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Original Paper

Self-Injurious Behavior in Adolescent Girls

Association with Psychopathology and Neuropsychological Functions
Ohmann S.a · Schuch B.a · König M.a, b · Blaas S.a · Fliri C.a · Popow C.a

Author affiliations

Departments of aChild and Adolescent Psychiatry and bPediatrics and Adolescent Medicine, Medical University of Vienna, Vienna, Austria

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Psychopathology 2008;41:226–235

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: December 12, 2005
Accepted: June 08, 2007
Published online: April 11, 2008
Issue release date: May 2008

Number of Print Pages: 10
Number of Figures: 0
Number of Tables: 6

ISSN: 0254-4962 (Print)
eISSN: 1423-033X (Online)

For additional information: https://www.karger.com/PSP

Abstract

Background: Self-injurious behavior (SIB) is increasingly popular in psychically ill adolescents, especially in girls with posttraumatic stress (PTSD) and personality disorders. Adolescents with SIB frequently exhibit neurofunctional and psychopathological deficits. We speculated that specific neuropsychological deficits and temperamental factors could predispose patients to SIB and prospectively explored adolescent psychiatric patients with and without SIB in order to find out differences in psychopathology, and neuropsychological or temperamental factors. Sampling and Methods: Ninety-nine psychically ill adolescent girls with SIB, aged 12–19 years and treated at our clinic, were prospectively recruited during a period of 5.5 years (1999–2005). The clinical (ICD-10) diagnoses were mainly substance abuse, eating disorders, depression, PTSD and personality disorders. The control group was also prospectively recruited during the same period and consisted of 77 girls with similar diagnoses and ages but no SIB. All patients were subjected to the same selection of clinical and neuropsychological tests, mainly self-rating questionnaires and tests evaluating executive functions. Results: Adolescent girls with psychiatric disease and SIB were more severely traumatized and depressed. They reported severe emotional and behavioral problems and deficits of self-regulation. In addition, their parents more frequently had psychiatric problems. Temperament, intelligence, investigated executive functions and presence of dissociative symptoms were not different in patients with and without SIB. Conclusions: We could not verify our primary hypothesis that SIB is related to specific neuropsychological deficits or temperamental factors. SIB was associated with traumatic experience, depression, problems of self-regulation and parental psychiatric disease. The prevention of SIB should therefore focus on improving affect regulation, the management of emotional distress and problem-solving strategies.

