Non-suicidal self-injury in young adults with and without borderline personality disorder: the role of emotion dysregulation and negative urgency

Authors

DOI: https://doi.org/10.6018/analesps.492631
Keywords: Self-harm, Emotion dysregulation, Negative urgency, Self-harm functions

Abstract

Non-suicidal self-injury (NSSI) is defined as self-inflicted pain, and it is used as a mechanism to alleviate psychological distress. Although NSSI is prevalent in Borderline Personality Disorder (BPD), it is also an increasing concern among college student populations. While emotion dysregulation and negative urgency are associated with NSSI, little is known about which dimensions specifically predict the motivations (NSSI-functions) and frequency of self-harm. The current study explored the relationship between emotion dysregulation, negative urgency, and NSSI in 86 young adults, divided into three groups: college students with NSSI, BPD patients with NSSI, and a healthy control group without NSSI. We conducted multiple regression analyses to predicted NSSI-functions and NSSI-frequency. Non-acceptance of emotions, a specific dimension of emotion dysregulation, uniquely predicted intrapersonal NSSI-functions (e.g., regulating distressing emotions), but not interpersonal NSSI-functions (e.g., communicating distress). Lastly, poor emotion regulation strategies predicted NSSI-frequency only in individuals with high negative urgency, that is, individuals who tend to act impulsively when experiencing negative emotions, but not in those with low negative urgency. Findings shed light on the underlying motivations for engaging in self-injury, and they reveal facets of emotion dysregulation relevant for NSSI treatment.

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References

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. Journal of Abnormal Child Psychology, 39(3), 389–400. https://doi.org/10.1007/s10802-010-9465-3

Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review, 30(2), 217–237. https://doi.org/10.1016/j.cpr.2009.11.004

Allen, K. J. D., & Hooley, J. M. (2019). Negative Emotional Action Termination (NEAT): Support for a cognitive mechanism underlying negative urgency in nonsuicidal self-injury. Behavior Therapy, 50(5), 924–937. https://doi.org/10.1016/j.beth.2019.02.001

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association. https://doi.org/10.1176/appi.books.9780890425596

Anderson, N. L., & Crowther, J. H. (2012). Using the experiential avoidance model of non-suicidal self-injury: understanding who stops and who continues. Archives of Suicide Research : Official Journal of the International Academy for Suicide Research, 16(2), 124–134. https://doi.org/10.1080/13811118.2012.667329

Andover, M. S. (2014). Non-suicidal self-injury disorder in a community sample of adults. Psychiatry Research, 219(2), 305–310. https://doi.org/10.1016/j.psychres.2014.06.001

Bados, A., Solanas A., & Andrés, R. (2005). Psychometric properties of the Spanish version of Depression, Anxiety and Stress Scales (DASS). Psicothema, 17(4), 679–683.

Barrachina, J., Soler, J., Campins, M. J., Tejero, A., Pascual, J. C., Alvarez, E., Zanarini, M. C., & Pérez Sola, V. (2004). [Validation of a Spanish version of the Diagnostic Interview for Bordelines-Revised (DIB-R)]. Actas Espanolas de Psiquiatria, 32(5), 293–298. http://www.ncbi.nlm.nih.gov/pubmed/15529214

Bresin, K., Carter, D. L., & Gordon, K. H. (2013). The relationship between trait impulsivity, negative affective states, and urge for nonsuicidal self-injury: a daily diary study. Psychiatry Research, 205(3), 227–231. https://doi.org/10.1016/j.psychres.2012.09.033

Chanen, A. M., Jackson, H. J., McCutcheon, L. K., Jovev, M., Dudgeon, P., Yuen, H. P., Germano, D., Nistico, H., McDougall, E., Weinstein, C., Clarkson, V., & McGorry, P. D. (2008). Early intervention for adolescents with borderline personality disorder using cognitive analytic therapy: randomised controlled trial. The British Journal of Psychiatry : The Journal of Mental Science, 193(6), 477–484. https://doi.org/10.1192/bjp.bp.107.048934

