Neurobiologie und Umweltfaktoren im Kontext der nicht suizidalen Selbstverletzung

Zusammenfassung

Die nicht suizidale Selbstverletzung (NSSV) ist ein häufiges und in seiner Prävalenz vermutlich zunehmendes Phänomen unter jungen Menschen. Das wissenschaftliche und öffentliche Interesse an der NSSV hat im letzten Jahrzehnt enorm zugenommen, was zu einem immensen Wissenszuwachs und besseren Verständnis der NSSV bei Jugendlichen und jungen Erwachsenen geführt hat. Nichtsdestotrotz gibt es hinsichtlich der Entstehung der NSSV mehr offene Fragen als Antworten. Diese Übersichtsarbeit versucht die Forschung hinsichtlich neurobiologisch und umweltbedingter Faktoren, die in der Entstehung der NSSV wahrscheinlich eine Rolle spielen, darzustellen und diese Faktoren in ein gemeinsames Modell zur Entwicklung der NSSV zu integrieren.

Summary

Nonsuicidal self-injury (NSSI) is a common and probably increasing phenomenon amongst youth. Scientific but also public interest has enormously increased during the past decade which led to a dramatic increase of knowledge and a better understanding of NSSI in youth. Nevertheless, there are still more open questions than answers regarding the development of NSSI. This review tries to summarise previous research on neurobiological and environmental factors, which are supposed to play a role in the development of NSSI; and to integrate these factors in a common model of the development of NSSI.

Schlüsselwörter

Selbstverletzung - Selbstschädigung - Neurobiologie - Umwelt - Jugendliche

Keywords

Self-injury - self-harm - neurobiology - environment - adolescents

• Literatur

• 1 Favazza AR. The coming of age of self-mutilation. Journal of Nervous and Mental Disease 1998; 186: 259-268.
• 2 Pattison EM, Kahan J. The deliberate self-harm syndrome. American Journal of Psychiatry 1983; 140: 867-872.
• 3 Lloyd-Richardson EE, Perrine N, Dierker L, Kelley ML. Characteristics and functions of non-suicidal self-injury in a community sample of adolescents. Psychological Medicine 2007; 37: 1183-1192.
• 4 Nock MK, Joiner TE, Gordon KH, Lloyd-Richardson E, Prinstein MJ. Non-suicidal self-injury among adolescents: diagnostic correlates and relation to suicide attempts. Psychiatry Research 2006; 144: 65-72.
• 5 Nock MK. Self-injury. Annual Reviews of Clinical Psychology 2010; 06: 339-363.
• 6 Brunner R, Parzer P, Haffner J, Steen R, Roos J, Klett M. et al. Prevalence and Psychological Correlates of Occasional and Repetitive Deliberate Selfharm in Adolescents. Archives of Pediatric and Adolescent Medicine 2007; 161: 641-649.
• 7 Kaess M, Brunner R, Resch F. Selbstverletzendes Verhalten – ein zunehmendes Problem bei Jugendlichen. Kinder-und Jugendmedizin. Kinderund Jugendmedizin 2010; 10: 89-94.
• 8 Pies RW, Popli AP. Self-injurious behavior: pathophysiology and implications for treatment. Journal of Clinical Psychiatry 1995; 56: 580-588.
• 9 Plener PL, Brunner R, Resch F, Fegert JM, Libal G. Selbstverletzendes Verhalten im Jugendalter. Zeitschrift für Kinder-und Jugendpsychiatrie und Psychotherapie 2010; 38: 77-88.
• 10 Roberts N. Adolescent self-mutilatory behavior: Psychopharmacological treatment. Child and Adolescent Psychopharmacology 2003; 08: 10-12.
• 11 Stanley B, Winchel R, Molcho A, Simeon D, Stanley M. Suicide and the self-harm continuum: Phenomenological and biochemical evidence. International Review of Psychiatry 1992; 04: 149-155.
• 12 Coccaro EF, Siever LJ, Klar HM, Maurer G, Cochrane K, Cooper TB. et al. Serotonergic studies in patients with affective and personality disorders. Correlates with suicidal and impulsive aggressive behavior. Archives of General Psychiatry 1989; 46: 587-599.
