ORCID Profile
0000-0001-8747-3385
Current Organisations
KU Leuven
,
Tilburg University
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Publisher: Springer Science and Business Media LLC
Date: 10-10-2020
Publisher: Wiley
Date: 14-12-2021
DOI: 10.1111/SLTB.12721
Abstract: The Interpersonal Theory of Suicide (IPTS) posits fearlessness of death and pain tolerance as two components of suicide capability. The German Capability for Suicide Questionnaire (GCSQ) is the first measure of both these components, but few data are available on its psychometrics. We (a) examined the psychometric properties of the GCSQ and used it to test (b) the latent structure of suicide capability and (c) its associations with suicidal behavior. As part of the WHO World Mental Health International College Student Initiative, Belgian ( N = 3715) and Australian ( N = 2828) students completed the GCSQ (Dutch or English versions). The factor structure of the GCSQ was well represented by two first‐order factors (fearlessness of death, pain tolerance) and a higher‐order suicide capability factor. The fearlessness of death scale and pain tolerance scale (minus two reverse‐scored items) showed good reliability (α = 0.81– 0.90). Fearlessness of death was associated with suicidal behaviors, but the pain tolerance scale was inversely associated with suicidal behaviors. Consistent with the Interpersonal Theory of Suicide, fearlessness of death and pain tolerance are components of a higher‐order suicide capability construct. The GCSQ is a reliable measure of this construct, though its pain tolerance scale requires modification.
Publisher: Cambridge University Press (CUP)
Date: 14-08-2017
DOI: 10.1017/S0033291717002215
Abstract: Adolescence and young adulthood carry risk for suicidal thoughts and behaviours (STB). An increasing subpopulation of young people consists of college students. STB prevalence estimates among college students vary widely, precluding a validated point of reference. In addition, little is known on predictors for between-study heterogeneity in STB prevalence. A systematic literature search identified 36 college student s les that were assessed for STB outcomes, representing a total of 634 662 students [median s le size = 2082 (IQR 353–5200) median response rate = 74% (IQR 37–89%)]. We used random-effects meta-analyses to obtain pooled STB prevalence estimates, and multivariate meta-regression models to identify predictors of between-study heterogeneity. Pooled prevalence estimates of lifetime suicidal ideation, plans, and attempts were 22.3% [95% confidence interval (CI) 19.5–25.3%], 6.1% (95% CI 4.8–7.7%), and 3.2% (95% CI 2.2–4.5%), respectively. For 12-month prevalence, this was 10.6% (95% CI 9.1–12.3%), 3.0% (95% CI 2.1–4.0%), and 1.2% (95% CI 0.8–1.6%), respectively. Measures of heterogeneity were high for all outcomes ( I 2 = 93.2–99.9%), indicating substantial between-study heterogeneity not due to s ling error. Pooled estimates were generally higher for females, as compared with males (risk ratios in the range 1.12–1.67). Higher STB estimates were also found in s les with lower response rates, when using broad definitions of suicidality, and in s les from Asia. Based on the currently available evidence, STB seem to be common among college students. Future studies should: (1) incorporate refusal conversion strategies to obtain adequate response rates, and (2) use more fine-grained measures to assess suicidal ideation.
Publisher: Elsevier BV
Date: 04-2017
Publisher: Springer Science and Business Media LLC
Date: 21-03-2019
DOI: 10.1007/S10802-019-00531-8
Abstract: Non-suicidal self-injury (NSSI) constitutes a significant mental health concern that is highly prevalent in adolescence. Theoretical accounts and empirical research suggest that, in the short-term, NSSI may provide instant relief from intense psychological distress and ruminative thoughts. However, much less is known about these associations over time throughout adolescence. Therefore, we designed a three-year longitudinal study and examined the bidirectional prospective associations between psychological distress, rumination, and NSSI. We assessed 528 secondary school students (at Time 1: Mean age = 15.0 years, SD = 1.85, range 11 to 19 years, 50.6% female, 98.7% of Belgian nationality) using self-report questionnaires at three annual measurement points. Cross-lagged structural equation modelling was performed to examine the directionality of associations. Results indicated positive bidirectional associations between (1) distress and NSSI and positive unidirectional associations between (2) distress and rumination, and (3) NSSI and rumination. The current study embeds NSSI in a broader network of cognitive and emotional antecedents and consequents, and is the first to consider the long-term influence these components exert on each other. As NSSI may play a significant part in increasing distress and rumination, the behaviour potentially sustains a longer-term maladaptive cycle between emotion, cognition, and NSSI. Clinical implications of these findings are discussed.
Publisher: Elsevier BV
Date: 09-2016
Publisher: Springer Science and Business Media LLC
Date: 17-09-2015
Publisher: JMIR Publications Inc.
Date: 08-05-2023
DOI: 10.2196/48821
Publisher: JMIR Publications Inc.
Date: 19-11-2021
DOI: 10.2196/30915
Abstract: Although nonsuicidal self-injury (NSSI)—deliberate damaging of body tissue without suicidal intent—is a behavior that occurs in interaction with real-world contexts, studying NSSI in the natural environment has historically been impossible. Recent advances in real-time monitoring technologies have revolutionized our ability to do exactly that, providing myriad research and clinical practice opportunities. In this viewpoint paper, we review new research pathways to improve our ability to understand, predict, and prevent NSSI, and provide critical perspectives on the responsibilities inherent to conducting real-time monitoring studies on NSSI. Real-time monitoring brings unique opportunities to advance scientific understanding about (1) the dynamic course of NSSI, (2) the real-time predictors thereof and ability to detect acute risk, (3) the ecological validity of theoretical models, (4) the functional mechanisms and outcomes of NSSI, and (5) the promotion of person-centered care and novel technology-based interventions. By considering the opportunities of real-time monitoring research in the context of the accompanying responsibilities (eg, inclusive recruitment, sound and transparent research practices, participant safety and engagement, measurement reactivity, researcher well-being and training), we provide novel insights and resources to open the black box of daily life in the next decade(s) of NSSI research.
Publisher: JMIR Publications Inc.
