Features of Non-Suicidal Self-Harm in Adolescents with Schizotypal Personality Disorder

Background: the problem of autoaggressive behavior in adolescents is of particular importance due to its high prevalence and the severity of its consequences. Despite the large number of publications devoted to this phenomenon, the relationship between the personality structure developing during puberty and non-suicidal self-injury (NSSI) remains poorly studied. The aim of study was to analyze data on the characteristics of non-suicidal self-harming behavior in adolescents with schizotypal personality disorder (STPD). Patients: the study made up 45 adolescents (m -41; f -4) aged 10−17 with schizotypal personality disorder, who sought treatment at the outpatient department of FSBSI Russian Mental Health Research Centre. Manifestations of NSSI were detected in current status or history of patients. Methods: clinical-psychopathological, retrospective-analytical, psychometric, statistical. Results: the phenomenology of NSSI correlated with the age of its onset. Autoaggressive behavior from 5 to 12 years manifested itself through cases of dacnomania, skin gratting, self-beating, and hair pulling. At age from 13 to 17 years, NSSI manifested through self-cutting and tattooing. Pathogenetic variants of NSSI were identified in adolescents with STPD including depressive, neurosis-like, delusional and pathological character as a pathway. NSSI coexisted with moderate and mild depressive disorders in 91.1% of cases. Behavioral patterns of autoaggression were prone to iteration, transforming into a stereotypical abnormal response of the patient to individually significant triggers. An expansion of the repertoire and an increase in the severity of NSSI indicated a decompensation of STPD in adolescents and an increased risk of developing psychosis. Conclusions: the study provided new data on the pathological mechanisms underlying the development of NSSI, its clinical presentation, modes of manifestation, dynamics, and coexistence with other psychopathological entities in adolescents with STPD. The findings are of practical signi cance for the development of preventive and rehabilitative interventions for this patient.

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