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Connection between Parenting Styles and Self-harm in Adolescence



The aim of this study was to investigate possible associations between parenting styles and the occurrence of self-harm in adolescence, in the context of potential gender differences. In a large-scale survey, we administered a questionnaire asking about basic demographic characteristics, perceived quality of relationships within the respondents’ families, and the occurrence of self-injurious behavior. The questionnaire therefore contained the Self-Harm Behavior Questionnaire (Gutierrez, 2001) and the Self-Harm Inventory (Sansone, Sansone & Wiedermann, 1995), and the Questionnaire for the Assessment of Parenting Styles in the Family (Čáp, 1994). The research sample consisted of 1,466 respondents aged between 11 and 16 years, of whom almost 20% had at least some experience with self-harm. Adolescents living in two-parent families were less likely to harm themselves: Nearly 60% of all adolescents coming from complete families had no experience with self-harm at all. Adolescents from single-parent families, on the other hand, were most frequently found among experimenters and chronic self-harmers – in both groups they constituted more than 20% of respondents. The study yielded interesting findings regarding the quality of respondents’ relationships with parents as well as perceived parenting styles, with self-harm occurring very frequently with weak and inconsistent parenting styles (around 40% each).
Procedia - Social and Behavioral Sciences 171 ( 2015 ) 1106 – 1113
Available online at
1877-0428 © 2015 Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license
Peer-review under responsibility of the Organizing Committee of ICEEPSY 2014.
doi: 10.1016/j.sbspro.2015.01.272
Connection between parenting styles and self-harm in adolescence
Burešová, I.*, Bartošová, K., Čerňák, M.
Department of Psychology, Faculty of Arts, Masaryk university, Arne Nováka 1, 628 00, Brno, Czech Republic
The aim of this study was to investigate possible associations between parenting styles and the occurrence of
self-harm in adolescence, in the context of potential gender differences. In a large-scale survey, we administered a
questionnaire asking about basic demographic characteristics, perceived quality of relationships within the
respondents’ families, and the occurrence of self-injurious behavior. The questionnaire therefore contained the Self-
Harm Behavior Questionnaire (Gutierrez, 2001) and the Self-Harm Inventory (Sansone, Sansone & Wiedermann,
1995), and the Questionnaire for the Assessment of Parenting Styles in the Family (Čáp, 1994). The research sample
consisted of 1,466 respondents aged between 11 and 16 years, of whom almost 20% had at least some experience
with self-harm. Adolescents living in two-parent families were less likely to harm themselves: Nearly 60% of all
adolescents coming from complete families had no experience with self-harm at all.
Adolescents from single-parent
families, on the other hand, were most frequently found among experimenters and chronic self-harmers – in both
groups they constituted more than 20% of respondents. The study yielded interesting findings regarding the quality
of respondents’ relationships with parents as well as perceived parenting styles, with self-harm occurring very
frequently with weak and inconsistent parenting styles (around 40% each).
© 2015 The Authors. Published by Elsevier Ltd.
Peer-review under responsibility of the Organizing Committee of ICEEPSY 2014.
Keywords: parenting style; parental guidance; self-harm; adolescence; gender
1. Introduction
In the past few years, there has been a visible increase in the prevalence of self-harm in non-clinical adolescent
population. Definitions and categorizations of self-harm behaviour are largely diverse in scientific literature, which
seriously impedes – if not prevents – integration of findings from different studies in the area. However, there are
several basic features which are common for all these conceptualizations: Self-harmers direct injurious behaviour
against themselves purposefully and deliberately, they use physical violence and have no suicidal intentions in doing
© 2015 Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license
Peer-review under responsibility of the Organizing Committee of ICEEPSY 2014.
I. Burešová et al. / Procedia - Social and Behavioral Sciences 171 ( 2015 ) 1106 – 1113
so. Also, the self-injuries are not inflicted for decorative, ritual or sexual purposes. In literature published in English,
these characteristics best define what is referred to as the “non-suicidal self-injury” (NSSI), a term especially used
by in the American context (Lloyd et al., 2007).
The prevalence of self-harm reported by different studies varies depending on the methodology used; however,
the most common figures range between 20-40%. Swahn et al. (2012) reported 20.3% prevalence in a sample of
4,100 students of primary and secondary schools in the urban areas of the U.S.; Plener et al. (2009) found 25.6%
prevalence in German adolescents. Similar findings have been reported by a number of other authors (e.g., Izutsu et
al., 2006; Portzky, De Wilde & van Heeringen, 2008; Kvernmo & Rosenvinge, 2009). A behaviour which was just
recently considered highly pathological has now become such a common occurrence that as many as 20%
adolescents try it at least one in their lifetime. This means that self-harm can no longer be approached only from the
perspective of psychiatric disorders of impaired personality development. Neither can influential theories of self-
harm as conformist behaviour capture the wide range of variables affecting the phenomenon. The aim of the present
study is to explore self-harm in relation to the relatively narrow but highly significant domain of family relationships
and parenting styles, as these two have an indisputable impact on the healthy or impaired development of any
2. Background
The significance of family relationships in chronic self-harm behaviour in adolescence has been evidenced by
numerous studies (Ross & Heath, 2002; Lieberman, 2004; Laye-Gindhu & Schonert-Reichl, 2005; Kvermo &
Rosenvinge, 2009; Tan et al., 2012, etc.). Normal development in this turbulent period full of rapid physical,
cognitive and emotional transformations is strongly affected by parental interest and emotional involvement, as well
as by parenting styles, which largely determine the overall climate and communication in the family.
Many models have been published attempting to explain self-harm behaviour. It turns out that this spreading
phenomenon probably has a multi-causal background, with parenting style being one of the most influential factors.
Suyemoto (1998) reviewed six models explaining the function of self-mutilation: the environmental model, the
antisuicide model, the sexual model, the affect regulation model, the dissociation model, and the boundaries model.
