Emotion Dysregulation Mediates the Relationship Between Child Maltreatment and Non-Suicidal Self-Injury

One risk factor for non-suicidal self-injury (NSSI) in adolescents is exposure to traumatic experiences, particularly child maltreatment. However, the mechanisms through which childhood maltreatment predicts NSSI are largely unknown. Emotion dysregulation (ED) is likely an important mechanism in this relationship. Therefore, this study examined the relationship between childhood maltreatment, ED, and NSSI in a sample of adolescent inpatients (n = 53). Results demonstrated that child physical and emotional maltreatment, but not child sexual abuse, was significantly associated with NSSI frequency. More specifically, ED mediated the relationship between child physical and emotional maltreatment and NSSI frequency. Findings support the importance of ED as a mediating factor in the relationship between childhood maltreatment and NSSI behaviors and highlight the need for teaching emotion regulation skills to youth affected by trauma.     

Maternal Emotion Dysregulation Predicts Emotion Socialization Practices and Adolescent Emotion Lability: Conditional Effects of Youth ADHD Symptoms

Research on Child and Adolescent Psychopathology - Maternal emotional functioning and emotion socialization practices can facilitate or hinder children’s emotional development, and youth with...     

Daily Peer Hassles and Non-Suicidal Self-Injury in Adolescence: Gender Differences in Avoidance-Focused Emotion Regulation Processes

This study aimed to examine the mediating role of rumination, experiential avoidance, dissociation and depressive symptoms in the association between daily peer hassles and non-suicidal self-injury among adolescents. Additionally, this study explored gender differences in these associations and tested whether the proposed model was invariant across genders. The sample consisted of 776 adolescents, of them 369 are males (47.6%) and 407 are females (52.4%), aged between 12 and 18 years old from middle and high schools in Portugal. Participants completed self-report questionnaires to assess daily peer hassles, rumination in its severe component (i.e., brooding), experiential avoidance, dissociation, depressive symptoms and non-suicidal self-injury. Path analysis showed that daily peer hassles indirectly impact on non-suicidal self-injury through increased levels of brooding, experiential avoidance, dissociation, and depressive symptoms. Results indicated significant gender differences in mean scores and path analysis. Male adolescents were more likely to engage in brooding and experiential avoidance in response to external distress (particularly, daily peer hassles), whereas female adolescents were more likely to engage in non-suicidal self-injury in response to internal distress (particularly, depressive symptoms). These findings suggest relevant preventive and intervention actions to address emotion dysregulation in adolescence, by teaching them acceptance and mindfulness skills as a way of coping with stressful experiences and internal distress.     

Poor Sleep as a Risk Factor for Nonsuicidal Self-Injury in Adolescent Girls

The purpose of this study was to examine the relation between poor sleep and nonsuicidal self-injury (NSSI), and to test the hypothesis that poor sleep is a risk factor for the development of NSSI in young adolescents. Questionnaire data were used from a 2-wave longitudinal study of a community sample of 881 young Swedish adolescents. The results showed that 7 % of the girls reported poor sleep (never or seldom sleeping well), and 20–26 % of the girls reported repeated NSSI (at least 5 instances). Poor sleep was associated prospectively with NSSI among girls, but not among boys. Of girls who responded that they seldom or never slept well at T1, 77 % reported repeated NSSI 1 year later. Poor sleep at T1 was found to predict the incidence of new cases of repeated NSSI in girls at T2, independently of their degree of psychopathology. No similar relationship between poor sleep and NSSI was found in boys. The present results suggest that screening for poor sleep in adolescents may serve to identify a subgroup of girls at risk for developing NSSI. It is concluded that poor sleep in young girls should be taken seriously, even in the absence of other self-reported psychological problems, and that interventions targeted at sleep disturbances may be important for prevention.     

A Multi-Method,Multi-Informant Test of Maternal Emotion Socialization in Relation to Adolescent Fears of Social Evaluation

Research on Child and Adolescent Psychopathology - Fears of negative and positive social evaluation are considered potential transdiagnostic mechanisms underpinning multiple internalizing disorders...     

Personality Correlates of Self-Injury in Adolescent Girls: Disentangling the Effects of Lifetime Psychopathology

