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      Problematic shopping and self-injurious behaviors in adolescents

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          Abstract

          Background and aims

          Self-injurious behaviors (SIBs) and problematic shopping (PS) are both prevalent in adolescents. These behaviors have been proposed as behavioral addictions and linked to impulsivity (Imp) and sensation-seeking (SS). They are also associated with negative mental health and psychosocial measures. This study examined relationships between PS and SIB in adolescents. It also examined how PS and SIB relate to Imp and SS, and interactions between PS and SIB in relation to health/functioning measures.

          Methods

          Survey data from 2,624 Connecticut high-school students were evaluated using chi-square analyses. Next, logistic regression models were used to assess relationships between PS and measures of SIB. T-tests compared Imp and SS in adolescents with and without PS and SIB. Interaction analyses assessed effects of PS on relationships between SIB and health/functioning measures.

          Results

          Adolescents with PS had 3.43-fold higher odds of endorsing lifetime SIB than those without PS, and were more likely to exhibit severe SIB and disruption due to SIB. PS and SIB were associated with elevated Imp and SS. Interaction analyses revealed that in adolescents with PS, the relationships between SIB and substance use was weaker than in adolescents without PS. This suggests PS accounts for variance in relationships between SIB and substance use.

          Discussion and conclusions

          PS is strongly related to SIB prevalence, severity, and impairment in adolescents, and weakens associations between SIB and substance use. PS should therefore be considered for prevention efforts for SIB. Further research should investigate mechanisms connecting PS and SIB and explore possible interventions targeting associated features like Imp and SS.

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          Most cited references47

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          Deliberate self-harm within an international community sample of young people: comparative findings from the Child & Adolescent Self-harm in Europe (CASE) Study.

          Nicola Madge, Anthea Hewitt, Keith Hawton … (2008)
          Deliberate self-harm among young people is an important focus of policy and practice internationally. Nonetheless, there is little reliable comparative international information on its extent or characteristics. We have conducted a seven-country comparative community study of deliberate self-harm among young people. Over 30,000 mainly 15- and 16-year-olds completed anonymous questionnaires at school in Australia, Belgium, England, Hungary, Ireland, the Netherlands and Norway. Study criteria were developed to identify episodes of self-harm; the prevalence of self-harm acts and thoughts, methods used, repetition, reasons given, premeditation, setting for the act, associations with alcohol and drugs, hospitalisation, and whether other people knew, were examined. Self-harm was more than twice as common among females as males and, in four of the seven countries, at least one in ten females had harmed herself in the previous year. Additional young people had thought of harming themselves without doing so. More males and females in all countries except Hungary cut themselves than used any other method, most acts took place at home, and alcohol and illegal drugs were not usually involved. The most common reasons given were 'to get relief from a terrible state of mind' followed by 'to die', although there were differences between those cutting themselves and those taking overdoses. About half the young people decided to harm themselves in the hour before doing so, and many did not attend hospital or tell anyone else. Just over half those who had harmed themselves during the previous year reported more than one episode over their lifetime. Deliberate self-harm is a widespread yet often hidden problem in adolescents, especially females, which shows both similarities and differences internationally.
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            The natural history of self-harm from adolescence to young adulthood: a population-based cohort study.

            Paul Moran, Carolyn Coffey, Helena Romaniuk … (2012)
            Knowledge about the natural history of self-harm is scarce, especially during the transition from adolescence to young adulthood, a period characterised by a sharp rise in self-inflicted deaths. From a repeated measures cohort of a representative sample, we describe the course of self-harm from middle adolescence to young adulthood. A stratified, random sample of 1943 adolescents was recruited from 44 schools across the state of Victoria, Australia, between August, 1992, and January, 2008. We obtained data pertaining to self-harm from questionnaires and telephone interviews at seven waves of follow-up, commencing at mean age 15·9 years (SD 0·49) and ending at mean age 29·0 years (SD 0·59). Summary adolescent measures (waves three to six) were obtained for cannabis use, cigarette smoking, high-risk alcohol use, depression and anxiety, antisocial behaviour and parental separation or divorce. 1802 participants responded in the adolescent phase, with 149 (8%) reporting self-harm, More girls (95/947 [10%]) than boys (54/855 [6%]) reported self-harm (risk ratio 1·6, 95% CI 1·2-2·2). We recorded a substantial reduction in the frequency of self-harm during late adolescence. 122 of 1652 (7%) participants who reported self-harm during adolescence reported no further self-harm in young adulthood, with a stronger continuity in girls (13/888) than boys (1/764). During adolescence, incident self-harm was independently associated with symptoms of depression and anxiety (HR 3·7, 95% CI 2·4-5·9), antisocial behaviour (1·9, 1·1-3·4), high-risk alcohol use (2·1, 1·2-3·7), cannabis use (2·4, 1·4-4·4), and cigarette smoking (1·8, 1·0-3·1). Adolescent symptoms of depression and anxiety were clearly associated with incident self-harm in young adulthood (5·9, 2·2-16). Most self-harming behaviour in adolescents resolves spontaneously. The early detection and treatment of common mental disorders during adolescence might constitute an important and hitherto unrecognised component of suicide prevention in young adults. National Health and Medical Research Council, Australia, and operational infrastructure support programme, Government of Victoria, Australia. Copyright © 2012 Elsevier Ltd. All rights reserved.
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              Non-suicidal self-injury in United States adults: prevalence, sociodemographics, topography and functions.