Power & Brown (2010) provided further subdivision of these six types. Sutton (2005) described self-harm as a
coping strategy which should help alleviate psychological pain or regain emotional balance. Chapman et al. (2006)
view the onset and recurrence of self-harm as a means of avoiding negative affect – an effective way to manage
negative emotions, thought, or social experience. Nock & Prinstein (2004), drawing on existing research, proposed
and tested yet another model, based on the assumption that self-harm is driven by two types of behaviour – social
(interpersonal) and automatic (intrapersonal). This idea was supported, for example, by Tan and colleagues (2012);
on a sample of Singaporean adolescents, they found that intrapersonal motives (i.e. emotion regulation) prevailed
over interpersonal ones. Lieberman (2004) argued that many self-harmers show low self-confidence and problems
with emotion regulation. Furthermore, in comparison with non-self-harmers, they more often tended to be neglected
and rejected by their parents as children, were denied sufficient parental care, and/or came from divorced families.
Wedig & Nock (2007) explored parental expressed emotion (parental criticism and emotional overinvolvement) in
relation to self-harm in adolescents. The association proved significant; specifically, parental criticism/hostility
strongly correlated with both self-injurious thought and behaviour. Similarly, Polk & Liss (2007) argued that self-
harmers might lack adequate emotional nurturance in the long term. Together with authoritarian parenting style and
overly strict rules, indicators of emotional nurturance predicted self-injurious behaviour in their study. With regard
to all these findings, an inspiring thought was expressed by Miller et al. (2007) that change or adjustment of
parenting styles, especially extreme ones, can help reduce self-harm behaviour regardless of its primary causes, as
extreme parenting styles typically act as stressors not only for the adolescents, but for their parents as well. The
authors especially focused on six types (three dimensions) of extreme parenting styles (Table 1). All of these
extremes can increase the risk of maladaptive behaviour in adolescents, and parents should therefore always strive to
achieve balance between them.
Table 1: Extrem
e parenting styles (Miller et al., 2007)
1108 I. Burešová et al. / Procedia - Social and Behavioral Sciences 171 ( 2015 ) 1106 – 1113
Be excessively lenient and place too few demands Be authoritarian and place overly tight controls
Show little concern and not take the
adolescent’s behavioural problems seriously
Worry too much and view the adolescent’s
behaviour as overly problematic
Be insufficiently protective and allow
the adolescent too much freedom
Be overly protective and not allow
the adolescent enough freedom
There are also other studies suggesting that the quality of family relationships and parenting styles have a strong
impact on the presence and frequency of self-injurious behaviour in adolescents. Because adolescence is a
vulnerable, turbulent period, both of these factors tend to fuel maladaptive emotional responses, which can directly
lead to self-harm (Adrian et al., 2011). Baetens and colleagues (2013) point out that insufficient emotional support
on the part of the parents not only directly affects the occurrence of self-harm, but also increases the risk of self-
harm indirectly through increasing the frequency of depressive moods in adolescents. For example, highly critical
parents are likely to foster excessive self-criticism in their children, which, in turn, might become a trigger of self-
injurious behaviour.
In conclusion, it can be said that adequate parenting style is considered one of the best protective factors against
self-harm, and conversely, inadequate parenting style is a reliable positive predictor of its occurrence. Therefore, the
main objective of the present study was to investigate possible associations between parenting styles and the
occurrence of self-harm during adolescence in the Czech population, with regard to potential gender differences.
3. Method
The study was a part of a large research project “Validation of tools for screening of self-harm in early
adolescents”. The aim was to explore potential associations between self-harm, family situation of adolescents, and
perceived parenting styles. In accordance with the research objectives, what we were interested in were quantitative,
exploratory data, best obtainable through a one-shot cross-sectional survey using self-report measures. The measures
of self-harm included the Self-Harm Inventory (SHI; Sansone, Sansone & Wiederman, 1995) and the Self-Harm
Behavior Questionnaire (SHBQ; Gutierrez, 2001).
The original version of the SHI asks about the respondent’s experience with 22 different forms of self-harm and
the frequency of their occurrence in the respondent’s personal history. For the purpose of our study, we excluded all
items which were inadequate for the target population. The final version was only 14 items long. The SHBQ
(Gutierrez, 2001) measures self-harm and suicidal behaviour. With respect to our research objective, only Scale I,
measuring self-harm behaviour, was included in the survey. The scale contained 11 items. The other sections, which
address suicidal behaviour, were omitted.
For the measurement of parenting styles, we used the Parenting Styles in the Family Questionnaire (Čáp, 1994).
The questionnaire consists of two parallel sets of 40 items, which are answered separately for mother and father, and
measures two components of parenting style: the quality of emotional relationship of each parent to the child
(warm/cold), and parental guidance/control. Data on both parents are then combined to identify the overall quality of
relationships and parental guidance in the family as a whole.
3.1. Data Collection
The data was collected through random sampling, with an increased emphasis on ethical issues involved. First, a
pilot study (N = 235) was conducted, successfully validating basic psychometric properties of the research tools
used. In the next stage, the questionnaire was administered to a large sample of 1,466 adolescent respondents aged
between 11-16 years. Prior to the data analysis, the obtained sample was balanced in terms of age and gender, to
contain an equal number of boys and girls, and an equal number of 13-, 14- and 15-year-olds. The pruned sample
consisted of 1,110 respondents (370 adolescents in each age group, 185 female and 185 male). 650 respondents
came from two-parent families, 460 from divorced (single-parent) families.
I. Burešová et al. / Procedia - Social and Behavioral Sciences 171 ( 2015 ) 1106 – 1113
4. Results
The information on the occurrence of self-harm obtained by the SHI Section IV was used to divide the
respondents into three groups: respondents who had no experience with self-harm at all (“Non-self-harmers”),
respondents who harmed themselves no more than 4 times (“Experimenters”), and respondents whose experience
with self-harm exceeded 4 cases (“Self-harmers”). The number of respondents in each group is shown in Table 1.
Table 2: Numbers of respondents in three self-harm occurrence groups
N % Cumulative %
Non-self-harmers 618 55.7 55.7
Experimenters 221 19.9 75.6
Self-harmers 271 24.4 100.0
Total 1110 100.0
Table 3 shows numbers of respondents in each group by gender, indicating distribution differences:
Table 3: Research sample divided by self-harm occurrence and gender
Male Female
Group Non-self-harmers Count 349 269 618
% within Group 56.5% 43.5% 100.0%
% within Gender 62.9% 48.5% 55.7%
Experimenters Count 92 129 221
% within Group 41.6% 58.4% 100.0%
% within Gender 16.6% 23.2% 19.9%
Self-harmers Count 114 157 271
% within Group 42.1% 57.9% 100.0%
% within Gender 20.5% 28.3% 24.4%
Total Count 555 555 1110
% within Group 50.0% 50.0% 100.0%
% within Gender 100.0% 100.0% 100.0%
As seen in Table 3, 62.9% of boys and 48.5% of girls reported no experience with self-harm at all. On the other
hand, both the Experimenter and the Self-harmer group contained a greater proportion of girls (23.2% and 28.3%
respectively) than boys (16.6% and 20.5%, respectively). Occurrence of self-harm also seemed to increase with age
(Table 4).