Adolescent non-suicidal self-injury (aNSSI) is associated with abnormal scores on personality traits, such as high neuroticism. However, no studies to date have examined personality facets of self-injury in a cohort younger than college-age. Plus, adolescent psychopathologies, especially Depressive Disorders, are associated with a similar personality profile and are highly comorbid with aNSSI. Consequently, it remains unclear whether personality provides insights about aNSSI in youth beyond that due to underlying psychopathology. 550 community-dwelling 13- to 15-year-old never-depressed adolescent girls were interviewed for lifetime aNSSI and lifetime psychopathology. Personality traits, broad domains and specific facets, were assessed by self-report. Never-depressed adolescent girls who endorse aNSSI often met lifetime criteria for psychiatric disorders (NSSI: 20/43; 46.5% vs. non-aNSSI: 131/507; 26.1%). aNSSI and lifetime psychopathology were each independently associated with several traits (e.g., high neuroticism and conscientiousness), whereas some traits only discriminated aNSSI (e.g., high melancholia, a facet of neuroticism related to sadness and negative self-evaluation) or lifetime psychopathology independent of each other (e.g., low positive emotionality; low agreeableness). Furthermore, a multivariate model identified high melancholia, high openness to experience, and low conscientiousness as incrementally independent correlates of lifetime aNSSI over and above psychiatric illness. Proneness to melancholia, interest in new things, and poor self-control incrementally track aNSSI in never-depressed adolescent girls. Importantly, this emerges early in course (13–15 years of age) and is independent of lifetime psychiatric diagnosis. Implications for updating etiological models and clinical utility of personality assessment are discussed.     

Emotional Dysregulation and Interpersonal Difficulties as Risk Factors for Nonsuicidal Self-Injury in Adolescent Girls

The purpose of this study was to examine a model of factors that place psychiatrically hospitalized girls at risk for non-suicidal self-injury (NSSI). The role of familial and peer interpersonal difficulties, as well as emotional dysregulation, were examined in relationship to NSSI behaviors. Participants were 99 adolescent girls (83.2% Caucasian; M age = 16.08) admitted to a psychiatric hospital. Structural equation modeling indicated the primacy of emotional dysregulation as an underlying process placing adolescents at risk for NSSI and mediating the influence of interpersonal problems through the family and peer domains. When family and peer relationships were characterized by conflict and lack of support for managing emotions, adolescents reported more dysregulated emotion processes. Family relational problems were directly and indirectly related to NSSI through emotional dysregulation. The indirect processes of peer relational problems, through emotional dysregulation, were significantly associated with NSSI frequency and severity. The findings suggest that the process by which interpersonal difficulties contribute to NSSI is complex, and is at least partially dependent on the nature of the interpersonal problems and emotion processes.     

The Association Between Observed Parental Emotion Socialization and Adolescent Self-Medication

The current study examined the moderating influence of observed parental emotion socialization (PES) on self-medication in adolescents. Strengths of the study include the use of a newly developed observational coding system further extending the study of PES to adolescence, the use of an experience sampling method to assess the daily covariation between negative affect and substance use, and a focus on PES styles defined by the interaction of emotion-dismissing and emotion-coaching behaviors. Using multi-leveling modeling, we tested PES as a moderator of daily negative mood-substance use relation in a sample of 65 elevated-risk adolescents (48% male, 58% Caucasian, with a median age of 14). Results showed a three-way interaction between emotion-coaching PES, emotion-dismissing PES and daily negative mood in predicting daily substance use. Results are discussed in terms of the importance of PES styles and their effects on self-medication through compromised emotion regulation and interpersonal processes.

Initial Psychometric Validation of the Non-Suicidal Self-Injury Scar Cognition Scale

Given the growing literature on the detrimental psychological consequences of NSSI, it is surprising that scarce research has focused on the permanent physical consequences of NSSI, scarring to one’s tissue (Burke et al. Psychiatry Research 228, 416–424, 2015; Lewis The Journal of Nervous and Mental Disease, 204(1), 33–35 2016). Indeed, with recent research suggesting that upwards of half of those with a history of NSSI bear scarring as a result of the behavior (Burke et al. Comprehensive Psychiatry, 65, 79–87 2016), the psychological implications of scarring are important to understand. Given preliminary literature suggesting that the vast majority of individuals who bear NSSI scars ascribe a great deal of meaning to their scarring, and that this meaning varies widely, a psychometrically sound scale is needed to comprehensively and systematically assess NSSI scar-related cognitions. The present study examined the psychometric properties of the Non-Suicidal Self-Injury Scar Cognition Scale (NSSI-SCS). A sample of 110 undergraduates with at least one scar from NSSI completed the NSSI-SCS as well as measures of concurrent and divergent validity. Exploratory Factor Analysis was conducted to determine the factor structure of the NSSI-SCS. Results indicated that a five-factor solution offered the best fit for the data. Psychometric analyses support the validity of the NSSI-SCS given evidence of concurrent validity, divergent validity, and reliability. Future research should examine the test-retest reliability of the NSSI-SCS, as well as its sensitivity to change, particularly in the context of treatment research.     