Chapman, A. L., Gratz, K. L., & Brown, M. Z. (2006). Solving the puzzle of deliberate self-harm: the experiential avoidance model. Behaviour Research and Therapy, 44(3), 371–394. https://doi.org/10.1016/j.brat.2005.03.005

Chapman, A. L., Specht, M. W., & Cellucci, T. (2005). Borderline personality disorder and deliberate self-harm: Does experiential avoidance play a role? Suicide and Life-Threatening Behavior, 35(4), 388–399. https://doi.org/10.1521/suli.2005.35.4.388

Chen, W.-L., & Chun, C.-C. (2019). Association between emotion dysregulation and distinct groups of non-suicidal self-injury in Taiwanese female adolescents. International Journal of Environmental Research and Public Health, 16(18). 3361. https://doi.org/10.3390/ijerph16183361

Crowell, S. E., Beauchaine, T. P., & Linehan, M. M. (2009). A biosocial developmental model of borderline personality: Elaborating and extending linehan’s theory. Psychological Bulletin, 135(3), 495–510. https://doi.org/10.1037/a0015616

Cyders, M. A., & Smith, G. T. (2008). Emotion-based dispositions to rash action: Positive and negative urgency. Psychological Bulletin, 134(6), 807–828. https://doi.org/10.1037/a0013341

First, M. B., Gibbon, M., Spitzer, R. L, Williams J. B. W., & Benjamin, L. S. (1997). Structured Clinical Interview for DSM-IV Axis II Personality Disorders (SCID-II). American Psychiatric Press.

Fonseca-Pedrero, E., Paino, M., Lemos-Giráldez, S., Sierra-Baigrie, S., González, M. P. G.-P., Bobes, J., & Muňiz, J. (2011). Borderline personality traits in nonclinical young adults. Journal of Personality Disorders, 25(4), 542–556. https://doi.org/10.1521/pedi.2011.25.4.542

Fox, K. R., Franklin, J. C., Ribeiro, J. D., Kleiman, E. M., Bentley, K. H., & Nock, M. K. (2015). Meta-analysis of risk factors for nonsuicidal self-injury. Clinical Psychology Review, 42, 156–167. https://doi.org/10.1016/j.cpr.2015.09.002

Glenn, C. R., & Klonsky, E. D. (2013). Nonsuicidal self-injury disorder: an empirical investigation in adolescent psychiatric patients. Journal of Clinical Child and Adolescent Psychology : The Official Journal for the Society of Clinical Child and Adolescent Psychology, American Psychological Association, Division 53, 42(4), 496–507. https://doi.org/10.1080/15374416.2013.794699

Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in Emotion Regulation Scale. Journal of Psychopathology and Behavioral Assessment, 26(1), 41–54. https://doi.org/10.1023/B:JOBA.0000007455.08539.94

Gross, J. J. (2015). Emotion regulation: Current status and future prospects. Psychological Inquiry, 26(1), 1–26. https://doi.org/10.1080/1047840X.2014.940781

Guérin-Marion, C., Martin, J., Lafontaine, M.-F., & Bureau, J.-F. (2020). Invalidating caregiving environments, specific emotion regulation deficits, and non-suicidal self-injury. Child Psychiatry & Human Development, 51(1), 39–47. https://doi.org/10.1007/s10578-019-00908-2

Hair, J. F., Black, W. C., Babin, B. J. (Eds.) (2010). Multivariate data analysis: A global perspective. Pearson Education.