1110 I. Burešová et al. / Procedia - Social and Behavioral Sciences 171 ( 2015 ) 1106 – 1113
Table 4: Research sample divided by self-harm occurrence and age
Total 13 14 15
Group Non-self-harmers Count 225 199 194 618
% within Group 36.4% 32.2% 31.4% 100.0%
% within Age 60.8% 53.8% 52.4% 55.7%
Experimenters Count 69 73 79 221
% within Group 31.2% 33.0% 35.7% 100.0%
% within Age 18.6% 19.7% 21.4% 19.9%
Self-harmers Count 76 98 97 271
% within Group 28.0% 36.2% 35.8% 100.0%
% within Age 20.5% 26.5% 26.2% 24.4%
Total Count 370 370 370 1110
% within Group 33.3% 33.3% 33.3% 100.0%
% within Age 100.0% 100.0% 100.0% 100.0%
Two-sample t-test did not reveal any significant gender differences regarding the age at either the first or the last
episode of self-harm. Altogether, only 216 respondents answered the question about the first episode: The average
age was 12.49 years for boys and 12.63 years for girls. 208 respondents answered the question about how long the
self-harm episode had lasted: for boys, it was .99 years, for girls, .94 years on average. Again, the difference was
non-significant (p = .78).
4.1. Parenting styles
The Parenting Style in the Family Questionnaire yields three general outputs: quality of emotional relationships
in the family score, parental guidance/control in the family score, and an overall parenting style, which is
represented by one of nine fields (see below). In all of these three variables, we found significant differences
between the three self-harm occurrence groups.
4.1.1. Quality of emotional relationships in the family (warmth)
In boys, extremely warm emotional relationships with parents were reported in 18.1% of Non-self-harmers, as
opposed to only 5.4% of Experimenters and 8.8% of Self-harmers. Conversely, 36% of male Non-self-harmers
reported cold relationships – less than the 53.3% of Experimenters or 52.6% of Self-harmers. In girls, the tendency
was similar, although somewhat less pronounced: 21.9% of Non-self-harmers reported extremely warm
relationships with parents, while only 15.5% of Experimenters and 16.6% of Self-harmers did so. On the other hand,
cold relationships were reported by 36.8% of female Non-self-harmers, 47.3% of Experimenters, and 52.2% of Self-
4.1.2. Parental guidance/control
Interesting results, especially in terms of application in counselling and therapy, emerged regarding the parental
control/guidance dimension. Male Non-self-harmers perceived parental control as weak (41.8%) or inconsistent
I. Burešová et al. / Procedia - Social and Behavioral Sciences 171 ( 2015 ) 1106 – 1113
(34.4%) much more frequently than strong (9.2%) or moderate (4.9%). Similarly, female Non-self-harmers reported
weak control (40.1%) and inconsistent control (32.7%) much more often than strong or moderate control (8.6%
each). In both male and female Experimenters, reported parental control was mostly inconsistent (50% and 41.1%,
respectively), followed by weak (28.3% and 38.0%, respectively). Again, strong control was found in much less
respondents (9.8% boys; 9.3% girls), and moderate control was very scarce (2.2% boys; 3.9% girls). Very similar
results were obtained in the Self-harmer group in both male and female respondents.
4.1.3. General parenting style in the family
The procedure by which general parenting style in the family is identified involves, in the first step,
identification of the emotional relationship of the parent to the child (warm v. cold) and parental control style
(demands v. freedom) for each parent separately. In the second step, all four outputs are combined to obtain one of
the fields described in the Nine Field Model. In the present study, the distributions of the three self-harm occurrence
group members within the nine fields differed significantly (Cramer’s V = .19, p < .01). Significant gender
differences were not found.
Field 1: Strong or moderate control and cold relationships: This parenting style occurred in 5.2% of male and
6.3% female Non-self-harmers, 4.3% of male and 7.0% female Experimenters and 7.9% of male and 8.3% female
Field 2: Weak control and cold relationships: Male Non-self-harmers reported this style in 6%, Experimenters in
5.4%, and Self-Harmers in 11.4% of cases. For girls, the frequencies were 8.9%, 10.9% and 15.3%, respectively. It
is worth noting that the author of the questionnaire views this style as the most adverse one for both emotional
stability and conscientiousness.
Field 3: Inconsistent control and cold relationships: This was the most frequently assigned field, which included
21.8% of male and 19.3% female Non-self-harmers, 41.3% of male and 28.7% female Experimenters, and 30.7% of
male and 26.1% female Self-harmers. This field is also perceived as adverse for both conscientiousness and
Field 4: Strong control and warm or extremely warm relationships: This style was only found in 4.3% of male
and 2.6% female Non-self-harmers, 4.3% of male and 1.6% female Experimenters, and 0.9% of male and 2.5%
female Self-harmers. The author of the questionnaire finds this field favourable for the development of
Field 5: Moderate control and warm or extremely warm relationships: This field was assigned to 3.7% of male
and 6.3% female Non-self-harmers, 2.2% of male and 3.1% female Experimenters, and 5.3% of male and 3.2%
female Self-harmers. These numbers are quite low, despite the fact that this field is considered optimal for both
conscientiousness and stability.
Field 6: Weak control and warm relationships: This was the second most frequent field, incorporating 20.1% of
male and 15.2% female Non-self-harmers, 17.4% of male and 12.4% female Experimenters, and 10.5% of male and
12.7% female Self-harmers.
Field 7: Inconsistent control and warm or extremely warm relationships: This style was reported by 10.0% of
male and 8.2% female Non-self-harmers, 4.3% of male and 6.2% female Experimenters, and 12.3% of male and 7%
female Self-harmers.