Date: 15-06-2023
DOI: 10.2196/46244
Abstract: Nonsuicidal self-injury (NSSI) is a major mental health concern. Despite increased research efforts on establishing the prevalence and correlates of the presence and severity of NSSI, we still lack basic knowledge of the course, predictors, and relationship of NSSI with other self-damaging behaviors in daily life. Such information will be helpful for better informing mental health professionals and allocating treatment resources. The DAILY (Detection of Acute rIsk of seLf-injurY) project will address these gaps among in iduals seeking treatment. This protocol paper presents the DAILY project’s aims, design, and materials used. The primary objectives are to advance understanding of (1) the short-term course and contexts of elevated risk for NSSI thoughts, urges, and behavior (2) the transition from NSSI thoughts and urges to NSSI behavior and (3) the association of NSSI with disordered eating, substance use, and suicidal thoughts and behaviors. A secondary aim is to evaluate the perspectives of in iduals seeking treatment and mental health professionals regarding the feasibility, scope, and utility of digital self-monitoring and interventions that target NSSI in daily life. The DAILY project is funded by the Research Foundation Flanders (Belgium). Data collection involves 3 phases: a baseline assessment (phase 1), 28 days of ecological momentary assessment (EMA) followed by a clinical session and feedback survey (phase 2), and 2 follow-up surveys and an optional interview (phase 3). The EMA protocol consists of regular EMA surveys (6 times per day), additional burst EMA surveys spaced at a higher frequency when experiencing intense NSSI urges (3 surveys within 30 minutes), and event registrations of NSSI behavior. The primary outcomes are NSSI thoughts, NSSI urges, self-efficacy to resist NSSI, and NSSI behavior, with disordered eating (restrictive eating, binge eating, and purging), substance use (binge drinking and smoking cannabis), and suicidal thoughts and behaviors surveyed as secondary outcomes. The assessed predictors include emotions, cognitions, contextual information, and social appraisals. We will recruit approximately 120 in iduals seeking treatment aged 15 to 39 years from mental health services across the Flanders region of Belgium. Recruitment began in June 2021 and data collection is anticipated to conclude in August 2023. The findings of the DAILY project will provide a detailed characterization of the short-term course and patterns of risk for NSSI and advance understanding of how, why, and when NSSI and other self-damaging behaviors unfold among in iduals seeking treatment. This will inform clinical practice and provide the scientific building blocks for novel intervention approaches outside of the therapy room that support people who self-injure in real time. DERR1-10.2196/46244
Publisher: Springer Science and Business Media LLC
Date: 24-12-2015
Publisher: Elsevier BV
Date: 2018
DOI: 10.1016/J.COMPPSYCH.2017.10.007
Abstract: Non-Suicidal Self-Injury (NSSI) has emerged as an important mental-health concern. However, epidemiological features like age of onset of NSSI have remained understudied. Therefore, the current study investigated the distribution of age of onset of NSSI in pooled s le of Dutch-speaking adolescents and emerging adults using event history analysis. Eleven datasets measuring age at first NSSI in community and clinical participants collected by researchers in the Dutch-speaking part of Belgium were pooled together. The final dataset consisted of 1973 community males, 1901 community females, and 505 clinical females. Discrete-time event history analysis was used to model the effect of gender and psychiatric disorders on the age of onset of NSSI. Twenty-one percent of adolescents from the community s les engaged in at least one episode of NSSI by the age of 25years. Irrespective of the type of s le (community or psychiatric disorder), the probability of age of onset peaked around the age of 14-15years. A second peak was observed around the age of 20 and 24years in the community and psychiatric s les respectively. Psychosocial interventions for prevention of NSSI should not only target adolescence through school mental health programs but also target emerging adults at the university level.
Publisher: Wiley
Date: 08-03-2016
DOI: 10.1111/SLTB.12237
Abstract: We examined whether nonsuicidal self-injury (NSSI) is associated with academic performance in college freshmen, using census-based web surveys (N = 7,527 response = 65.4%). NSSI was assessed with items from the Self-Injurious Thoughts and Behaviors Interview and subsequently linked with the administratively recorded academic year percentage (AYP). Freshmen with lifetime and 12-month NSSI showed a reduction in AYP of 3.4% and 5.9%, respectively. The college environment was found to moderate the effect of 12-month NSSI, with more strongly reduced AYPs in departments with higher-than-average mean departmental AYPs. The findings suggest that overall stress and test anxiety are underlying processes between NSSI membership and academic performance.
Publisher: MDPI AG
Date: 18-09-2023
Publisher: Elsevier BV
Date: 09-2023
Publisher: Apollo - University of Cambridge Repository
Date: 2018
DOI: 10.17863/CAM.34102
Publisher: Frontiers Media SA
Date: 29-05-2020
Publisher: Springer Science and Business Media LLC
Date: 30-09-2021
DOI: 10.1186/S40634-021-00394-3
Abstract: The aims of this study were to (1) investigate the effect of hydrodilatation in frozen shoulder patients on objective indices of shoulder functionality and subjective outcomes of pain, mobility, kinesiophobia, depression, and anxiety, and (2) progress knowledge about the reciprocal temporal relationship between psychological parameters at baseline and objective and subjective outcomes at 3-month follow-up. We evaluated the clinical and psychological status of 72 patients with a frozen shoulder before and after hydrodilatation, using the Constant Murley score, the Visual Analogue score, the T a Scale for Kinesiophobia, the Hospital Anxiety and Depression Scale, and the Shoulder Pain And Disability Index. We noted a significant improvement in functionality, pain and disability ( p .001). Depression and anxiety improved significantly ( p .001) between baseline and 3-month follow-up. Prospective analyses demonstrated that psychological factors are more likely to predict outcomes of hydrodilatation than vice versa. Hydrodilatation followed by physiotherapy is an excellent way to treat patients with recalcitrant frozen shoulder, resulting in a continuous improvement of ROM and pain. Physiotherapists and physicians should be aware that psychological factors might have an impact on the treatment outcome.
