Mechanisms of Contextual Risk for Adolescent Self-Injury: Invalidation and Conflict Escalation in Mother–Child Interactions

Abstract

OBJECTIVE According to developmental theories of self-injury, both child characteristics and environmental contexts shape and maintain problematic behaviors. Although progress has been made toward identifying biological vulnerabilities to self-injury, mechanisms underlying psychosocial risk have received less attention. METHOD In the present study, we compared self-injuring adolescents (n=17) with typical controls (n=20) during a mother-child conflict discussion. Dyadic interactions were coded using both global and microanalytic systems, allowing for a highly detailed characterization of mother-child interactions. We also assessed resting state psychophysiological regulation, as indexed by respiratory sinus arrhythmia (RSA). RESULTS Global coding revealed that maternal invalidation was associated with adolescent anger. Furthermore, maternal invalidation and coerciveness were both related to adolescent opposition/defiance. Results from the microanalytic system indicated that self-injuring dyads were more likely to escalate conflict, suggesting a potential mechanism through which emotion dysregulation is shaped and maintained over time. Finally, mother and teen aversiveness interacted to predict adolescent resting RSA. Low-aversive teens with highly aversive mothers had the highest RSA, whereas teens in high-high dyads showed the lowest RSA. CONCLUSIONS These findings are consistent with theories that emotion invalidation and conflict escalation are possible contextual risk factors for self-injury.

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

“…It might be that NSSI attempt (unsuccessfully) to regulate their emotions, whereas DEP youth (who experience less intense affect than NSSI but who also have fewer regulatory skills than HC) engage the posterior CMS to a lesser extent than both NSSI and HC during this perspective. Greater precuneus and PCC activity for NSSI youth resembles findings among self-harming adults during regulation of aversive emotions (Crowell et al, 2013; Davis et al, 2014) and, as scholars have previously suggested, may indicate accessing of autobiographical memories (Lang et al, 1983) or the anticipation of negative stimuli (Scherpiet et al, 2014). Thus, it is possible that NSSI youth hold negative cognitions regarding their peers, or recall negative interactions with peers, when engaging in self-processing from classmates’ perspectives.…”

“…Combined with prior research regarding associations between negative parent-child relationships and NSSI (Adrian et al, 2011; Yurkowski et al, 2015), our follow-up analyses demonstrating correlations between low maternal emotional support and high limbic activity suggest that NSSI youths’ limbic hyperactivation during self-referential processing from their mother’s perspective may be linked with maternal emotional invalidation. This notion is bolstered by prior research that has shown hostile mother-child relationships are linked with altered psychophysiology of emotion regulation and with intense anger among self-injurious adolescents (Crowell et al, 2013). …”

“…Specifically, caregiver emotional invalidation, conceptualized as parenting practices which imply the child’s opinions and emotions are invalid, irrational or unimportant (Linehan, 1993), have been linked to emotion dysregulation and NSSI (Adrian et al, 2011; Sturrock and Mellor, 2014; Tan et al, 2014; Yurkowski et al, 2015). Indeed, when accounting for multiple interpersonal characteristics, retrospective self-reports of experiencing maternal antipathy has been shown to be the sole significant predictor of NSSI behavior (Kaess et al, 2013), and observed maternal emotional invalidation and coerciveness have been linked to greater conflict in interactions between adolescent self-injurers and their mothers (Crowell et al, 2013). With respect to peers, conflict in peer relationships is also associated with youth NSSI behavior (e.g., (Hilt et al, 2008), perhaps by placing continued stress on already dysregulated emotional processing systems, or by serving as distressing triggers for NSSI engagement.…”

Emotion dysregulation and dyadic conflict in depressed and typical adolescents: Evaluating concordance across psychophysiological and observational measures

“…This results in a total of 25 content × 3 affect combinations. In order to examine aversiveness, we followed a strategy developed and validated by Snyder and colleagues (1994) and tested in a sample of adolescent females (Crowell, Baucom et al, 2013). Each of the 75 codes (25 content × 3 affect) was reduced into a single number on a 10-point scale ranging from highly positive utterances ( 0 ) to coercive or attacking utterances ( 9 ).…”

Toward Developing Laboratory-Based Parent–Adolescent Conflict Discussion Tasks that Consistently Elicit Adolescent Conflict-Related Stress Responses: Support from Physiology and Observed Behavior

“…Understanding the nature of social stress—often measured with indices of psychophysiological, emotional, and behavioral arousal—in parent-adolescent conflict interactions has become a recent focus of the field due to its link with maladaptive youth outcomes (Chaplin et al, 2014; Chaplin et al, 2012; Crowell et al, 2013; Crowell et al, 2014; Moed et al, 2015; Van der Giessen et al, 2015). Psychophysiological stress during parent-adolescent conflict is frequently assessed via cardiovascular response.…”