Top

Child and Adolescent Psychiatry and Mental Health

Published in:

Open Access 01-12-2017 | Research article

Specific coping strategies moderate the link between emotion expression deficits and nonsuicidal self-injury in an inpatient sample of adolescents

Authors: Kristel Thomassin, Camille Guérin Marion, Myriam Venasse, Anne Shaffer

Published in: Child and Adolescent Psychiatry and Mental Health | Issue 1/2017

Abstract

Background

Non-suicidal self-injury (NSSI) is a behavior of increasing prevalence in adolescents with links to various negative mental health and adjustment outcomes. Poor emotion expression has been linked with NSSI use, whereas the use of adaptive coping strategies has been identified as a protective factor against NSSI. The current study examined whether specific coping strategies moderate the relation between poor emotion expression and NSSI, and whether moderation is conditional on adolescent gender.

Methods

Ninety-five adolescents hospitalized on an acute care inpatient psychiatric unit completed questionnaires measuring NSSI, emotion expression and use of specific coping strategies (i.e., problem-focused coping, positive reframing coping, support seeking, avoidance, and distraction).

Results

Results indicated that poor emotion expression was positively associated with NSSI. Positive reframing and support seeking emerged as significant moderators of the poor emotion expression—NSSI link. This result was not conditional upon adolescent gender. Problem-focused coping, avoidance, and distraction did not emerge as significant moderators.

Conclusions

Encouraging youth to use particular coping strategies might protect against the negative impact of emotion expression deficits for both boys and girls.

Favazza AR. The coming of age of self-mutilation. J Nerv Ment Dis. 1998;186:259–68.CrossRefPubMed

Klonsky ED, Victor SE, Saffer BY. Nonsuicidal self-injury: what we know, and what we need to know. Can J Psychiatry. 2014;59:565–8.PubMedPubMedCentral

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

Cloutier P, Martin J, Kennedy A, Nixon MK, Muehlenkamp JJ. Characteristics and co-occurrence of adolescent non-suicidal self-injury and suicidal behaviours in pediatric emergency crisis services. J Youth Adolesc. 2010;39:259–69. doi:10.1007/s10964-009-9465-1.CrossRefPubMed

Linehan M. Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford Press; 1993.

Crowell SE, Beauchaine TP, Linehan M. A biosocial developmental model of borderline personality: elaborating and extending Linehan’s theory. Psychol Bull. 2009;135:495–510. doi:10.1037/a0015616.CrossRefPubMedPubMedCentral

Berenbaum H, Raghavan C, Le HN, Vernon LL, Gomez JJ. A taxonomy of emotional disturbances. Clin Psychol Sci Pract. 2003;10:206–26.CrossRef

Yates TM. The developmental psychopathology of self-injurious behavior: compensatory regulation in posttraumatic adaptation. Clin Psychol Rev. 2014;24:35–74. doi:10.1016/j.cpr.2003.10.001.CrossRef

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

10.

Sim L, Adrian M, Zeman J, Cassano M, Friedrich WN. Adolescent deliberate self-harm: linkages to emotion regulation and family emotional climate. J Res Adolesc. 2009;19:75–91. doi:10.1111/j.1532-7795.2009.00582.x.CrossRef

11.

Evren C, Evren B. Self-mutilation in substance dependent patients and relationship with childhood abuse and neglect, alexithymia and temperament and character dimensions of personality. Drug Alcohol Depend. 2005;80:15–22. doi:10.1016/j.drugalcdep.2005.03.017.CrossRefPubMed

12.

Gratz KL. Risk factors for deliberate self-harm among female college students: the role and interaction of childhood maltreatment, emotional inexpressivity, and affect intensity/reactivity. Am J Orthopsychiatry. 2006;76:238–50. doi:10.1037/0002-9432.76.2.238.CrossRefPubMed

13.

Thomassin K, Shaffer A, Madden A, Londino D. Specificity of childhood maltreatment and emotion deficits in nonsuicidal self-injury in an inpatient sample of youth. Psychiatry Res. 2016;244:103–8. doi:10.1016/j.psychres.2016.07.050.CrossRefPubMed

14.