Hamza, C. A., Willoughby, T., & Heffer, T. (2015). Impulsivity and nonsuicidal self-injury: A review and meta-analysis. Clinical Psychology Review, 38, 13–24. https://doi.org/10.1016/j.cpr.2015.02.010

Kashdan, T. B., Barrios, V., Forsyth, J. P., & Steger, M. F. (2006). Experiential avoidance as a generalized psychological vulnerability: comparisons with coping and emotion regulation strategies. Behaviour Research and Therapy, 44(9), 1301–1320. https://doi.org/10.1016/j.brat.2005.10.003

Klonsky, E. D., & Glenn, C. R. (2009). Assessing the functions of non-suicidal self-injury: Psychometric properties of the Inventory of Statements About Self-injury (ISAS). Journal of Psychopathology and Behavioral Assessment, 31(3), 215–219. https://doi.org/10.1007/s10862-008-9107-z

Klonsky, E. D., Glenn, C. R., Styer, D. M., Olino, T. M., & Washburn, J. J. (2015). The functions of nonsuicidal self-injury: converging evidence for a two-factor structure. Child and Adolescent Psychiatry and Mental Health, 9(1), 44. https://doi.org/10.1186/s13034-015-0073-4

Krantz, L. H., McMain, S., & Kuo, J. R. (2018). The unique contribution of acceptance without judgment in predicting nonsuicidal self-injury after 20-weeks of dialectical behaviour therapy group skills training. Behaviour Research and Therapy, 104, 44–50. https://doi.org/10.1016/j.brat.2018.02.006

Lieb, K., Zanarini, M. C., Schmahl, C., Linehan, M. M., & Bohus, M. (2004). Borderline personality disorder. Lancet (London, England), 364(9432), 453–461. https://doi.org/10.1016/S0140-6736(04)16770-6

Linehan, M. M. (1993). Cognitive-behavioral treatment of borderline personality disorder. Guilford Press.

Linehan, M. M. (2014). DBT Skills Training Manual (2nd ed.). Guilford Press.

Linehan, M. M, Korslund, K. E., Harned, M. S., Gallop, R. J., Lungu, A., Neacsiu, A. D., McDavid, J., Comtois, K. A., & Murray-Gregory, A. M. (2015). Dialectical behavior therapy for high suicide risk in individuals with borderline personality disorder: a randomized clinical trial and component analysis. JAMA Psychiatry, 72(5), 475–482. https://doi.org/10.1001/jamapsychiatry.2014.3039

Muehlenkamp, J. J., Claes, L., Havertape, L., & Plener, P. L. (2012). International prevalence of adolescent non-suicidal self-injury and deliberate self-harm. Child and Adolescent Psychiatry and Mental Health, 6, 10. https://doi.org/10.1186/1753-2000-6-10

Nock, M. K. (2010). Self-Injury. Annual Review of Clinical Psychology, 6, 339–363. https://doi.org/10.1146/annurev.clinpsy.121208.131258

Peckham, A. D., Jordan, H., Silverman, A., Jarvi Steele, S., Björgvinsson, T., & Beard, C. (2020). From urges to action: Negative Urgency and nonsuicidal self-injury in an acute transdiagnostic sample. Archives of Suicide Research : Official Journal of the International Academy for Suicide Research, 24(3), 367–383. https://doi.org/10.1080/13811118.2019.1625831

Poreh, A. M., Rawlings, D., Claridge, G., Freeman, J. L., Faulkner, C., & Shelton, C. (2006). The BPQ: a scale for the assessment of borderline personality based on DSM-IV criteria. Journal of Personality Disorders, 20(3), 247–260. https://doi.org/10.1521/pedi.2006.20.3.247

Preacher, K. J., Curran, P. J., & Bauer, D. J. (2006). Computational tools for probing interactions in multiple linear regression, multilevel modeling, and latent curve analysis. Journal of Educational and Behavioral Statistics, 31(4), 437–448. https://doi.org/10.3102/10769986031004437

Ribeiro, J. D., Franklin, J. C., Fox, K. R., Bentley, K. H., Kleiman, E. M., Chang, B. P., & Nock, M. K. (2016). Self-injurious thoughts and behaviors as risk factors for future suicide ideation, attempts, and death: a meta-analysis of longitudinal studies. Psychological Medicine, 46(2), 225–236. https://doi.org/10.1017/S0033291715001804

