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

Wolff, Jennifer C.; Thompson, Elizabeth; Thomas, Sarah A.; Nesi, Jacqueline; Bettis, Alexandra H.; Ransford, Briana; Scopelliti, Katie M; Frazier, Elisabeth A.; Liu, Richard T.

doi:10.1016/j.eurpsy.2019.03.004

Cited by 242 publications

(231 citation statements)

References 101 publications

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“…These findings, as summarized in recent meta-analyses, support the emotion dysregulation hypothesis (e.g., Wolff et al, 2018), yet it is important to note that some sources of evidence are less conclusive. For example, although numerous studies demonstrate low parasympathetic nervous system (PNS) tone and excessive PNS withdrawal during negative emotion inductions among those who engage in NSSI and SBs (Crowell, Baucom, et al, 2014; Crowell et al, 2005, 2008, 2013, 2014, 2017; Kuo & Linehan, 2009), autonomic hyperreactivity is not as consistent when using (a) other markers, such as sympathetic nervous system (SNS) responding, and (b) non–emotion induction paradigms, such as cold-pressor, acoustic startle, and public speaking tasks.…”

Section: Traditional Conceptualizations Of Nssi and Suicidal Behaviormentioning

confidence: 65%

Nonsuicidal Self-Injury and Suicidal Behaviors in Girls: The Case for Targeted Prevention in Preadolescence

Beauchaine

Hinshaw

Bridge

2019

Clinical Psychological Science

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Nonsuicidal self-injury (NSSI) affects 15% to 20% of adolescents—disproportionately girls—and is a strong predictor of eventual suicide attempts and suicide. Many girls now initiate NSSI before age 10. These early starters exhibit greater frequency of NSSI, use more diverse methods, and are hospitalized more often than later starters, yet there are no empirically supported prevention programs for preadolescents. Obstacles to prevention include ascertaining who is sufficiently vulnerable and specifying mechanistic intervention targets. Recent research indicates that (a) preadolescent girls with ADHD who are also maltreated are at alarming risk for NSSI and suicide attempts by adolescence and (b) the conjoint effects of these vulnerabilities are sufficiently potent for targeted prevention. Research also indicates that existing interventions are effective in altering child- and family-level mechanisms of NSSI. These interventions alter neurobiological markers of vulnerability, which can be used as proximal efficacy signals of prevention response without waiting for NSSI and suicide attempts to emerge.

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Section: Traditional Conceptualizations Of Nssi and Suicidal Behaviormentioning

confidence: 65%

Nonsuicidal Self-Injury and Suicidal Behaviors in Girls: The Case for Targeted Prevention in Preadolescence

Beauchaine

Hinshaw

Bridge

2019

Clinical Psychological Science

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“…Emotion dysregulation is a frequently cited risk factor for both non-suicidal self-injury (NSSI) and suicidal behaviour [ 30 , 31 ]. From a community study through self-report questionnaires and semi-structured interview about NSSI behaviours, Kranzler et al found that emotion dysregulation was indirectly associated with suicide attempt frequency, via internalising symptoms and NSSI frequency, suggesting that when faced with stress or negative affect, individuals with emotion regulation deficits may be less able to tolerate these difficult emotions and more likely to internalise their distress [ 30 ].…”

Section: Discussionmentioning

confidence: 99%

High-school students and self-injurious thoughts and behaviours: clues of emotion dysregulation

et al. 2021

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Background Suicide attempts and self-harm in adolescence are a major public health concern: they are among the main causes of disability-adjusted life-years worldwide, with severe long-term health consequences in terms of mental illness and psychiatric hospitalisation and a significantly increased risk of suicide. Several studies recently focused on the hypothesis that adolescents may be particularly vulnerable to emotional dysregulation and on the relation between problems with emotion regulation and suicidal and self-harming behaviours. Italian epidemiological data about prevalence of these behaviours at the community level are lacking. Our study aimed to estimate the prevalence of self-injurious thoughts and behaviours (SITBs) in a representative sample of community adolescents, and to examine the association between SITBs and the emotional and behavioural profiles. Methods Anonymous self-report questionnaires were completed by 1507 students aged 11–18 years from 24 high schools in the North-eastern Italian region of Friuli Venezia Giulia. Information was collected on SITBs, on the socio-environmental context, and on the psychological profile (‘Achenbach’s YSR questionnaire 11–18, Multidimensional Test of Self-harm and Multi-Attitude Suicide Tendency Scale). Results Overall, 11.1% of adolescents reported self-harming behaviours without suicide ideation or attempts, 6.4% declared having thought to suicide without acting a suicide attempt or self-harm, 1.4% declared having attempted suicide and really thought to take away their life. Access to health services following a suicide thought, a self-harming behaviour or suicide attempt was infrequent, particularly for suicide ideation. At the YSR, all the SITBs groups reported high scores in almost all scales, with the most evident differences in the self-harming groups in which adolescents reported significantly higher scores in all scales, both internalising and externalising. An emotion dysregulation profile was found in almost all the groups. Conclusions This study provides us with an estimate of the prevalence of SITBs in the adolescent population and confirms the importance of further investigating the association between SITBs and emotion dysregulation. The naturalistic setting of community studies appears to be useful for studies in this field, and it allows to approach the onerous and often neglected issue of adolescent suicidality.

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“…People who self‐harm have been found to have difficulties in emotion regulation (Wolff, Thompson, Thomas, Nesi, Bettis & Ransford, 2019) and the empirical and theoretical literature positions self‐harm as a means of regulating unwelcome emotional experience (Chapman, Gratz & Brown, 2006; Klonsky, 2007; McKenzie & Gross, 2014). The association between self‐harm and alexithymia may be due in part to a lack of recourse to more adaptive regulation strategies.…”

Section: Introductionmentioning

confidence: 99%

The relationship between self‐harm and alexithymia: A systematic review and meta‐analysis

Norman

Oskis

Marzano

et al. 2020

Scandinavian J Psychology

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Self-harm, defined for the purpose of this review as any act of self-injury without explicit suicidal intent, is an increasing public health concern, with potential long-term implications for those who engage in it. Previous research has identified a correlational relationship between self-harm and alexithymia, an emotion processing deficit characterized by difficulties identifying and describing feelings, and an externally orientated thinking style. Through a systematic search of the literature, the current review examines the association between alexithymia and self-harm. A meta-analysis based on 23 studies found a significant, positive relationship between self-harm and alexithymia, with a medium effect size (g = 0.57, 95% CI 0.46-0.69). All 23 studies used the Toronto Alexithymia Scale (TAS20) to measure alexithymia. The alexithymia subcomponents difficulty identifying feelings and difficulty describing feelings were significantly associated with self-harm, but there was no significant association between self-harm and externally orientated thinking. The effect size of the relationship was significantly larger in adolescent samples compared with adult samples and in female compared with male samples. The definition of self-harm did not affect the effect size of the relationship between alexithymia and self-harm and the results are consistent with previous metaanalyses focused more narrowly on non-suicidal self-injury and, separately, suicidal behaviors. Heterogeneity between the included studies was high. The results support an affect regulation model of self-harm, in which self-harm is used to regulate an emotional experience that is poorly understood.

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

Cited by 242 publications

References 101 publications

Nonsuicidal Self-Injury and Suicidal Behaviors in Girls: The Case for Targeted Prevention in Preadolescence

Nonsuicidal Self-Injury and Suicidal Behaviors in Girls: The Case for Targeted Prevention in Preadolescence

High-school students and self-injurious thoughts and behaviours: clues of emotion dysregulation

The relationship between self‐harm and alexithymia: A systematic review and meta‐analysis

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