Zlotnick C, Shea MT, Pearlstein T, Simpson E, Costello E, Begin A. The relationship between dissociative symptoms, alexithymia, impulsivity, sexual abuse, and self-mutilation. Compr Psychiatry. 1996;37:12–6. doi:10.1016/S0010440X(96)90044-9.CrossRefPubMed

15.

Gross JJ, Levenson RW. Emotional suppression: physiology, self-report, and expressive behavior. J Personal Soc Psychol. 1993;64:970–86.CrossRef

16.

Frydenberg E, Lewis R, Kennedy G, Ardila R, Frindte W, Hannoun R. Coping with concerns: an exploratory comparison of Australian, Colombian, German, and Palestinian adolescents. J Youth Adolesc. 2003;32:59–66. doi:10.1023/A:1021084524139.CrossRef

17.

Evans E, Hawton K, Rodham K. In what ways are adolescents who engage in self-harm or experience thoughts of self-harm different in terms of help seeking, communication and coping strategies? J Adolesc. 2005;28:573–87. doi:10.1016/j.adolescence.2004.11.001.CrossRefPubMed

18.

Polanco-Roman L, Jurska J, Quinones V, Miranda R. Brooding, reflection, and distraction: relation to nonsuicidal self-injury versus suicide attempts. Arch Suicide Res. 2015;19:350–65. doi:10.1080/13811118.2014.981623.CrossRefPubMed

19.

Guerreiro DF, Cruz D, Frasquilho D, Santos JC, Figueira ML, Sampaio D. Association between deliberate self-harm and coping in adolescents: a critical review of the last 10 years’ literature. Arch Suicide Res. 2013;17:91–105. doi:10.1080/13811118.2013.776439.CrossRefPubMed

20.

Santos JC, Saraiva CB, De Sousa L. The role of expressed emotion, self-concept, coping, and depression in parasuicidal behaviour: a follow-up study. Arch Suicide Res. 2009;13:358–67. doi:10.1080/13811110903266590.CrossRefPubMed

21.

Voon D, Hasking P, Martin G. Change in emotion regulations strategy use and its impact on non-suicidal self-injury: a three-year longitudinal analysis using latent growth modeling. J Abnorm Psychol. 2014;123:487–98. doi:10.1037/a0037024.CrossRefPubMed

22.

Williams F, Hasking P. Emotion regulation, coping and alcohol use as moderators in the relationship between non-suicidal self-injury and psychological distress. Prev Sci. 2010;11:33–41. doi:10.1007/s11121-009-0147-8.CrossRefPubMed

23.

Brody LR, Hall JA. Gender and emotion in context. In: Lewis M, Haviland-Jones JM, Barrett LF, editors. Handbook of emotions. New York: Guilford Press; 2010. p. 395–408.

24.

Bresin K, Schoenleber M. Gender differences in the prevalence of nonsuicidal self-injury: a meta-analysis. Clin Psychol Rev. 2015;38:55–64. doi:10.1016/j.cpr.2015.02.009.CrossRefPubMed

25.

Sornberger MJ, Heath NL, Toste JR, McLouth R. Nonsuicidal self-injury and gender: patterns of prevalence, methods, and locations among adolescents. Suicide Life Threat Behav. 2012;42:266–78. doi:10.1111/j.1943-278X.2012.0088.x.CrossRefPubMed

26.

Hampel P, Petermann F. Age and gender effects on coping in children and adolescents. J Youth Adolesc. 2005;34:73–83. doi:10.1007/s10964-005-3207-9.CrossRef

27.

Gratz KL. Measurement of deliberate self-harm: preliminary data on the Deliberate Self-Harm Inventory. J Psychopathol Behav Assess. 2001;23:253–63. doi:10.1023/A:1012779403943.CrossRef

28.

Zetterqvist M, Lundh LG, Dahlstrom O, Svedin CG. Prevalence and function of non-suicidal self-injury (NSSI) in a community sample of adolescents, using suggested DSM-5 criteria for a potential NSSI disorder. J Abnorm Child Psychol. 2013;41:759–73. doi:10.1007/s10802-013-9712-5.CrossRefPubMed

29.

