Auditory Hallucinations and Self-Injurious Behavior in General Population Adolescents: Modeling Within-Person Effects in the Tokyo Teen Cohort

• Published in: Schizophrenia bulletin 2023-03, Vol.49 (2), p.329-338
• Main Authors: Stanyon, Daniel, DeVylder, Jordan, Yamasaki, Syudo, Yamaguchi, Satoshi, Ando, Shuntaro, Usami, Satoshi, Endo, Kaori, Miyashita, Mitsuhiro, Kanata, Sho, Morimoto, Yuko, Hosozawa, Mariko, Baba, Kaori, Nakajima, Naomi, Niimura, Junko, Nakanishi, Miharu, Hiraiwa-Hasegawa, Mariko, Kasai, Kiyoto, Nishida, Atsushi
• Format: Article
• Language: English
• Subjects: Adolescent; Hallucinations - epidemiology; Hallucinations - etiology; Hallucinations - psychology; Humans; Mental Disorders; Regular; Self-Injurious Behavior - epidemiology; Tokyo
• ISSN: 0586-7614; 1745-1701
• DOI: 10.1093/schbul/sbac155

Abstract Background and Hypotheses A wealth of evidence suggests that adolescent psychotic experiences (PEs), and especially auditory hallucinations (AHs), are associated with an increased risk for self-injurious behavior (SIB). However, the directionality and specificity of this association are not well understood, and there are no published studies investigating within-person effects over time. The present study aimed to test whether AHs and SIB prospectively increase reciprocal risk at the individual level during early-to-middle adolescence. Study Design Three waves (12y, 14y, and 16y) of self-reported AHs and SIB data from a large Tokyo-based adolescent birth cohort (N = 2825) were used. Random Intercept Cross-Lagged Panel Model (RI-CLPM) analysis was conducted to test the within-person prospective associations between AHs and SIB. Study Results At the within-person level, AHs were associated with subsequent SIB over the observation period (12y–14y: β = .118, P < .001; 14–16y: β = .086, P = .012). The reverse SIB->AHs relationship was non-significant at 12–14y (β = .047, P = .112) but emerged from 14y to 16y as the primary direction of influence (β = .243, P < .001). Incorporating depression as a time-varying covariate did not meaningfully alter model estimates. Conclusions A complex bi-directional pattern of relationships was observed between AHs and SIB over the measurement period, and these relationships were independent of depressive symptoms. Adolescent AHs may be both a predictor of later SIB and also a manifestation of SIB-induced psychological distress.