title: Impulsivity and clinical symptoms among adolescents with non-suicidal self-injury with or without attempted suicide.
abstract: This study examined clinical characteristics and laboratory-measured impulsive behavior of adolescents engaging in either non-suicidal self-injury with (NSSI+SA; n=25) or without (NSSI-Only; n=31) suicide attempts. We hypothesized that adolescent with NSSI+SI would exhibit more severe clinical symptoms and higher levels of behavioral impulsivity compared to adolescents with NSSI-Only. Adolescents were recruited from an inpatient psychiatric hospital unit and the two groups were compared on demographic characteristics, psychopathology, self-reported clinical ratings, methods of non-suicidal self-injury, and two laboratory impulsivity measures. Primary evaluations were conducted during psychiatric hospitalization, and a subset of those tested during hospitalization was retested 4-6 weeks after discharge. During hospitalization, NSSI+SA patients reported worse depression, hopelessness, and impulsivity on standard clinical measures, and demonstrated elevated impulsivity on a reward-directed laboratory measure compared to NSSI-Only patients. In the follow-up analyses, depression, hopelessness, suicidal ideation, and laboratory impulsivity were improved for both groups, but the NSSI+SA group still exhibited significantly more depressive symptoms, hopelessness, and impulsivity than the NSSI-Only group. Risk assessments for adolescents with NSSI+SA should include consideration not only of the severity of clinical symptoms but of the current level impulsivity as well.
authors.affiliation: Neurobehavioral Research Laboratory and Clinic, Department of Psychiatry, The University of Texas Health Science Center at San Antonio, TX 78229-3900, USA. doughertyd@uthscsa.edu
authors.forename: Donald M
authors.initials: DM
authors.lastname: Dougherty
authors.forename: Charles W
authors.initials: CW
authors.lastname: Mathias
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Marsh-Richard
authors.forename: Kristen N
authors.initials: KN
authors.lastname: Prevette
authors.forename: Michael A
authors.initials: MA
authors.lastname: Dawes
authors.forename: Erin S
authors.initials: ES
authors.lastname: Hatzis
authors.forename: Guy
authors.initials: G
authors.lastname: Palmes
authors.forename: Sylvain O
authors.initials: SO
authors.lastname: Nouvion
mesh_terms: D000293:Adolescent; D005260:Female; D006306:Health Surveys; D006801:Humans; D007175:Impulsive Behavior / Q000503:physiopathology / Q000523:psychology; D008297:Male; D010552:Personality Assessment; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D016728:Self-Injurious Behavior / Q000523:psychology*; D013406:Suicide, Attempted / Q000523:psychology* / Q000706:statistics & numerical data