• 13 Herpertz S, Steinmeyer SM, Marx D, Oidtmann A, Sass H. The significance of aggression and impulsivity for self-mutilative behavior. Pharmacopsychiatry 1995; 28: 64-72.
• 14 Bronisch T. Neurobiologie von suizidalem Verhalten und Aggression. Psychotherapie 2009; 14: 58-79.
• 15 Crowell SE, Beauchaine TP, McCauley E, Smith CJ, Vasilev CA, Stevens AL. Parent-child interactions, peripheral serotonin, and self-inflicted injury in adolescents. Journal of Consulting and Clinical Psychology 2008; 76: 15-21.
• 16 Kleindienst N, Bohus M, Ludascher P, Limberger MF, Kuenkele K, Ebner-Priemer UW. et al. Motives for nonsuicidal self-injury among women with borderline personality disorder. Journal of Nervous and Mental Disease 2008; 196: 230-236.
• 17 Plotsky PM, Meaney MJ. Early, postnatal experience alters hypothalamic corticotropin-releasing factor (CRF) mRNA, median eminence CRF content and stress-induced release in adult rats. Molecular Brain Research 1993; 18: 195-200.
• 18 Ladd CO, Owens MJ, Nemeroff CB. Persistent changes in corticotropin-releasing factor neuronal systems induced by maternal deprivation. Endocrinology 1996; 137: 1212-1218.
• 19 Suomi SJ. Early stress and adult emotional reactivity in rhesus monkeys. Ciba Foundation Symposium 1991; 156: 171-188.
• 20 Yehuda R. Biology of posttraumatic stress disorder. Journal of Clinical Psychiatry 2001; 62: 41-46.
• 21 Coplan JD, Andrews MW, Rosenblum LA, Owens MJ, Friedman S, Gorman JM. et al. Persistent elevations of cerebrospinal fluid concentrations of corticotropin-releasing factor in adult nonhuman primates exposed to early-life stressors: implications for the pathophysiology of mood and anxiety disorders. Proceedings of the National Academy of Science of the United States of America 1996; 93: 1619-1623.
• 22 Carpenter LL, Tyrka AR, McDougle CJ, Malison RT, Owens MJ, Nemeroff CB. et al. Cerebrospinal fluid corticotropin-releasing factor and perceived early-life stress in depressed patients and healthy control subjects. Neuropsychopharmacology 2004; 29: 777-784.
• 23 Zimmerman DJ, Choi-Kain LW. The hypothalamic-pituitary-adrenal axis in borderline personality disorder: a review. Harvard Review of Psychiatry 2009; 17: 167-183.
• 24 Jovev M, Garner B, Phillips L, Velakoulis D, Wood SJ, Jackson HJ. et al. An MRI study of pituitary volume and parasuicidal behavior in teenagers with first-presentation borderline personality disorder. Psychiatry Research Neuroimaging 2008; 163: 273-277.
• 25 Kaess M, Hille M, Parzer P, Maser-Gluth C, Resch F, Brunner R. Alterations in the neuroendocrinological stress response to acute psychosocial stress in adolescents engaging in nonsuicidal self-injury. Psychoneuroendocrinology 2012; 37: 157-161.
• 26 Nixon MK, Cloutier PF, Aggarwal S. Affect regulation and addictive aspects of repetitive self-injury in hospitalized adolescents. Journal of the American Academy of Child and Adolescent Psychiatry 2002; 41: 1333-1341.
• 27 Resch F, Karwautz A, Schuch B, Lang E. Kann Selbstverletzung als süchtiges Verhalten bei Jugendlichen angesehen werden?. Zeitschrift für Kinderund Jugendpsychiatrie und Psychotherapie 1993; 21: 253-259.
• 28 Osuch EA, Payne GW. Neurobiological perspectives on self-injury. In: Nixon MK, Heath NL. (eds.). Self-injury in youth. New York: Routledge; 2009
• 29 Saito Y, Takashima S. Neurotransmitter changes in the pathophysiology of Lesch-Nyhan syndrome. Brain & Development 2000; 22: 122-131.