Reconsidering Criterion A for the Diagnosis of Non-Suicidal Self-Injury Disorder

Empirical research is needed to verify that the DSM-5 proposed diagnostic criteria for non-suicidal self-injury (NSSI) disorder provide a valid and clinically meaningful symptom set. The current study used data-driven methods to examine the diagnostic validity of the frequency and recency thresholds (i.e., Criterion A) for NSSI disorder. Data were collected from a random sample (n = 2206) of undergraduates. Participants completed counter-balanced questionnaires assessing the frequency, recency, and functions of NSSI, psychopathology symptoms, and indicators of distress and functional impairment. Discriminant functional analyses identified a significant differentiation for frequency between 10 or more acts of NSSI and 1–9 acts. Groups were also differentiated with a split on recency between less than 12-months ago and more than 12-months ago. After re-grouping the sample into categories based on the new frequency and 12-month recency threshold, the 10+ NSSI group reported significantly more functions for NSSI, including higher scores on affect regulation, self-punishment, and sensation seeking, than the subthreshold NSSI group. The 10+ NSSI group also reported significantly worse psychopathology, greater distress, and more impairment than both the subthreshold group and controls (no NSSI history). These findings indicate the current DSM-5 diagnostic criteria for NSSI disorder may be too liberal, and offer support for increasing the frequency thresholds for the diagnosis to ensure clinical validity and utility.     

Rates of Non-Suicidal Self-Injury: A Cross-Sectional Analysis of Exposure

Research on the social influences associated with rates of non-suicidal self-injury (NSSI) is scarce and limited to studies of contagion within inpatient and residential treatment settings. Using an archival dataset that included 1,965 college students, the current study examined whether exposure to acts of NSSI and/or suicidal behavior in others was associated with increased rates of NSSI. Results supported hypotheses in that participants who knew someone who had engaged in NSSI only, or knew someone who engaged in both NSSI and suicidal behavior were more likely to have engaged in NSSI compared to those not exposed. The findings provide preliminary, albeit indirect, evidence of the potential for social modeling to influence rates of NSSI within college students. Directions for future studies are offered.     

Maternal Emotion Socialization and the Development of Inhibitory Control in an Emotional Condition

Although several studies have implicated parental socialization in children's development of multiple executive functions, little is known about how parenting may predict inhibitory control when emotion is involved. In this study, 42 children completed two tasks with their mothers at 3.5 years. Maternal emotion language was coded during a storybook task, and maternal scaffolding was coded during a puzzle task. At 3.5 and 4 years, children's inhibitory control was assessed with Day–Night and Happy–Sad card games, Stroop‐like tasks that differ in that the latter contains emotion content. Accuracy and latency on Happy–Sad were predicted by maternal emotion language but not scaffolding. In contrast, latency on Day–Night was predicted by scaffolding but not emotion language. This shows context‐specificity in the links between parenting and cognitive control, such that emotion socialization predicted children's performance in an emotional context only, while more general scaffolding behaviours predicted inhibitory control in the non‐emotional condition. Copyright © 2016 John Wiley & Sons, Ltd.     

自伤行为研究：现状、问题与建议

自我伤害行为指个体在没有明确自杀意图的情况下, 故意、重复地改变或伤害自己的身体组织。这种行为虽不致死, 但极具危险性。对自伤的诊断一直存在争议, 争议的焦点主要是自伤与自杀、自伤与边缘型人格障碍的关系问题。从流行学调查结果看, 国内普通青少年自伤比例高于西方, 达36%~57%, 但该行为在国内所受关注不多、相关研究甚少。影响自伤的危险因子, 总体可分为早年创伤性经验和个体易感性两大类, 后者包括情绪管理障碍、冲动性和生物学因素, 但各因素对自伤的影响程度尚不清楚。从病因和病理学研究现状看, 很多理论模型被提出来解释自伤的动机和原因, 包括功能性模型、发展病理性模型和整合模型等。自伤领域的研究虽然在近10年有飞跃性的增长, 但仍然有很多问题值得进一步探讨, 未来研究可以考虑进行自伤的分类研究、某些主题的细化研究、跨学科和跨文化研究等。     

The Difficulties in Emotion Regulation Scale: Factor Structure and Association with Nonsuicidal Self-Injury in Adolescent Inpatients

Research suggests that difficulties in emotion regulation are an important correlate of nonsuicidal self-injury (NSSI) in adults. Research examining this link in adolescents is limited by the lack of comprehensive instruments to assess difficulties in emotion regulation. Against this background, the aims of the current study were to (a) confirm the six-factor structure of the Difficulties in Emotion Regulation Scale (DERS; Gratz & Roemer, Journal of Psychopathology and Behavioral Assessment, 23(4), 253?C263, 2004) in a sample of adolescent inpatients (N?=?218); (b) explore the relation between different aspects of emotion dysregulation and lifetime NSSI while controlling for psychopathology and sex; and (c) assess the clinical utility of the DERS in detecting lifetime NSSI status. Fit indices obtained through Confirmatory Factor Analysis indicated that the six-factor structure of the DERS fit the data adequately and that most items loaded strongly on their respective latent factor. All six latent factors were significantly correlated with each other, with the exception of lack of emotional awareness and difficulties engaging in goal-directed behavioral when distressed. Regression analyses revealed that only the limited access to emotion regulation strategies subscale accounted for a significant portion of the variance in NSSI when controlling for other aspects of emotion dysregulation, sex, and psychopathology. Receiver Operating Characteristic analysis indicated that the DERS limited access to emotion regulation strategies subscale score has moderate diagnostic accuracy in detecting the presence of NSSI. The optimal cut-off score was 21.5 when detecting NSSI among inpatient adolescents. Results provide further support for the relation between emotion regulation difficulties and NSSI. The DERS appears to be a useful measure of detecting NSSI in clinical samples of adolescents.     

