control participants. Among participants who self-injured, those with longer histories of self-injury had higher pain thresholds. Duration of self-injury was unrelated to pain endurance. Instead, greater pain endurance was predicted by higher levels of introversion and neuroticism and by more negative beliefs about one's self-worth. A highly self-critical cognitive style was the strongest predictor of prolonged pain endurance. People who self-injure may regard suffering and pain as something that they deserve. Our findings also have implications for understanding factors that might be involved in the development and maintenance of self-injury. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Retrospective analysis of social factors and nonsuicidal self-injury among young adults.

Retrospective reports of social influences in nonsuicidal self-injury (NSSI) with regard to initiation, disclosure, methods, and motivations for engaging in the behaviour were examined in 23 (2 male, 21 female) self-injuring university students. Parent and peer social support was compared between the NSSI group and a comparison group that did not engage in NSSI. Lifetime frequency of NSSI and social support were evaluated. NSSI behaviours were found to be highly socially influenced in several ways, with 65% reporting that they talk to their friends about self-injury, 58.8% indicating that a friend had been the first to engage in self-injury, and 17.4% had self-injured in front of friends. Almost all participants endorsed emotional motivations for engaging in NSSI (91%); however, social motivations were also common (65.2%). Social support from peers was less for the NSSI group than the non-NSSI group, although social support was not found to be related to lifetime frequency of NSSI. The implications for understanding NSSI as a socially influenced behaviour are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A multimethod analysis of impulsivity in nonsuicidal self-injury.

Impulsivity has been proposed as an important construct in nonsuicidal self-injury (NSSI). Yet, research on the relationship of impulsivity to NSSI has been mixed. The present study clarified this relationship using a multifaceted measure of impulsivity (i.e., UPPS Impulsive Behavior Scale), and a computer-based behavioral measure of inhibitory control (i.e., a stop-signal task). Participants were 82 confirmed self-injurers and 86 controls recruited from a college population. Self-injurers and controls performed similarly on the stop-signal task. On the UPPS, self-injurers were best distinguished by Urgency (committing rash decisions when faced with negative emotions), and distinguished to a lesser degree by lack of Premeditation (inability to delay action in order to plan) and Sensation Seeking (seeking excitement and adventure). Among self-injurers, lack of Perseverance (inability to stay with a task through completion) predicted more recent and frequent NSSI. Conceptual and clinical implications are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

The virtual cutting edge: The Internet and adolescent self-injury.

The 2 studies reported here use observational data from message boards to investigate how adolescents solicit and share information related to self-injurious behavior. Study 1 examines the prevalence and nature of these message boards, their users, and most commonly discussed topics. Study 2 was intended to explore the correlations between content areas raised for discussion. Both studies were intended to shed light on the role of message boards in spreading information about self-injurious practices and influencing help-seeking behavior. More than 400 self-injury message boards were identified. Most are populated by females who describe themselves as between 12 and 20 years of age. Findings show that online interactions clearly provide essential social support for otherwise isolated adolescents, but they may also normalize and encourage self-injurious behavior and add potentially lethal behaviors to the repertoire of established adolescent self-injurers and those exploring identity options. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Revealing the form and function of self-injurious thoughts and behaviors: A real-time ecological assessment study among adolescents and young adults.

Self-injurious behaviors are among the leading causes of death worldwide. However, the basic nature of self-injurious thoughts and behaviors (SITBs) is not well understood because prior studies have relied on long-term, retrospective, aggregate, self-report assessment methods. The authors used ecological momentary assessment methods to measure suicidal and nonsuicidal SITBs as they naturally occur in real time. Participants were 30 adolescents and young adults with a recent history of self-injury who completed signal- and event-contingent assessments on handheld computers over a 14-day period, resulting in the collection of data on 1,262 thought and behavior episodes. Participants reported an average of 5.0 thoughts of nonsuicidal self-injury (NSSI) per week, most often of moderate intensity and short duration (1–30 min), and 1.6 episodes of NSSI per week. Suicidal thoughts occurred less frequently (1.1 per week), were of longer duration, and led to self-injurious behavior (i.e., suicide attempts) less often. Details are reported about the contexts in which SITBs most often occur (e.g., what participants were doing, who they were with, and what they were feeling before and after each episode). This study provides a first glimpse of how SITBs are experienced in everyday life and has significant implications for scientific and clinical work on self-injurious behaviors. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Underage drinking among young adolescent girls: The role of family processes.

