The moderating role of dissociation in the relation between borderline features and factors of self-injury in adolescents.
Journal
Personality and mental health
ISSN: 1932-863X
Titre abrégé: Personal Ment Health
Pays: England
ID NLM: 101473502
Informations de publication
Date de publication:
05 2020
05 2020
Historique:
received:
04
05
2019
revised:
11
10
2019
accepted:
20
01
2020
pubmed:
7
2
2020
medline:
16
4
2021
entrez:
7
2
2020
Statut:
ppublish
Résumé
Self-injurious behaviours (SIB) occur frequently in individuals with borderline personality disorder (BPD). While multiple factors may explain the association between SIB and BPD, studies in adults have pointed to dissociation as factor worth considering. However, this relationship has not been examined in adolescents. The current study investigated the role of dissociation as a potential moderator between borderline features and SIB, with the expectation that this association would be stronger in the presence of dissociation. One hundred forty-four adolescent inpatients were compared on measures of BPD, non-suicidal self-injury (NSSI) and suicidal behaviour. The relationships between borderline features and self-injury outcomes were evaluated using linear and logistic regression with dissociation as a moderator. Borderline features and dissociation were found to be significantly associated with history of NSSI, history of suicide attempt, suicidal ideation (SI) intensity and SI severity. However, dissociation was a significant moderator only in the relationship between borderline features and SI intensity. Higher levels of dissociation were associated with more engagement with suicidal thoughts but did not necessarily contribute to SIB. Further research into differential patterns of association of self-injury in patients with BPD may investigate other models where dissociation may more strongly factor into outcomes. © 2020 John Wiley & Sons, Ltd.
Sections du résumé
BACKGROUND
Self-injurious behaviours (SIB) occur frequently in individuals with borderline personality disorder (BPD). While multiple factors may explain the association between SIB and BPD, studies in adults have pointed to dissociation as factor worth considering. However, this relationship has not been examined in adolescents.
AIMS
The current study investigated the role of dissociation as a potential moderator between borderline features and SIB, with the expectation that this association would be stronger in the presence of dissociation.
METHODS
One hundred forty-four adolescent inpatients were compared on measures of BPD, non-suicidal self-injury (NSSI) and suicidal behaviour. The relationships between borderline features and self-injury outcomes were evaluated using linear and logistic regression with dissociation as a moderator.
RESULTS
Borderline features and dissociation were found to be significantly associated with history of NSSI, history of suicide attempt, suicidal ideation (SI) intensity and SI severity. However, dissociation was a significant moderator only in the relationship between borderline features and SI intensity.
CONCLUSION
Higher levels of dissociation were associated with more engagement with suicidal thoughts but did not necessarily contribute to SIB. Further research into differential patterns of association of self-injury in patients with BPD may investigate other models where dissociation may more strongly factor into outcomes. © 2020 John Wiley & Sons, Ltd.
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
215-226Informations de copyright
© 2020 John Wiley & Sons, Ltd.
Références
Turner B, Dixon-Gordon K, … SA-P, 2015 U. Non-suicidal self-injury with and without borderline personality disorder: differences in self-injury and diagnostic comorbidity. Psychiatry Res [Internet]. 2015 [cited 2019 Apr 24]; Available from: https://www.sciencedirect.com/science/article/pii/S0165178115005156
Yen S, Gagnon K, Spirito A. Borderline personality disorder in suicidal adolescents. Personal Ment Health [Internet]. 2013 May [cited 2019 Apr 24];7(2):89-101. Available from: http://doi.wiley.com/10.1002/pmh.1216, DOI: https://doi.org/10.3390/biom3020270
Forman EM, Berk MS, Henriques GR, Brown GK, Beck AT. History of multiple suicide attempts as a behavioral marker of severe psychopathology. Am J Psychiatry 2004; 161(3): 437-443. https://doi.org/10.1176/appi.ajp.161.3.437.
Goodman M, Tomas IA, Temes CM, Fitzmaurice GM, Aguirre BA, Zanarini MC. Suicide attempts and self-injurious behaviours in adolescent and adult patients with borderline personality disorder. Personal Ment Health [Internet] 2017 Aug [cited 2019 Apr 24]; 11(3): 157-163. Available from:. http://doi.wiley.com/10.1002/pmh.1375, https://doi.org/10.9740/mhc.2017.03.069.
