Autonomic dysregulation and self‐injurious thoughts and behaviours in children and young people: a systematic review and meta‐analysis
Autonomic dysregulation and self‐injurious thoughts and behaviours in children and young people: a systematic review and meta‐analysis
Background: self-injurious thoughts and behaviours (SITBs) have been associated with dysfunction of the Autonomic Nervous System (ANS) in children and young people, suggesting that objective ANS measures may aid assessment of suicide risk, but a systematic synthesis of this literature is currently lacking.
Methods: following a pre-registered protocol (PROSPERO CRD42022327605), we conducted a systematic search of PubMed, Medline, Embase, PsycINFO, and Web of Science, for empirical studies published until 10th May 2022 that compared indices of ANS functioning in individuals aged 0–25 years with versus without SITBs, or reported continuous associations between ANS measures and SITBs. Study quality was assessed with the Newcastle-Ottawa Scales. Pooled effect sizes (Hedge's g) were estimated with random-effects meta-analytic models.
Results: twenty studies (1979 participants) were included in our systematic review, with 16 included in meta-analyses. Results suggested that SITBs were associated with altered cardiac indices of arousal (g = −0.328, p < 0.001), which was driven by lower heart rate variability in individuals with SITBs (g = −0.375, p = 0.025). Overall results for electrodermal activity were not significant (g = 0.026, p = 0.857), but subgroup analyses showed increased activity in studies of individuals who engaged specifically in non-suicidal self-harm (g = 0.249, p = 0.014) but decreased activity in the remaining studies (g = −0.567, p = 0.004).
Conclusions: our systematic review and meta-analysis found evidence of reduced parasympathetic regulation as well as more tentative evidence of altered electrodermal activity in children and young people displaying SITBs. Future longitudinal studies should test the clinical utility of these markers for detecting and monitoring suicide risk.
e12148
Bellato, Alessio
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Admani, Muskaan Aleeza
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Deak, Camila
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Farhat, Luis Carlos
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Fontana Antunes De Oliveira, Maria Carolina
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Vasconcelos, Rebeca
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Malanchini, Margherita
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Shephard, Elizabeth
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Michelini, Giorgia
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14 September 2023
Bellato, Alessio
0ee4c34f-3850-4883-8b82-5717b74990f7
Admani, Muskaan Aleeza
3901936b-46fb-437c-b41d-68de2c755f2a
Deak, Camila
34676e45-a117-407d-98c8-e9aa2817b519
Farhat, Luis Carlos
fd7d10e5-ad81-4b9d-a595-8f7850eaafd4
Fontana Antunes De Oliveira, Maria Carolina
66a0439f-dbe2-4922-a318-ed282786b64f
Vasconcelos, Rebeca
1f2a05fc-d949-47a4-a539-12625bd56f95
Malanchini, Margherita
9a199fe2-5bf4-4608-b87f-928e28a9c7fb
Shephard, Elizabeth
fe77e2bc-ba7c-4f7f-9d2f-29b49f7eb006
Michelini, Giorgia
bcd4e55d-d4df-4b09-9369-08fd1c7ca3fb
Bellato, Alessio, Admani, Muskaan Aleeza, Deak, Camila, Farhat, Luis Carlos, Fontana Antunes De Oliveira, Maria Carolina, Vasconcelos, Rebeca, Malanchini, Margherita, Shephard, Elizabeth and Michelini, Giorgia
(2023)
Autonomic dysregulation and self‐injurious thoughts and behaviours in children and young people: a systematic review and meta‐analysis.
JCPP advances, 3 (3), , [e12148].
(doi:10.1002/jcv2.12148).
Abstract
Background: self-injurious thoughts and behaviours (SITBs) have been associated with dysfunction of the Autonomic Nervous System (ANS) in children and young people, suggesting that objective ANS measures may aid assessment of suicide risk, but a systematic synthesis of this literature is currently lacking.
Methods: following a pre-registered protocol (PROSPERO CRD42022327605), we conducted a systematic search of PubMed, Medline, Embase, PsycINFO, and Web of Science, for empirical studies published until 10th May 2022 that compared indices of ANS functioning in individuals aged 0–25 years with versus without SITBs, or reported continuous associations between ANS measures and SITBs. Study quality was assessed with the Newcastle-Ottawa Scales. Pooled effect sizes (Hedge's g) were estimated with random-effects meta-analytic models.
Results: twenty studies (1979 participants) were included in our systematic review, with 16 included in meta-analyses. Results suggested that SITBs were associated with altered cardiac indices of arousal (g = −0.328, p < 0.001), which was driven by lower heart rate variability in individuals with SITBs (g = −0.375, p = 0.025). Overall results for electrodermal activity were not significant (g = 0.026, p = 0.857), but subgroup analyses showed increased activity in studies of individuals who engaged specifically in non-suicidal self-harm (g = 0.249, p = 0.014) but decreased activity in the remaining studies (g = −0.567, p = 0.004).
Conclusions: our systematic review and meta-analysis found evidence of reduced parasympathetic regulation as well as more tentative evidence of altered electrodermal activity in children and young people displaying SITBs. Future longitudinal studies should test the clinical utility of these markers for detecting and monitoring suicide risk.
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JCPP Advances - 2023 - Bellato (1)
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Accepted/In Press date: 15 January 2023
e-pub ahead of print date: 23 March 2023
Published date: 14 September 2023
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© 2023 The Authors. JCPP Advances published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.
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Local EPrints ID: 482045
URI: http://eprints.soton.ac.uk/id/eprint/482045
ISSN: 2692-9384
PURE UUID: 2f996269-7ee3-47b4-9b79-7c76bdbd4298
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Date deposited: 18 Sep 2023 16:39
Last modified: 18 Mar 2024 04:16
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Author:
Alessio Bellato
Author:
Muskaan Aleeza Admani
Author:
Camila Deak
Author:
Luis Carlos Farhat
Author:
Maria Carolina Fontana Antunes De Oliveira
Author:
Rebeca Vasconcelos
Author:
Margherita Malanchini
Author:
Elizabeth Shephard
Author:
Giorgia Michelini
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