Non-suicidal self-injury (NSSI) is becoming increasingly common in adolescents and seriously affects their physical and mental health, and it is also a major risk factor for suicide among adolescents. NSSI has now become a public health issue of general concern; however, the identification of cognitive dysfunction in NSSI is still based on neuropsychological cognitive assessment and subjective questionnaire assessment, with a lack of objective evaluation indicators. As a method for studying the cognitive neural mechanism of NSSI, electroencephalography is a reliable tool for finding objective biomarkers of NSSI. This article reviews the recent research on electrophysiology associated with cognitive dysfunction in adolescents with NSSI.
Humans ; Adolescent ; Self-Injurious Behavior ; Cognitive Dysfunction ; Electroencephalography ; Neuropsychological Tests ; Risk Factors

OBJECTIVE: To present an approach to phenotyping ACEs and explore the association between ACEs and adolescent health risky behaviors based on the social context of China. METHODS: Totally, 5,726 adolescents aged 12-18 years were investigated about their ACEs in the family, peer, school, and personal domains and the occurrence of six types of risky health behaviors (i.e., smoking, drinking, sexual intercourse, self-harm, and suicidal ideation and attempts). Latent class analysis (LCA) was used to explore the ACE patterns. RESULTS: Six latent classes of ACEs were identified, including low adversity, school adversity, school adversity and peer victimization, peer victimization, maltreatment and peer victimization, and high adversity, and associated with risky health behaviors in adolescents. Being physically punished by a teacher, experiencing sexual abuse, and experiencing family trauma most strongly differentiated from the six ACE classes and were correlated with an increased risk for risky adolescent health behaviors. CONCLUSION This study supports a positive association between ACEs and risky adolescent health behaviors. Peer victimization, school adversity and associated contexts need to be considered in future ACE studies.
Adverse Childhood Experiences ; Health Risk Behaviors ; Humans ; Phenotype ; Self-Injurious Behavior/epidemiology*

OBJECTIVES: To investigate the differences in non-suicidal self-injury (NSSI) behaviors between only-child and non-only-child adolescents with mood disorders. METHODS: A three-stage sampling method was used to perform a cross-sectional survey of 529 adolescents, aged 12-18 years, who had mood disorders and NSSI behaviors. These adolescents were sampled from the outpatient service of 20 mental hospitals in 9 provinces of China from August to November 2020. A self-made questionnaire was used to collect general demographic data. The Functional Assessment of Self-Mutilation, Beck Scale for Suicide Ideation, Kessler Psychological Distress Scale, Stress Mindset Measure-General, Multidimensional Scale of Perceived Social Support, Multidimensional Students' Life Satisfaction Scales, and Rosenberg Self-Esteem Scale were used to collect the information on self-injury behaviors and psychological factors in these adolescents. RESULTS: A total of 529 adolescents with mood disorders and NSSI behaviors were surveyed, among whom 375 were only-child adolescents and 154 were non-only-child adolescents. Compared with the non-only-child group, the only-child group had a significantly higher total score of Functional Assessment of Self-Mutilation (P<0.05) .The type and frequency of self-injury in the only-child group were significantly higher than those in the non-only-child group (P<0.05). Psychological analysis showed that compared with the non-only-child group, the only-child group had a significantly lower score of self-esteem (P<0.05) and significantly higher scores of psychological distress and depressive symptoms (P<0.05). The multiple linear regression analysis showed that the score of suicidal ideation was positively correlated with the frequency of NSSI behaviors in both only-child and non-only-child adolescents with mood disorders (P<0.05); in the only-child adolescents, the level of self-esteem was negatively correlated with the frequency of NSSI behaviors (P<0.05), and the score of stress perception was positively correlated with the frequency of NSSI behaviors (P<0.05); in the non-only-child adolescents, the score of anxious emotion was positively correlated with the frequency of NSSI behaviors (P<0.05). CONCLUSIONS Among the adolescents with mood disorders and NSSI behaviors, the only-child adolescents tend to have a higher frequency of self-injury and poorer mental health, and therefore, the only-child adolescents with mood disorders and NSSI behaviors need more attention.
Adolescent ; Cross-Sectional Studies ; Humans ; Mood Disorders ; Risk Factors ; Self Mutilation ; Self-Injurious Behavior/psychology* ; Suicide, Attempted/psychology*