© 2008 S. Karger AG, Basel


References

  1. Wood A, Trainor G, Rothwell J, Moore A, Harrington R: Randomized trial of group therapy for repeated deliberate self-harm in adolescents. J Am Acad Child Adolesc Psychiatry 2001;40:1246–1253.
  2. De Leo D, Heller TS: Who are the kids who self-harm? An Australian self-report school survey. Med J Aust 2004;181:140–144.
  3. Hawton K, James A: Suicide and deliberate self-harm in young people. BMJ 2005;330:891–894.
  4. Briere J, Gil E: Self-mutilation in clinical and general population samples: prevalence, correlates, and functions. Am J Orthopsychiatry 1998;68:609–620.
  5. Evans E, Hawton K, Rodham K, Deeks J: The prevalence of suicidal phenomena in adolescents: a systematic review of population-based studies. Suicide Life Threat Behav 2005;35:239–250.
  6. Yates TM: The developmental psychopathology of self-injurious behavior: compensatory regulation in posttraumatic adaptation. Clin Psychol Rev 2004;24:35–74.
  7. Claassen CA, Trivedi MH, Shimizu I, Stewart S, Larkin GL, Litovitz T: Epidemiology of nonfatal deliberate self-harm in the United States as described in three medical databases. Suicide Life Threat Behav 2006;36:192–212.
  8. Fortune SA, Hawton K: Deliberate self-harm in children and adolescents: a research update. Curr Opin Psychiatry 2005;18:401–406.
  9. Spicer RS, Miller TR: Suicide acts in 8 states: incidence and case fatality rates by demographics and method. Am J Public Health 2000;90:1885–1891.
  10. Olfson M, Gameroff MJ, Marcus SC, Greenberg T, Shaffer D: Emergency treatment of young people following deliberate self-harm. Arch Gen Psychiatry 2005;62:1122–1128.
  11. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders, ed 4. Washington, American Psychiatric Association, 2000.
  12. Favazza AR: The coming of age of self-mutilation. J Nerv Ment Dis 1998;186:259–268.
  13. Beautrais AL, Joyce PR, Mulder RT: Precipitating factors and life events in serious suicide attempts among youths aged 13 through 24 years. J Am Acad Child Adolesc Psychiatry 1997;37:504–511.
    External Resources
  14. Ystgaard M, Reinholdt NP, Husby J, Mehlum L: Deliberate self-harm in adolescents. Tidsskr Nor Laegeforen 2003;123:2241–2245.
    External Resources
  15. Hawton K, Cole D, O’Grady J, Osborn M: Motivational aspects of deliberate self-poisoning in adolescents. Br J Psychiatry 1982;141:286–291.
  16. Linehan MM: Cognitive Behavior Therapy of Borderline Personality Disorder. New York, Guilford, 1993.
  17. Low G, Jones D, MacLeod A, Power M, Duggan C: Childhood trauma, dissociation and self-harming behaviour: a pilot study. Br J Med Psychol 2000;73:269–278.
  18. Van der Kolk BA, Perry JC, Herman JL: Childhood origins of self-destructive behaviour. Am J Psychiatry 1991;148:1665–1676.
  19. Brunner R, Parzer P, Resch F: Dissociative symptoms and traumatic life experiences in adolescents with borderline personality disorder. Persönlichkeitsstörungen 2001;5:4–12.
  20. Hawton K, Kingsbury S, Steinhardt K, James A, Fagg J: Repetition of deliberate self-harm by adolescents: the role of psychological factors. J Adolesc 1999;22:369–378.
  21. Kumar G, Pepe D, Steer RA: Adolescent psychiatric inpatients’ self-reported reasons for cutting themselves. J Nerv Ment Dis 2004;192:830–836.
  22. Burgess S, Hawton K, Loveday G: Adolescents who take overdoses: outcome in terms of changes in psychopathology and the adolescents’ attitudes to their care and their overdoses. J Adolesc 1998;21:209–218.
  23. Clery C: Self-directed violence in adolescence: a psychotherapeutic perspective; in Boswell G (ed): Violent Children and Adolescents: Asking the Question Why. London, Whurr, 2000, pp 91–103.
  24. Favaro A, Santonastaso P: Impulsive and compulsive self-injurious behavior in bulimia nervosa: prevalence and psychological correlates. J Nerv Ment Dis 1998;186:157–165.
  25. Kisiel CL, Lyons JS: Dissociation as mediator of psychopathology among sexually abused children and adolescents. Am J Psychiatry 2001;158:1034–1039.
  26. Brodsky BS, Cliotre M, Dulit RA: Relationship of dissociation to self-mutilation and childhood abuse in borderline personality disorder. Am J Psychiatry 1995;152:1788–1792.
  27. Fliege H, Becker J, Weber C, Schoeneich F, Klapp BF, Rose M: Disturbed regulation of self-esteem in patients with overt versus covert self-destructive behaviour. Z Psychosom Med Psychother 2003;49:151–163.
  28. Davidson RJ, Pizzagalli D, Nitschke JB, Putnam K: Depression: perspectives from affective neuroscience. Annu Rev Psychol 2002;53:545–574.
  29. Coolidge FL, Segal DL, Stewart S, Ellett JA: Neuropsychological dysfunction in children with borderline personality disorder features: a preliminary investigation. J Res Pers 2000;34:554–561.
    External Resources
  30. Bronisch T, Brunner J, Haberger C: Neuropsychologie und suizidales Verhalten; in Bronisch T, Felber W, Wolfersdorf M (eds): Neurobiologie suizidalen Verhaltens. Regensburg, Roderer, 2001, pp 28–42.
  31. Shear PK, DelBello MP, Lee Rosenberg H, Strakowski SM: Parental reports of executive dysfunction in adolescents with bipolar disorder. Child Neuropsychol 2002;8:285–295.
  32. Haerting C, Markowitsch HJ: Neuropsychologische Befunde der Zwangsstörung. Fortschr Neurol Psychiatr 1997;65:509–515.
  33. Channon S, Pratt P, Robertson MM: Executive function, memory, and learning in Tourette’s syndrome. Neuropsychology 2003;17:247–254.
  34. Nestor PG, Kimble M, Berman I, Haycock J: Psychosis, psychopathy and homicide: a preliminary neuropsychological inquiry. Am J Psychiatry 2002;159:138–140.
