Zelfverwondend gedrag in detentie : prevalentie, risicofactoren en preventie

ACHTERGROND: Hoewel zelfverwondend gedrag (ZVG) internationaal een ernstig probleem vormt bij gedetineerden, zijn hieromtrent geen empirische gegevens beschikbaar in de Belgische detentiecontext. DOEL: De prevalentie van, en risicofactoren voor, ZVG nagaan in de Vlaamse gevangenissen. METHODE: Dwarsdoorsnedeonderzoek bij een representatieve steekproef van 1326 gedetineerden (1203 mannen en 123 vrouwen), willekeurig gerekruteerd uit 15 Vlaamse gevangenissen. RESULTATEN: Van alle gedetineerden gaf 17,3% aan zichzelf ooit in het leven opzettelijk verwond te hebben. Eén op twaalf (8,6%) rapporteerde ZVG tijdens de detentieperiode, wat significant geassocieerd was met zowel statische risicofactoren (jongere leeftijd, een definitieve veroordeling en gewelddadige delicten) als dynamische risicofactoren (psychiatrische stoornissen, distress en copingstrategieën). CONCLUSIE: De omvang van ZVG bij gedetineerden in Vlaanderen is aanzienlijk. De geïdentificeerde risicofactoren vormen belangrijke aanknopingspunten voor preventie en interventie in detentie.BACKGROUND: Although non-suicidal self-injury (NSSI) is a serious health concern among prisoners worldwide, no empirical data on this issue are currently available specifically for Belgium. AIM: To investigate the prevalence rates of, and risk factors for, NSSI in Flemish prisons. METHOD: A cross-sectional study based on a representative sample of 1326 prisoners (1203 men and 123 women), randomly selected from 15 Flemish prisons. RESULTS: Overall, 17.3% of prisoners self-reported a lifetime history of NSSI. One in 12 prisoners (8.6%) engaged in NSSI whilst incarcerated; this was significantly associated with both static (younger age, sentenced status, and violent offending) and dynamic (psychiatric disorders, distress, and coping strategies) risk factors. CONCLUSION: The extent of NSSI among prisoners in Flanders is considerable. The identified risk factors present important targets for prevention and intervention in a custodial setting

Starting from scratch : prevalence, methods, and functions of non-suicidal self-injury among refugee minors in Belgium

Abstract Background As many refugee minors have gone/go through stressful life experiences and uncertainty, one might expect mental health issues, including self-injury. However, literature on non-suicidal self-injury (NSSI) in refugee minors is scarce. This study explores the prevalence, methods, and functions of NSSI in refugee minors in Belgium, and compares research results to the existing literature on NSSI in Western adolescents. Methods Data were obtained from 121 refugee minors (mean age = 16.12, SD = 1.23; range 14–18 years) through schools located in the Flemish and Brussels-Capital regions of Belgium. The sample consists of 39.7% girls and 60.3% boys. Self-report questionnaires were used to explore socio-economic data, NSSI behaviour (e.g. The Brief Non-Suicidal Self-injury Assessment Tool; BNNSI-AT) and emotional and behavioural difficulties (The Strengths and Difficulties Questionnaire; SDQ). Non-parametric Chi square tests were used for statistical comparisons of the obtained data as well as independent-sample t-tests and Fisher’s exact tests. Results Results show a lifetime NSSI prevalence rate of 17.4%. Being accompanied or not, having both parents around, or living in an asylum centre did not influence NSSI prevalence. An average of 2.65 methods of NSSI was applied (SD = 2.50; range 1–9). The mean number of functions per person was six (SD = 4.97, range 0–16), with automatic functions reported the most. The data do point towards a greater psychological strain, with 68.4% reporting more than five acts of NSSI. Results of the SDQ’s Total Difficulties Scale and, more specifically, of the Emotional Problems, Conduct Problems, Peer Problems and Impact Scales indicate a substantial risk of clinically significant problems within the NSSI group. The Peer Problems and Impact Scales also point towards a high risk for suicidality amongst self-injuring refugees. Conclusions Prevalence rates, methods and functions are comparable to Western samples. However, the higher incidence of the NSSI and the results on the SDQ also emphasise the vulnerability of refugee minors

Attachment and non-suicidal self-injury among young adolescents : the indirect role of behavioral problems

