Abstract
This study examined the indirect effects of distinct aspects of invalidating caregiving environments (i.e., paternal maltreatment, maternal maltreatment, and perceived alienation) on non-suicidal self-injury (NSSI) via six specific emotion regulation difficulties. We hypothesized that specific emotion regulation deficits would mediate associations between invalidating environments and NSSI. Participants included 114 young adults (57 self-injurers; 57 age- and sex-matched comparison participants) aged 17–25 years. Three parallel mediation models tested hypotheses. Results showed that maternal maltreatment, paternal maltreatment, and perceived alienation indirectly predicted NSSI through poor emotional clarity. Maternal maltreatment uniquely predicted NSSI through limited access to regulation strategies. Lastly, maternal maltreatment and perceived alienation were both linked to greater difficulties engaging in goal-directed behavior during emotional upsets; however, contrary to hypotheses, this particular deficit was associated with decreased odds of engaging in NSSI. Findings illustrate how different aspects of invalidating environments and specific emotion regulation deficits may be implicated in NSSI engagement.
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Notes
The term “self-injurers” will be used herein to refer to young adults with a history of NSSI.
References
Nock MK, Favazza AR (2009) Nonsuicidal self-injury: definition and classification. In: Nock MK (ed) Understanding non-suicidal self-injury: origins, assessment and treatment. American Psychological Association, Washington, DC, pp 9–18
Swannell S, Martin G, Page A, Hasking P, St John NJ (2014) Prevalence of nonsuicidal self-injury in nonclinical samples: systematic review, meta-analysis and meta-regression. Suicide Life Threat Behav 44:273–303
Klonsky ED, May AM, Glenn CR (2013) The relationship between nonsuicidal self-injury and attempted suicide: converging evidence from four samples. J Abnorm Child Psychol 122:231–237
Olfson M, Gameroff MJ, Marcus SC, Greenberg T, Shaffer D (2005) Emergency treatment of young people following deliberate self-harm. Arch Gen Psychiatry 62:1122–1128
Hamza C, Willoughby T (2015) Nonsuicidal self-injury and affect regulation: recent findings from experimental and ecological momentary assessment studies and future directions. J Clin Psychol 71:561–574
McKenzie KC, Gross JJ (2014) Nonsuicidal self-injury: an emotion regulation perspective. Psychopathology 47:207–219
Sim L, Adrian M, Zeman J, Cassano M, Friedrich WN (2009) Adolescent deliberate self-harm: linkages to emotion regulation and family emotional climate. J Res Adolesc 19:75–91
Swannell S, Martin G, Page A, Hasking P, Hazell P, Taylor A et al (2012) Child maltreatment, subsequent non-suicidal self-injury and the mediating roles of dissociation, alexithymia and self-blame. Child Abuse Negl 36:572–584
Yurkowski K, Martin J, Levesque C, Bureau J-F, Lafontaine M-F, Cloutier P (2015) Emotion dysregulation mediates the influence of relationship difficulties on non-suicidal self-injury behavior in young adults. Psychiatry Res 228:871–878
Liu RT, Scopelliti KM, Pittman SK, Zamora AS (2018) Childhood maltreatment and non-suicidal self-injury: a systematic review and meta-analysis. Lancet Psychiatry 5:51–64
Linehan M (1993) Cognitive-behavioral treatment of borderline personality disorder. Guilford Press, New York
Thompson RA (1994) Emotion regulation: a theme in search of definition. Monogr Soc Res Child Dev 59:25–52
Klonsky ED (2007) The functions of deliberate self-injury: a review of the evidence. Clin Psychol Rev 27:226–239
Nock MK, Prinstein MJ (2004) A functional approach to the assessment of self-mutilative behavior. J Consult Clin Psychol 72:885–890
Paivio SC, McCulloch CR (2004) Alexithymia as a mediator between childhood trauma and self-injurious behaviors. Child Abuse Negl 28:339–354
Thomassin K, Shaffer A, Madden A, Londino DL (2016) Specificity of childhood maltreatment and emotion deficit in nonsuicidal self-injury in an inpatient sample of youth. Psychiatry Res 244:103–108
Gratz KL, Roemer L (2004) Multidimensional assessment of emotion regulation and dysregulation: development, factor structure, and initial validation of the Difficulties in Emotion Regulation Scale. J Psychopathol Behav Assess 26:41–54
Gratz KL, Roemer L (2008) The relationship between emotion dysregulation and deliberate self-harm among female undergraduate students at an urban commuter university. Cogn Behav Ther 37:14–25