Publisher: Cambridge University Press (CUP)
Date: 06-2019
DOI: 10.1016/J.EURPSY.2019.04.002
Abstract: Despite increased awareness that non-suicidal self-injury (NSSI) poses a significant public health concern on college c uses worldwide, few studies have prospectively investigated the incidence of NSSI in college and considered targeting college entrants at high risk for onset of NSSI. Using data from the Leuven College Surveys (n = 4,565 56.8%female, M age = 18.3, SD = 1.1), students provided data on NSSI, sociodemographics, traumatic experiences, stressful events, perceived social support, and mental disorders. A total of 2,163 baseline responders provided data at a two-year annual follow-up assessment (63.2% conditional response rate). One-year incidence of first onset NSSI was 10.3% in year 1 and 6.0% in year 2, with a total of 8.6% reporting sporadic NSSI (1–4 times per year) and 7.0% reporting repetitive NSSI (≥ 5 times per year) during the first two years of college. Many hypothesized proximal and distal risk factors were associated with the subsequent onset of NSSI (ORs = 1.5–18.2). Dating violence prior to age 17 and severe role impairment in daily life were the strongest predictors. Multivariate prediction suggests that an intervention focused on the 10% at highest risk would reach 23.9% of students who report sporadic, and 36.1% of students who report repetitive NSSI during college (cross-validated AUCs =.70–.75). The college period carries high risk for the onset of NSSI. In idualized web-based screening may be a promising approach for detecting young adults at high risk for self-injury and offering timely intervention.
Publisher: Elsevier BV
Date: 06-2023
Publisher: JMIR Publications Inc.
Date: 08-05-2023
Abstract: lthough mental health problems occur in interaction with the natural environment, bringing this contextualized information into the therapy room is challenging. The experience s ling method (ESM) may facilitate this by assessing clients' thoughts, feelings, symptoms, and behavior as they are experienced in everyday life. However, ESM is still primarily used in research settings with little uptake in clinical practice. One aspect that may facilitate clinical implementation concerns the use of 'ESM protocols', which involves providing practitioners with ready-to-use ESM questionnaires, s ling schemes, visualizations, and training. his pilot study's objective was to evaluate the usability of an ESM protocol in clinical practice using a mixed-methods approach. n this pilot study, we created an ESM protocol and tested its usability in clinical practice. The ESM protocol was tailored to the m-Path software platform, consisting of a dashboard for practitioners and an app for clients. The dashboard was used to configure an ESM questionnaire template we designed. Additionally, the dashboard contained custom data visualizations that were made based on end-user feedback. The app was used for completing ESM assessments. A total of 8 practitioners and 17 clients used ESM in practice between December 2020 and July 2021. Usability was assessed using questionnaires, ESM compliance rates, and semi-structured interviews. he usability was overall rated reasonable to good by practitioners (Mean scores to usability items ranging from 5.33 [SD = 0.91] to 6.06 [SD = 0.73] on a cale from 1 to 7]). However, practitioners expressed difficulty personalizing the template and reported insufficient guidelines on how to use ESM in clinical practice. On average, clients completed 55% (SD=25%) of the ESM questionnaires. They rated the usability as reasonable to good but slightly lower and more variable than the practitioners (mean scores to usability items ranging from 4.18 [SD = 1.7] to 5.94 [SD = 1.5] on a cale from 1 to 7). Clients also voiced several concerns over the piloted ESM template, with some indicating no interest in the continued use of ESM. he findings suggest that using an ESM protocol may facilitate the implementation of ESM as a mobile health assessment tool in psychiatry. However, further adaptions should be made prior to further implementation. Adaptions include training on personalizing questionnaires, adding additional s ling scheme formats, and creating a dynamic data visualization interface. Future studies should also identify factors determining the suitability of ESM for specific treatment goals among different client populations.
Publisher: MDPI AG
Date: 23-09-2021
DOI: 10.3390/NU13103327
Abstract: Although it has been postulated that eating disorders (EDs) and obesity form part of a broad spectrum of eating- and weight-related disorders, this has not yet been tested empirically. In the present study, we investigated interin idual differences in sensitivity to punishment, sensitivity to reward, and effortful control along the ED/obesity spectrum in women. We used data on 286 patients with eating disorders (44.6% AN-R, 24.12% AN-BP, and 31.82% BN), 126 healthy controls, and 640 Class II/III obese bariatric patients (32.81% Class II and 67.19% Class III) with and without binge eating. Participants completed the behavioral inhibition and behavioral activation scales, as well as the effortful control scale, to assess sensitivity to punishment and reward and effortful control. Results showed that patients with EDs scored significantly higher on punishment sensitivity (anxiety) compared to healthy controls and Class II/III obese patients the different groups did not differ significantly on reward sensitivity. Patients with binge eating or compensatory behaviors scored significantly lower on effortful control than patients without binge eating. Differences in temperamental profiles along the ED/obesity spectrum appear continuous and gradual rather than categorical. This implies that it may be meaningful to include emotion regulation and impulse regulation training in the treatment of both EDs and obesity.
Publisher: Hindawi Limited
Date: 26-04-2018
DOI: 10.1002/DA.22754
Abstract: Approximately one in five college students report a history of nonsuicidal self-injury. However, it is unclear how many students meet criteria for the recently proposed DSM-5 nonsuicidal self-injury disorder (NSSI-D). In this study, we used full NSSI-D criteria to identify those students most in need of clinical care. Using data from the Leuven College Surveys (n = 4,565), we examined the 12-month prevalence of DSM-5 NSSI-D in a large and representative s le of incoming college students. We also explored the optimal frequency threshold as a function of interference in functioning due to NSSI, and examined comorbidity patterns with other 12-month mental disorders (i.e., major depressive disorder, broad mania, generalized anxiety disorder, panic disorder, and alcohol dependence) and suicidal thoughts and behaviors (STB). Twelve-month NSSI-D prevalence was 0.8% and more common among females (1.1%) than males (0.4%). The proposed 5+ diagnostic threshold was confirmed as yielding highest discrimination between threshold and subthreshold cases in terms of distress or disability due to NSSI. A dose-response relationship was observed for NSSI recency-severity (i.e., 12-month NSSI-D, subthreshold 12-month NSSI-D, past NSSI, no history of NSSI) with number of 12-month mental disorders and STB. NSSI-D occurred without comorbid disorders for one in five in iduals, and remained associated with severe role impairment when controlling for the number of comorbid disorders. These findings offer preliminary evidence that DSM-5 NSSI-D is uncommon among incoming college students, but may help to improve the deployment of targeted resource allocation to those most in need of services. More work examining the validity of NSSI-D is required.
