Emotion dysregulation mediates the influence of relationship difficulties on non-suicidal self-injury behavior in young adults

Microstructural abnormalities of white matter in the cingulum bundle of adolescents with major depression and non-suicidal self-injury

BACKGROUND

Non-suicidal self-injury (NSSI) is prevalent in major depressive disorder (MDD) during adolescence, but the underlying neural mechanisms are unclear. This study aimed to investigate microstructural abnormalities in the cingulum bundle associated with NSSI and its clinical characteristics.

METHODS

130 individuals completed the study, including 35 healthy controls, 47 MDD patients with NSSI, and 48 MDD patients without NSSI. We used tract-based spatial statistics (TBSS) with a region of interest (ROI) analysis to compare the fractional anisotropy (FA) of the cingulum bundle across the three groups. receiver-operating characteristics (ROC) analysis was employed to evaluate the ability of the difficulties with emotion regulation (DERS) score and mean FA of the cingulum to differentiate between the groups.

RESULTS

MDD patients with NSSI showed reduced cingulum integrity in the left dorsal cingulum compared to MDD patients without NSSI and healthy controls. The severity of NSSI was negatively associated with cingulum integrity (r = -0.344, p = 0.005). Combining cingulum integrity and DERS scores allowed for successful differentiation between MDD patients with and without NSSI, achieving a sensitivity of 70% and specificity of 83%.

CONCLUSIONS

Our study highlights the role of the cingulum bundle in the development of NSSI in adolescents with MDD. The findings support a frontolimbic theory of emotion regulation and suggest that cingulum integrity and DERS scores may serve as potential early diagnostic tools for identifying MDD patients with NSSI.

Peer victimization and non-suicidal self-injury among high school students: the mediating role of social anxiety, mobile phone addiction, and sex differences

BACKGROUND

Peer victimization (PV) is one of the major causes of non-suicidal self-injury. Non-suicidal self-injury (NSSI), peer victimization, social anxiety, and mobile phone addiction are significantly related; however, the interaction mechanism and effect of sex differences remain to be determined.

OBJECTIVE

Herein, we investigated the relationship between peer victimization and NSSI among Chinese high school students. We also explored the chain mediating roles of social anxiety and mobile phone addiction and the regulatory role of sex. The findings of this study provide insights for theoretical interventions based on internal mechanisms.

METHOD

A self-reported survey of 14,666 high school students from Sichuan County was conducted using a peer victimization scale, NSSI scale, social anxiety scale, and mobile phone addiction scale. A self-administered questionnaire was used to capture sociodemographic information.

RESULTS

Peer victimization, social anxiety, and mobile phone addiction were positively correlated with NSSI. Peer victimization had significant direct predictive effects on NSSI (95% CI: 0.341, 0.385) and significant indirect predictive effects on NSSI through social anxiety (95% CI: 0.008, 0.019) or mobile phone addiction (95% CI: 0.036, 0.053). Peer victimization had significant indirect predictive effects on NSSI through social anxiety as well as mobile phone addiction (95% CI: 0.009, 0.014). The first stage (predicting the effect of peer victimization on NSSI) and the third stage (predicting the effect of mobile phone addiction on NSSI) were both moderated by sex.

CONCLUSIONS

Peer victimization could directly predict NSSI and indirectly predict NSSI through social anxiety and mobile phone addiction. Thus, social anxiety and mobile phone addiction exhibited chain mediating effects between peer victimization and NSSI in high school students; moreover, sex might be involved in the regulation of the mediation process.

Harsh parenting and adolescent non-suicidal self-injury: A moderated mediation model of alienation and cognitive reappraisal

OBJECTIVE

Harsh parenting has been shown to be associated with non-suicidal self-injury (NSSI) in adolescents. Based on the integrated theoretical model of the development of NSSI and the cognitive-emotional model of NSSI, we proposed a moderated mediation model to investigate "how" and "when" harsh parenting is associated with adolescent NSSI. Specifically, we tested whether feelings of alienation mediated the association between harsh parenting and NSSI, and whether this indirect effect was weakened by cognitive reappraisal as an adaptive emotion regulation strategy.

METHODS

A total of 1638 Chinese adolescents (54.7 % girls; ages 12-19 years) completed self-report questionnaires in their classrooms. The questionnaires assessed harsh parenting, feelings of alienation, cognitive reappraisal skills, and incidents of NSSI.