Selby, E. A., & Joiner, T. E. (2009). Cascades of emotion: the emergence of borderline personality disorder from emotional and behavioral dysregulation. Review of General Psychology, 13(3), 219–229. https://doi.org/10.1037/a0015687

Sheppes, G., Suri, G., & Gross, J. J. (2015). Emotion regulation and psychopathology. Annual Review of Clinical Psychology, 11, 379–405. https://doi.org/10.1146/annurev-clinpsy-032814-112739

Swannell, S. V, Martin, G. E., Page, A., Hasking, P., & St John, N. J. (2014). Prevalence of nonsuicidal self-injury in nonclinical samples: systematic review, meta-analysis and meta-regression. Suicide & Life-Threatening Behavior, 44(3), 273–303. https://doi.org/10.1111/sltb.12070

Taylor, P. J., Jomar, K., Dhingra, K., Forrester, R., Shahmalak, U., & Dickson, J. M. (2018). A meta-analysis of the prevalence of different functions of non-suicidal self-injury. Journal of Affective Disorders, 227, 759–769. https://doi.org/10.1016/j.jad.2017.11.073

Turner, B. J., Chapman, A. L., & Layden, B. K. (2012). Intrapersonal and interpersonal functions of non suicidal self-injury: associations with emotional and social functioning. Suicide & Life-Threatening Behavior, 42(1), 36–55. https://doi.org/10.1111/j.1943-278X.2011.00069.x

Vega, D., Sintes, A., Fernández, M., Puntí, J., Soler, J., Santamarina, P., Soto, À., Lara, A., Méndez, I., Martínez-Giménez, R., Romero, S., & Pascual, J. C. (2018). Review and update on non-suicidal self-injury: who, how and why? Actas Espanolas de Psiquiatria, 46(4), 146–155. http://www.ncbi.nlm.nih.gov/pubmed/30079928

Vega, D., Torrubia, R., Soto, À., Ribas, J., Soler, J., Pascual, J. C., Rodríguez-Fornells, A., & Marco-Pallarés, J. (2017). Exploring the relationship between non suicidal self-injury and borderline personality traits in young adults. Psychiatry Research, 256, 403–411. https://doi.org/10.1016/j.psychres.2017.07.008

Verdejo-García, A., Lozano, O., Moya, M., Alcázar, M. A., & Pérez-García, M. (2010). Psychometric properties of a Spanish version of the UPPS-P impulsive behavior scale: reliability, validity and association with trait and cognitive impulsivity. Journal of Personality Assessment, 92(1), 70–77. https://doi.org/10.1080/00223890903382369

Victor, S. E., & Klonsky, E. D. (2016). Validation of a Brief Version of the Difficulties in Emotion Regulation Scale (DERS-18) in five samples. Journal of Psychopathology and Behavioral Assessment, 38(4), 582–589. https://doi.org/10.1007/s10862-016-9547-9

Wolff, J. C., Thompson, E., Thomas, S. A., Nesi, J., Bettis, A. H., Ransford, B., Scopelliti, K., Frazier, E. A., & Liu, R. T. (2019). Emotion dysregulation and non-suicidal self-injury: A systematic review and meta-analysis. European Psychiatry: The Journal of the Association of European Psychiatrists, 59, 25–36. https://doi.org/10.1016/j.eurpsy.2019.03.004

You, J., Deng, B., Lin, M.-P., & Leung, F. (2016). The interactive effects of impulsivity and negative emotions on adolescent nonsuicidal self-injury: A latent growth curve analysis. Suicide & Life-Threatening Behavior, 46(3), 266–283. https://doi.org/10.1111/sltb.12192

Published
27-08-2023
How to Cite
Schmidt, C., Briones-Buixassa, L. ., Nicolaou, S. ., Soler, J. ., Pascual, J. C., & Vega, D. . (2023). Non-suicidal self-injury in young adults with and without borderline personality disorder: the role of emotion dysregulation and negative urgency. Anales de Psicología / Annals of Psychology, 39(3), 345–353. https://doi.org/10.6018/analesps.492631
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Clinical and Health Psychology

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