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>A theoretically-based etiological model of deliberate self-harm: The role of childhood maltreatment, affect intensity/reactivity, emotional inexpressivity, and emotion dysregulation in self-harm behavior.
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A theoretically-based etiological model of deliberate self-harm: The role of childhood maltreatment, affect intensity/reactivity, emotional inexpressivity, and emotion dysregulation in self-harm behavior.
Despite the clinical importance of deliberate self-harm (the deliberate, direct destruction or alteration of body tissue without conscious suicidal intent, but resulting in injury severe enough for tissue damage to occur), empirical research in this area has been limited. Although research has examined some of the environmental risk factors for self-harm, no studies known to this author have examined the ways in which individual and environmental risk factors interact to influence the development of this behavior. Furthermore, although many researchers conceptualize self-harm as an emotion regulation strategy (see Haines & Williams, 1997; Linehan, 1993), little empirical research has examined the functions of self-harm. Therefore, this study tested a theoretically-derived model of the etiology and function of self-harm among a non-clinical sample of women, examining the ways in which childhood maltreatment (in the form of sexual abuse, physical abuse, and emotional neglect), emotional vulnerability (in the form of affect intensity/reactivity), and emotional inexpressivity interact to influence self-harm behavior. The central prediction was that the interaction of these factors would result in emotion dysregulation, which would, in turn, result in a greater likelihood of engaging in self-harm. Exploratory analyses examined the adequacy of the proposed model among men. Questionnaire data was collected from 373 college students, with a final sample size of 359 (262 women and 97 men).; Results provide support for the role of both environmental and individual factors in risk for self-harm among women; specifically, this study found that childhood maltreatment, emotional inexpressivity, low positive affect intensity/reactivity, emotion dysregulation, and the interaction of maltreatment and emotional inexpressivity contributed to self-harm behavior among women. Partial support was provided for the mediating role of emotion dysregulation in self-harm, as results suggest that emotion dysregulation: (a) partially mediated the relationship between emotional inexpressivity and self-harm, and (b) mediated the marginally significant impact of negative affect intensity/reactivity on self-harm. Results indicate that childhood maltreatment, low positive affect intensity/reactivity, and emotion dysregulation increased risk for self-harm among men (although no evidence was provided for the mediating role of emotion dysregulation). Emotional inexpressivity was not a risk factor among men. Treatment implications of results are discussed.
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