RESULTS

Path analyses showed that harsh parenting positively predicted NSSI, and alienation mediated this association. Both the direct effect of harsh parenting on NSSI and the indirect effect through alienation were moderated by cognitive reappraisal. Specifically, cognitive reappraisal skills weakened the direct and indirect associations between harsh parenting and NSSI.

CONCLUSIONS

Adolescents may benefit from interventions that decrease feelings of alienation and increase cognitive reappraisal strategies to reduce the risk of NSSI in the context of harsh parenting.

Peer Victimization and Adolescent Non-Suicidal Self-Injury: The Mediating Role of Alienation and Moderating Role of Mindfulness

Peer victimization and non-suicidal self-injury (NSSI) are two major public health problems, with the former being associated with outward attack and the latter characterizing inward attack. Peer victimization has been shown to be associated with adolescents' NSSI. However, less is known about the mechanism underlying the association. Based on the experiential avoidance model of NSSI, this study tested whether the sense of alienation mediated the association between peer victimization and NSSI, and whether this process was weakened by mindfulness. A total of 1,574 Chinese adolescents (51.1% girls; ages 12-16 years) completed questionnaires concerning NSSI, peer victimization, alienation, and mindfulness. Regression-based analyses indicated that peer victimization predicted adolescents' NSSI through the indirect effect of alienation, and mindfulness weakened this indirect effect. These findings suggest that victimized adolescents may injure themselves as an emotion regulation strategy. The results highlight the importance to implement programs aimed to improve the school climate to reduce the risk of adolescent NSSI. Furthermore, we underscore the need to include emotion-regulation training (e.g., mindful practice) into bully intervention programs to prevent NSSI.

Translating core intervention strategies into action: Interpersonal validation among self-injuring adolescents and their mothers

INTRODUCTION

Most evidence-supported treatments for psychiatric problems teach clients skills to incorporate into their daily lives. Yet little research rigorously examines the extent to which individuals absorb these strategies and can competently apply them outside of the therapeutic relationship.

OBJECTIVES

The current study examined the degree to which self-injuring adolescents and their mothers (n = 30 dyads) and typical control mother-daughter dyads (n = 30) were able to utilize a multicomponent interpersonal validation-oriented skill from dialectical behavior therapy, after a single teaching. We also aimed to assess whether variance in Gentle, Interested, Validate, and Easy (GIVE) skill practice was associated with a physiological index of emotion regulation (respiratory sinus arrhythmia [RSA]).

METHOD

An observational coding system was developed to measure skill-related behavior across four key domains (be[ing] gentle, act[ing] interested, validation, and us[ing] an easy manner; GIVE) and applied during two family conflict discussions (pre- and postskills training). Mother and adolescent RSA data were collected at rest and across discussion tasks.

RESULTS

Behavioral indicators of skill use improved pre-to-post skills training across the entire sample, except in one GIVE domain (easy manner). Self-injuring youth and their mothers demonstrated greater improvements than control dyads with respect to being gentle. RSA reactivity scores predicted behavioral validation, such that higher RSA was associated with higher validation scores.

CONCLUSIONS

As a field, we currently have a limited understanding of how intervention skills are used, and what factors predict effective skill application. Results suggest self-injuring adolescents and their mothers can learn and improve on most aspects of a core intervention strategy after a single teaching and that better physiological regulation during conflict is associated with more validating behaviors.

The relationship between negative peer relationship and non-suicidal self-injury in Chinese adolescents: A moderated-mediation model

Objective

The objective of the study was to investigate the mediating effect of regulatory emotional self-efficacy (RESE) between negative peer relationship and non-suicidal self-injury (NSSI), as well as the moderating effect of gender difference.

Methods

A study of 578 Chinese adolescents (46.9% males, mean age = 16.32 years, SD =0.54) was conducted using the Child and Adolescent Peer Relationship Inventory, Regulatory Emotional Self-Efficacy Scale, and the Adolescent Self-Injury Questionnaire.

Results

Negative peer relationship was positively correlated with NSSI, and RESE was negatively correlated with negative peer relationship and NSSI. RESE mediated the association between negative peer relationship and NSSI. The first stage(predicting the effect of negative peer relationship on RESE) and the second stage (predicting the effect of RESE on NSSI) of the mediation effect of RESE were both moderated by gender. Specifically, compared with boys, the effect of negative peer relationship on RESE was stronger for girls, and the effect of RESE on NSSI was stronger for girls than boys.