OBJECTIVES: Adolescents are at high risk of non-suicidal self-injury (NSSI). Currently, there is no clinical assessment tool for adolescent NSSI behaviors measurement with global consistency. The Ottawa Self-injury Inventory (OSI) is considered as a relatively comprehensive assessment tool for NSSI, but the questionnaire is discussed with excessive content and timecostly, which may affect the reliability of the measurement results for adolescent.Thus, this study, based on OSI, aims to revise the assessment tool for adolescent with NSSI that is suitable for both clinically and scientifically, referring to the diagnostic criteria for NSSI in the 5th Diagnostic and Statistical Manual of Mental Disorder (DSM-5). METHODS: This study was led by the Second Xiangya Hospital of Central South University and collaborated with 6 mental health service institutions in China from August to December 2020. Adolescent aged from 12 to 24 years old who had self-injury behavior and met the DSM-5 diagnostic criteria for NSSI were continuously recruited in the psychiatric outpatient department or ward. After clinical diagnosis by an experienced attending psychiatrist or above, the general information and OSI were collected by questionnaires. SPSS 24.0 and AMOS structural equation model statistical softwares were used to conduct item analysis and exploratory factor analysis on the obtained data to complete the revision of the scale. Cronbach's alpha coefficient, split-half reliability, test-retest reliability, and content validity and structure validity were performed to analyze the reliability and validity and confirmatory factor analysis was carried out to test the structure validity for the revised scale. RESULTS: A total of 234 adolescent with NSSI were enrolled, including 33 (14.1%) males and 201 (85.9%) females with the mean age of (16.2±2.6) years old. The most common clinical diagnoses were depression disorder (57.4%), bipolar disorder (20.9%), adolescent mood disorder (17.1%), etc. Nine items (item 2, 7, 11, 13, 23, 24, 10, 17, 18) in the functional scale of OSI were deleted according to extreme grouping method, correlation analysis, and principal component analysis in exploratory factor analysis. The revised functional scale for NSSI consisted of 15 items. The reliability analysis showed that the Cronbach's alpha coefficients of NSSI thought and behavior frequency, addiction characteristics, and function scales were 0.799, 0.798, and 0.835, respectively, and the split-half coefficients were 0.714, 0.727, and 0.852, respectively. The test-retest coefficients of the latter 2 scales were 0.466 and 0.560, respectively. The correlation coefficient between sub-items and total scores in each part of the scale showed good content validity. The exploratory factor analysis showed that a component was extracted from the frequency of thoughts and behaviors of NSSI, one component was extracted from the addictive characteristics, and three components were extracted from the functional part. The three functional subscales were social influence, external emotion regulation, and internal emotion regulation. The factor load of each item was >0.400. CONCLUSIONS The revised Chinese version OSI targeted the adolescent patients with mental disorders has relatively ideal reliability and validity. The scale shows high stability, dependability, and a reasonable degree of fit. It is a suitable assessment tool for clinical and scientific research on adolescent with NSSI.
Adolescent ; Adult ; Child ; Factor Analysis, Statistical ; Female ; Humans ; Male ; Mental Disorders/diagnosis* ; Psychometrics/methods* ; Reproducibility of Results ; Self-Injurious Behavior/psychology* ; Surveys and Questionnaires ; Young Adult

OBJECTIVE: This study aimed to determine the methods of self-injurious behavior and related psychiatric disorder among patients seen at Baguio General Hospital and Medical Center. METHODS: This was a cross-sectional study which used convenience sampling. It involved 53 patients with self-injurious behavior brought to Baguio General Hospital and Medical Center and assessed by the Department of Psychiatry. Data was gathered through a Psychiatric interview done by a co-investigator to eliminate interviewer’s bias. Statistical analyses used were both descriptive (percentages, mean, and frequency) and inferential in the form of chisquare test. RESULTS: Socio-demographic profile of patients showed that the mean age of patients with self-injurious behavior was 26-27 (26.8), predominantly female, single and high school graduate. For the factors leading to self-injury, it showed that self-injurious patients had a family history of psychiatric disorder and a previous history of self-injury. The predominant method used by the patients in the study was ingestion. The major psychiatric disorder found among patients was Depressive Disorder. There was no association noted between the method of self-injurious behavior employed and the specific psychiatric disorder. CONCLUSION Patients brought to the hospital due to self-injury commonly had an ongoing psychiatric pathology, majority of whom had a Depressive Disorder. Since the method used for self-injury was not found to be associated with the type of psychiatric disorder, it would be too risky to conclude that patients with minor methods of self-injury ( e.g. scratching) would only have a minor psychiatric disturbance. It is, therefore, recommended that a comprehensive psychiatric assessment should be conducted for all patients with self-injurious behavior irrespective of the level of lethality of their method self-injury.
Self-Injurious Behavior ; Mental Disorders

Adolescent ; Child ; China ; epidemiology ; Female ; Humans ; Male ; Puberty ; Self-Injurious Behavior ; epidemiology ; Sex Characteristics ; Sex Factors ; Students ; statistics & numerical data ; Violence ; statistics & numerical data

From September 2017 to February 2018, 650 disabled children and adolescents aged 6-to 17-year-old in Beijing were matched 1∶1 to those in normal physical condition with same age, gender and place of residence. All children and adolescents were investigated for self-injury status in the last year to understand the difference of self-injury incidence between groups. Multivariate unconditional logistic regression model was applied for exploring relevant factors of self-injury of children and adolescents. This study found that the disability, insufficient sleep, difficulty falling asleep, and sleeping late were associated with self-injury of children and adolescents.
Adolescent ; Beijing ; epidemiology ; Child ; Cross-Sectional Studies ; Disabled Children ; statistics & numerical data ; Humans ; Logistic Models ; Self-Injurious Behavior ; epidemiology ; Sleep