Publisher: Center for Open Science
Date: 16-11-2022
Abstract: Objective: Non-suicidal self-injury (NSSI) is a major public health issue. Despite increased research efforts in clinical s les, we still have little understanding of the short-term correlates, predictors, and targets of NSSI among treatment-seeking in iduals. The current study was designed to (a) evaluate how suicidal thoughts, interpersonal difficulties, hopelessness, and affective states are associated with same-day and next-day NSSI (b) identify which factors may be effective targets in treatment through network modelling.Methods: Data from 1,265 psychiatric inpatients who self-injured throughout their visit to a psychiatric hospital self-reported their suicidal ideation, negative affect, and positive affect on a daily basis (in total 36,345 prospective reports). An additional 632 patients were also surveyed regarding feelings of hopelessness, wish to live, and interpersonal difficulties. Using multilevel structural equation modelling, we examined contemporaneous and time-lagged associations with NSSI. Multilevel network analyses assessed interconnectedness of daily predictors, and were compared with a matched s le of 1,265 patients who did not self-injure during their stay. Results: Increases in suicidal ideation were associated with increased probability of same-day and next-day self-injury, and an inverse relationship was observed for wish to live. Increases in positive affect were also significantly associated with decreased probability of next-day self-injury. Perceived burdensomeness had high centrality in network models, particularly among patients who self-injured, indicating it is susceptible to activation and directly associated with all predictors.Conclusions: Routine monitoring may improve prediction of when a patient is at short-term risk to self-injure and provides person-specific data that can assist in targeting risk and protective factors during treatment.
Publisher: Informa UK Limited
Date: 04-07-2019
DOI: 10.1080/13811118.2018.1494651
Abstract: 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 s les 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 s le 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.
Publisher: Cambridge University Press (CUP)
Date: 19-05-2020
DOI: 10.1017/S109285292000142X
Abstract: The Leuven Affect and Pleasure Scale (LAPS) was developed as an outcome measure in major depressive disorder (MDD) tha treflects patient treatment expectations. The present report investigates whether the LAPS negative affect, the LAPS positive affect, and the LAPS hedonic tone have added value on top of the Hamilton Depression Rating Scale (HAMD) in explaining generic as well as patient-centered outcomes. A total of 109 outpatients with Diagnostic and Statistical Manual of Mental Disorders, fifth edition, criteria for MDD were assessed over 8 weeks of antidepressant treatment. At baseline and after 2, 4, and 8 weeks, the LAPS, HAMD, Snaith–Hamilton Pleasure Scale (SHAPS), Positive and Negative Affect Scale (PANAS), and Sheehan Disability Scale were administered. The Clinical Global Impression of Improvement (CGI-I) and the Patient Global Impression of Improvement (PGI-I) were also administered at endpoint. Changes in LAPS negative affect, LAPS positive affect, and LAPS hedonic tone explain 14% of the additional variance in CGI-I, 21% in PGI-I, 37% in cognitive functioning, 32% in overall functioning, 31% in “my life is meaningful,” and 45% in “I feel happy.” Compared to standard scales (PANAS and SHAPS), the LAPS negative affect, LAPS positive affect, and LAPS hedonic tone differentiate better between different levels of CGI-I or PGI-I. The LAPS has added value (on top of the HAMD) in explaining changes in both generic outcomes (CGI-I/PGI-I) and patient-centered dimensions. The LAPS negative and positive affects and the LAPS hedonic tone differentiate CGI-I and PGI-I scores better than corresponding scales supposed to cover the same domains.
Publisher: MDPI AG
Date: 25-10-2023
DOI: 10.3390/NU15214531
Publisher: Elsevier BV
Date: 10-2018
DOI: 10.1016/J.JAD.2018.06.033
Abstract: Theoretical and empirical literature suggests that non-suicidal self-injury (NSSI) is an important correlate of suicide risk. The present study was designed to evaluate: (a) whether NSSI is associated with increased odds of subsequent onsets of suicidal thoughts and behaviors (STB) independent of common mental disorders, (b) whether NSSI is associated with increased risk of transitioning from suicide ideation to attempt, and (c) which NSSI characteristics are associated with STB after NSSI. Using discrete-time survival models, based on retrospective age of onset reports from college students (n = 6,393, 56.8% female), we examined associations of temporally prior NSSI with subsequent STB (i.e., suicide ideation, plan, and attempt) controlling mental disorders (i.e., MDD, Broad Mania, GAD, Panic Disorder, and risk for Alcohol Dependence). NSSI characteristics associated with subsequent STB were examined using logistic regressions. NSSI was associated with increased odds of subsequent suicide ideation (OR = 2.8), plan (OR = 3.0), and attempt (OR = 5.5) in models that controlled for the distribution of mental disorders. Further analyses revealed that NSSI was associated with increased risk of transitioning to a plan among those with ideation, as well as attempt among those with a plan (ORs = 1.7-2.1). Several NSSI characteristics (e.g., automatic positive reinforcement, earlier onset NSSI) were associated with increased odds of experiencing STB. Surveys relied on self-report, and thus, there is the potential for recall bias. This study provides support for the conceptualization of NSSI as a risk factor for STB. Investigation of the underlying pathways accounting for these time-ordered associations is an important avenue for future research.