Conclusion

Negative peer relationships may influence NSSI of adolescents through the mediating effect of RESE and the moderating role of gender.

Borderline personality traits mediate the relationship between low perceived social support and non-suicidal self-injury in a clinical sample of adolescents

BACKGROUND

Non-suicidal self-injury (NSSI) is a serious public health concern among adolescents, especially in clinical settings. Social support plays a critical role in the onset and maintenance of NSSI in adolescence. NSSI is closely associated with borderline personality disorder (BPD), yet no previous work has analyzed the mediating role of borderline traits in the relationship between perceived social support (PSS) and NSSI. This study aimed to address this gap.

METHODS

Participants were 228 adolescent patients (12 to 18 years old), who completed a clinical interview and self-report measures of BPD-traits, current psychological distress, emotion dysregulation and PSS. They were grouped based on the presence (vs. absence) of NSSI. Univariate and multivariate logistic regression analyses were used to identify risk factors of NSSI, and a mediation analysis was conducted to examine the intermediary role of borderline traits in the relationship between PSS and NSSI.

RESULTS

NSSI was highly prevalent in our sample (58%) and was associated with higher clinical severity. Low PSS predicted NSSI in univariate, but not multivariate regression. Mediation analyses showed that borderline traits fully accounted for the relationship between low PSS and NSSI, even when controlling for current psychological distress and gender.

LIMITATIONS

Cross-sectional design through self-report assessment.

CONCLUSIONS

Findings suggest that adolescents with low PSS are especially vulnerable for developing NSSI due to elevated BPD traits. In clinical settings, interventions aimed to reduce borderline symptoms may be a promising treatment option for adolescents with NSSI and low PSS.

Disruption of Neural Activity and Functional Connectivity in Adolescents With Major Depressive Disorder Who Engage in Non-suicidal Self-Injury: A Resting-State fMRI Study

Background: Non-suicidal self-injury (NSSI), which commonly occurs during adolescence, often co-occurs with major depressive disorder (MDD). However, the underlying neurobiological mechanisms in adolescents with MDD who engage in NSSI remain unclear. The current study examined the aberrant local neural activity in certain areas of the visual regions and the default mode network (DMN) and the resting-state functional connectivity (rs-FC) in changed brain regions in adolescents with MDD who engage in NSSI and adolescents with MDD only. Methods: A total of 67 adolescents with MDD were divided into two groups based on their NSSI behavior: the NSSI group (n = 31) and an age-, gender-, and education-matched MDD group (n = 36). The Hamilton Depression Rating Scale (HAMD) was used to assess the severity of MDD. Amplitude of low-frequency fluctuation (ALFF) analysis was used to detect alterations in local neural activity. Brain regions with aberrant neural activity were considered regions of interest (ROI). ALFF-based rs-FC analysis was used to further explore the underlying changes in connectivity between ROI and other areas in the NSSI group. Correlation analyses were performed to examine the relationship between neural changes and clinical characteristics. Results: There was no significant difference in HAMD scores between the two groups. ALFF analysis revealed that, compared to adolescents with MDD only, adolescents with MDD who engaged in NSSI displayed significantly enhanced neural activity in the right fusiform gyrus (FFG. R) and the right median cingulate and paracingulate gyri (DCG. R). Significantly reduced rs-FC of the FFG. R-bilateral medial orbital of the superior frontal gyrus (ORBsupmed. L/R)/bilateral medial superior frontal gyrus (SFGmed. L/R), FFG. R-bilateral posterior cingulate gyrus (PCG. L/R), DCG. R-left pallidum (PAL. L), DCG. R-right superior temporal gyrus (STG. R), and DCG. R-right postcentral gyrus (PoCG. R)/right inferior parietal lobule (IPL. R) was found in adolescents with MDD who were engaged in NSSI. Additionally, no significant correlations were observed between ALFF or rs-FC values and the HAMD scores between the two groups. Limitations: Owing to the cross-sectional design, the alterations in ALFF and rs-FC values in the FFG. R and DCG. R could not demonstrate that it was a state or feature in adolescents with MDD who engaged in NSSI. Additionally, the sample size was relatively small. Conclusions: This study highlights changes in regional brain activity and remote connectivity in the FFG. R and DCG. R in adolescents with MDD who engage in NSSI. This could provide a new perspective for further studies on the neurobiological mechanism of NSSI behavior in adolescents with MDD.