• 30 Karwautz A, Resch F, Wöber-Bingöl C, Schuch B. Self-mutilation in adolescence as addictive behaviour. Wiener Klinische Wochenschrift 1996; 108: 82-84.
• 31 Barron J, Sandman CA. Relationship of sedativehypnotic response to self-injurious behavior and stereotypy by mentally retarded clients. American Journal of Mental Deficiency 1983; 88: 177-186.
• 32 Brunner R, Schmahl C. Nicht-suizidale Selbstverletzung (NSSV) bei Jugendlichen und jungen Erwachsenen. Kindheit & Entwicklung 2012; 21: 5-15.
• 33 Thompson T. Self-injurious behavior as endogenous neurochemical self-administration. Mental Retardation in Developmental Disabilities Research Reviews 1995; 01: 137-148.
• 34 Sandman CA, Hetrick WP. Opiate mechanisms in self-injury. Mental Retardation in Developmental Disabilities Research Reviews 1995; 01: 130-136.
• 35 Sonne S, Rubey R, Brady K, Malcolm R, Morris T. Naltrexone treatment of self-injurious thoughts and behaviors. Journal of Nervouse and Mental Disease 1996; 184: 192-195.
• 36 Russ MJ, Roth SD, Kakuma T, Harrison K, Hull JW. Pain perception in self-injurious borderline patients: naloxone effects. Biological Psychiatry 1994; 35: 207-209.
• 37 Plener PL, Bubalo N, Fladung AK, Ludolph AG, Lulé D. Prone to excitement: adolescent females with Non-suicidal Self-Injury (NSSI) show changed cortical pattern to emotional and NSSI related material. Psychiatry Research Neuroimage 2012; 203: 146-152.
• 38 Herpertz SC, Werth U, Lukas G, Qunaibi M, Schuerkens A, Kunert HJ. et al. Emotion in criminal offenders with psychopathy and borderline personality disorder. Archives of General Psychiatry 2001; 58: 737-745.
• 39 Donegan NH, Sanislow CA, Blumberg HP, Fulbright RK, Lacadie C, Skudlarski P. et al. Amygdala hyperreactivity in borderline personality disorder: implications for emotional dysregulation. Biological Psychiatry 2003; 54: 1284-1293.
• 40 Schmahl CG, Vermetten E, Elzinga BM, Douglas JBremner. Magnetic resonance imaging of hippocampal and amygdala volume in women with childhood abuse and borderline personality disorder. Psychiatry Research 2003; 122: 193-198.
• 41 Schmahl CG, Vermetten E, Elzinga BM, Bremner JD. A positron emission tomography study of memories of childhood abuse in borderline personality disorder. Biological Psychiatry 2004; 55: 759-765.
• 42 Vollm B, Richardson P, Stirling J, Elliott R, Dolan M, Chaudhry I. et al. Neurobiological substrates of antisocial and borderline personality disorder: preliminary results of a functional fMRI study. Criminal Behaviour and Mental Health 2004; 14: 39-54.
• 43 Driessen M, Beblo T, Mertens M, Piefke M, Rullkoetter N, Silva-Saavedra A. et al. Posttraumatic stress disorder and fMRI activation patterns of traumatic memory in patients with borderline personality disorder. Biological Psychiatry 2004; 55: 603-611.
• 44 Schnell K, Dietrich T, Schnitker R, Daumann J, Herpertz SC. Processing of autobiographical memory retrieval cues in borderline personality disorder. Journal of Affective Disorders 2007; 97: 253-259.
• 45 Valerius G, Schmahl C. Neurobiologie der Borderline-Persönlichkeitsstörung. In: Brunner R, Resch F. (eds.). Borderline-Störungen und selbstverletzendes Verhalten bei Jugendlichen. Göttingen: Vandenhoeck & Ruprecht; 2008
• 46 Schmahl C, Greffrath W, Baumgartner U, Schlereth T, Magerl W, Philipsen A. et al. Differential nociceptive deficits in patients with borderline personality disorder and self-injurious behavior: laser-evoked potentials, spatial discrimination of noxious stimuli, and pain ratings. Pain 2004; 110: 470-479.
