Blair W. Morris

The co-occurrence of non-suicidal self-injury and attempted suicide among adolescents: distinguishing risk factors and psychosocial correlates

Although attempted suicide and non-suicidal self-injury (NSSI) are distinct behaviors differing in intent, form, and function, the behaviors co-occur at a high rate in both adults and adolescents. Researchers have begun to investigate the association between attempted suicide and NSSI among adolescents. The purpose of this paper is to present current research on this association. First, we discuss definitional issues associated with self-injurious behaviors. Next, we present research on the co-occurrence of attempted suicide and NSSI, including prevalence and associations with self-injury characteristics. We then discuss psychosocial variables associated with engaging in both NSSI and attempted suicide or one type of self-injury alone. Finally, we present the research to date on risk factors uniquely associated with either attempted suicide or NSSI. Implications for mental health professionals and future avenues of research are discussed.

Expanding and Clarifying the Role of Emotion Regulation in Nonsuicidal Self-Injury

Objective: Deficits in emotion regulation have been implicated in nonsuicidal self-injury (NSSI) by both theory and research. Research indicates that NSSI is commonly performed as an emotion regulation strategy, as it often decreases the experience of negative affect. People who engage in NSSI often report greater emotion dysregulation than those without an NSSI history. Further, interventions that have demonstrated effectiveness in reducing NSSI involve a focus on emotion regulation skills. Given the important role of emotion regulation in NSSI, research should continue to develop our understanding of this construct. Methods: We conducted a review of relevant research in emotion regulation and dysregulation and specific emotion regulation strategies in NSSI. Results: First, we provide an overview of current research on emotion regulation and dysregulation in NSSI. Second, we discuss the application of a specific emotion regulation model to NSSI research, and review research on NSSI supporting the use of this model. Conclusion: NSSI has been associated with an emotion regulation function and trait emotion dysregulation among people who self-injure. Relevant research provides initial support for the applicability of a specific model of emotion regulation to NSSI. We suggest directions for future research to continue to cultivate our understanding of emotion regulation in NSSI.

A Systematic Review of the Frequency and Correlates of Partner Abuse in HIV-Infected Women and Men Who Partner With Men

&NA; Partner abuse (PA) is a highly prevalent and devastating social phenomenon, extracting an economic toll of more than

Development of an Intervention for Nonsuicidal Self-Injury in Young Adults: An Open Pilot Trial

8 billion annually in the United States due to lost productivity alone. Many of the risk factors for PA increase vulnerability to acquiring HIV as well, yet little research has explored these overlapping epidemics. In this systematic review, we examine the frequency of PA victimization from male partners among persons living with HIV—both men who have sex with men (MSM) and women. We located 31 manuscripts reporting data from 24 unique samples, indicating a high lifetime frequency (but large range) of estimates for women/MSM, respectively, for physical (26–62%/15–39%), sexual (22–44%/8–33%), and psychological abuse (55%/22–73%). Data indicate strong and consistent associations of PA with poor mental health, engagement in health risk behaviors, and nonadherence to HIV medication for both groups. We discuss implications for clinical practice as well as future research directions.

Predicting Risk for Suicide: A Preliminary Examination of Non-Suicidal Self-Injury and the Acquired Capability Construct in a College Sample

Nonsuicidal self-injury (NSSI) is a prevalent and dangerous behavior among young adults, but no treatments specific to NSSI have been developed for patients without borderline personality disorder. The purpose of this study was to develop and investigate a novel intervention for NSSI among young adults. The intervention is a 9-session behavioral treatment designed to decrease the frequency of NSSI behaviors and urges. Using an open pilot design, feasibility and acceptability were investigated in a small sample (n = 12) over a 3-month follow-up period. A preliminary investigation of change in NSSI was also conducted. Feasibility and acceptability of the intervention were supported. Medium to large effect sizes were found for decreases in NSSI behaviors and urges over the follow-up period. Results of this open pilot trial support the further evaluation of this intervention.