Publisher: Elsevier BV
Date: 2019
DOI: 10.1016/J.JAD.2019.09.009
Abstract: Non-suicidal self-injury (NSSI) is a serious public health concern in adolescents. In 2013, DSM-5 recognized NSSI as a distinct clinical phenomenon and made a call for more systematic research by including Non-Suicidal Self-Injury-Disorder (NSSI-D) as a condition requiring further research. Yet, few studies have examined the prevalence of NSSI-D in adolescents using the exact DSM-5 criteria. Additionally, the few studies available criticised several of the proposed diagnostic criteria and pointed out that more research is needed. Therefore, we examined prevalence rates of NSSI-D and investigated the four most controversial criteria (i.e., criteria A, B/C, and E) in a large community s le of adolescents (N = 2,130 54% female M Our results show an overall NSSI-D prevalence rate of 7.6%, with significantly more girls (11.7%) than boys (2.9%) meeting the diagnosis. The prevalence of NSSI-D dropped to 5.5% when an alternative criterion A (i.e., ≥10 days of NSSI in the past year) was implemented. In our s le, 87% and 99% of adolescents with lifetime NSSI met criteria B and C, which clearly questions the clinical utility of these criteria for the DSM-5 diagnosis of NSSI-D. Importantly, however, although criterion E received relatively low endorsement, it significantly distinguished adolescents with and without NSSI-D from one another. Although our conclusions are restricted by the cross-sectional nature of our study, these findings show that NSSI-D is common in community adolescents and offer new insights in the endorsement and clinical utility of specific NSSI-D criteria.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2017
Publisher: Physicians Postgraduate Press, Inc
Date: 23-08-2017
DOI: 10.4088/JCP.17M11485
Publisher: Cambridge University Press (CUP)
Date: 18-06-2023
DOI: 10.1017/S0033291721002245
Abstract: Although non-suicidal self-injury (NSSI) is an issue of major concern to colleges worldwide, we lack detailed information about the epidemiology of NSSI among college students. The objectives of this study were to present the first cross-national data on the prevalence of NSSI and NSSI disorder among first-year college students and its association with mental disorders. Data come from a survey of the entering class in 24 colleges across nine countries participating in the World Mental Health International College Student (WMH-ICS) initiative assessed in web-based self-report surveys (20 842 first-year students). Using retrospective age-of-onset reports, we investigated time-ordered associations between NSSI and Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-IV) mood (major depressive and bipolar disorder), anxiety (generalized anxiety and panic disorder), and substance use disorders (alcohol and drug use disorder). NSSI lifetime and 12-month prevalence were 17.7% and 8.4%. A positive screen of 12-month DSM-5 NSSI disorder was 2.3%. Of those with lifetime NSSI, 59.6% met the criteria for at least one mental disorder. Temporally primary lifetime mental disorders predicted subsequent onset of NSSI [median odds ratio (OR) 2.4], but these primary lifetime disorders did not consistently predict 12-month NSSI among respondents with lifetime NSSI. Conversely, even after controlling for pre-existing mental disorders, NSSI consistently predicted later onset of mental disorders (median OR 1.8) as well as 12-month persistence of mental disorders among students with a generalized anxiety disorder (OR 1.6) and bipolar disorder (OR 4.6). NSSI is common among first-year college students and is a behavioral marker of various common mental disorders.
Publisher: American Psychological Association (APA)
Date: 06-2023
DOI: 10.1037/CCP0000812
Publisher: Informa UK Limited
Date: 14-02-2023
Publisher: Wiley
Date: 20-02-2020
DOI: 10.1002/ERV.2722
Publisher: Elsevier BV
Date: 11-2015
Publisher: Center for Open Science
Date: 08-09-2022
Abstract: Psychotic disorders are among the most burdensome mental health problems, requiring ongoing care and support. While the Experience s ling method (ESM), a structured self-monitoring technique, offers a promising approach to supporting person-centered care, there has been a general lack of user involvement in implementing these digital innovations in routine mental health care. The present study explored the perspective of people with a history of psychotic disorders using a user-centered design within focus groups. While people with lived experience recognize the potential of ESM to become more aware and increase control over their mental health through early detection of symptoms, concerns were voiced about the validity and burden of mental health self-monitoring. Participants indicated that ESM tools should allow for a high degree of personalization and enable assessing a broad range of daily-life experiences not limited to psychotic symptoms (i.e., including moods and emotions, social functioning, and general functioning). Future developments of clinical ESM tools for the management of psychosis should allow for a broad assessment of in iduals’ daily life experiences, identify solutions for easy personalization, and address potential barriers for use by identifying factors that influence the perceived burden of ESM and strategies to strengthen confidence in self-monitoring.
Publisher: JMIR Publications Inc.
Date: 03-06-2021
Abstract: lthough nonsuicidal self-injury (NSSI)—deliberate damaging of body tissue without suicidal intent—is a behavior that occurs in interaction with real-world contexts, studying NSSI in the natural environment has historically been impossible. Recent advances in real-time monitoring technologies have revolutionized our ability to do exactly that, providing myriad research and clinical practice opportunities. In this viewpoint paper, we review new research pathways to improve our ability to understand, predict, and prevent NSSI, and provide critical perspectives on the responsibilities inherent to conducting real-time monitoring studies on NSSI. Real-time monitoring brings unique opportunities to advance scientific understanding about (1) the dynamic course of NSSI, (2) the real-time predictors thereof and ability to detect acute risk, (3) the ecological validity of theoretical models, (4) the functional mechanisms and outcomes of NSSI, and (5) the promotion of person-centered care and novel technology-based interventions. By considering the opportunities of real-time monitoring research in the context of the accompanying responsibilities (eg, inclusive recruitment, sound and transparent research practices, participant safety and engagement, measurement reactivity, researcher well-being and training), we provide novel insights and resources to open the black box of daily life in the next decade(s) of NSSI research.
Publisher: Elsevier BV
Date: 03-2023
Publisher: Elsevier BV
Date: 2017
Publisher: Elsevier BV
Date: 07-2022
Publisher: Hindawi Limited
Date: 06-12-2018
DOI: 10.1002/DA.22867
Publisher: Springer Science and Business Media LLC
Date: 09-02-2022
DOI: 10.3758/S13428-021-01777-1
Abstract: The experience s ling method (ESM) has revolutionized our ability to conduct psychological research in the natural environment. However, researchers have a large degree of freedom when preprocessing ESM data, which may hinder scientific progress. This study illustrates the use of multiverse analyses regarding preprocessing choices related to data exclusion (i.e., based on various levels of compliance and exclusion of the first assessment day) and the calculation of constructs (i.e., composite scores calculated as the mean, median, or mode) by reanalyzing established group differences in negative affect, stress reactivity, and emotional inertia between in iduals with and without psychosis. Data came from five studies and included 233 in iduals with psychosis and 223 healthy in iduals (in total, 26,892 longitudinal assessments). Preprocessing choices related to data exclusion did not affect conclusions. For both stress reactivity and emotional inertia of negative affect, group differences were affected when negative affect was calculated as the mean compared to the median or mode. Further analyses revealed that this could be attributed to considerable differences in the within- and between-factor structure of negative affect. While these findings show that observed differences in affective processes between in iduals with and without psychosis are robust to preprocessing choices related to data exclusion, we found disagreement in conclusions between different central tendency measures. Safeguarding the validity of future experience s ling research, scholars are advised to use multiverse analysis to evaluate the robustness of their conclusions across different preprocessing scenarios.