• 47 Schmahl C, Bohus M, Esposito F, Treede RD, Di Salle F, Greffrath W. et al. Neural correlates of antinociception in borderline personality disorder. Archives of General Psychiatry 2006; 63: 659-667.
• 48 Bohus M, Limberger M, Ebner U, Glocker FX, Schwarz B, Wernz M. et al. Pain perception during self-reported distress and calmness in patients with borderline personality disorder and selfmutilating behavior. Psychiatry Research 2000; 95: 251-260.
• 49 Ludascher P, Greffrath W, Schmahl C, Kleindienst N, Kraus A, Baumgartner U. et al. A cross-sectional investigation of discontinuation of self-injury and normalizing pain perception in patients with borderline personality disorder. Acta Psychiatrica Scandinavia 2009; 120: 62-70.
• 50 Chanen AM, Kaess M. Developmental pathways to borderline personality disorder. Current Psychiatry Reports 2012; 14: 45-53.
• 51 Kendler KS, Aggen SH, Czajkowski N, Roysamb E, Tambs K, Torgersen S. et al. The structure of genetic and environmental risk factors for DSM-IV personality disorders: a multivariate twin study. Archives of General Psychiatry 2008; 65: 1438-1446.
• 52 Distel MA, Middeldorp CM, Trull TJ, Derom CA, Willemsen G, Boomsma DI. Life events and borderline personality features: the influence of geneenvironment interaction and gene-environment correlation. Psychological Medicine 2011; 41: 849-860.
• 53 Ni X, Chan K, Bulgin N, Sicard T, Bismil R, McMain S. et al. Association between serotonin transporter gene and borderline personality disorder. Journal of Psychiatric Research 2006; 40: 448-453.
• 54 Steiger H, Richardson J, Joober R, Gauvin L, Israel M, Bruce KR. et al. The 5HTTLPR polymorphism, prior maltreatment and dramatic-erratic personality manifestations in women with bulimic syndromes. Journal of Psychiatry and Neuroscience 2007; 32: 354-362.
• 55 Ni X, Chan D, Chan K, McMain S, Kennedy JL. Serotonin genes and gene-gene interactions in borderline personality disorder in a matched casecontrol study. Progress in Neuropsychopharmacology and Biological Psychiatry 2009; 33: 128-133.
• 56 Ni X, Bismil R, Chan K, Sicard T, Bulgin N, McMain S. et al. Serotonin 2A receptor gene is associated with personality traits, but not to disorder, in patients with borderline personality disorder. Neuroscience Letters 2006; 408: 214-219.
• 57 Perez-Rodriguez MM, Weinstein S, New AS, Bevilacqua L, Yuan Q, Zhou Z. et al. Tryptophan-hydroxylase 2 haplotype association with borderline personality disorder and aggression in a sample of patients with personality disorders and healthy controls. Journal of Psychiatric Research 2010; 44: 1075-1081.
• 58 Ni X, Sicard T, Bulgin N, Bismil R, Chan K, McMain S. et al. Monoamine oxidase a gene is associated with borderline personality disorder. Psychiatric Genetics 2007; 17: 153-157.
• 59 Schmahl C, Bremner JD. Neuroimaging in borderline personality disorder. Journal of Psychiatric Research 2006; 40: 419-427.
• 60 Brunner R, Henze R, Parzer P, Kramer J, Feigl N, Lutz K. et al. Reduced prefrontal and orbitofrontal gray matter in female adolescents with borderline personality disorder: is it disorder specific?. Neuroimage 2010; 49: 114-120.
• 61 Plener PL, Libal G, Keller F, Fegert JM, Muehlenkamp JJ. An international comparison of adolescent non-suicidal self-injury (NSSI) and suicide attempts: Germany and the USA. Psychological Medicine 2009; 39: 1549-1558.