Guided by family interaction theory, this study examined the influences of psychological, peer, and familial processes on alcohol use among young adolescent girls and assessed the contributions of familial factors. An ethnically diverse sample of 1,187 pairs of girls (M age = 12.83 years), and their mothers completed surveys online. Questionnaires assessed girls’ lifetime and recent alcohol use, as well as girls’ demographic, psychological, peer, and family characteristics. Hierarchical logistic regression models showed that although girls’ drinking was associated with a number of psychological and peer factors, the contributions of family domain variables to girls’ drinking were above and beyond that of psychological and peer factors. The interaction analyses further highlighted that having family rules, high family involvement, and greater family communication may offset risks in psychological and peer domains. Study findings underscore the multifaceted etiology of drinking among young adolescent girls and assert the crucial roles of familial processes. Prevention programs should be integrative, target processes at multiple domains, and include work with parents. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The nature, assessment, and treatment of adolescent self-injury.

Reviews the book, Adolescent self-injury: A comprehensive guide for counselors and health care professionals by Amelio A. D'Onofrio (see record 2007-02689-000). To date there have been few publications in the professional literature addressing the needs of school personnel in regards to self-injury in school-age populations. This book attempts to address this gap in the literature. According to the author, the intent of the book is to assist "frontline professionals in developing a working understanding of the nature, meaning, and function of adolescent self-injurious behavior." In doing so, the author presents information from the research literature in such disparate areas as psychology, psychiatry, nursing, sociology, and feminist studies. Although written for both school and health care professionals, there is a strong focus in the book on school-based practice. The book is divided into three parts that together provide an overview of self-injury, strategies for assessment and treatment, and information on related issues. The text is well-written and provides practical, evidence-based information that should prove highly useful to school psychologists and other professionals responding to and working with adolescents who engage in self-injury. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Suicide Attempt Self-Injury Interview (SASII): Development, reliability, and validity of a scale to assess suicide attempts and intentional self-injury.

The authors describe the development of the Suicide Attempt Self-Injury Interview (SASII), an instrument designed to assess the factors involved in nonfatal suicide attempts and intentional self-injury. Using 4 cohorts of participants, authors generated SASII items and evaluated them with factor and content analyses and internal consistency statistics. The final measure was assessed for reliability and validity with collateral measures. The SASII assesses variables related to method, lethality and impulsivity of the act, likelihood of rescue, suicide intent or ambivalence and other motivations, consequences, and habitual self-injury. The SASII was found to have very good interrater reliability and adequate validity. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Posttraumatic stress symptoms mediate the relation between childhood sexual abuse and nonsuicidal self-injury.

Prior research consistently has shown a strong relation between childhood abuse and nonsuicidal self-injury (NSSI), yet it is unclear why this relation exists. The authors examined 2 specific posttraumatic stress disorder (PTSD) symptom clusters as potential mechanisms through which childhood abuse may be related to NSSI. Participants were 86 adolescents (78% female, 22% male; 73% Caucasian, 27% other races/ethnicities; mean age = 17.03 years, range = 12-19 years) who completed measures of childhood abuse, Diagnostic and Statistical Manual of Mental Disorders (4th ed.) PTSD symptoms, and NSSI. Analyses revealed a significant relation between childhood sexual abuse in particular and the presence and frequency of NSSI. Moreover, data supported a theoretical model in which PTSD reexperiencing and avoidance/numbing symptoms independently mediate this relation. Future research must test the temporal relation between childhood sexual abuse, PTSD symptoms, and NSSI and identify additional pathways to engagement in NSSI. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Nonsuicidal self-injury among "privileged" youths: Longitudinal and cross-sectional approaches to developmental process.

