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Child and Adolescent Psychiatry and Mental Health

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Open Access 01-12-2015 | Research article

Non-suicidal self-injury maintenance and cessation among adolescents: a one-year longitudinal investigation of the role of objectified body consciousness, depression and emotion dysregulation

Authors: Jamie Duggan, Nancy Heath, Tina Hu

Published in: Child and Adolescent Psychiatry and Mental Health | Issue 1/2015

Abstract

Using the objectification theory, scholars have theorized the sense of detachment and disregard for the body that results from continued body objectification are believed to put a person at greater risk for non-suicidal self-injury (NSSI), due to a lack of emotional investment in the body. The goal of the current study was to longitudinally investigate the association between body objectification and NSSI among an early adolescent sample. The overall sample consisted of 120 participants (56 % female) who ranged in age from 11 to 13 years of age (M = 12.34, SD = .48). Participants were followed over the course of a 12-month period, and classified into three groups of interest; adolescents who reported maintaining NSSI behaviour over the course of a year (NSSI Maintain group, n = 20), adolescents who reported stopping the behaviour over the course of a year (NSSI Stop group, n = 40), and a comparison group of adolescents who did not report engaging in NSSI (n = 60). Using a 3 (NSSI Maintain, NSSI Stop, and Comparison) X 2 (Gender) X 2 (Time 1 and Time 2) repeated measures multiple analysis of variance (MANOVA), results indicated a significant group by time interaction, showing group differences with respect to body shame and body surveillance over time. Specifically, both NSSI groups reported significantly greater body shame and body surveillance over time than the non-NSSI group. Additionally, the NSSI Maintain group reported significantly greater body surveillance at T2 when compared to the NSSI Stop and non-NSSI group. The NSSI Maintain group also reported significantly more emotion dysregulation difficulties and depressive symptoms at T2 when compared to the NSSI Stop and non-NSSI group. The influence of body objectification as a core intrapersonal risk factor related to the maintenance and cessation of NSSI behaviour is discussed, as are clinical implications considering body objectification as an important variable in prevention and treatment efforts.

Favazza AR. The coming of age of self-mutilation. J Nerv Ment Dis. 1998;186:259–68. doi:10.1097/00005053-199805000-00001.CrossRefPubMed

Nock MK, Prinstein MJ. A functional approach to the assessment of self-mutilative behavior. J Consult Clin Psychol. 2004;72(5):885–90. doi:10.1037/0022-006X.72.5.885. Epub 2004/10/16. PubMed.CrossRefPubMed

Nixon MK, Cloutier PF, Aggarwal S. Affect regulation and addictive aspects of repetitive self-injury in hospitalized adolescents. J Am Acad Child Adolesc Psychiatry. 2002;41(11):1333–41. doi:10.1097/00004583-200211000-00015. PubMed.CrossRefPubMed

Briere J, Gil E. Self-mutilation in clinical and general population samples: prevalence, correlates, and functions. Am J Orthopsychiatry. 1998;68(4):609–20. PubMed.CrossRefPubMed

Claes K, Vandereycken W, Vertommen H. Self-injury in female versus male psychiatric patients: A comparison of characteristics, psychopathology and aggression regulation Personality and Individual Differences. 2007;42:611–21. doi:10.1016/j.paid.2006.07.021.

Heath NL, Ross S, Toste JR, Charlebios A, Nedecheva T. Restrospective analysis of social factors and nonsuicidal self-injury among young. Can J Behav Sci. 2009;41:180–6. doi:10.1037/a0015732.CrossRef

Whitlock J, Eckenrode J, Silverman D. Self-injurious behaviors in a college population. Pediatrics. 2006;117(6):1939–48. doi:10.1542/peds.2005-2543. Epub 2006/06/03. PubMed.CrossRefPubMed

Hankin BL, Abela JR. Nonsuicidal self-injury in adolescence: prospective rates and risk factors in a 2(1/2) year longitudinal study. Psychiatry Research. 2011;186(1):65–70. doi:10.1016/j.psychres.2010.07.056. PubMed PMID: 20807667; PubMed Central PMCID: PMC3008214.CrossRefPubMedPubMedCentral

Yates TM, Tracy AJ, Luthar SS. Nonsuicidal self-injury among “privileged” youths: longitudinal and cross-sectional approaches to developmental process. J Consult Clin Psychol. 2008;76(1):52–62. doi:10.1037/0022-006X.76.1.52. PubMed.CrossRefPubMedPubMedCentral

10.

Heath NL, Schaub KM, Holly S, Nixon MK. Self-injury today: review of population and clinical studies in adolescents. In: Nixon MK, Heath NL, editors. Self-injury in youth: The essential guide to assessment and intervention. New York, NY: Routledge Press; 2009. p. 9–28.

11.

Rodham K, Hawton K. Epidemiology and phenomenology of nonsuicidal self-injury. In: Nock MK, editor. Understanding nonsuicidal self-injury: Origins, assessment, and treatment. Washington, DC: American Psychological Association; 2009.

12.