Non-suicidal self-injury (NSSI) often occurs before age 15, yet the majority of research on risk factors for this dangerous behavior has focused on samples of older participants. Insecure attachment has been previously identified as a risk factor for both NSSI and behavioral problems, and behavioral problems appear to be particularly associated with NSSI among young populations. Redressing the lack of young adolescent NSSI research, the present study uses longitudinal data from a sample of young adolescents to test a model in which insecure attachment acts as a prospective risk factor for NSSI via emotional and behavioral problems. Data on NSSI, child-mother attachment, and emotional and behavioral problems were collected from 559 (41.1% male) Flemish adolescents when they were 13 years old (M = 12.71, SD =0.32), and again 1 year later. Insecure attachment was measured using maternal items on the Experiences in Close Relationships-Revised Child scale. Psychological adjustment was assessed with the Strengths and Difficulties Questionnaire. We found that anxious and avoidant attachment were indirectly associated with NSSI through behavioral problems but not through emotional problems. Findings highlight the role of behavioral problems as a risk factor for NSSI in early adolescence, a rarely studied developmental period during which NSSI often first starts. Findings suggest that one possible pathway for the attachment-NSSI association among young adolescents is through behavioral problems. Therapies that improve child-parent attachment may reduce NSSI among young adolescents both directly, and indirectly by improving behavioral problems

Attachment and Non-Suicidal Self-Injury among Young Adolescents: The Indirect Role of Behavioral Problems.

Non-suicidal self-injury (NSSI) often occurs before age 15, yet the majority of research on risk factors for this dangerous behavior has focused on samples of older participants. Insecure attachment has been previously identified as a risk factor for both NSSI and behavioral problems, and behavioral problems appear to be particularly associated with NSSI among young populations. Redressing the lack of young adolescent NSSI research, the present study uses longitudinal data from a sample of young adolescents to test a model in which insecure attachment acts as a prospective risk factor for NSSI via emotional and behavioral problems. Data on NSSI, child-mother attachment, and emotional and behavioral problems were collected from 559 (41.1% male) Flemish adolescents when they were 13 years old (M = 12.71, SD =0.32), and again 1 year later. Insecure attachment was measured using maternal items on the Experiences in Close Relationships-Revised Child scale. Psychological adjustment was assessed with the Strengths and Difficulties Questionnaire. We found that anxious and avoidant attachment were indirectly associated with NSSI through behavioral problems but not through emotional problems. Findings highlight the role of behavioral problems as a risk factor for NSSI in early adolescence, a rarely studied developmental period during which NSSI often first starts. Findings suggest that one possible pathway for the attachment-NSSI association among young adolescents is through behavioral problems. Therapies that improve child-parent attachment may reduce NSSI among young adolescents both directly, and indirectly by improving behavioral problems

Non-suicidal self-injury in adolescence: a longitudinal study of the relationship between NSSI, psychological distress and perceived parenting

Objective: The present study investigates whether either adolescents' psychological distress and/or perceived parenting predicted the occurrence of NSSI. Furthermore, the consequences of NSSI are examined in a three-wave longitudinal study. Design: The sample at time 1 (age 12) consisted of 1396 adolescent reports and 1438 parent reports. At time 2 (age 13), 827 adolescent reports and 936 parent reports were obtained. Time 3 (age 14) included 754 adolescent reports and 790 parent reports. Psychological distress of adolescents was measured using the Strengths and Difficulties Questionnaire. Perceived parenting behaviors were examined by the Parental Behavior Scale and the Psychological Control Scale. Results: A total of 10% of the adolescents engaged in NSSI at least once before age 15. Higher psychological distress of adolescents at time 1 was associated with the presence of NSSI at time 2 or 3. The association between psychological distress at time 1 and perception of decreased parental rule setting at time 3 was mediated by the presence of NSSI at time 2. Conclusions: The present study showed that psychological distress at age 12 predicts NSSI over time and that parental awareness of NSSI changes the perception of parenting behaviors. (C) 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved

The effects of nonsuicidal self-injury on parenting behaviors: A longitudinal analyses of the perspective of the parent