              E. Klonsky (2011)
              Non-suicidal self-injury (NSSI) has received increased attention in the mental health literature and has been proposed as a diagnostic entity for DSM-5. However, data on NSSI in the United States adult population are lacking. The prevalence and nature of NSSI were examined in a random-digit dialing sample of 439 adults in the United States. Participants were recruited during July and August of 2008. Lifetime prevalence of NSSI was 5.9%, including 2.7% who had self-injured five or more times. The 12-month prevalence was 0.9%. Methods of NSSI reported included cutting/carving, burning, biting, scraping/scratching skin, hitting, interfering with wound healing and skin picking. Half of self-injurers reported multiple methods. The average age of onset was 16 years (median 14 years). Instances of NSSI infrequently co-occurred with suicidal thoughts and with use of alcohol or drugs and rarely required medical treatment. Most injurers reported that NSSI functioned to alleviate negative emotions. Fewer reported that they self-injured to punish themselves, to communicate with others/get attention or to escape a situation or responsibility. NSSI was associated with younger age, being unmarried and a history of mental health treatment, but not with gender, ethnicity, educational history or household income. Results are largely consistent with previous research in adolescent and young adult samples. Study limitations notwithstanding, this study provides the most definitive and detailed information to date regarding the prevalence and characteristics of NSSI in US adults. In the future, it will be important for large-scale epidemiological studies of psychopathology to include questions about NSSI.
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                Author and article information

                Contributors
                Marc N. Potenza:
                ORCID: 0000-0002-6323-1354
                Journal
                Journal ID (publisher-id): 2006
                Title: Journal of Behavioral Addictions
                Abbreviated Title: JBA
                Publisher: Akadémiai Kiadó (Budapest )
                ISSN (Print): 2062-5871
                ISSN (Electronic): 2063-5303
                Publication date (Print): 15 January 2021
                Publication date (Electronic): 08 December 2020
                Volume: 9
                Issue: 4
                Pages: 1068-1078
                Affiliations
                [1 ] Yale School of Medicine , New Haven, CT, USA
                [2 ] Program in Neuroscience, Middlebury College , Middlebury, VT, USA
                [3 ] Department of Psychiatry, Yale School of Medicine , New Haven, CT, USA
                [4 ] Connecticut Mental Health Center , New Haven, CT, USA
                [5 ] Connecticut Council on Problem Gambling , Wethersfield, CT, USA
                [6 ] Child Study Center, Yale School of Medicine , New Haven, CT, USA
                [7 ] Department of Neuroscience, Yale University , New Haven, CT, USA
                Author notes
                [* ]Corresponding author. marc.potenza@ 123456yale.edu
                Author information
                https://orcid.org/0000-0002-6323-1354
                Article
                DOI: 10.1556/2006.2020.00093
                PMC ID: 8969728
                PubMed ID: 33289692
                SO-VID: d9aa1390-d29c-49e2-9f96-b723b91add65
                Copyright © © 2020 The Author(s)
                License:

                Open Access. This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License ( https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and reproduction in any medium for non-commercial purposes, provided the original author and source are credited, a link to the CC License is provided, and changes – if any – are indicated.

                History
                Date received : 19 June 2020
                Date: 27 September 2020
                Date: 30 October 2020
                Date accepted : 30 October 2020
                Page count
                Tables: 6, Equations: 0, References: 46, Pages: 11
                Funding
                Funded by: National Institute of Health
                Award ID: R01 DA019039
                Award ID: RL1 AA017539
                Categories
                Subject: Full-Length Report

                ScienceOpen disciplines: Medicine,Psychology,Social & Behavioral Sciences,Clinical Psychology & Psychiatry
                Keywords: self-injurious behaviors,addictive behaviors,impulsivity,non-suicidal self-injury,compulsive buying,problematic shopping
                Data availability:
                ScienceOpen disciplines: Medicine, Psychology, Social & Behavioral Sciences, Clinical Psychology & Psychiatry
                Keywords: self-injurious behaviors, addictive behaviors, impulsivity, non-suicidal self-injury, compulsive buying, problematic shopping

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