Invalidating Caregiving Environments, Specific Emotion Regulation Deficits, and Non-suicidal Self-injury

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.

Association between Emotion Dysregulation and Distinct Groups of Non-Suicidal Self-Injury in Taiwanese Female Adolescents

Background: Previous studies revealed that female adolescents are more likely than males to engage in non-suicidal self-injury (NSSI) to regulate negative emotions; however, the dimensions of emotion regulation that are associated with NSSI behavior in adolescents require further examination. The present study aimed to identify Taiwanese female adolescent clusters with NSSI engagement frequency and to evaluate the association of specific forms of emotion dysregulation with NSSI. Methods: The participants were 438 female adolescents (mean age = 15.23 years, SD = 1.24, range between 13 and 18) recruited from 11 high schools. Self-report questionnaires assessing NSSI, difficulties in emotion regulation, and positive and negative affect were administered, and 37% of respondents reported a history of NSSI. Results: The analysis of NSSI frequency yielded three groups: severe, moderate, and non-NSSI. High negative affect, low positive affect, and difficulties in all aspects of emotion regulation differentiated female adolescents in the severe NSSI group from their counterparts in the non-NSSI group. The moderate and severe NSSI groups were further distinguished by age of onset, negative affect, emotion regulation strategies, and impulse control. Adolescents classified in the severe group reported earlier onset of NSSI, higher negative affect, less emotion regulation strategies, and more difficulty with impulse control. Conclusions: The results indicate that assessments of NSSI and emotion regulation should be incorporated in youth mental health screening. The clinical implications of NSSI behavior intervention require further discussion.

Peer victimization, depressive symptoms and non-suicidal self-injury behavior in Chinese migrant children: the roles of gender and stressful life events

Background

Non-suicidal self-injury (NSSI) has become a worldwide health concern, especially for the disadvantaged group such as Chinese rural-to-urban migrant children. Peer victimization is a risk factor for NSSI and is quite common among Chinese migrant children. However, few studies that focused on this group have paid attention to the relationship between peer victimization and NSSI. The current study addressed this gap in the literature by examining the mediating role of depressive symptoms and the moderating role of stressful life events in the relationship between peer victimization and NSSI in male and female migrant children.

Methods

A total of 650 migrant children completed self-report surveys that addressed peer victimization, NSSI, depressive symptoms, and stressful life events.

Results

Results showed that peer victimization was significantly related to NSSI for both migrant girls and boys. Depressive symptoms mediated the relationship between peer victimization and NSSI among girls, but not among boys. Additionally, stressful life events significantly moderated the relationships between depressive symptoms and NSSI and between peer victimization and NSSI among girls; higher levels of depressive symptoms or peer victimization coupled with more stressful life events related to a higher probability of NSSI. For boys, stressful life events moderated the relationship between peer victimization and NSSI; higher levels of peer victimization combined with increased NSSI behaviors among the boys who reported more stressful life events.

Conclusions

These findings contribute to the understanding of the mechanisms that inform the relationship between peer victimization and NSSI. Moreover, they indicate that future interventions can be enhanced by targeting depressive symptoms among girls and stressful life events among both girls and boys.

I Want You to Want Me: Interpersonal Stress and Affective Experiences as Within-Person Predictors of Nonsuicidal Self-Injury and Suicide Urges in Daily Life

OBJECTIVE

To investigate near-term risk for self-injurious urges, we evaluated how within-person changes in internalizing and externalizing negative affect, as well as interpersonal rejection and criticism, impact subsequent nonsuicidal self-injury (NSSI) and suicide urges in daily life.

METHOD

Young adult women (N = 62) from an ongoing community cohort study with past-year self-injurious thoughts completed a 21-day ecological momentary assessment protocol. We used multilevel path analyses to model within-person effects of negative affect and interpersonal stress on subsequent suicide and NSSI urges within several hours.

RESULTS

When modeled simultaneously, within-person changes in internalizing, but not externalizing, negative affect predicted later self-injurious urges. Rejection and criticism predicted later self-injurious urges, with rejection showing a unique relationship to NSSI urges specifically. Effects of rejection and criticism on later NSSI and suicide urges were mediated by internalizing negative affect; rejection also retained a significant direct effect on NSSI urges.