Field 8: Weak control and extremely warm relationships: This field contained 11.5% of male and 14.1% female
Non-self-harmers, 3.3% of male and 11.6% of female Experimenters, and 3.5% of male and 7.6% female Self-
harmers. The field is viewed as favourable for both conscientiousness and emotional stability.
Field 9: Weak/moderate/strong/inconsistent control and ambiguous cold-warm relationships: This final field was
assigned only to 2.6% of male and 4.8% female Non-self-harmers, 3.3% of male and 3.9% female Experimenters,
and 2.6% male and 3.2% female Self-harmers.
4.1. Limitations
Apart from the common limitations of self-report surveys, such as subjective responding, data verifiability, etc.,
there are several specific problems in this type of research. One of them is social stigmatization, potentially
connected with the status of a self-harmer. Because the data are typically collected through group administrations in
the class, absolute privacy in responding cannot be completely ensured, which means that the data might become
1112 I. Burešová et al. / Procedia - Social and Behavioral Sciences 171 ( 2015 ) 1106 – 1113
somewhat biased by social desirability. The students might also be distrustful of the researchers’ promise of
anonymity and provide untruthful data out of fear that the information will be passed on to their teachers and/or
parents. A specific category is constituted by the problem of comparability of research findings across studies,
which often yield different results due to terminological inconsistency typical of this research area, extreme
differences in research samples (nonclinical v. clinical population, adults v. adolescents, etc.), or unequal
methodological choices (self-harm questionnaires v. single-item responses).
5. Conclusion
The importance of family, family relationships and parenting styles for harmonious development of the child is
hardly questionable. In the present sample, we asked whether the respondents came from single-parent/divorced (n =
460) or two-parent (n = 650) families. Adolescents from single-parent families occurred more frequently in the
Experimenter and Self-harmer groups (more than 20% each). This finding points to the fact that disruptions in the
family system might act as a risk factor in the development of self-harm behaviour.
We also found significant associations between self-harm occurrence and parenting styles within the Nine Field
Model. Gender differences were not observed. The most obvious differences between adolescents who never self-
harmed and those who did we found in Field 3 (inconsistent parental control and cold relationships) and Field 8
(weak control and extremely warm relationships): The former field was assigned to a substantially larger proportion
of Self-harmers and Experimenters than Non-self-harmers, while the latter occurred more frequently in Non-self-
harmers. Thus, the parenting style which is most typical of families of self-harming adolescents can be characterized
by rejection of the child and ambivalent approach to control and guidance, which might result in chaotic and non-
transparent family situation. What is interesting, most respondents, regardless of self-harm, perceived their parents’
control and guidance as weak or inconsistent; the presumably most optimal moderate control, on the other hand, was
only reported by a relatively small group of adolescents. This is an alarming finding, considering that inappropriate
parenting style is one of the main factors affecting the development of adolescent risk behaviours far beyond self-
Our research sample contained 221 respondents who reported having self-harmed no more than 4 times and 271
respondents whose experience with self-harm exceeded 4 cases. A majority of respondents who reported self-harm
(65.7 %) had told someone else about the issue. In most cases (67.5%), the information was shared among peers;
only 15.3 % told their parents and just a mere 2% consulted a professional. All of the alarming results presented in
this article should be taken into consideration when developing effective intervention programs addressing the issue
of self-harm in senior elementary school / junior high school students.
5.1. Further research and applications
Our findings will surely find application in the sphere of educational and psychological counselling. We advise
that helping professionals focus their attention on pedagogical guidance of adolescents both at school and in the
family, including rule setting, the degree and regularity of adherence to the rules, perceived emotional support, and
the degree of freedom the child is allowed. Further research should be directed more closely at the potential
associations between adolescents’ motivation to and preferred forms of self-harm and parenting styles employed by
their parents.
Acknowledgment: Funding for the study was provided by the Specific Research grant programme of Masaryk
University, project no. MUNI/A/0887/2012.
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American Academy of Child and Adolescent Psychiatry, 46(9), 1171-1178.
... Diversos artículos acerca de las ALNS (Asociación Española de Psiquiatría del Niño y el Adolescente [AEPNYA], 2008;Baetens et al., 2014;Burešová et al., 2015;Curtis et al., 2018;Echuburúa, 2015;Fleta, 2017;Garisch et al., 2017;Glazebrook, Townsend, & Sayal, 2015;Obando et al., 2018;Whitlock et al., 2012) han investigado la conceptualización del término, su prevalencia, comorbilidad, estrategias de afrontamiento, las funciones psicológicas involucradas, el perfil psicológico de las personas que se autolesionan y sus características familiares, pero el presente estudio se enfoca en indagar sobre la importancia de los vínculos afectivos y su posible relación con el comportamiento autolesivo. ...
... 19 No. 1, pp 1-18 la construcción de relaciones positivas con los padres resulta eficaz para la disminución del riesgo suicida en jóvenes con historial de ALNS. Así mismo, Burešová et al. (2015) investigaron sobre la relación entre los estilos de crianza y las ALNS en un grupo de 1,110 adolescentes entre los 13 y 15 años de edad, y demostraron que los estilos de crianza adecuados son un factor de protección ante las ALNS; por el contrario, la crianza inadecuada (rechazo al niño y la forma ambivalente de orientación y control) puede considerarse un factor predictivo para la aparición de ALNS. ...
... En esta misma línea, se encontró que los problemas familiares, específicamente con los padres, influyen significativamente en las ALNS. Esto coincide con Baetens et al. (2014), Burešová et al. (2015), Echeburúa (2015) y Fleta (2017), para quienes las dificultades familiares son factores que contribuyen en dichas conductas. ...
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Las autolesiones no suicidas (ALNS) son consideradas como un problema importante de salud pública debido a que es frecuente en muestras clínicas y no clínicas de adolescentes. En este estudio, las ALNS se relacionan con los vínculos afectivos familiares, por tal motivo, el objetivo de este trabajo es identificar la posible relación entre los vínculos afectivos familiares y la acción de adoptar conductas autolesivas no suicidas en adolescentes de sexo femenino, con edades comprendidas entre los 11 y 14 años. Los instrumentos empleados son Self-Harm Questionnaire (SHQ-E), Self-Injurious Thoughts and Behaviors Interview (SITBI), Inventario de Apego con Padres y Pares (IPPA) y una entrevista semi-estructurada. Los resultados evidencian que no existe relación estadísticamente significativa entre ambas variables, pero permiten identificar métodos empleados en las ALNS, así como niveles de apego parental. Se propone que deben realizarse futuras investigaciones que proporcionen más información sobre factores afectivos relacionados con conductas autolesivas no suicidas en adolescentes.
