Non-suicidal self-injury and emotion regulation: a review on facial emotion recognition and facial mimicry

Abstract

Non-suicidal self-injury (NSSI) is an increasingly prevalent, clinically significant behavior in adolescents and can be associated with serious consequences for the afflicted person. Emotion regulation is considered its most frequent function. Because the symptoms of NSSI are common and cause impairment, it will be included in Section 3 disorders as a new disorder in the revised Diagnostic and Statistical Manual of Mental Disorders (DSM-5). So far, research has been conducted mostly with patients with borderline personality disorder (BPD) showing self-injurious behavior. Therefore, for this review the current state of research regarding emotion regulation, NSSI, and BPD in adolescents is presented. In particular, the authors focus on studies on facial emotion recognition and facial mimicry, as social interaction difficulties might be a result of not recognizing emotions in facial expressions and inadequate facial mimicry. Although clinical trials investigating the efficacy of psychological treatments for NSSI among adolescents are lacking, especially those targeting the capacity to cope with emotions, clinical implications of the improvement in implicit and explicit emotion regulation in the treatment of NSSI is discussed. Given the impact of emotion regulation skills on the effectiveness of psychotherapy, neurobiological and psychophysiological outcome variables should be included in clinical trials.

The Four-Function Model of Nonsuicidal Self-Injury

“…For example, preliminary research using self-injury implicit-association tests (e.g., Nock & Banaji, 2007) might be extended to address social functions specifically. Similarly, as a result of observed problems with a range of communication skills in selfinjuring individuals, researchers may consider the employment of objective measures of specific interpersonal skills (e.g., facial emotion recognition, facial mimicry; In-Albon, Bürli, Ruf, & Schmid, 2013) in future studies on NSSI. Findings from this research may illuminate fundamental characteristics of social-reinforcement functions and continue to invalidate the common belief that socially reinforced NSSI is unrelated to psychopathology (Nock & Prinstein, 2005).…”

Confirmatory factor analysis of the Inventory of Statements About Self‐injury in a Spanish clinical sample

“…NSSI is comorbid with several mental disorders (In‐Albon et al, ), especially mood disorders, anxiety, substance abuse disorders, and externalizing disorders (Nitkowski & Petermann, ). In addition, the relationship between NSSI, eating disorders, and borderline personality disorder (BPD) has been well documented: Some studies have found that between 25.4% and 55.2% of eating disorder patients report NSSI (Claes et al, ; Claes, Vandereycken, & Vertommen, ), and have reported a relationship between body image dissatisfaction and NSSI (Pérez et al, ).…”

Non-suicidal self-injury behaviors` features and relationship with adolescents` daily life activities and mental status

“…Regarding the literature, although some studies reported that smoking, alcohol and substance use increased NSSI, some other studies did not demonstrate any correlation with alcohol and substance use 10,12,26,[30][31][32][33][34][35] . During the alcohol and substance use, the increase of the impulsivity and the inhibition of superego might facilitate the commitment of NSSI.…”