Andrewes HE, Hulbert C, Cotton SM, Betts J, Chanen AM. Relationships between the frequency and severity of non-suicidal self-injury and suicide attempts in youth with borderline personality disorder. Early Interv Psychiatry 2017.
Sharp C, Tackett JL. Introduction: An idea whose time has come. In: Handbook of Borderline Personality Disorder in Children and Adolescents [Internet]. New York, NY: Springer New York; 2014 [cited 2019 Apr 24]. p. 3-8. Available from: http://link.springer.com/10.1007/978-1-4939-0591-1_1, DOI: https://doi.org/10.1371/journal.pntd.0007967
Yalch MM, Hopwood CJ, Fehon DC, Grilo CM. The influence of borderline personality features on inpatient adolescent suicide risk. Personal Disord Theory, Res Treat [Internet]. 2014 [cited 2019 Apr 24];5(1):26-31. Available from: http://doi.apa.org/getdoi.cfm?doi=10.1037/per0000027
Glenn CR, Bagge CL, Osman A. Unique associations between borderline personality disorder features and suicide ideation and attempts in adolescents. J Pers Disord [Internet]. 2013 Oct [cited 2019 Apr 24];27(5): 604-16. Available from: http://guilfordjournals.com/doi/10.1521/pedi_2013_27_102
You J, Leung F, Lai CM, Fu K. The associations between non-suicidal self-injury and borderline personality disorder features among Chinese adolescents. J Pers Disord 2012; 26(2): 226-237. https://doi.org/10.1521/pedi.2012.26.2.226.
Sharp C, Ha C, Michonski J, Venta A, Carbone C. Borderline personality disorder in adolescents: Evidence in support of the childhood interview for DSM-IV borderline personality disorder in a sample of adolescent inpatients. Compr Psychiatry 2012; 53(6): 765-774. https://doi.org/10.1016/j.comppsych.2011.12.003.
Gratz KL, Dixon-Gordon KL, Tull MT. Self-injurious behaviors in adolescents with borderline personality disorder, pp. 195-210. Handbook of Borderline Personality Disorder in Children and Adolescents, Springer, 2014.
Crowell SE, Beauchaine TP, Hsiao RC, Vasilev CA, Yaptangco M, Linehan MM et al. Differentiating adolescent self-injury from adolescent depression: Possible implications for borderline personality development. J Abnorm Child Psychol 2012; 40(1): 45-57. https://doi.org/10.1007/s10802-011-9578-3.
Calati R, Bensassi I, Courtet P. The link between dissociation and both suicide attempts and non-suicidal self-injury: Meta-analyses. Psychiatry Res 2017; 251: 103-114. https://doi.org/10.1016/j.psychres.2017.01.035.
Wedig M, Frankenburg F, Reich D et al. GF-P, 2013 U. Predictors of suicide threats in patients with borderline personality disorder over 16 years of prospective follow-up. Psychiatry Res [Internet] 2013 [cited 2019 Apr 24; Available from:208: 252-256. https://www.sciencedirect.com/science/article/pii/S0165178113002680.
Low G, Jones D, MaCleod A, Power M, Duggan C. Childhood trauma, dissociation and self-harming behaviour: A pilot study. Br J Med Psychol [Internet] 2000 Jun [cited 2019 Apr 24]; 73(2): 269-278. Available from:. http://doi.wiley.com/10.1348/000711200160363, https://doi.org/10.1023/a:1008942223938.
Matsumoto T, Yamaguchi A, Chiba Y, Asami T, Iseki E, Hirayasu Y. Self-burning versus self-cutting: Patterns and implications of self-mutilation; a preliminary study of differences between self-cutting and self-burning in a Japanese juvenile detention center. Psychiatry Clin Neurosci [Internet] 2005 Feb [cited 2019 Apr 24]; 59(1): 62-69. Available from:. http://doi.wiley.com/10.1111/j.1440-1819.2005.01333.x.
Saxe GN, Chawla N, Van der Kolk B. Self-destructive behavior in patients with dissociative disorders. Suicide Life-Threatening Behav [Internet] 2002 Sep [cited 2019 Apr 24]; 32(3): 313-320. Available from:. http://doi.wiley.com/10.1521/suli.32.3.313.22174, https://doi.org/10.1109/titb.2002.806094.