... Studies also demonstrated that adverse childhood experiences such as parental conflicts, abuse or parental neglect and/or loss or separation of parents are the key influences of poor emotional regulation and primary triggers of deliberate self-harm (Gratz, 2006). Increased occurrence of chronic self-harm is associated with inconsistent and weak parenting styles (Buresova, Bartosova & Cernak, 2015) with poor parent-child relationship indicated as the most prominent cause of self-injury (Suyemoto, 1998). Baumrind (1968) suggested that authoritarian parenting is the most controlling parenting style in which parents expect children to immediately abide by their rules and standards. ...
... Baumrind (1968) suggested that authoritarian parenting is the most controlling parenting style in which parents expect children to immediately abide by their rules and standards. Studies worldwide have highlighted that authoritarian parenting can increase the likelihood of chronic self-harm and trigger vulnerability towards suicide among children with authoritarian parents (Buresova et al., 2015;Lai, McBride-Chang, 2001;Martin & Waite, 1994). In Sri Lanka, many people have self-harmed when interpersonal conflicts occurred with family, especially with parents. ...
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Self-harm is the intentional destruction of the body tissue with or without a suicidal purpose. Self-harm is the second leading cause of death across the world and it is most prevalent among young people. Although parenting style and parental attachment have shown to have a direct impact on chronic self-harm, surprisingly there is very limited research exploring the complex interplay between these factors and cultural differences. Therefore, this study aimed to explore whether parenting style (using the Parental Authority Questionnaire) and the quality of parent-child attachment (using the Inventory of Parents and Peer Attachments) has an impact on self-harming in young people from the UK (n = 100) and Sri Lanka (n = 100), using a questionnaire-based quantitative design. Results indicated that Sri Lankan students currently self-harm more compared to the British students, although a substantial difference in the parenting style was not found between the two cultures. Irrespective of the cultural background, participants from both countries were more likely to self-harm in the absence of strong, secure attachments with parents. Authoritarian parenting style also had a direct impact on self-harm. Clinical implications highlighted the importance of awareness of the pivotal role of parenting when managing a young person who is self-harming. Furthermore, clinicians would benefit from incorporating culturally relevant treatment methods when working in multicultural settings.
... The sample selection may be considered adequate, as the prevalence of self-harming behaviour was 29.7%, which corresponds to the prevalence levels reported by other authors in neighbouring countries (e.g. Czech Republic - Buresova, Bartosova & Cernak 2015;Germany -Plener et al. 2009) as well as in more distant countries (e.g. USA - Swahn et al. 2012). ...
... Several studies have indicated a slight rise in the prevalence of self-harm with age during adolescence (e.g. Buresova, Bartosova & Cernak 2015), but no significant increase in the prevalence of selfharm with increasing age was found in the population of Slovak adolescents. Instead, age was associated with changes in the form of self-harmthe occurrence of indirect and mental forms of self-harm was more typical of older adolescents and, vice versa, the occurrence of the "classic" physical forms (e.g. ...
Conference Paper
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Over the last decade, the analysis of deliberate self-harm in children and youths has provided some worrying findings-an increase in the prevalence and forms of self-harm, the severity of its consequences as well as a decrease in the age of occurrence have been reported. One of the rarely studied issues is the motivation for this behaviour. Literature repeatedly claims that the motivation for self-harm is to provide relief from distressing emotions. However, analyses of self-harming behaviour have indicated that the motivation for such behaviour might be more complex and include several different motives. This paper provides the first descriptive data from a sample of almost 1,500 Slovak adolescents aged between 11 and 19 related to the motivation behind their self-harm. The self-assessment questionnaire examined 13 areas of motivation and found that the strongest motivators are "affect regulation" and "self-punishment". The study also examines the age and gender specificities of the observed motives-for girls, self-harm is mainly a way to mark their distress and punish themselves, for boys it is a way to show they are tough or appease their desire to seek sensations. The majority of the motives were not found to be age specific.
... Several studies have indicated a slight rise in the prevalence of self-harm with age during adolescence (e.g. Buresova, Bartosova & Cernak 2015), but no significant increase in the prevalence of selfharm with increasing age was found in the population of Slovak adolescents. Instead, age was associated with changes in the form of self-harmthe occurrence of indirect and mental forms of self-harm was more typical of older adolescents and, vice versa, the occurrence of the "classic" physical forms (e.g. ...
... for the problem of self-harm may be considered adequate, as the prevalence of self-harming behaviour was 29.7%, which corresponds to the prevalence levels reported by other authors in neighbouring countries (e.g. Czech Republic - Buresova, Bartosova & Cernak 2015;Germany -Plener et al. 2009) as well as in more distant countries (e.g. USA - Swahn et al. 2012). ...
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Self-harm is a very common form of high-risk behaviour prevalent among children and youths. In addition to studying the forms and types of this behaviour, one of the key issues is to reveal what motivates young people to commit intentional self-harm. Information on what motivates them enables us to not only understand the psychological mechanisms that lie behind the phenomenon of self-harm, but it also provides valuable data that is critical for clinical interventions and prevention. Using the Inventory of Statements about Self-Injury, this study provides an overview of the prevalence of thirteen different motives for self-harm on a group of 390 Slovak adolescents aged between 11 and 19 who have self-harmed. It also identifies the most frequent motives, explores the presence of cross-gender differences, and searches for a link between the individual motives and the ages of the participants.
... Empirical evidence indicated that some parenting styles are associated with NSSI behaviour. Adolescents from single families (Burešová et al., 2015), and invalidating family background (Du et al., 2017) have been proven to be linked According to the attachment theory, Bowlby (1988) explained that parent-child relationship is the key factor that determines the child's social and emotional development. Certainly, parents play an important role as a social agent (Baferani, 2015). ...