An intervention for nonsuicidal self-injury in young adults: A pilot randomized controlled trial.

The interpersonal psychological theory of suicide provides a useful framework for considering the relationship between non-suicidal self-injury and suicide. Researchers propose that NSSI increases acquired capability for suicide. We predicted that both NSSI frequency and the IPTS acquired capability construct (decreased fear of death and increased pain tolerance) would separately interact with suicidal ideation to predict suicide attempts. Undergraduate students (N = 113) completed self-report questionnaires, and a subsample (n = 66) also completed a pain sensitivity task. NSSI frequency significantly moderated the association between suicidal ideation and suicide attempts. However, in a separate model, acquired capability did not moderate this relationship. Our understanding of the relationship between suicidal ideation and suicidal behavior can be enhanced by factors associated with NSSI that are distinct from the acquired capability construct.

Pediatric Obsessive-Compulsive Disorder: An Illustration of Intensive Family-Based Treatment Delivered via Web Camera

Objective: Nonsuicidal self-injury (NSSI) is prevalent among young adults and associated with negative medical and psychological consequences, necessitating its treatment. However, few treatments have been developed to treat NSSI specifically, or to treat the behavior among individuals without borderline personality disorder. The purpose of this study was to investigate the Treatment for Self-Injurious Behaviors (T-SIB), a brief, behavioral intervention specifically developed to treat NSSI among young adults, in a pilot randomized controlled trial (RCT). Method: Young adults (N = 33; age: M = 22.36 years, SD = 3.40) meeting inclusion and exclusion criteria were randomly assigned to the treatment (T-SIB; n = 15) or treatment as usual (n = 18) condition. The sample was 93.9% female, 42.4% Caucasian, and 30.3% Hispanic/Latino. Results: Feasibility and acceptability of the study and intervention were supported, and medium effects were found for decreased NSSI frequency in the T-SIB group using intent-to-treat analyses. Conclusion: Results of this study support the further evaluation of T-SIB in a larger RCT.

Non-Suicidal Self-Injury

Effective treatment for childhood obsessive-compulsive disorder (OCD) is available, including exposure with response prevention and other cognitive-behavioral interventions. However, many children with OCD reside in locations in which few providers have adequate training to implement these procedures correctly. Family accommodation of childhood OCD symptoms further complicates the delivery of existing treatments. The advent of web camera technology has created the opportunity to provide therapy to individuals who otherwise could not access expert care. This case illustrates the treatment of an 8-year-old child with severe OCD who lived in a remote region of the United States. Treatment was administered twice daily for 5 days via web camera. At a 3-month follow-up, the child showed significant improvement in her OCD symptoms and in overall disability. Other symptoms (anxiety and anxiety sensitivity) were reduced, but not at a statistically significant level. The implications for treatment are considered.

Assessment of Suicidal and Non-suicidal Self-injury in Anxiety Disorders

Non-suicidal self-injury (NSSI) is a prevalent and concerning behavior among adolescents and young adults that usually begins in early adolescence. The purpose of this chapter is to provide an overview of the behavior, its inclusion in the Diagnostic and Statistical Manual, and factors related to the development of NSSI. As such, we review research on biological and genetic factors, as well as research on individual, family, social, and community risk and protective factors, that may influence risk for engaging in NSSI. Finally, we review evidence-based intervention and prevention programs for NSSI and present best practices for clinicians working with adolescents who engage in the behavior.

Suicidal and nonsuicidal self-injury in the obsessive-compulsive spectrum.

Suicide assessment is an important component of any thorough evaluation of symptoms associated with anxiety disorders. Nonsuicidal self-injury is less commonly assessed, but no less important as it contributes to morbidity in the target anxiety condition. Assessment methods, including functional evaluation and risk assessment, are described in order to fully integrate treatment of this facet of psychopathology into alleviating anxiety symptoms.