Publisher: Center for Open Science
Date: 14-04-2023
Abstract: Background: Non-suicidal self-injury (NSSI) is a major mental health concern. Despite increased research efforts on establishing the prevalence and correlates of the presence or severity of NSSI, we still lack basic knowledge of the course, predictors, and relationship of NSSI with other self-harming behaviors in daily life. Such information will be helpful for better informing mental health professionals and allocating treatment resources. The Detection of Acute rIsk of seLf-injurY (DAILY) project will address these gaps among treatment-seeking in iduals.Objectives: This protocol paper presents the DAILY project's aims, design, and materials. The objectives are to advance understanding of (1) the short-term course and contexts of elevated risk of NSSI thoughts, urges, and behavior, (2) the transition from NSSI thoughts/urges to NSSI behavior, (3) and the association of NSSI with disordered eating, substance use, and suicidal thoughts and behaviors. A secondary aim is to evaluate the perspectives of treatment-seeking in iduals and mental health professionals regarding the feasibility, scope, and utility of digital self-monitoring and interventions that target NSSI in daily life.Methods: The DAILY project is funded by the Research Foundation Flanders (Belgium). Data collection involves three phases, including a baseline assessment (Phase 1), 28 days of Ecological Momentary Assessment (EMA) followed by a clinical session and feedback survey (Phase 2), two follow-up surveys and an optional interview (Phase 3). The EMA protocol consists of regular EMA surveys (six times per day), additional burst EMA surveys spaced at a higher frequency when experiencing intense NSSI urges (three times within 30 minutes), and event registrations of NSSI behavior. Primary outcomes are NSSI thoughts, NSSI urges, self-efficacy to resist NSSI, and NSSI behavior, with disordered eating (restrictive eating, binge eating, purging), substance use (binge drinking, smoking cannabis), and suicidal thoughts and behaviors surveyed as secondary outcomes. Assessed predictors include emotions, cognitions, contextual information, and social appraisals.Results: We will recruit approximately 120 treatment-seeking in iduals aged 15-39 years from mental health services across the Flanders region of Belgium. Recruitment began in June 2021 and is anticipated to conclude in spring 2023.Conclusions: The findings of the DAILY project will provide a detailed characterization of the short-term course of NSSI and advance understanding of how, why, and when NSSI and other self-harming behaviors unfold among treatment-seeking in iduals. This will inform clinical practice and provide the scientific building blocks for novel intervention approaches outside the therapy room that support people who self-injure in real-time.
Publisher: Springer Science and Business Media LLC
Date: 23-08-2021
Publisher: Elsevier BV
Date: 04-2018
Publisher: Hogrefe Publishing Group
Date: 11-2018
DOI: 10.1027/1015-5759/A000464
Abstract: Abstract. In this study, we investigated the factor structure and measurement invariance of three brief emotion regulation questionnaires in s les of young adults (17–30 years) with and without a history of non-suicidal self-injury (NSSI n = 705–836). Results revealed configural, full metric, and full scalar invariance for the Difficulties in Emotion Regulation Scale – Short Form (DERS-SF) and the Cognitive Emotion Regulation Questionnaire – Short (CERQ-S). In addition, the CERQ-S also showed full residual error invariance. In contrast, the proposed factor structure of the Emotion Regulation Questionnaire (ERQ) was not confirmed in either s le. Further, we observed that some items function differently for people who self-injure and people who do not, which could result in artificial differences being reported in use of cognitive reappraisal. While the current findings offer confidence that observed differences using the DERS-SF and CERQ-S reflect reliable discrepancies in emotion regulation processes between people who self-injure and do not, the validity of statistical inferences using the ERQ could not be ensured and need further psychometric evaluation.
Publisher: Cambridge University Press (CUP)
Date: 07-08-2015
DOI: 10.1016/J.EURPSY.2015.06.007
Abstract: This study examines: (1) the prevalence of Non-Suicidal Self-Injury (NSSI) among Dutch and Belgian adolescents, (2) the associations between Big Five personality traits and NSSI engagement/versatility (i.e., number of NSSI methods), and (3) whether these associations are mediated by perceived stress and coping. A total of 946 Flemish (46%) and Dutch (54%) non-institutionalized adolescents (Mean age = 15.52 SD = 1.34, 44% females) were surveyed. Measures included the NSSI subscale of the Self-Harm-Inventory, the Dutch Quick Big Five Personality questionnaire, the Perceived Stress Scale and the Utrecht Coping List for Adolescents. Examination of zero-order correlations was used to reveal associations, and hierarchical regression analysis was used to reveal potential mediators which were further examined within parallel mediation models by using a bootstrapping-corrected procedure. Lifetime prevalence of NSSI was 24.31%. Neuroticism perceived stress and distractive, avoidant, depressive, and emotional coping were positively associated with NSSI engagement, whereas Agreeableness, Conscientiousness and active, social, and optimistic coping were negatively associated with NSSI engagement. Observed relationships between personality traits and NSSI engagement were consistently explained by perceived stress and depressive coping. A higher versatility of NSSI was not associated with any Big Five personality trait, but was associated with higher scores on perceived stress and depressive coping and with lower scores on active and optimistic coping. Our study suggests that a specific personality constellation is associated with NSSI engagement via high stress levels and a typical depressive reaction pattern to handle stressful life events.
Publisher: Hogrefe Publishing Group
Date: 09-2021
DOI: 10.1027/1015-5759/A000623
Abstract: Abstract. Identity difficulties have been associated with various psychiatric conditions and are considered a central issue in personality pathology. Following the Alternative Model for Personality Disorders, measures of self- and interpersonal functioning have been developed. Although these measures were intended to be separate ratings of self-other deficits, only a global rating was obtained. Moreover, these measures fall short in bridging the gap between developmental and clinical identity work. To capture both adaptive and disturbed identity dimensions, Kaufman et al. (2015) developed the Self-Concept and Identity Measure (SCIM) that assesses consolidated identity, disturbed identity, and lack of identity. Using two-wave longitudinal data (2,150 adolescents 54.2% girls age range = 12–19), this study investigated the factor structure and reliability of the Dutch SCIM, its measurement invariance across time, its longitudinal measurement invariance across gender and age groups, and associations of the SCIM with identity synthesis and confusion, Big-Five personality traits, and borderline personality disorder features. Consolidated identity scores were positively related to identity synthesis and adaptive Big-Five traits, whereas negatively related to identity confusion, neuroticism, and borderline features. Opposite associations were obtained for disturbed identity and lack of identity scores. The Dutch SCIM appeared to produce valid and reliable scores and seemed suited to assess longitudinal identity functioning in Belgian adolescents.