Shelef L, Levi-Belz Y, Fruchter E. Dissociation and acquired capability as facilitators of suicide ideation among soldiers. Crisis [Internet] 2014 Nov [cited 2019 Apr 24]; 35(6): 388-397. Available from:. https://econtent.hogrefe.com/doi/10.1027/0227-5910/a000278, https://doi.org/10.1080/13811118.2013.845121.
Speckhard A. Understanding suicide terrorism: Countering human bombs and their senders. researchgate.net [Internet]. [cited 2019 Apr 24]; Available from: https://www.researchgate.net/profile/Anne_Speckhard/publication/237238076_Understanding_Suicide_Terrorism_Countering_Human_Bombs_and_Their_Senders/links/54bfc78e0cf21674ce9c7f5d/Understanding-Suicide-Terrorism-Countering-Human-Bombs-and-Their-Senders.pdf
Levinger S, Somer E, Holden RR. The importance of mental pain and physical dissociation in youth suicidality. J Trauma Dissociation [Internet] 2015 May 27 [cited 2019 Apr 24]; 16(3): 322-339. Available from:. http://www.tandfonline.com/doi/full/10.1080/15299732.2014.989644.
Kılıç F, Coşkun M, Bozkurt H et al. İK-P, 2017 U. Self-injury and suicide attempt in relation with trauma and dissociation among adolescents with dissociative and non-dissociative disorders. Psychiatry Investig [Internet] 2017 [cited 2019 Apr 24]; Available from:14: 172-178. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5355015/.
Garnefski N, Legerstee J, Kraaij V, van Den Kommer T, Teerds JAN. Cognitive coping strategies and symptoms of depression and anxiety: A comparison between adolescents and adults. J Adolesc 2002; 25(6): 603-611. https://doi.org/10.1006/jado.2002.0507.
Giedd JN. The teen brain: Insights from neuroimaging. J Adolesc Health 2008; 42(4): 335-343. https://doi.org/10.1016/j.jadohealth.2008.01.007.
Ross CA, Ryan L, Anderson G, Ross D. Dissociative experiences in adolescents and college students. Dissociation: Prog Dissociative Disord 1989.
Torem MS, Hermanowski RW, Curdue KJ. Dissociation phenomena and age. Stress Med 1992; 8(1): 23-25. https://doi.org/10.1002/smi.2460080104.
Posner K, Brown GK, Stanley B, Brent DA, Yershova KV, Oquendo MA et al. The Columbia-Suicide Severity Rating Scale: Initial validity and internal consistency findings from three multisite studies with adolescents and adults. Am J Psychiatry [Internet] 2011 Dec [cited 2019 Apr 24]; 168(12): 1266-1277. Available from:. http://psychiatryonline.org/doi/abs/10.1176/appi.ajp.2011.10111704, https://doi.org/10.1176/appi.ajp.2011.10111704.
Crick NR, Murray-Close D, Woods K. Borderline personality features in childhood: A short-term longitudinal study. Dev Psychopathol [Internet] 2005 Dec 12 [cited 2019 Apr 24]; 17(04): 1051-1070. Available from:. http://www.journals.cambridge.org/abstract_S0954579405050492.
Morey LC. The personality assessment inventory. In: Personality assessment, pp. 193-240. Routledge, 2014.
Chang B, Sharp C, Ha C. The criterion validity of the borderline personality features scale for children in an adolescent inpatient setting. J Pers Disord 2011; 25(4): 492-503. https://doi.org/10.1521/pedi.2011.25.4.492.
Zanarini MC. Childhood interview for DSM-IV borderline personality disorder (CI-BPD). MA McLean Hosp: Belmont, 2003, DOI: https://doi.org/10.1521/pedi.17.6.568.25355.
Hayes AF. Introduction to mediation, moderation, and conditional process analysis: A regression-based approach, p. 692, 2017.
Hatkevich C, Venta A, Sharp C. Theory of mind and suicide ideation and attempt in adolescent inpatients. J Affect Disord 2019. https://doi.org/10.1016/j.jad.2019.05.051.
Horesh N, Nachshoni T, Wolmer L, Toren P. A comparison of life events in suicidal and nonsuicidal adolescents and young adults with major depression and borderline personality disorder. Compr Psychiatry 2009; 50(6): 496-502. https://doi.org/10.1016/j.comppsych.2009.01.006.