OBJECTIVE: The purpose of this study was to validate and verify the Korean version of the Inventory of Statements about Self-Injury (ISAS) to better understand the psychopathological characteristics of nonsuicidal self-injury (NSSI) among young adults. METHODS: A total of 539 Korean adults (age: 19 to 30 years; 343 participants with a history of NSSI) completed a self-report online survey regarding NSSI validation research. The test-retest reliability, internal consistency, concurrent validity, and factor analysis of the ISAS behavioral scales and the ISAS functional scales were examined. The factor structure and construct validity were evaluated by performing exploratory factor analysis (EFA) and a confirmatory factor analysis (CFA). RESULTS: The results demonstrated the good internal consistency and temporal stability of the Korean version of the ISAS. The EFA revealed that the NSSI functions exhibited a two-factor structure: intrapersonal functions and interpersonal functions. The CFA also confirmed that the model fitness indicators of the 2-factor structure were appropriate. In addition, the ISAS functional scales were related to increased suicidal ideations and decreased resilience in participants with a history of NSSI. CONCLUSION: The current findings suggest that the Korean version of the ISAS is a robust measure of NSSI behaviors. Further research is needed to investigate the causal relationship between clinical symptoms, given the significant correlation between self-reported NSSI and suicidal ideation and decreased resilience.
Adult ; Humans ; Reproducibility of Results ; Self-Injurious Behavior ; Suicidal Ideation ; Suicide ; Weights and Measures ; Young Adult

This study aimed to analyze changing trends in child injury deaths from 2006 to 2016 and to provide basic data for initiatives to help prevent child injury deaths through improvements in social systems and education. Specific causes of death were analyzed using micro-data of the death statistics of Korea from 2006 to 2016, which were made available by Statistics Korea. Types and place of death were classified according to the KCD-7 (Korean Standard Classification of Diseases and Causes of Death). The data were compared to those of other Organization for Economic Cooperation and Development countries. Changing trends were presented. The number of child deaths by injury was 270 in 2016. The death rate was 8.1 per 100,000 population in 2006, while it was 3.9 in 2016. The death rate of boys was 1.7 times greater than that of girls. Unintentional injury deaths comprised 72.6% of all child injury deaths in 2016, while intentional injury deaths comprised 27.4%. The first leading cause of unintentional injury deaths in infants (less than 1-year-old) was suffocation, while that of children aged 1 to 14 years was transport accidents. The second leading cause of death in infants was transport accidents, that of children aged 1 to 4 was falling, and that of children aged 5 to 14 was drowning. Pedestrian accidents comprised 43.7% of the transport accidents from 2014 to 2016. To prevent child injury deaths by both unintentional and intentional causes, nation-wide policy measures and more specific interventions according to cause are required.
Accidental Falls ; Asphyxia ; Cause of Death ; Child ; Classification ; Drowning ; Education ; Female ; Humans ; Infant ; Korea ; Mortality ; Organisation for Economic Co-Operation and Development ; Republic of Korea ; Self-Injurious Behavior

OBJECTIVE: Mobile messengers are becoming common methods to communicate among people in various fields. This study investigated the effectiveness of mobile messengers as a tool for post-discharge case management of emergency department patients who attempted suicide and self-harm. METHODS: This study was a retrospective observational study of data collected prospectively. A total of 327 patients who attempted suicide and self-harm in the emergency department were divided into two groups: a conventional protocol group with a face-to-face or phone call interview and a new protocol group with added mobile messenger counseling. The basic characteristics, such as sex, age, methods of suicide and self-harm attempt, consent for case management, and admission to a ward, were surveyed. The rates of successful case management (transfer to a local community center or follow-up to neuropsychiatric outpatient clinic, or both) were compared as a primary outcome between the two groups. RESULTS: The conventional protocol group was 122 cases and the new protocol group was 205 cases. No significant differences in sex, age, methods of suicide and self-harm attempt, rate of consent to case management, and admission to a ward were observed between the two groups. On the other hand, the total successful management rate in mobile messenger group was higher than that of the other group (P=0.020). CONCLUSION: This study showed that mobile messengers could be an alternative communication tool for the post-discharge case management of patients who attempted suicide and self-injurious behavior. Nevertheless, a well-designed future study might be needed to determine if that method would reduce the reattempt rate.
Ambulatory Care Facilities ; Case Management ; Cell Phones ; Counseling ; Emergency Service, Hospital ; Follow-Up Studies ; Hand ; Humans ; Methods ; Observational Study ; Prospective Studies ; Retrospective Studies ; Self-Injurious Behavior ; Suicide ; Suicide, Attempted