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Background: Parents have a tremendous effect on adolescents' emotional and behavioural well-being. The importance of effective parental involvement in adolescents' health is evident in numerous literatures, however there are inadequate studies that focus on the relationship between helicopter parenting and non-suicidal self-injury (NSSI). Aim: The purpose of this study was to identify the prevalence of NSSI behaviour and to examine the relationship between helicopter parenting and NSSI among adolescents. Method: A cross-sectional study consisted of 242 secondary school students (70.2% female and 29.7% male), aged between 13 to 16 years old (Mage 14.42 SD=2.12) who completed the helicopter parenting and NSSI questionnaires. The respondents of this study were selected using a convenience sampling method from two secondary schools located in the Kulim district of Kedah, Malaysia. Findings: The results revealed that 81 (33.2%) out of 242 respondents reported having been involved in at least one incidence of NSSI in the previous 12 months, whereof banging the head is a frequent method of NSSI. Females reportedly engaged in a higher frequency of NSSI behaviour (M=13.42, SD=4.32) compared to males (M=12.68, SD=2.43). Besides this, the results also revealed significant relationship between helicopter parenting and NSSI behaviour among adolescents. Conclusion: The findings highlight that parents' behaviour continuously determined the emotional and behavioural well-being of adolescents and more research is warranted to establish a greater degree of accuracy on this matter.
... For instance, bullying victimization has documented associations with insufficient sleep (Meldrum et al., 2018), depressive symptoms , and digital self-harm (Patchin & Hinduja, 2017). Similarly, low self-control (Hagger, 2010;Hay & Meldrum, 2010), family dysfunction , and parenting style (Burešová, Bartošová, & Čerňák, 2015;Randler, Bilger, & Diaz-Morales, 2009) are each associated with sleep and physical self-harm behaviors, necessitating their inclusion in the multivariate approach to the present study. ...
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Background: This study examines the relationship between sleep duration, depression, and engagement in a novel cyber behavior, digital self-harm, among adolescents. Method: Logistic regression analyses were conducted using cross-sectional data from the 2019 Florida Youth Substance Abuse Survey (N = 9,819; 48% male; avg. grade level = 9th grade [SD = 1.9]) to analyze the association between sleep duration and digital self-harm. A Karlson-Holm-Breen (KHB) analysis was used to assess whether depressive symptoms attenuate this association. Results: Bivariate results indicated that longer sleep duration was associated with lower incidence of digital self-harm. Multivariate results showed that sleep duration was inversely associated with engaging in digital self-harm, net of all covariates. Depressive symptoms attenuated the influence of sleep duration on digital self-harm by 50.72%. Conclusions: Both insufficient sleep and depressive symptoms were associated with engagement in digital self-harm among adolescents. Prospective research is needed, however, to confirm this pathway. Practitioners and clinicians should consider discussing digital self-harm with adolescents and parents, especially if adolescents are experiencing poor sleep and depressive symptoms.
... Based on the proposed models, various studies have been conducted to investigate the factors affecting NSSI. Some factors are proper predictors of NSSI behavior, such as child maltreatment, parents' emotional neglect (13)(14)(15)(16)(17)(18)(19), maternal criticism (20), lack of parental expressed emotions (21)(22)(23), higher levels of emotion-focused coping, such as escape and avoidance (24), emotional reactivity (25)(26)(27)(28)(29), verbal aggression, hostility, and indirect aggression (30,31). ...
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Background: Non-suicidal self-injury (NSSI) is defined as inflicting damage to one’s own body. It begins in adolescence and tends to become chronic. Objectives: Considering the high prevalence and chronicity of NSSI among girls, the present study aimed to investigate the factors affecting the prevalence of NSSI in female adolescents from their perspective. Methods: The participants consisted of 604 female high-school students in Saveh, aged 14 - 17 years (14.29 ± 1.11), who were selected via random cluster sampling from November 2018 to January 2019. They answered six questionnaires, including the Inventory of Statements About Self-injury (ISAS), Ways of Coping questionnaire (WCQ), Child Abuse Self-report scale (CASRS), Family Emotional Involvement and Criticism scale (FEICS), Emotion Reactivity scale (ERS), and Aggression questionnaire (AQ). Data were analyzed using logistic regression analysis. Results: The predictor variables of child abuse, emotion reactivity, perceived parental criticism, family emotional involvement, and problem- and emotion-focused coping styles could successfully distinguish NSSI individuals from those without NSSI (P < 0.05). There were no significant differences between minor and moderate groups. Conclusions: Family emotional support is a protective factor, while criticism, child abuse, and emotion-focused coping style are risk factors for NSSI.
... In recent years, there has been a visible increase in the prevalence of self-harm in the non-clinical adolescent population in general [2]. Causal factors vary but the style of parenting attributed to B's mother is commonly seen in the families of selfharming teenagers-the child feels rejected by the parent and experiences an ambivalent approach to control, which leads to a chaotic and non-transparent family situation [3]. ...
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The story of 13-year-old B, a female adolescent with self-harming behavior, and her father and other family members, shows the importance and impact of multicultural factors both in early child development and in establishing identity in adolescence. Born from a mixed marriage between an English mother and a Bulgarian father, B experiences a series of traumatic separations arising from clashes between the expectations and values of her parents’ respective cultures. Presented in a series of distinct episodes, B’s story illustrates the impact of the values conflicts arising in the context of our increasingly multicultural society, and the role of cross-cultural psychology in values-informed family therapy aimed at addressing such conflicts.
... The effect of parenting style or the perception of their parents' parenting style by adolescents could differ between developed and undeveloped nations [34,59]. Moreover, a study in Czech adolescents of 11-16 years of age indicated that weak control and more warm relations can have a reducing effect on adolescent's self-harm behavior [87]; these are characteristics similar to the authoritative style of parenting. Similarly, another study in the US reported that both higher support and boundaries by parents for their children, which are also characteristics of authoritative parenting, were found to be protective against suicidal behavior among adolescent students of 7th and 9th grades, and on top of this relationship, the self-esteem of the adolescents had a mediating effect [58]. ...