  35. Hill J: Biological, psychological and social processes in the conduct disorders. J Child Psychol Psychiatry 2002;43:133–164.
  36. Diforio D, Walker EF, Kestler LP: Executive functions in adolescents with schizotypal personality disorder. Schizophr Res 2000;42:125–134.
  37. Barkley RA, Edwards G, Laneri M, Fletcher K, Metevia L: Executive functioning, temporal discounting, and sense of time in adolescents with attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD). J Abnorm Child Psychol 2001;29:541–556.
  38. Biederman J, Monuteaux MC, Doyle AE, Seidman LJ, Wilens TE, Ferrero F, Morgan CL, Faraone SV: Impact of executive function deficits and attention-deficit/hyperactivity disorder (ADHD) on academic outcomes in children. J Consult Clin Psychol 2004;72:757–766.
  39. Giancola PR, Mezzich AC, Tarter RE: Disruptive, delinquent and aggressive behavior in female adolescents with a psychoactive substance use disorder: relation to executive cognitive functioning. J Stud Alcohol 1998;59:560–567.
  40. Cloninger CR: A systematic model for clinical description and classification of personality variants. Arch Gen Psychiatry 1987;44:573–588.
  41. Cloninger CR, Svrakic DM, Przybeck TR: A psychobiological model of temperament and character. Arch Gen Psychiatry 1993;50:975–990.
  42. Barnow S, Ruge J, Spitzer C, Freyberger HJ: Temperament and character in persons with borderline personality disorder. Nervenarzt 2005;76:839–840, 842–844, 846–848.
  43. Kernberg PF: Update of borderline disorders in children. Psychiatr Hosp 1983;13:137–141.
  44. Van Reekum R: Acquired and developmental brain dysfunction in borderline personality disorder. Can J Psychiatry 1993;38(suppl 1):4–9.
  45. World Health Organization: Multiaxial Classification of Child and Adolescent Psychiatric Disorders. Cambridge, Cambridge University Press, 1996.
  46. Tewes U, Rossmann P, Schallberger U: Hamburg-Wechsler-Intelligenztest für Kinder III (HAWIK-III). Göttingen, Hogrefe, 2000.
  47. Tewes U: Hamburg-Wechsler-Intelligenztest für Erwachsene (HAWIE-R). Bern, Huber, 1991.
  48. Grant DA, Berg EA: Wisconsin Card Sorting Test (WCST). Göttingen, Hogrefe, 1993.
  49. Bäumler G: Farbe-Wort-Interferenztest (FWIT). Göttingen, Hogrefe, 1985.
  50. Hautzinger M, Bailer M, Worall H, Keller F: Beck-Depressions-Inventar (BDI). Bern, Huber, 1995.
  51. Deneke FW, Hilgenstock B: Das Narzissmusinventar. Bern, Huber, 1989.
  52. Brunner R, Resch F, Parzer P, Koch E: Heidelberger Dissoziations-Inventar (HDI). Frankfurt/Main, Swets Test Services, 1999.
  53. Schmeck K, Goth K, Meyenburg B, Poustka F: Persönlichkeitsfragebogen für Jugendliche (JTCI/12–18). Göttingen, Hogrefe, 2000.
  54. Ellis LK, Rothbart MK: Revision of the Early Adolescent Temperament Questionnaire (EATQ-R). Eugene, University of Oregon, 2001.
  55. Döpfner M, Plück J, Bölte S, Lenz K, Melchers P, Heim K: Fragebogen für Jugendliche. Deutsche Bearbeitung des Youth Self-Report (YSR), ed 2. Köln, KJFD, Arbeitsgruppe Kinder-, Jugend- und Familiendiagnostik, 1998.
  56. Achenbach TM, Edelbrock C: Manual for the Child Behavior Checklist/4–18 and Revised Child Behavior Profile. Burlington, University of Vermont, Department of Psychiatry, 1983.
  57. Rodham K, Hawton K, Evans E: Reasons for deliberate self-harm: comparison of self-poisoners and self-cutters in a community sample of adolescents. J Am Acad Child Adolesc Psychiatry 2004;43:80–87.
  58. Antonovsky A: Unraveling the Mystery of Health – How People Manage Stress and Stay Well. San Francisco, Jossey-Bass, 1987.
  59. Van Heeringen C, Audenaert K, Van Laere K, Dumont F, Slegers G, Mertens J, Dierckx RA: Prefrontal 5-HT2a receptor binding index, hopelessness and personality characteristics in attempted suicide. J Affect Disord 2003;74:149–158.
  60. Favazza AR: Self-mutilation; in Jacobs DG (ed): The Harvard Medical School Guide to Suicide Assessment and Intervention. San Francisco, Jossey-Bass, 1999, pp 125–145.
  61. Atlas JA, Wolfson MA: Depression and dissociation as features of borderline personality disorder in hospitalized adolescents. Psychol Rep 1996;78:624–626.
  62. Orbach I, Kedem P, Herman L, Apter A: Dissociative tendencies in suicidal, depressed, and normal adolescents. J Soc Clin Psychol 1995;14:393–408.
  63. Lipschitz D, Winegar B, Hartnick E, Foote B, Southwick S: Posttraumatic stress disorder in hospitalized adolescents: psychiatric comorbidity and clinical correlates. J Am Acad Child Adolesc Psychiatry 1999;38:385–392.
  64. Grucza RA, Przybeck TR, Spitznagel EL, Cloninger CR: Personality and depressive symptoms: a multi-dimensional analysis. J Affect Disord 2003;74:123–130.
  65. Joyce PR, Mulder RT, Luty SE, McKenzie JM, Sullivan PF, Cloninger RC: Borderline personality disorder in major depression: symptomatology, temperament, character, differential drug response, and 6-month outcome. Compr Psychiatry 2003;44:35–43.
  66. Becerra B, Paez F, Robles-Garcia R, Vela G: Temperament and character profile of persons with suicide attempt. Actas Esp Psiquiatr 2005;33:117–122.

Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: December 12, 2005
Accepted: June 08, 2007
Published online: April 11, 2008
Issue release date: May 2008

Number of Print Pages: 10
Number of Figures: 0
Number of Tables: 6

ISSN: 0254-4962 (Print)
eISSN: 1423-033X (Online)

For additional information: https://www.karger.com/PSP


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