Ross S, Heath NL. A study of the frequency of self-mutilation in a community sample of adolescents. J Youth Adolesc. 2002;31(1):67–77.CrossRef

13.

Gratz KL. Risk factors for and functions of deliberate self-harm: an empirical and conceptual review. Clin Psychol Sci Pract. 2003;10:192–205. doi:10.1093/clipsy.bpg022.CrossRef

14.

Klonsky ED. The functions of deliberate self-injury: a review of the evidence. Clin Psychol Rev. 2007;27(2):226–39. doi:10.1016/j.cpr.2006.08.002. Epub 2006/10/04. PubMed.CrossRefPubMed

15.

Nock MK. Self-injury. Annual Review of Clinical Psychology. 2010;6:339–63. Epub 2010/03/03. doi: 10.1146/annurev.clinpsy.121208.131258. PubMed.

16.

Gratz KL. Targeting emotion dysregulation in the treatment of self-injury. J Clin Psychol. 2007;63(11):1091–103. doi:10.1002/jclp.20417. PubMed.CrossRefPubMed

17.

Klonsky ED, Muehlenkamp JJ. Self-injury: a research review for the practitioner. J Clin Psychol. 2007;63(11):1045–56. doi:10.1002/jclp.20412. Epub 2007/10/13. PubMed.CrossRefPubMed

18.

Nelson A, Muehlenkamp JJ. Body attitudes and objectification in non-suicidal self-injury: comparing males and females. Arch Suicide Res. 2012;16(1):1–12. doi:10.1080/13811118.2012.640578. PubMed.CrossRefPubMed

19.

Duggan JM, Toste JR, Heath NL. An examination of the relationship between body image factors and non-suicidal self-injury in young adults: the mediating influence of emotion dysregulation. Psychiatry Res. 2013;206(2–3):256–64. doi:10.1016/j.psychres.2012.11.016. PubMed.CrossRefPubMed

20.

Muehlenkamp JJ, Claes L, Smits D, Peat CM, Vandereycken W. Non-suicidal self-injury in eating disordered patients: a test of a conceptual model. Psychiatry Res. 2011;188(1):102–8. doi:10.1016/j.psychres.2010.12.023. PubMed.CrossRefPubMed

21.

Muehlenkamp JJ, Bagge CL, Tull MT, Gratz KL. Body regard as a moderator of the relation between emotion dysregulation and nonsuicidal self-injury. Suicide Life Threat Behav. 2013;43(5):479–93. doi:10.1111/sltb.12032. PubMed.PubMed

22.

Orbach I. The role of body experience in self-destruction. Clin Child Psychol Psychiatry. 1996;1:607–19. doi:10.1177/1359104596014012.CrossRef

23.

Ross S, Heath NL, Toste JR. Non-suicidal self-injury and eating pathology in high school students. Am J Orthopsychiatry. 2009;79(1):83–92. doi:10.1037/a0014826. Epub 2009/03/18. PubMed.CrossRefPubMed

24.

Muehlenkamp JJ, Swanson JD, Brausch AM. Self-objectification, risk taking, and self-harm in college women. Psychol Women Q. 2005;29:24–32. doi:10.1111/j.1471-6402.2005.00164.x.CrossRef

25.

Fredrickson BL, Roberts TA. Objectification theory. Psychol Women Q. 1997;21:173–206. doi:10.1111/j.1471-6402.1997.tb00108.x.CrossRef

26.

McKinley NM. Women and objectified body consciousness: Mothers’ and daughters’ body experience in cultural, developmental, and familial context. Dev Psychol. 1999;35(3):760–9. PubMed.CrossRefPubMed

27.

McKinley NM, Hyde JS. The objectified body consciousness scale development and validation. Psychol Women Q. 1996;20:181–215. doi:10.1111/j.1471-6402.1996.tb00467.x.CrossRef

28.

Brausch AM, Gutierrez PM. Differences in non-suicidal self-injury and suicide attempts in adolescents. J Youth Adolesc. 2010;39(3):233–42. doi:10.1007/s10964-009-9482-0. PubMed.CrossRefPubMed

29.

Muehlenkamp JJ, Brausch AM. Body image as a mediator of non-suicidal self-injury in adolescents. J Adolesc. 2012;35(1):1–9. doi:10.1016/j.adolescence.2011.06.010. Epub 2011/07/23. PubMed.CrossRefPubMed

30.

Levine MP, Smolak L. Ecological and activism approaches to the prevention of body image approaches. In: Cash TF, Pruzinsky T, editors. Body image: A handbook of theory, research, and clinical practice. New York, NY: Guilford Press; 2002. p. 497–505.

31.

Moradi B, Huang YP. Objectification theory and pschology of women: a decade of advances and future directions. Psychol Women Q. 2008;32:377–98. doi:10.1111/j.1471-6402.2008.00452.x.CrossRef

32.

Lunde C, Frisen A, Hwang CP. Ten-year-old girls’ and boys’ body composition and peer victimization experiences: prospective associations with body satisfaction. Body Image. 2007;4(1):11–28. doi:10.1016/j.bodyim.2006.10.002. PubMed.CrossRefPubMed

33.