Longitudinal Links among Mother and Child Emotion Regulation,Maternal Emotion Socialization,and Child Anxiety

Research on Child and Adolescent Psychopathology - Models of transdiagnostic family emotion processes recognize parents’ emotion-related characteristics and behaviors as key contributors to...     

Effects of Parent Emotion Socialization on the Neurobiology Underlying Adolescent Emotion Processing: A Multimethod fMRI Study

Research on Child and Adolescent Psychopathology - Parents’ emotion socialization (ES) practices impact socioemotional development throughout adolescence. Little is known, however, regarding...     

Maternal Emotion Socialization,Depressive Symptoms and Child Emotion Regulation: Child Emotionality as a Moderator

This study tested a model of children's emotionality as a moderator of the links between maternal emotion socialization and depressive symptoms and child emotion regulation. Participants were 128 mother–preschooler dyads. Child emotion expression and emotion regulation strategies were assessed observationally during a disappointment task, and a principal component analysis revealed three factors: passive soothing (including sadness and comfort seeking), negative focus on distress (including anger, focus on distress and low active distraction) and positive engagement (including positive emotion, active play and passive waiting, which was loaded negatively). Hierarchical linear regression models revealed that child positive emotionality (PE) and negative emotionality (NE) moderated the links between maternal support/positive emotion expression and child emotion regulation strategies. In particular, children's low PE exacerbated the association between lack of maternal support and child passive soothing, whereas high PE enhanced the association between maternal positive expression and reduced negative focus on distress. Furthermore, the associations of mothers' support and reduced passive soothing and negative focus on distress, as well as the association between mothers' positive expression and child positive engagement, were stronger for children with low levels of NE, compared with those with average and high levels of NE. Findings partially support a diathesis–stress model in understanding the effects of both child characteristics and the familial influence on child emotion regulation. Copyright © 2016 John Wiley & Sons, Ltd.     

Maternal Emotion Socialization and Child Outcomes among African Americans and European Americans

Mothers’ emotion socialization practices are very important for children’s later outcomes; however, we know very little about how these practices may lead to different outcomes for European American (EA) and African American (AA) children. In the current study, maternal emotion socialization practices were investigated in relation to child emotion-related outcomes in 122 pairs of mothers and preschool-age children, and differences in associations were examined for EA and AA families. Mothers were assessed for their expressions of positive emotion with their child and their responses to their child’s negative emotions, including support of sadness/fear and magnification of anger, when children were 3. Children were assessed for their expression of positive emotion with their mother and their internalizing and externalizing problem behaviors when they were 4. When ethnicity was included as a moderator, results revealed that when AA mothers expressed more positive emotion, their children were also more positive 1 year later. Additionally, as AA mothers provided greater support for their children’s sadness/fear, these children tended to have fewer later internalizing problems. Finally, when AA mothers responded with more magnification of their children’s anger, these children tended to have greater internalizing and externalizing problems 1 year later. These associations were not found for EA families. Results highlighted differential effects based on the type of support provided by mothers and the role that mothers played in encouraging or suppressing their child’s expressions. The overall findings highlight the need to consider maternal emotion socialization from a culturally-informed perspective.     

The Mediatory Role of Maladaptive Schema Modes Between Parental Care and Non-Suicidal Self-Injury

Non-suicidal self-injury (NSSI) is being increasingly recognised as a behaviour of significant clinical importance. Yet, there remains uncertainty regarding the underlying mechanisms of NSSI. This study aimed to explore the relationship between maladaptive schema modes, parental bonding, and NSSI. Seventy psychiatric outpatients with a history of NSSI completed the Deliberate Self-Harm Inventory, Schema Mode Inventory, and Parental Bonding Inventory. Results revealed that maladaptive schema modes were significantly associated with low parental care and with an earlier age of onset, longer duration, and higher number of methods of NSSI. Maladaptive schema modes also significantly mediated the relationship between parental care and age of onset of NSSI and between parental care and duration of NSSI. Two maladaptive schema modes (namely, Punitive Parent and Angry Child) were also found to be significant mediators in this relationship. The clinical implications of this research are discussed.