• 62 O’Connor RC, Rasmussen S, Miles J, Hawton K. Self-harm in adolescents: self-report survey in schools in Scotland. British Journal of Psychiatry 2009; 194: 68-72.
• 63 Hilt LM, Cha CB, Nolen-Hoeksema S. Nonsuicidal self-injury in young adolescent girls: moderators of the distress-function relationship. Journal of Consulting and Clinical Psychology 2008; 76: 63-71.
• 64 Kaess M, Parzer P, Haffner J, Steen R, Roos J, Klett M. et al. Explaining gender differences in non-fatal suicidal behaviour among adolescents: a population-based study. BMC Public Health 2011; 11: 597.
• 65 Whitlock J, Eckenrode J, Silverman D. Self-injurious behaviors in a college population. Pediatrics 2006; 117: 1939-1948.
• 66 Brunner R, Resch F. Zur Abgrenzung der Borderline-Persönlichkeitsstörung von schweren Adoleszenzkrisen im Jugendalter. In: Brunner R, Resch F. (eds.). Borderline-Störungen und selbstverletzendes Verhalten bei Jugendlichen. Göttingen: Vandenhoeck & Ruprecht; 2008
• 67 Yates TM. The developmental psychopathology of self-injurious behavior: compensatory regulation in posttraumatic adaptation. Clinical Psychology Review 2004; 24: 35-74.
• 68 Nada-Raja S, Skegg K, Langley J, Morrison D, Sowerby P. Self-harmful behaviors in a populationbased sample of young adults. Suicide & Lifethreatening Behavior 2004; 34: 177-186.
• 69 Weierich MR, Nock MK. Posttraumatic stress symptoms mediate the relation between childhood sexual abuse and nonsuicidal self-injury. Journal of Consulting and Clinical Psychology 2008; 76: 39-44.
• 70 Yates TM, Tracy AJ, Luthar SS. Nonsuicidal selfinjury among “privileged” youths: longitudinal and cross-sectional approaches to developmental process. Journal of Consulting and Clinical Psychology 2008; 76: 52-62.
• 71 Muehlenkamp JJ, Kerr PL, Bradley AR, Adams MLarsen. Abuse subtypes and nonsuicidal self-injury: preliminary evidence of complex emotion regulation patterns. Journal of Nervous and Mental Disease 2010; 198: 258-263.
• 72 Dube SR, Anda RF, Felitti VJ, Chapman DP, Williamson DF, Giles WH. Childhood abuse, household dysfunction, and the risk of attempted suicide throughout the life span: findings from the Adverse Childhood Experiences Study. Journal of the American Medical Association 2001; 286: 3089-3096.
• 73 Romans SE, Martin JL, Anderson JC, Herbison GP, Mullen PE. Sexual abuse in childhood and deliberate self-harm. American Journal of Psychiatry 1995; 152: 1336-1342.
• 74 Gladstone GL, Parker GB, Mitchell PB, Malhi GS, Wilhelm K, Austin MP. Implications of childhood trauma for depressed women: an analysis of pathways from childhood sexual abuse to deliberate self-harm and revictimization. American Journal of Psychiatry 2004; 161: 1417-1425.
• 75 Klonsky ED, Moyer A. Childhood sexual abuse and non-suicidal self-injury: meta-analysis. British Journal of Psychiatry 2008; 192: 166-170.
• 76 Kaess M, Parzer P, Mattern M, Resch F, Bifulco A, Brunner R. Childhood Experiences of Care and Abuse (CECA) – Validierung der deutschen Version von Fragebogen und korrespondierendem Interview sowie Ergebnisse einer Untersuchung von Zusammenhängen belastender Kindheitserlebnisse mit suizidalen Verhaltensweisen. Zeitschrift für Kinder-und Jugendpsychiatrie und Psychotherapie 2011; 39: 243-252.
• 77 Wedig MM, Nock MK. Parental expressed emotion and adolescent self-injury. Journal of the American Academy of Child and Adolescent Psychiatry 2007; 46: 1171-1178.