Background: The present study is the first to examine predictors and consequences of nonsuicidal self-injury (NSSI) in adolescence using parent-reported data in a longitudinal design. Across three time points, we examined the reciprocal effects of parent-reported parenting behaviors as they are related to adolescents' NSSI. Methods: The present study is a three-wave prospective study in a large sample of community adolescents and their parents. At time 1 (age 12), the sample consisted of 1396 adolescent reports and 1438 parent reports. Time 2 (age 13) included 827 adolescent and 936 parent reports. At time 3 (age 14), 754 adolescent and 790 parent reports were obtained. Engagement in NSSI (adolescent report) was determined by an affirmative response to the item 'Have you intentionally injured yourself (e.g., cut, burn, scratch) this year, without the intent to die?'. Parental awareness of NSSI at age 13 and 14 was examined using a single-item screening question. Parenting behaviors were examined by the parent versions of the Parental Behavior Scale. Results: Results showed that although NSSI was reported by 10 % of the adolescents, only 3 % of the parents were aware of the NSSI behaviors of their children. Cross-lagged analyses showed a reciprocal relationship between NSSI and parenting behaviors over time. We found a significant effect of both positive parenting and controlling parenting on the presence of NSSI at time 2. But vice versa NSSI also has an effect on parenting behaviors over time. Results showed that NSSI at time 1 has an impact on controlling parenting behaviors, namely punishment at time 2. NSSI at time 2 showed an impact on parent's perception of positive parenting, parental rule setting, punishment and harsh punishment. Conclusions: The present study examined predictors and consequences of NSSI in a longitudinal design, and emphasized the importance of examining reciprocal interactions between NSSI and parenting behaviors. Furthermore, it is the first study to examine parent-reported data in a longitudinal design and gives insight into parents' perspectives

Non-Suicidal Self-Injury in Adolescence: Interplay between Psychological Distress and Parenting

Non-suicidal self-injury (NSSI) refers to socially unaccepted, intentional, and direct injury of one s own body tissue without suicidal intent (Nock & Favazza, 2009). The risk for engaging in NSSI seems to be particularly high in adolescence (Hooley, 2008), with a mean lifetime prevalence of 18% (Muehlenkamp, Claes, Havertape, & Plener, 2012). We chose to investigate NSSI in adolescence given the increased risk of onset of NSSI during this developmental period (Nixon & Heath, 2009). Comprehensive knowledge about NSSI among adolescents is critical to develop prevention and intervention programs for youth engaging in NSSI. This PhD dissertation focuses on adolescents psychological distress, parenting behaviors and their respective roles and interaction, in relation to NSSI in adolescence. Examining the role of intrapersonal and interpersonal risk factors is essential in obtaining a better understanding of the etiology of NSSI and is critical to building effective prevention and intervention programs for adolescents who engage in NSSI. A first line of research focuses on the prevalence of NSSI in Flanders. Chapter 2 examines the prevalence rate of NSSI (in comparison to suicidal self-injury, SSI) in a community sample of Flemish adolescents between the ages of 12 - 18 years. The prevalence rate of NSSI in Flanders is compared with prevalence rates of NSSI in other Western countries. Furthermore, we examine differences between adolescents engaging in NSSI and adolescents engaging in SSI with regard to sociodemographic correlates, functionality, and stressful life events.A second line of research investigates the role of intrapersonal risk factors in association with NSSI in adolescence. In the first study of Chapter 3, associations with psychological symptoms (internalizing and externalizing) are examined. In the second study, the associations between NSSI and temperament traits are described in a sample of adolescents between the ages of 14 - 19 years.A third line of research examines associations between NSSI and distal/proximal family risk factors: the associations between parenting behaviors, socioeconomic status (SES), family structure and NSSI are examined in a non-clinical sample of pre-adolescents (age 12) and their parents (Chapter 4).A fourth line of research focuses on the interplay between intrapersonal (psychological distress) and interpersonal risk factors in relation to NSSI in adolescence (Chapter 5). This research presents a promising avenue to gain further insight in NSSI in adolescence, and fills a gap in the international research on understanding NSSI in non-clinical samples of adolescents. In Chapter 6, we provide a summary of our findings and a discussion of strengths and limitations of this PhD dissertation, as well as perspectives for future research and clinical practice.status: publishe

Niet-suïcidale zelfbeschadiging/Nonsuicidal Self-Injury (NSSI)

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