CONCLUSION

Interpersonal stressors may be potent near-term risk factors for self-injurious urges by increasing internalizing negative affect among vulnerable individuals. The direct role of rejection and criticism on self-injurious urges is less clear, particularly for suicide. These findings have implications for understanding processes underlying self-injurious urges, as well as designing real-time interventions for these experiences in daily life.

Emotion dysregulation and non-suicidal self-injury: A systematic review and meta-analysis

BACKGROUND

Over the past several years there has been considerable interest in the relation between emotion dysregulation and non-suicidal self-injury (NSSI), particularly given that rates of NSSI have been increasing and NSSI is a critical risk factor for suicidal behavior. To date, however, no synthesis of empirical findings exists.

METHODS

The present study presents a comprehensive meta-analytic review of the literature on the association between NSSI and emotion dysregulation. A total of 48 publications, including 49 independent samples, were included in this analysis.

RESULTS

Overall, a significant association was found between emotion dysregulation and NSSI (pooled OR = 3.03 [95% CI = 2.56-3.59]). This association was reduced but remained significant (OR = 2.40 [95% CI = 2.01-2.86]) after adjustment for publication bias. Emotion dysregulation subscales most strongly associated with NSSI included limited access to regulation strategies, non-acceptance of emotional responses, impulse control difficulties, and difficulties engaging goal-directed behavior. Lack of emotional awareness/clarity and cognitive aspects of dysregulation yielded weaker, yet significant, positive associations with NSSI.

CONCLUSIONS

Findings support the notion that greater emotion dysregulation is associated with higher risk for NSSI among individuals across settings, regardless of age or sex. Furthermore, findings reveal facets of dysregulation that may have unique implications for NSSI. This meta-analysis highlights the importance of better understanding emotion dysregulation as a treatment target for preventing NSSI.

Maternal and peer attachment, identity formation, and non-suicidal self-injury: a longitudinal mediation study

BACKGROUND

Non-suicidal self-injury (NSSI) is defined as the repetitive, direct, and deliberate destruction of one's body tissue without an intention to die. Existing cross-sectional research indicates that the association between maternal/peer attachment and NSSI is mediated by identity synthesis and confusion. However, longitudinal confirmation of the aforementioned mediation models is necessary as cross-sectional models are known to be biased. Consequently, the aim of the present study was to investigate whether identity formation mediates the association between attachment and NSSI in a longitudinal design.

METHODS

Three waves of self-report questionnaires data (1 year apart) were collected on maternal and peer attachment, identity, and NSSI from students of a high school in Belgium (at Time 1: Mean age = 15.0 years, SD = 1.85, range = 11-19 years, 50.6% female). Both cross-lagged (between-person) and parallel process latent growth curve (within-person) mediation analyses were used to test the mediation models.

RESULTS

Findings of the cross-lagged analyses indicated unidirectional associations among the study variables, that is, from attachment to identity to NSSI. Parallel process latent growth mediation analyses showed that the association between the slope of maternal attachment and the slope of NSSI was mediated by the slopes of identity synthesis and confusion. Peer attachment models did not fit the data.

CONCLUSION

The current work demonstrated that dysfunctional maternal and peer attachment may lead to disturbances in identity formation, which, in turn, may lead to increased NSSI. Additionally, within-person analysis indicated that the growth rate of maternal attachment predicted the growth rate of NSSI through the growth rate of identity synthesis and confusion. The clinical relevance of these findings is discussed.

Associations of food addiction and nonsuicidal self-injury among women with an eating disorder: A common strategy for regulating emotions?

OBJECTIVE

We examined the association between lifetime nonsuicidal self-injury (NSSI), emotion regulation, and food addiction (FA) in women (n = 220) with eating disorders (ED) compared with (n = 121) healthy controls (HC).

METHOD

Participants were assessed via face-to-face interviews for ED diagnosis and lifetime NSSI. FA was assessed with Yale Food Addiction Scale 2.0 and emotion regulation using the Difficulty in Emotion Regulation Scale (DERS).

