Non-suicidal self-injury in adolescent depression: the role of sex and age characteristics and attenuated psychotic symptoms

Research into the ageand gender-specific characteristics and impact of attenuated psychotic symptoms (APS) on the presentation of non-suicidal self-injury (NSSI) is relevant for identifying risk factors and identifying targets for individualized psychotherapy strategies for depressive states in adolescent patients. Objectives. To identify ageand gender-specific characteristics of attitudes toward physical pain and parameters of psychological distress in NSSI in the structure of adolescent depression, depending on the presence of APS in the clinical picture. Methods: A total of 351 respondents aged 16 to 25 were surveyed. Participants included patients with depression, both with NSSI (main clinical group) and without NSSI (clinical comparison group), as well as healthy controls (control group). Clinical groups were further divided by the presence of APS. The following methods were used: Interpersonal Needs Questionnaire, Psychological Distress Diagnostic Questionnaire, Short Form Fear of Pain Questionnaire, Discomfort Intolerance Scale, and Pain Catastrophizing Scale.

Results. Attitudes toward physical pain and interpersonal domain parameters are not related to age. In the control group, female patients were found to catastrophize pain more and experience fear of pain, and to report more complaints reflecting psychological distress. Patients without APS reported more severe complaints related to psychological distress. Among patients with APS, fear of significant physical pain was lower in the NSSI group than in the non-NSSI group, which was not observed in the non-APS group. Conclusion. Significant differences were found within the control group. Attitudes toward physical pain, feelings of burden, and feelings of impaired belonging were virtually unrelated to age. Patients without APS report more severe complaints about their condition and are more likely to acknowledge the need for psychological help. In patients with APS the fear of significant physical pain in the NSSI group is lower than in the non-NSSI group.

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