In-Albon T, Burli M, Ruf C, Schmid M. Non-suicidal self-injury and emotion regulation: a review on facial emotion recognition and facial mimicry. Child Adolesc Psychiatry Ment Health. 2013;7(5):1–11. doi:10.1186/1753-2000-7-5.

30.

Lloyd-Richardson EE, Perrine N, Dierker L, Kelley ML. Characteristic and functions on non-suicidal self-injury in a community sample of adolescents. Psychol Med. 2007;37:1183–92. doi:10.1017/S003329170700027X.CrossRefPubMedPubMedCentral

31.

Zeman J, Penza-Clyve S. Initial validation of the emotion expression scale for children (EESC). J Clin Child Adolesc Psychol. 2002;31:540–7. doi:10.1207/S15374424JCCP3104_12.CrossRefPubMed

32.

Gaylord-Harden NK, Gipson P, Mance G, Grant KE. Coping patterns of African American adolescents: a confirmatory factor analysis and cluster analysis of the Children’s Coping Strategies Checklist. Psychol Assess. 2008;20:10–22. doi:10.1037/1040-3590.20.1.10.CrossRefPubMed

33.

Achenbach TM. Manual for the youth self-report and 1991 profile. Burlington: University of Vermont Department of Psychiatry; 1991.

34.

Muthén LK, Muthén BO. Mplus user’s guide. 7th ed. Los Angeles: Muthén & Muthén; 1998–2015.

35.

Field A. Discovering statistics using IBM SPSS statistics. Thousand Oaks: Sage; 2013.

36.

Borrill J, Fox P, Flynn M, Roger D. Students who self-harm: coping, rumination, and alexithymia. Couns Psychol Q. 2009;22:361–72. doi:10.1080/09515070903334607.CrossRef

37.

Yates T. Developmental pathways from child maltreatment to non-suicidal self-injury. In: Nock MK, editor. Understanding non-suicidal self-injury: origins, assessment and treatment. Washington: American Psychological Association; 2009. p. 117–38.CrossRef

38.

Andover MS, Pepper CM, Gibb BE. Self-mutilation and coping strategies in a college sample. Suicide Life Threat Behav. 2007;37:238–43. doi:10.1521/suli.2007.37.2.238.CrossRefPubMed

39.

McGregor LS, Melvin GA, Newman LK. Familial separations, coping styles, and PTSD symptomatology in resettled refugee youth. J Nerv Ment Dis. 2015;203:431–8. doi:10.1097/NMD.0000000000000312.CrossRefPubMed

40.

Seaton EK, Upton R, Gilbert A, Volpe V. A moderated mediation model: racial discrimination, coping strategies, and racial identity among black adolescents. Child Dev. 2014;85:882–90. doi:10.1111/cdev.12122.CrossRefPubMed

41.

American Psychiatric Association. Diagnostic and statistical manual of mental disorders. 5th ed. Washington, DC: Author; 2013.CrossRef

Title: Specific coping strategies moderate the link between emotion expression deficits and nonsuicidal self-injury in an inpatient sample of adolescents
Authors: Kristel Thomassin
Camille Guérin Marion
Myriam Venasse
Anne Shaffer
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: Child and Adolescent Psychiatry and Mental Health / Issue 1/2017
Electronic ISSN: 1753-2000
DOI: https://doi.org/10.1186/s13034-017-0158-3

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Specific coping strategies moderate the link between emotion expression deficits and nonsuicidal self-injury in an inpatient sample of adolescents

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2017

Elucidating adolescent aspirational models for the design of public mental health interventions: a mixed-method study in rural Nepal

Autism in adult and juvenile delinquents: a literature review

Characteristics of adolescents frequently restrained in acute psychiatric units in Norway: a nationwide study

Identifying cross-cultural variations in psychostimulant use for attention deficit hyperactivity disorder using linked data

Mental health literacy in adolescents: ability to recognise problems, helpful interventions and outcomes

A program of family-centered care for adolescents in short-term stay groups of juvenile justice institutions