Borderline Personality Disorder and Deliberate Self‐Harm: Does Experiential Avoidance Play a Role?

Abstract

The theory that borderline personality disorder (BPD) is associated with experiential avoidance, and that experiential avoidance mediates the association between BPD and deliberate, nonsuicidal self-harm was examined. Female inmate participants (N = 105) were given structured diagnostic assessments of BPD, as well as several measures of experiential avoidance. There was a high lifetime prevalence of past self-harm (47.6%). Higher dimensional scores representing BPD severity were associated with higher self-harm frequency and greater experiential avoidance. Structural equation modeling analyses indicated that experiential avoidance did not mediate the association between BPD and self-harm, although thought suppression was associated with self-harm frequency.

The role of emotion regulation strategies and dissociation in non-suicidal self-injury for women with borderline personality disorder and comorbid eating disorder

“…An increase in expressive suppression interferes with the beneficial effects that cognitive reappraisal has on NSSI. This finding supports previous research showing that the use of escape and avoidance emotion regulation strategies, specifically expressive suppression, is associated with a higher frequency of NSSI in individuals with BPD (Chapman et al, 2005); but it also goes a step further by showing that expressive suppression interferes with the ability to reinterpret the meaning of a situation that elicits an undesired emotion. The second interaction shows that an increase in dissociation is to some degree related to an increase in NSSI.…”

“…In patients with BPD research suggests that NSSI may be considered a maladaptive coping strategy (Welch, Linehan, Sylvers, Chittams, & Rizvi, 2008). In a research study the tendency to suppress unpleasant thoughts and/or emotions has been associated with a higher use of NSSI among incarcerated women with BPD but not among non-BPD individuals (Chapman et al, 2005). Moreover, in two other studies results showed that NSSI is seen as a means of providing relief from undesired thoughts and/or emotions (Chapman, Gratz, & Brown, 2006) or to escape from or avoid undesired emotions, situations, or aversive tension (Kleindienst et al, 2008) among BPD population.…”

“…BPD features are also associated with the use of escape and avoidance strategies to cope with undesired thoughts and emotions (e.g., Bijttebier & Vertommen, 1999;Chapman, Specht, & Cellucci, 2005). Experiential avoidance is broadly defined as attempts to avoid or escape thoughts, images, emotions, memories, physical sensations, or other internal experiences, even when this strategy, causes behavioral harm in the long-term (Hayes, Strosahl, & Wilson, 1999).…”

A new self‐report measure of emotion regulation in adolescents: The Regulation of Emotions Questionnaire

“…In contrast, strategies that do not process and use the information in a helpful way, perhaps rejecting or blocking emotions instead, would be considered dysfunctional. These strategies prevent the development of tolerance to emotions (Chapman, Specht, & Celluci, 2005) and may actually lead to amplification of emotional distress due to the generation of secondary emotions, such as feeling anxious about the initial 'bad' feelings (e.g., Linehan, 1993) or through the 'coupling' of emotions (e.g., Power & Dalgleish, 1997).…”

Thought suppression and suicidal ideation: preliminary evidence in support of a robust association

“…Support has emerged for models in which thought suppression mediates the relation between negative emotionality or emotional reactivity and suicidal ideation. [14,15] Chapman et al [16] similarly found that thought suppression was associated with a greater frequency of self-harm in a sample of female inmates with borderline personality disorder. Hence, converging evidence suggests that suppression of unwanted thoughts may be associated with greater suicidal ideation and potential for self-harm.…”