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Background: Suicide is the third leading cause of death in adolescents worldwide, self-esteem is a strong protective factor, and parents may be able to provide interventions. This cross-sectional study aimed to determine how parents can help enhance their adolescent's self-esteem and prevent suicidal behavior among adolescents in Nepal. Methods: Self-administered questionnaires were distributed to adolescents aged 13-19 years and their parents at eight high schools in three provinces in Nepal (n = 575 pairs). The data were analyzed using descriptive and inferential statistics (bivariate and multivariate regression analyses). Results: The mean self-esteem score of adolescents according to the Rosenberg Self-Esteem Scale was 16.59, and the prevalence of suicidal behavior was 11.3%. Parent's knowledge about the development of self-esteem in adolescents was significantly positively related to parenting practice (communication, support, positive reinforcement, etc.) (B = 1.0, 95% confidence interval, CI 0.89-1.11) and authoritative parenting style (B = 0.2, 95% CI 0.15-0.25). Parental authoritativeness was positively associated with the self-esteem of their adolescents (B = 0.1, 95% CI 0.01-0.18), while adolescents with authoritarian parents were prone to suicidal risk behavior (adjusted odds ratio, AOR = 1.1, 95% CI 1.0-1.19). Conclusion: Counseling to parents based on our findings would be helpful to enhance the self-esteem and prevent suicidal risk behavior in their adolescent children.
The current study focuses on teenage girls at risk in Israel’s Arab society (n = 60). Our aim was to explore the differences between them and between girls from the normative population (n = 60) by socio-demographic variables and by factors related to risk behaviors among teens: self-harm, traditionalism, self-control, and aggression. The findings indicate that despite the cultural and social uniqueness, different societies have universal features in common and there are similarities between western and traditional societies. Similar to western research findings, the girls at risk reported more self-harm than girls in a control group, the level of aggression among them was significantly higher than among the control group, and their self-control and traditionalism were lower. While all the girls came from traditional families, most of the at-risk girls defined themselves as less religious in comparison to the control group. The findings indicate the need for an in-depth study to examine factors that may be unique to a traditional religious society, and which are not usually taken into account in studies conducted on modern western societies. This applies mainly to the religiosity variable and to the meaning of the concept of conservatism in different social-cultural contexts.
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This mixed methods study examined the phenomenon of nonsuicidal self-injury (NSSI) of adolescents in Singapore. The researchers analyzed quantitative data to understand the functions of NSSI, the relationship of parental invalidation to NSSI, and the association between academic stress and parental invalidation. In addition, the researchers employed semi-structured qualitative interviews to provide supportive qualitative data. The participants were outpatients at the Child Guidance Clinic, Singapore, between the ages of 13 to 19 years old. Researchers compared 30 participants who engage in NSSI with 30 participants who do not engage in NSSI. The emotional regulation function was the most commonly endorsed function for NSSI. Adolescents who engage in NSSI have statistically significant (p < .01) higher mean parental invalidation scores than those who do not engage in NSSI. There is also a moderate, positive correlation between the level of parental invalidation and the level of academic stress for Singaporean adolescents. The researchers discuss the implications of this study for mental health professionals.
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This study examines self-harm in a community sample of adolescents. More specifically, the study identifies the prevalence and types of self-harm, elucidates the nature and underlying function of self-harm, and evaluates the relation of psychological adjustment, sociodemographic, and health-risk variables to self-harm. Self-report questionnaires assessing self-harm, adjustment, health behaviors, suicide history, and social desirability were completed by 424 school-based adolescents. Overall, 15% of the adolescents reported engaging in self-harm behavior. Analyses revealed gender differences across behaviors and motivations. Adolescents who indicated harming themselves reported significantly increased antisocial behavior, emotional distress, anger problems, health risk behaviors, and decreased self-esteem. Results provide support for the coping or affect regulation model of self-harm. Findings suggest that self-harm is associated with maladjustment, suicide, and other health behaviors indicative of risk for negative developmental trajectories.
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Currently little research exists examining self-mutilation (SM) in community samples of adolescents, despite tentative findings suggesting that self-harming behaviors, including SM may be increasing. The present study provides a comprehensive review of previous literature on the frequency of SM as well as preliminary epidemiological data concerning the frequency of SM in a community sample of high schools students. The relationship between SM, anxiety, and depressive symptomatology was also assessed. Four hundred and forty students from two schools, an urban and a suburban high school, were given a screening measure designed to assess for SM. Students who indicated that they hurt themselves on purpose also participated in a follow-up interview. Based on interviews it was found that 13.9% of all students reported having engaged in SM behavior at some time. Girls reported significantly higher rates of SM than did boys (64 vs. 36%, respectively). Self-cutting was found to be the most common type of SM, followed by self-hitting, pinching, scratching, and biting. Finally, students who self-mutilate reported significantly more anxiety and depressive symptomatology than students who did not self-mutilate. Results are also presented concerning demographic information and patterns of SM behavior.
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The extent to which self-harm and suicidal behavior overlap in community samples of vulnerable youth is not well known. Secondary analyses were conducted of the "linkages study" (N = 4,131), a cross-sectional survey of students enrolled in grades 7, 9, 11/12 in a high-risk community in the U.S. in 2004. Analyses were conducted to determine the risk and protective factors (i.e., academic grades, binge drinking, illicit drug use, weapon carrying, child maltreatment, social support, depression, impulsivity, self-efficacy, parental support, and parental monitoring) associated with both self-harm and suicide attempt. Findings show that 7.5% of participants reported both self-harm and suicide attempt, 2.2% of participants reported suicide attempt only, and 12.4% of participants reported self-harm only. Shared risk factors for co-occurring self-harm and suicide attempt include depression, binge drinking, weapon carrying, child maltreatment, and impulsivity. There were also important differences by sex, grade level, and race/ethnicity that should be considered for future research. The findings show that there is significant overlap in the modifiable risk factors associated with self-harm and suicide attempt that can be targeted for future research and prevention strategies.
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This investigation explored the psychological characteristics of self-injury, as well as the frequency of self-injury in a college sample. Two hundred and twenty individuals who self-injure were recruited from a self-help website. These were compared to college students who were not specifically seeking help for self-injury. It was found that 20% of the college students reported having self-injured at some point in their lives. The participants were given the following measures: Dissociative Experiences Scale (DES), Toronto Alexithymia Scale (TAS), the Childhood Trauma Questionnaire (CTQ), and the Trauma Symptoms Checklist (TSC). A discriminant function analysis was conducted to differentiate the groups. Depression from the TSC and emotional neglect from the CTQ most strongly differentiated the internet group from the college non-self-injuring group. Additionally, the TAS was strongly related to the function differentiating these groups. The college self-injury group could not be differentiated from either of the two groups. This study suggests that individuals who self-injure may not have received adequate emotional nurturance, and currently have high levels of negative affect which they wish to avoid.