• 78 Yates TM, Tracy AJ, Luthar SS. Nonsuicidal selfinjury among “privileged” youths: longitudinal and cross-sectional approaches to developmental process. Journal of Consulting and Clinical Psychology 2008; 76: 52-62.
• 79 Kaess M, Parzer P, Mattern M, Plener PL, Resch F, Bifulco A. et al. Adverse childhood experiences and their impact on frequency, severity, and the individual function of nonsuicidal self-injury in youth. Psychiatry Research. 2012 doi:10.1016/j.psychres. 2012.10.012.
• 80 Linehan M. Cognitive behavior therapy pf borderline personality disorder. New York: Guilford; 1993
• 81 Skegg K. Self-harm. Lancet 2005; 366: 1471-1483.
• 82 Kaess M. Selbstverletzendes Verhalten im Jugendalter. Schulte-Markwort M, Resch M. (eds.). Weinheim: Beltz-Verlag; 2012
• 83 Giletta M, Scholte RH, Engels RC, Ciairano S, Prinstein MJ. Adolescent non-suicidal self-injury: A cross-national study of community samples from Italy, the Netherlands and the United States. Psychiatry Research. 2012
• 84 Heath NL, Ross S, Toste JR, Charlebois A, Nedecheva T. Retrospective analysis of social factors and nonsuicidal self-injury among young adults. Canadian Journal Of Behavioral Science 2009; 41: 180-186.
• 85 Klonsky. The functions of deliberate self-injury: a review of the evidence. Clinical Psychology Review 2007; 27: 226-239.
• 86 Petermann F, Nitkowski D. Selbstverletzendes Verhalten: Erscheinungsformen, Risikofaktoren und Verlauf. Nervenarzt 2008; 79: 1017-1022.
• 87 Lieb K, Zanarini MC, Schmahl C, Linehan MM, Bohus M. Borderline personality disorder. Lancet 2004; 364: 453-461.
• 88 Hawton K, Rodham K, Evans E, Weatherall R. Deliberate self harm in adolescents: self report survey in schools in England. British Medical Journal 2002; 325: 1207-1211.
• 89 Thompson EA, Mazza JJ, Herting JR, Randell BP, Eggert LL. The mediating roles of anxiety depression, and hopelessness on adolescent suicidal behaviors. Suicide & Life-threatening Behavior 2005; 35: 14-34.
• 90 Salbach-Andrae H, Lenz K, Klinkowski N, Pfeiffer E, Lehmkuhl U. Selbstverletzendes Verhalten bei weiblichen Jugendlichen. Zeitschrift für Psychiatrie, Psychologie und Psychotherapie 2007; 55: 185-93.
• 91 Penn JV, Esposito CL, Schaeffer LE, Fritz GK, Spirito A. Suicide attempts and self-mutilative behavior in a juvenile correctional facility. Journal of the American Academy of Child and Adolescent Psychiatry 2003; 42: 762-769.
• 92 Matsumoto T, Yamaguchi A, Chiba Y, Asami T, Iseki E, Hirayasu Y. Self-burning versus self-cutting: patterns and implications of self-mutilation; a preliminary study of differences between self-cutting and self-burning in a Japanese juvenile detention center. Psychiatry and Clinical Neurosciences 2005; 59: 62-69.
• 93 Herpertz S, Sass H. Impulsivität und Impulskontrolle – Zur psychologischen und psychopathologischen Konzeptionalisierung. Nervenarzt 1997; 68: 171-183.
• 94 Ruuska J, Kaltiala-Heino R, Rantanen P, Koivisto AM. Psychopathological distress predicts suicidal ideation and self-harm in adolescent eating disorder outpatients. European Journal of Child and Adolescent Psychiatry 2005; 14: 276-281.
• 95 Plener PL, Kapusta ND, Kolch MG, Kaess M, Brunner R. Nicht-suizidale Selbstverletzung als eigenständige Diagnose. Implikationen des DSM-V Vorschlages für Forschung und Klinik selbstverletzenden Verhaltens bei Jugendlichen. Zeitschrift für Kinder-und Jugendpsychiatrie und Psychotherapie 2012; 40: 113-120.