Relationship between borderline personality features, emotion regulation, and non-suicidal self-injury in depressed adolescents: a cross-sectional study

Abstract

Objective Non-suicidal self-injury (NSSI) is common among adolescents and has been linked to mental disorders and suicide in addition to physical injuries. According to the empirical avoidance model, adolescents with NSSI have stronger emotional affect and poorer emotional regulation than those without NSSI, and these constitute core features of borderline personality disorder (BPD). The relationship between borderline personality features, emotional regulation, and NSSI in the population is unclear. This study explored these associations to provide a theoretical basis for the treatment of NSSI in the future. Methods Depressed adolescents (n = 1192) were evaluated using Chinese versions of the Function Assessment of Self-mutilation Scale, Emotional Regulation Questionnaire for Children and Adolescents, and Borderline Personality Features Scale for Children. Results The majority of depressed adolescents (71.3%, 850/1192) had demonstrated NSSI in the past year, with cutting or scratching being the most common form (57.4%). Pearson correlation analysis with NSSI as a fixed factor (NSSI = 1, no NSSI = 2) revealed a negative correlation between NSSI and borderline personality features (r = -0.314, P < 0.01) but a positive correlation between NSSI and emotional regulation capacity (r = 0.159, P < 0.01), which was positively correlated with the expression suppression dimension (r = 0.079, p < 0.01); however, there was no significant correlation between the cognitive reappraisal dimension and expression suppression (r = 0.022, p > 0.05). The occurrence of NSSI was also positively correlated with borderline personality features in general (r = 0.314, p < 0.01). These results were statistically significant. Emotional regulation played a mediating role between borderline personality traits and NSSI in adolescents with depression (effect value = 0.151). Conclusion Borderline personality features and emotional regulation ability were significantly correlated with NSSI in depressed adolescents. Borderline personality symptoms not only directly influenced NSSI risk in adolescents with depression, but also indirectly influenced NSSI risk through emotional regulation.

Maladaptive cognitive regulation moderates the mediating role of emotion dysregulation on the association between psychosocial factors and non-suicidal self-injury in depression

“…One study has been showed that depression plays a mediating role in the relationship between childhood maltreatment and NSSI, moderated by self-compassion ( 49 ). Another study drew a conclusion that emotional regulation mediated the association of borderline personality traits and NSSI in adolescents with depression ( 50 ). Borderline personality disorder (BPD) is frequently associated with NSSI and emotion dysregulation is also one of the core characteristics of BPD, which often contributes to self-injurious behaviors ( 51 ).…”

“…In addition to exploring the influencing factors of NSSI in depression ( 50 ), depression has also been proposed to mediate the relationship between the risk factors, such as childhood maltreatment, and NSSI ( 49 ). In this paper, although the levels of anxiety and depression were higher in NSSI+ individuals than NSSI− individuals in the current study, the depression symptoms appeared to be independent of the role of all the risk factors and modulators.…”