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To study the prevalence and psychosocial and ethnocultural correlates of self-mutilation and/or suicidal behaviour in Indigenous Sami and majority Norwegian adolescents in north Norway. A cross-sectional questionnaire study. A total of 487 students, aged 13-16 years in 21 junior high schools and 247 parents participated in this school based questionnaire study conducted in 1990 in Finnmark, the county in Norway with the highest suicide rates. Sociodemographics, substance use, thriving at school, ethnocultural factors such as ethnic context, ethnic identity, ethnic language competence and ethnic parentage, self-reported as well as parent-reported behavioural/emotional problems were assessed. Self-mutilation and/or suicidal attempts within the last 6 months were reported by 12.5% of the adolescents and 14.8% reported having suicidal thoughts. In univariate analyses, significant gender differences occurred for both ethnic groups, with more girls reporting self-mutilation and suicidal behaviour. However, in logistic regression analyses adjusting for all other significant variables, the gender difference disappeared. No significant ethnic differences occurred in prevalence. Although factors associated with self-mutilation and suicidal behaviour varied between Sami and Norwegian adolescents, self-reported anxiety/depression was a strong and significant correlate to both self-mutilation/suicide attempts and suicidal thoughts in both ethnic groups. Parents reported less emotional/behavioural problems associated with self-mutilation and/or suicidal behaviour than the adolescents did. Ethnic identification in Sami and ethnic context in Norwegian adolescents occurred in independent analyses as significantly related to self-mutilation and/or suicidal behaviour, but turned insignificant when adjusting for all other significant variables. In contrast to several other Indigenous groups the prevalence of self-mutilation and/or suicidal behaviour did not differ between Sami and Norwegian adolescents. In both ethnic groups, the effect of ethnocultural factors disappeared when controlled for other variables such as anxiety/depression. Across both ethnic groups, anxiety and depression problems occurred as a common and significant correlate for self-mutilation and suicidal behaviour.
OBJECTIVE: To determine the prevalence of five types of trauma and their relationship to borderline personality symptoms and self-destructive behaviors in female subjects recruited from a primary care setting. DESIGN: Consecutive sample. METHOD: Subjects completed a lengthy research booklet. SETTING: Primary care, outpatient, health maintenance organization setting. PATIENTS: One hundred fifty-two consecutive women, aged 18 to 45 years, who were scheduled for routine gynecological care by a female family physician. MAIN OUTCOME MEASURES: Measures included a demographic questionnaire, a trauma questionnaire (ie, sexual, physical, and emotional abuse, physical neglect, and witnessing of violence), the Borderline Personality Scale of the Personality Diagnostic Questionnaire-Revised; and the Self-Harm Inventory. RESULTS: Traumatic experiences were reported by 70.7% of the subjects (25.8%, sexual abuse; 36.4%, physical abuse; 43.7%, emotional abuse; 9.3%, physical neglect; and 43.0%, witnessing of violence). There was a significant correlation between the acknowledged number of abuse categories and borderline personality symptoms (r = .36, P = .01) as well as self-destructive behaviors (r = .43, P = .01). Sexual abuse and witnessing of violence were most associated with borderline personality symptoms; sexual abuse, physical abuse, and witnessing of violence were most associated with self-destructive behaviors. CONCLUSIONS: This study provides further evidence that abuse is a nonspecific but contributory factor to psychopathologic processes, in particular borderline personality symptoms and self-destructive behaviors. Language: en
The authors describe dialectical behavior therapy (DBT) as developed by Linehan for the treatment of adults with borderline personality disorder and explain how they have adapted DBT for the treatment of suicidal adolescents. The modifications involved in dialectical behavior therapy for adolescents include shortening the length of treatment from 1 year to 12 weeks, reducing the total number of skills taught, incorporating family members into the treatment, simplifying the language used in handouts and skills training lectures, and adding an optional 12 week follow-up Patient Consultation Group. The implementation of DBT for suicidal adolescents is then illustrated by a case study.
Perceived parental expressed emotions have a substantial effect on adolescents' well-being and non-suicidal self-injury (NSSI). The present study examines the mediating effects of self-criticism and depression in the relationship between perceived parental expressed emotions and NSSI. In total, 358 adolescents between the ages of twelve and twenty were examined. The brief NSSI assessment tool was used to assess NSSI. Depressive symptoms and self-criticism were examined with the Children's Depression Inventory (CDI-NL) and the Self Rating Scale. Finally, the self-report questionnaire of the level of expressed emotions was used to assess perceived parental expressed emotions. The lifetime prevalence of NSSI in the current study was 13.41 %. Results of a mediation analysis show the relationship between self-criticism and NSSI is mediated by depressive symptoms. Furthermore, results of a path model analysis, explaining 20 % of the variance in NSSI frequency, show a direct effect of perceived parental environment (perceived lack of emotional support and perceived parental criticism) on NSSI frequency, as well as indirect paths via adolescent risk factors (depressive symptoms and self-criticism). Perceived lack of parental emotional support had a direct effect on frequency of NSSI, as well as an indirect effect via depressive symptoms. Perceived parental criticism on the other hand, had no direct effect on frequency of NSSI, but showed an indirect effect through self-criticism. This study improves our understanding of the underlying mechanisms involved in NSSI by interrelating significant family and adolescent risk factors. Limitations and clinical implications of these findings are discussed.
The purpose of this study was to examine a model of factors that place psychiatrically hospitalized girls at risk for non-suicidal self-injury (NSSI). The role of familial and peer interpersonal difficulties, as well as emotional dysregulation, were examined in relationship to NSSI behaviors. Participants were 99 adolescent girls (83.2% Caucasian; M age = 16.08) admitted to a psychiatric hospital. Structural equation modeling indicated the primacy of emotional dysregulation as an underlying process placing adolescents at risk for NSSI and mediating the influence of interpersonal problems through the family and peer domains. When family and peer relationships were characterized by conflict and lack of support for managing emotions, adolescents reported more dysregulated emotion processes. Family relational problems were directly and indirectly related to NSSI through emotional dysregulation. The indirect processes of peer relational problems, through emotional dysregulation, were significantly associated with NSSI frequency and severity. The findings suggest that the process by which interpersonal difficulties contribute to NSSI is complex, and is at least partially dependent on the nature of the interpersonal problems and emotion processes.