RESULTS

The prevalence of FA was significantly higher among women with an ED when compared with HC (75.9% vs. 4.1%, p < 0.001). Similarly, subjects presenting FA showed a high prevalence of lifetime NSSI, in both ED and HC (40.7% and 60.0%, respectively). Our predictive model revealed FA and DERS total scores as indicators of the presence of lifetime NSSI independent of group assignment, ED diagnosis, and age.

CONCLUSIONS

These findings suggest a shared aetiology between ED, NSSI, and FA, explained possibly in part by emotion-regulation deficits.

Emotion Dysregulation in the Structure of Self-Injurious Behavior

We present the results of the research of the link between emotion regulation and self-injurious behavior. The sample consisted of 706 respondents aged 14—35 (467 female). Methods: Emotion Dysregulation Questionnaire (Polskaya, Razvaliaeva, 2017), Reasons for Self-Injury Scale (Polskaya, 2017), Coping Behavior Strategies Questionnaire (Vasserman et al., 2008), Psychological Mindedness Scale (Novikova, Kornilova, 2014), Positive and Negative Affect Scale (Osin, 2012). Results: we found out that self-injury is more frequent in females, self-injury risk is most severe at 14—21 years. Significant relationships were yielded for self-injurious behavior, emotion dysregulation, hindered awareness and access to emotions, and coping strategies — confrontation, avoidance, self-control, and responsibility. Regression analysis showed that avoidance as a strategy of emotion dysregulation mediates the influence of negative affect on self-injurious behavior; another form of emotion dysregulation — rumination — predicts the increase of negative and the decrease of positive affect. Conclusions: emotion dysregulation underlies the cycle of negative affect aggravation that leads to self-injury. Adolescence and youth are the most dangerous ages when self-injury is used for negative affect regulation.

What Predicts Ongoing Nonsuicidal Self-Injury?: A Comparison Between Persistent and Ceased Self-Injury in Emerging Adults

Although nonsuicidal self-injury (NSSI) peaks in adolescence, a significant proportion of young people continue to self-injure into emerging adulthood. Yet, little is known about factors prospectively associated with persistent NSSI. Using data from a 3-year longitudinal study (n = 1466), we compared 51 emerging adults (67.3% female; average age, 20.0 years) who continued to self-injure from adolescence and 50 emerging adults (83.7% female; average age, 20.3 years) who had ceased NSSI, on a broad range of psychosocial factors. More frequent NSSI, use of a greater number of methods, specific NSSI functions, academic and emotional distress, and lack of perceived emotion regulatory capability differentiated emerging adults who continued with NSSI and those who had ceased the behavior. Further, the relationships between social support, life satisfaction, and NSSI were mediated by perceived ability to regulate emotion. Findings from this study point to the role of personal belief in the ability to effectively regulate emotion in the cessation of NSSI. Future research directions and clinical implications are discussed.

Cannabis Involvement and Nonsuicidal Self-Injury: A Discordant Twin Approach

OBJECTIVE

Cannabis use, particularly at an early age, has been linked to suicidal thoughts and behavior, but minimal work has examined the association between cannabis use and lifetime nonsuicidal self-injury (NSSI). The current study aims to characterize the overlap between lifetime and early cannabis use and NSSI and to examine genetic and environmental mechanisms of this association.

METHOD

Adult male and female twins from the Australian Twin Registry (N = 9,583) were used to examine the odds of NSSI associated with lifetime cannabis use and early cannabis use (i.e., <17 years of age). These associations were also examined within monozygotic (MZ) twins discordant for cannabis use and MZ twins discordant for early cannabis use. Analyses were replicated in an independent sample of female twins (n = 3,787) accounting for the age at onset of cannabis use and NSSI.

RESULTS

Lifetime cannabis use (odds ratio [OR] = 2.84, 95% CI [2.23, 3.61]) and early cannabis use were associated with increased odds of NSSI (OR = 2.15, 95% CI [1.75, 2.65]), and this association remained when accounting for covariates. The association was only significant, however, in MZ twin pairs discordant for early cannabis use (OR = 3.20, 95% CI [1.17, 8.73]). Replication analyses accounting for the temporal ordering of cannabis use and NSSI yielded similar findings of nominal significance.

CONCLUSIONS

Results suggest that NSSI is associated with cannabis involvement via differing mechanisms. For lifetime cannabis use, the lack of association in discordant pairs suggests the role of shared genes and family environment. However, in addition to such shared familial influences, person-specific and putatively causal factors contribute to the relationship between early cannabis use and NSSI. Therefore, delaying the onset of cannabis use may reduce exposure to influences that exacerbate vulnerabilities to NSSI.