This investigation examined process-level pathways to nonsuicidal self-injury (NSSI; e.g., self-cutting, -burning, -hitting) in 2 cohorts of suburban, upper-middle-class youths: a cross-sectional sample of 9th-12th graders (n = 1,036, 51.9% girls) on the West Coast and a longitudinal sample followed annually from the 6th through 12th grades (n = 245, 53.1% girls) on the East Coast. High rates of NSSI were found in both the cross-sectional (37.2%) and the longitudinal (26.1%) samples. Zero-inflated Poisson regression models estimated process-level pathways from perceived parental criticism to NSSI via youth-reported alienation toward parents. Pathways toward the initiation of NSSI were distinct from those accounting for its frequency. Parental criticism was associated with increased NSSI, and youth alienation toward parents emerged as a relevant process underlying this pathway, particularly for boys. The specificity of these pathways was explored by examining separate trajectories toward delinquent outcomes. The findings illustrate the prominence of NSSI among "privileged" youths, the salience of the caregiving environment in NSSI, the importance of parental alienation in explaining these relations, and the value of incorporating multiple systems in treatment approaches for adolescents who self-injure. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Extending research on the utility of an adjunctive emotion regulation group therapy for deliberate self-harm among women with borderline personality pathology.

Deliberate self-harm (DSH) is a clinically important behavior commonly associated with borderline personality disorder (BPD). Despite the clinical relevance and associated negative consequences of this behavior, however, there are few empirically supported treatments for DSH among individuals with BPD, and those that exist are difficult to implement in many clinical settings (due to their duration and intensity). To address this limitation, Gratz and Gunderson (2006) examined the efficacy of a 14-week, adjunctive emotion regulation group therapy (ERGT) for DSH among women with BPD. Although the results of this initial trial were promising (indicating positive effects of this treatment on DSH, emotion dysregulation, experiential avoidance, and psychiatric symptoms), they require replication and extension. Thus, the purpose of this study was to further develop this ERGT by examining its utility across other settings, a more diverse group of patients, a wider range of outcomes, and group leaders other than the principal investigator. Twenty-three women received this ERGT in addition to their ongoing treatment in the community. Self-report and interview-based measures of DSH and other self-destructive behaviors, psychiatric symptoms, adaptive functioning (including social and vocational impairment and quality of life), and the proposed mechanisms of change (emotion dysregulation and experiential avoidance) were administered pre- and posttreatment. Results indicate significant changes over time (accompanied by large effect sizes) on all outcome measures except quality of life and self-destructive behaviors (although the latter was a large-sized effect). Further, 55% of participants reported abstinence from DSH during the last two months of the group. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Trajectories of perceived support in mother–adolescent relationships: The poor (quality) get poorer.

The authors examined decreases across the early adolescent years in child reports of perceived support from mothers to determine whether the rate of decline differed as a function of the initial amount of perceived negativity in the mother–child relationship. Participants included a diverse sample of 197 girls and 116 boys who were in the 1st year of middle school (6th grade, ages 11 to 13 years) at the beginning of the study. Separate growth curve models revealed associations between the rate of change in child-reported perceived support and the initial level of both child-reported perceived negativity and mother-reported perceived negativity. Over-time declines in child-reported perceived support were larger for adolescents whose initial levels of perceived negativity were greater. The findings are consistent with the claim that mothers and children with the worst relationships at the outset of adolescence experience the greatest deterioration in relations across the early adolescent years. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The role of family relationship quality and testosterone levels in adolescents' peer experiences: A biosocial analysis.

Grounded in a biosocial model, this study examines the interaction between adolescents' testosterone levels and qualities of the parent-adolescent and sibling-adolescent relationship in adolescents' peer experiences and contributes to empirical research on the role of biological factors and family socialization processes in adolescents' peer competence and involvement. Participants included 331 adolescents (M=14.68 years of age, SD=1.53) and their mothers and fathers in 173 families. During home visits, data were collected from family members regarding adolescents' family relationships, peer relationships, and psychosocial adjustment; daily time-use data were gathered during a series of 7 nightly phone interviews; and testosterone levels were assessed through saliva samples. Hierarchical regression results revealed that when boys had close relationships with mothers and sisters, testosterone was positively associated with their peer competence and involvement. Discussion focuses on the value of exploring biosocial interactions and highlights the particular importance of boys' relationships with opposite-sex family members in efforts to understand their peer experiences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The changing family relationships of adolescent girls.

The TAT is used to investigate the changing relationships of adolescent girls to their parents. The hypothesis posed is that the relationship between mother and daughter should be characterized by more conflict during the pubertal period, the relationship between father and daughter being more tranquil during the same period. Greater interaction, both disharmony and harmony, in the mother-off-spring relationship than in the father-offspring relationship is noted at all five age levels used in the experiment. However, the proportions of themes classified as equilibrium and disequilibrium remains the same in both relationships, suggesting the greater mother-offspring disharmony to be a function of greater interaction of mothers and daughters. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Introduction to the special section on suicide and nonsuicidal self-injury: A review of unique challenges and important directions for self-injury science.