Plener PL, Libal G, Keller F, Fegert JM, Muehlenkamp JJ (2009) An international comparison of adolescent non-suicidal self-injury (NSSI) and suicide attempts: Germany and the USA. Psychol Med 39:1549–1558
Muehlenkamp JJ, Kerr PL, Bradley AR, Adams Larsen M (2010) Abuse subtypes and nonsuicidal self-injury: preliminary evidence of complex emotion regulation patterns. J Nerv Ment Dis 198:258–263
Gratz KL, Conrad SD, Roemer L (2002) Risk factors for deliberate self-harm among college students. Am J Orthopsychiatry 72:128–140
Martin J, Bureau J-F, Yurkowski K, Fournier TR, Lafontaine M-F, Cloutier P (2016) Family-based risk factors for non-suicidal self-injury: considering influences of maltreatment, adverse family-life experiences, and parent–child relational risk. J Adolesc 49:170–180
Tatnell R, Hasking P, Newman L (2017) Multiple mediation modelling exploring relationships between specific aspects of attachment, emotion regulation, and non-suicidal self-injury. Aust J Psychol 70:1–9
Guérin-Marion C, Martin J, Deneault A-A, Lafontaine M-F, Bureau J-F (2018) The functions and addictive features of non-suicidal self-injury: a confirmatory factor analysis of the Ottawa self-injury inventory in a community sample of young adults. Psychiatry Res 264:316–321
Adrian M, Zeman J, Erdley C, Lisa L, Sim L (2011) Emotional dysregulation and interpersonal difficulties as risk factors for nonsuicidal self-injury in adolescent girls. J Abnorm Child Psychol 39:389–400
Bureau J-F, Martin J, Freynet N, Poirier AA, Lafontaine M-F, Cloutier P (2010) Perceived dimensions of parenting and non-suicidal self-injury in young adults. J Youth Adolesc 39:484–494
Yates TM, Tracy AJ, Luthar SS (2008) Nonsuicidal self-injury among ‘privileged’ youths: longitudinal and cross-sectional approaches to developmental process. J Consult Clin Psychol 76:52–62
Higgins DJ, McCabe MP (2001) The development of the comprehensive child maltreatment scale. J Fam Stud 7:7–28
Armsden GC, Greenberg MT (1987) The inventory of parent and peer attachment: individual differences and their relationship to psychological well-being in adolescence. J Youth Adolesc 16:427–454
Cloutier PF, Nixon MK (2003) The Ottawa Self-Injury Inventory: a preliminary evaluation. Abstracts to the 12th International congress European Society for Child and Adolescent Psychiatry. Eur Child Adolesc Psychiatry 12(Suppl. 1):1–94
Martin J, Cloutier PF, Levesque C, Bureau J-F, Lafontaine M-F, Nixon MK (2013) Psychometric properties of the functions and addictive features scales of the Ottawa Self-Injury Inventory: a preliminary investigation using a university sample. Psychol Assess 25:1013–1018
Hayes AF (2017) Introduction to mediation, moderation, and conditional process analysis: a regression-based approach. Guilford Publications, New York
McFadden D (1974) Conditional logit analysis of qualitative choice behavior. In: Zarembka P (ed) Frontiers in econometrics. Academic Press, New York, pp 104–142
Morris AS, Silk JS, Steinberg L, Myers SS, Robinson LR (2007) The role of the family context in the development of emotion regulation. Soc Dev 16:361–388
Flett GL, Goldstein AL, Hewitt PL, Wekerle C (2012) Predictors of deliberate self-harm behavior among emerging adolescents: an initial test of a self-punitiveness model. Curr Psychol 31:49–64
Whitlock J, Eckenrode J, Silverman D (2006) Self-injurious behaviors in a college population. Pediatrics 117:1939–1948
Bresin K, Gordon KH (2013) Endogenous opioids and nonsuicidal self-injury: a mechanism of affect regulation. Neurosci Biobehav Rev 37:374–383
Muehlenkamp JJ (2012) Body regard in nonsuicidal self-injury: theoretical explanations and treatment directions. J Cogn Psychother 26:331–347
Buser TJ, Pitchko A, Buser JK (2014) Naturalistic recovery from nonsuicidal self-injury: a phenomenological inquiry. J Couns Dev 92:438–444
Funding
This research was supported by Joseph-Armand Bombardier Canadian Graduate Scholarships (Doctoral) from the Social Sciences and Humanities Research Council awarded to C. Guérin-Marion, and by a Louise and Alan Edwards Postdoctoral Fellowship in Pediatric Pain awarded to J. Martin.
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Guérin-Marion, C., Martin, J., Lafontaine, MF. et al. Invalidating Caregiving Environments, Specific Emotion Regulation Deficits, and Non-suicidal Self-injury. Child Psychiatry Hum Dev 51, 39–47 (2020). https://doi.org/10.1007/s10578-019-00908-2
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DOI: https://doi.org/10.1007/s10578-019-00908-2