The development of the «emotion dysregulation» questionnaire

We present the “Emotion Dysregulation” questionnaire aimed at assessing the types of emotion dysregulation. The theoretic model of the questionnaire is based on two dimensions of emotion dysregulation: impulsivity/rigidity of affective reactions and cognitive distortions/deficits. The questionnaire consists of three scales: rumination, avoidance, and mentalization difficulties. The three-factor structure of the questionnaire was supported by confirmatory factor analysis. The research sample (N=210) consisted of high school students and working adults aged 15—45, 108 of the female and 102 male. The scales have adequate internal consistency, test-retest reliability, and convergent and divergent validity. The questionnaire can be used for research purposes.

The neurobiology of self-knowledge in depressed and self-injurious youth

There is limited information regarding the neurobiology underlying non-suicidal self-injury (NSSI) in clinically-referred youth. However, the salience of disturbed interpersonal relationships and disrupted self-processing associated with NSSI suggests the neural basis of social processes as a key area for additional study. Adolescent participants (N=123; M=14.75 years, SD=1.64) were divided into three groups: NSSI plus depression diagnosis (NSSI), depression only (DEP), healthy controls (HC). In the scanner, participants completed an Interpersonal Self-Processing task by taking direct (own) and indirect (mothers', best friends', or classmates') perspectives regarding self-characteristics. Across all perspectives, NSSI showed higher BOLD activation in limbic areas, and anterior and posterior cortical midline structures versus DEP and HC, while HC showed greater activity in rostrolateral, frontal pole and occipital cortex than NSSI and DEP youth. Moreover, NSSI youth showed heightened responses in amygdala, hippocampus, parahippocampus, and fusiform when taking their mothers' perspective, which were negatively correlated with self-reports of the mother's support of adolescents' emotional distress in the NSSI group. NSSI youth also yielded greater precuneus and posterior cingulate cortex activity during indirect self-processing from their classmates' perspective. Findings suggest a role for disruptions in self- and emotion-processing, and conflicted social relationships in the neurobiology of NSSI among depressed adolescents.

The Mediating Effects of Emotion Regulation and Dyadic Coping on the Relationship Between Romantic Attachment and Non-suicidal Self-injury

Insecure attachment is believed to play a fundamental role in non-suicidal self-injury (NSSI). In fact, the quality of parent-child attachment relationships has become an emerging topic attracting a growing number of theoretical and research contributions in the field of NSSI. However, despite these considerable advances in the scientific study of NSSI, progress pertaining to investigating the quality of romantic attachment relationship is lacking. In an effort to expand current knowledge, the present study aims to not only explore the relationships between romantic attachment and NSSI, but also to explore the mechanisms by which these two variables relate by examining the mediating role that emotion regulation and dyadic coping might play in this relationship. Participants consisted of 797 (81.9 % female) university students, all of whom were involved in a romantic relationship for at least 6 months and between the ages of 17 and 25. Results revealed that although difficulties in emotion regulation mediated the relationships between romantic attachment insecurity (i.e., attachment anxiety and avoidance) and NSSI, dyadic coping was not found to be a significant mediator. These results highlight the importance of attachment security and internal processes to manage stress in the prevention of NSSI.

Family-based risk factors for non-suicidal self-injury: Considering influences of maltreatment, adverse family-life experiences, and parent-child relational risk

The current investigation addressed the potential for unique influences of perceived childhood maltreatment, adverse family-life events, and parent-child relational trauma on the lifetime occurrence and addictive features of non-suicidal self-injury (NSSI). Participants included 957 undergraduate students (747 females; M = 20.14 years, SD = 3.88) who completed online questionnaires regarding the key variables under study. Although self-injuring youth reported more experiences with each family-based risk factor, different patterns of association were found when lifetime engagement in NSSI or its addictive features were under study. Perceived parent-child relational trauma was uniquely linked with NSSI behavior after accounting for perceived childhood maltreatment; adverse family-life events had an additional unique association. In contrast, perceived paternal maltreatment was uniquely related with NSSI's addictive features. Findings underline the importance of studying inter-related family-based risk factors of NSSI simultaneously for a comprehensive understanding of familial correlates of NSSI behavior and its underlying features.