Rosenblum GD, Lewis M. The relations among body image, physical attractiveness, and body mass in adolescence. Child Dev. 1999;70(1):50–64. PubMed.CrossRefPubMed

34.

Heath NL, Ross S. How I deal with stress. 2007.

35.

Toste JR, Christie M, Heath NL. How do I deal with stress (HIDS): Evidence for the use of an NSSI screening questionnaire among young adults. New York, NY: International Society for the Study of Self-Injury; 2011.

36.

Lindberg SM, Hyde JS, McKinley NM. A measure of objectified body consciousness for preadolescent and adolescent youth. Psychol Women Q. 2006;30:65–76. doi:10.1111/j.1471-6402.2006.00263.x.CrossRef

37.

Beck JS, Beck AT, Jolly JB, Steer RA. Beck youth inventories for children and adolescents manual. 2nd ed. San Antonio, TX: PsychCorp; 2005.

38.

Osman A, Barrios FX, Gutierrez PM, Williams JE, Bailey J. Psychometric properties of the Beck Depression Inventory-II in nonclinical adolescent samples. J Clin Psychol. 2008;64(1):83–102. doi:10.1002/jclp.20433. PubMed.CrossRefPubMed

39.

Gratz KL, Roemer L. Multidimensional assessment of emotion regulation and dysregulation: development, factor structure, and initial validation of the difficulties in emotion regulation scale. J Psychopathol Behav Assess. 2004;26:41–54. doi:10.1023/B:JOBA.0000007455.08539.94.CrossRef

40.

Heath NL, Toste JR, Nedecheva T, Charlebois A. An examination of nonsuicidal self-injury among college students. J Ment Health Counsel. 2008;30(2):137–56.CrossRef

41.

Field A. Discovering statistics using SPSS. 2nd ed. London, United Kingdom: Sage; 2005.

42.

Tatnell R, Kelada L, Hasking P, Martin G. Longitudinal analysis of adolescent NSSI: the role of intrapersonal and interpersonal factors. J Abnorm Child Psychol. 2014;42(6):885–96. doi:10.1007/s10802-013-9837-6. PubMed.CrossRefPubMed

43.

Cicchetti D, Valentino K. An ecological transactional perspective on child maltreatment: failure of the average expectable environment and its influence upon child development. In: Cicchetti D, Cohen DJ, editors. Developmental Psychopathology: Risk, Disorder, and Adaptation. 3. 2nd ed. New York, NY: Wiley; 2006.

44.

Lang CM, Sharma-Patel K. The relation between childhood maltreatment and self-injury: a review of the literature on conceptualization and intervention. Trauma Violence Abuse. 2011;12(1):23–37. doi:10.1177/1524838010386975. PubMed.CrossRefPubMed

45.

Curran PJ, Obeidat K, Losardo D. Twelve frequently asked questions about growth curve modeling. J Cogn Dev. 2010;11(2):121–36. doi:10.1080/15248371003699969. PubMed PMID: 21743795; PubMed Central PMCID: PMC3131138.CrossRefPubMedPubMedCentral

46.

Young R, Sproeber N, Groschwitz RC, Preiss M, Plener PL. Why alternative teenagers self-harm: exploring the link between non-suicidal self-injury, attempted suicide and adolescent identity. BMC Psychiatry. 2014;14:137. doi:10.1186/1471-244X-14-137. PubMed PMID: 24885081; PubMed Central PMCID: PMC4067739.CrossRefPubMedPubMedCentral

47.

Kazdin AE, Nock MK. Delineating mechanisms of change in child and adolescent therapy: methodological issues and research recommendations. Journal of Child Psychology and Psychiatry. 2003;44(8):1116–29. PubMed.CrossRefPubMed

48.

Walsh BW. Treating self-injury: a practical guide. 2nd ed. New York: Guilford Press; 2012. p. 413.

49.

Yates TM. Developmental pathways from child maltreatment to non-suicidal self-injury. In: Nock MK, editor. Understanding non-suicidal self-injury: Origins, assessment and treatment. Washington, DC: American Psychological Association; 2009. p. 117–37.CrossRef

50.

Walsh BW. Treating self-injury: A practical guide. 1st ed. New York, NY: Guilford Press; 2006.

51.

Tiggemann M. Body image development: media influences. In: Cash TF, Pruzinsky T, editors. Body images: A handbook of theory, research, and clinical practice. New York, NY: Guilford Press; 2002.

Title: Non-suicidal self-injury maintenance and cessation among adolescents: a one-year longitudinal investigation of the role of objectified body consciousness, depression and emotion dysregulation
Authors: Jamie Duggan
Nancy Heath
Tina Hu
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: Child and Adolescent Psychiatry and Mental Health / Issue 1/2015
Electronic ISSN: 1753-2000
DOI: https://doi.org/10.1186/s13034-015-0052-9

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Non-suicidal self-injury maintenance and cessation among adolescents: a one-year longitudinal investigation of the role of objectified body consciousness, depression and emotion dysregulation

Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

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