Publisher: Center for Open Science
Date: 25-11-2019
Abstract: Introduction: Although research over the past decade has resulted in significantly increased knowledge about distal risk factors for non-suicidal self-injury (NSSI), little is known about short-term (proximal) factors that predict NSSI thoughts and behaviors. Drawing on contemporaneous theories of NSSI, as well as the concept of ideation-to-action, the present study clarifies (a) real-time factors that predict NSSI thoughts and (b) the extent to which theoretically important momentary factors (i.e., negative affect, positive affect, and self-efficacy to resist NSSI) predict NSSI behavior in daily life, beyond NSSI thoughts.Methods: Using Experience S ling Methodology (ESM), intensive longitudinal data was obtained from 30 young adults with frequent NSSI episodes in the last year. Participants completed assessments up to eight times per day for 12 consecutive days (signal-contingent s ling). This resulted in the collection of 2,222 assessments (median compliance = 79.2%) during which 591 NSSI thoughts and 270 NSSI behaviors were recorded. Using the dynamic structural equation modeling framework, multilevel vector autoregressive models were constructed. Results: Within the same assessment, negative affect was positively associated with NSSI thoughts, whereas positive affect and self-efficacy to resist NSSI were each negatively associated with NSSI thoughts. Across assessments, higher-than-usual negative affect and self-efficacy to resist NSSI were predictive of short-term change in NSSI thoughts. While fluctuations in both negative affect and positive affect prospectively predicted NSSI behavior, these factors became non-significant in models that controlled for the predictive effect of NSSI thoughts. In contrast, self-efficacy to resist NSSI incrementally predicted a lower probability of engaging in NSSI, above and beyond NSSI thoughts. Discussion: This study provides preliminary evidence that affective fluctuations may uniquely predict NSSI thoughts but not NSSI behaviors, and point to the role of personal belief in the ability to resist NSSI in preventing NSSI behavior. These findings illustrate the need to differentiate between the development of NSSI thoughts and the progression from NSSI thoughts to behavior, as these are likely distinct processes, with different predictors.
Publisher: Springer Science and Business Media LLC
Date: 16-03-2021
Publisher: Elsevier BV
Date: 2017
Publisher: Frontiers Media SA
Date: 20-03-2020
Publisher: Cambridge University Press (CUP)
Date: 03-11-2022
DOI: 10.1017/S0033291722003178
Abstract: Although non-suicidal self-injury (NSSI) is known typically to begin in adolescence, longitudinal information is lacking about patterns, predictors, and clinical outcomes of NSSI persistence among emerging adults. The present study was designed to (1) estimate NSSI persistence during the college period, (2) identify risk factors and high-risk students for NSSI persistence patterns, and (3) evaluate the association with future mental disorders and suicidal thoughts and behaviors (STB). Using prospective cohorts from the Leuven College Surveys ( n = 5915), part of the World Mental Health International College Student Initiative, web-based surveys assessed mental health and psychosocial problems at college entrance and three annual follow-up assessments. Approximately one in five (20.4%) students reported lifetime NSSI at college entrance. NSSI persistence was estimated at 56.4%, with 15.6% reporting a high-frequency repetitive pattern (≥five times yearly). Many hypothesized risk factors were associated with repetitive NSSI persistence, with the most potent effects observed for pre-college NSSI characteristics. Multivariate models suggest that an intervention focusing on the 10–20% at the highest predicted risk could effectively reach 34.9–56.7% of students with high-frequency repetitive NSSI persistence (PPV = 81.8–93.4, AUC = 0.88–0.91). Repetitive NSSI persistence during the first two college years predicted 12-month mental disorders, role impairment, and STB during the third college year, including suicide attempts. Most emerging adults with a history of NSSI report persistent self-injury during their college years. Web-based screening may be a promising approach for detecting students at risk for a highly persistent NSSI pattern characterized by subsequent adverse outcomes.
Publisher: Center for Open Science
Date: 11-11-2022
Abstract: Although the literature suggests trait-like differences in affective and cognitive vulnerabilities between in iduals with and without a history of non-suicidal self-injury (NSSI), little is known about how these dispositional differences are experienced in the natural environment. The present study compares the intensity, inertia, interaction, and variability of affective (negative and positive affect) and cognitive states (rumination, self-criticism) in the everyday lives of in iduals who do and do not engage in NSSI. Using experience s ling methodology (ESM), 60 emerging adults (ages=18-22 years) with and without past-year NSSI (equally distributed) completed a baseline battery of questionnaires and an ESM s ling protocol consisting of eight questionnaires per day for 12 days (in total, 96 questionnaires per participant), resulting in 4,587 assessments (median compliance=83.3% IQR=71.9-91.7). In a dynamic structural equation modeling framework, dynamic parameters (i.e., mean intensity, carryover effects, spillover effects, and within-person variability) were evaluated using multilevel vector autoregressive models. Emerging adults who engage in NSSI experience higher intensity and greater variability of negative affect, rumination, and self-criticism, whereas lower intensity and greater variability of positive affect. In addition, past-year NSSI predicted stronger affective-cognitive interactions over time, with stronger spillover effects of negative and positive affect on subsequent rumination and self-criticism in in iduals who engage in NSSI. Depressive symptoms and trait levels of emotion dysregulation and self-criticism partially negated these differences. Our findings provide evidence that emerging adults who self-injure experience more negative affective-cognitive states in daily life and point to the potential relevance of boosting positive emotions to buffer negative cognitions.
Publisher: Cambridge University Press (CUP)
Date: 09-11-2017
DOI: 10.1017/S1092852917000578
Abstract: Presence of negative mood (depressed mood) and anhedonia (lack of interest and pleasure) are considered core symptoms of depression, while absence of positive mood is not taken into account. It is therefore remarkable that the depression scales routinely used to assess changes during antidepressant treatment (Hamilton Depression Rating Scale [HDRS], Montgomery–Åsberg Depression Rating Scale [MADRS]) do not really take into account anhedonia. Several scales were developed to assess positive mood and hedonic tone, but they only partially cover the multidimensional concept. Therefore we developed a new 16-item questionnaire, the Leuven Affect and Pleasure Scale (LAPS), to assess negative affect, positive affect, and hedonic tone. This first article on the LAPS questionnaire reports on the correlations between the different items, on the factor analysis, and on the differences found in 3 groups of subjects : healthy college students (N=138), depressed but still functioning college students (N=27), and severely depressed inpatients (N=38). These differences were calculated using univariate general linear models with Bonferroni post-hoc testing, and effect sizes were expressed in η 2 . Negative and positive affect were only moderately correlated, and the 4 independent variables (cognitive functioning, overall functioning, meaningful life, and happiness) had stronger correlations with positive affect than with negative affect. The major difference in negative affect was between healthy college students and depressed college students, positive affect was different between the 3 groups, and the major difference for hedonic tone was between depressed college students and depressed inpatients. Affiliative positive affect and the affiliative hedonic function were well preserved, even in depressed inpatients. This preliminary report suggests that the LAPS offers a comprehensive assessment of negative and positive affect, of hedonic tone, and of independent variables (cognitive functioning, overall functioning, meaningful life, and happiness). Clinically relevant differences in subscores were found in 3 groups of subjects with variable levels of depression (healthy subjects, mildly depressed subjects, and severely depressed inpatients).