Self-injurious behaviors, including nonsuicidal self-injury (NSSI) and suicidal behaviors, are remarkably prevalent and woefully understudied. This area of research involves numerous methodological, ethical, and practical challenges that have limited progress in understanding some of the most basic characteristics and correlates of self-injurious behavior. To date, relatively little data are available to develop empirically based preventions or interventions, and no empirically supported treatments currently are available to reduce NSSI or suicidality in most populations. The articles in this special section offer examples of methodologically innovative, theoretically based work that address these research needs. Articles in this special section include studies of functional models of NSSI, studies that examine more distal risk factors for NSSI, and studies of suicidality. A brief review of current research in these areas is offered. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A study of self-injurious and suicidal behavior in a veteran population.

This patient safety improvement study was conducted (1) to establish a database of intentional patient self-injuries and suicidal behavior among veterans in a large urban VA health care system, and (2) to investigate whether there were demographic and/or clinical characteristics of veterans who self-injure that might predict seriousness of suicidal intent and aid in future efforts at prevention. A total of 175 clinician-administered, post self-injury interviews were completed between 2006 and 2008 in a VA health care system in the Northeast. Findings suggest that self-injuries with high suicidal intent were characterized by male gender, older age, planning of self-injury, no wish to be saved, and a negative feeling about having survived. Additional results indicated that staff ratings of patient intent to die were significantly lower than patient self-rated intent to die, a finding that gives rise to questions of whether staff may tend to underestimate patient suicidal intent. Also, although more than 80% of the veterans in this sample considered their self-injurious actions impulsive, planning of self-injury was significantly associated with higher intent to die. Veterans who completed suicide during the study time period were significantly more likely than those who had nonfatal self-injuries to have experienced combat. The implications of these findings are discussed, including whether combat exposure may lead to an acquired capacity for lethal behaviors such as suicide (Joiner, 2005). (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

A review of sex differences in peer relationship processes: Potential trade-offs for the emotional and behavioral development of girls and boys.

Theory and research on sex differences in adjustment focus largely on parental, societal, and biological influences. However, it also is important to consider how peers contribute to girls' and boys' development. This article provides a critical review of sex differences in several peer relationship processes, including behavioral and social-cognitive styles, stress and coping, and relationship provisions. The authors present a speculative peer-socialization model based on this review in which the implications of these sex differences for girls' and boys' emotional and behavioral development are considered. Central to this model is the idea that sex-linked relationship processes have costs and benefits for girls' and boys' adjustment. Finally, the authors present recent research testing certain model components and propose approaches for testing understudied aspects of the model. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Adolescent sibling relationships in Mexican American families: Exploring the role of familism.

To address a significant gap in the literature on normative processes in minority families, the authors studied adolescents' sibling relationships in two-parent Mexican American families and explored connections between sibling relationship characteristics and familism. Participants were 246 adolescent Mexican American sibling pairs who participated in (a) home interviews during which adolescents described their sibling relationships and familism values and (b) a series of 7 nightly phone calls during which adolescents reported their daily activities, including time spent with siblings and family members. Siblings described their relationships as both intimate and conflictual, and daily activity data revealed that they spent an average of 17.2 hr per 7 days in shared activities. Sibling relationship qualities were linked to familism values and practices, and stronger patterns of association emerged for sisters than brothers. Discussion highlights the significance of studying the processes that underlie within-group variations among families of different cultural backgrounds. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Developmental changes in gender composition of friendship networks in adolescent girls and boys.

This article describes both normative changes and individual differences in the gender composition of girls' and boys' friendship networks across adolescence and predicts variations in these changes. It also examines changes in the characteristics (context, age difference, closeness, and support) of same- and other-sex friendships in the network. Girls and boys (N=390) were interviewed annually from Grades 6 to 10 (76% retention). Growth in the proportion of other-sex friends was significantly more pronounced for girls and was related to different predictors for girls and boys. Moreover, over time, girls had other-sex friends that were increasingly older than themselves, and most of these friendships took place outside of the school, which was not the case for boys. Growth in the proportion of other-sex friends was more pronounced for secondary than for best friends. Finally, both girls and boys reported receiving higher levels of help from girls than from boys. These findings suggest that other-sex friendships might place some of the girls on a problematic developmental trajectory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)