Publisher: Center for Open Science
Date: 12-03-2021
Abstract: Although non-suicidal self-injury (NSSI) - deliberate damaging of body tissue without suicidal intent - is a behavior that occurs in interaction with real-world contexts, studying NSSI in the natural environment has historically been impossible. Recent advances in real-time monitoring technologies have revolutionized our ability to do exactly that, providing myriad research and clinical practice opportunities. In this vision paper, we review new research pathways to improve our ability to understand, predict and prevent NSSI, and provide critical perspectives on the responsibilities inherent to conducting real-time monitoring studies on NSSI. Real-time monitoring brings unique opportunities to advance scientific understanding about: (I) the dynamic course of NSSI, (II) the real-time predictors thereof and ability to detect acute risk, (III) the ecological validity of theoretical models, (IV) the functional mechanisms and outcomes of NSSI, and (V) the promotion of person-centered care and novel technology-based interventions. By considering the opportunities of real-time monitoring research in the context of the accompanying responsibilities (e.g., inclusive recruitment, sound and transparent research practices, participant safety and engagement, measurement reactivity, and researcher well-being and training), we provide novel insights and resources to open the black box of daily life in the next decade(s) of NSSI research.
Publisher: Center for Open Science
Date: 20-11-2022
Abstract: Facilitating the uptake and making better use of technological advances will be pivotal for counseling and clinical psychology to respond to the rising call for more community-based and person-centered care. While the Experience S ling Method (ESM), a structured self-report digital diary, could help facilitate this transition, it is currently unclear how practitioners envision using ESM in clinical practice. Focus groups were organized with 36 mental health practitioners (Mage = 39.37, SDage = 12.18, 58.33% female) across Flanders (Belgium). Four broad topics were discussed: (1) how to use ESM, (2) how to visualize clinically relevant information, (3) the software requirements thereof, and (4) barriers and facilitators for implementing ESM in clinical practice. Thematic analysis was conducted and Cohen's Kappa was calculated to measure inter-rater reliability. Cohen's Kappa was .79, indicating good inter-rater reliability. Different clinical applications emerged (e.g., screening, evaluation of treatment). Practitioners expressed difficulty determining how to visualize ESM data, and novel features for use emerged (e.g., integration with electronic health records). Various barriers (e.g., lack of best-practice guidelines) and facilitators (e.g., simplicity) to clinical implementation were identified. Implications for clinical implementation and future software development work are discussed.
Publisher: Wiley
Date: 23-12-2019
DOI: 10.1002/EAT.23211
Abstract: Binge eating and purging behaviors (BPB) are common among college students, but evidence is scant on prevalence and associations of BPB with mental health problems and objective academic performance. This study aims to investigate: (a) 12-month prevalence of BPB among college first-year students, (b) comorbidity patterns of BPB with various mental health problems, and (c) the association of BPB with objective academic functioning. Using data from the Leuven College Surveys (Belgium), as part of the World Mental Health Surveys International College Student initiative, we cross-sectionally assessed 12-month BPB and mental health problems among college first-year students (n = 4,889 response rate = 73.2%) at the beginning of the academic year. Objective measures of academic functioning (final grades, expressed in academic year percentage "AYP" [0-100%] and academic failure) were obtained from administrative records at the end of the academic year. Twelve-month prevalence of BPB was 7.6% (7.3%binge eating and 1.0%purging), with higher rates among females than males. Bivariate models showed an association between BPB and numerous mental health problems (ORs = 3.4-18.4). Multivariate models showed associations with non-suicidal self-injury, post-traumatic stress, internalizing/externalizing problems and suicidal ideation. After controlling for sociodemographic characteristics and comorbid mental health problems, BPB were still associated with lower AYP (-4.1 to -11.2% range) and elevated odds of academic year failure (ORs = 1.4-4.2). BPB (especially binge eating) are relatively common and associated with mental health problems, comparatively low academic performance, and higher risk of academic failure among college first-year students. Further study is needed to examine the causal dynamics underlying these associations.
Publisher: Cambridge University Press (CUP)
Date: 19-05-2020
DOI: 10.1017/S1092852920001418
Abstract: The Leuven Affect and Pleasure Scale (LAPS) is a depression outcome measure aiming to better reflect patient treatment expectations. We investigated the evolution of the LAPS and some comparator scales during antidepressant treatment and compared scores of remitters with scores of healthy controls. A total of 109 outpatients with Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) major depressive disorder were assessed over 8 weeks of antidepressant treatment. At baseline and after 2, 4, and 8 weeks, the LAPS as well as the Hamilton Depression Rating Scale (HAMD), the Snaith–Hamilton Pleasure Scale (SHAPS), the Positive and Negative Affect Scale (PANAS), and the Sheehan Disability Scale (SDS) were administered. Healthy controls consisted of 38 Italian adults and 111 Belgian students. Correlations between baseline positive and negative affect were only moderate (R between −0.20 and −0.41). LAPS positive affect and hedonic tone showed higher correlations with LAPS cognitive functioning, overall functioning, meaningfulness of life, and happiness than HAMD scores or PANAS negative affect. HAMD remission was associated with normal levels of LAPS negative affect but with significantly lower levels of LAPS positive affect, hedonic tone, cognitive functioning, overall functioning, meaningfulness of life, and happiness. The scores on the latter subscales only reached healthy control scores when the HAMD approached a score of 0 or 1. The standard definition of remission (HAMD cutoff of 7) is probably adequate for remitting negative mood, but not good enough for recovering positive mood, hedonic tone, functioning, or meaningfulness of life.
No related grants have been discovered for Glenn Kiekens.