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Self-Injurious Behaviors in Adolescents with Borderline Personality Disorder

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Handbook of Borderline Personality Disorder in Children and Adolescents

Abstract

Adolescence marks a period of high-risk for the onset of self-injurious behaviors (SIB), including both deliberate self-harm (DSH) and suicidal behaviors. Adolescents with BPD constitute a particularly vulnerable population for SIB, with research revealing robust associations between SIB and BPD pathology in adolescents. Further, developmental theories suggest that SIB may be an early indicator of BPD in adolescents, reflecting a key step for some youth in the developmental trajectory toward BPD. According to Crowell and colleagues’ (2008; 2009) developmental model of SIB and BPD, trait impulsivity and emotion dysregulation are the key features underlying the development of both BPD and SIB. A review of the research literature supports this theory, revealing significant associations between SIB and both self-reported and biological indices of emotion dysregulation and, with a few exceptions, trait impulsivity among adolescents in general (as well as adolescents with BPD in particular). As such, both theoretical and empirical literature support the role of impulsivity and emotion dysregulation as key mechanisms contributing to SIB among adolescents with BPD. Clinical implications of this research are discussed, as are needed future directions in this line of inquiry.

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References

  • Adrian, M., Zeman, J., Erdley, C., Lisa, L., & Sim, L. (2011). Emotional dysregulation and interpersonal difficulties as risk factors for nonsuicidal self-injury in adolescent girls. Journal of Abnormal Child Psychology, 39, 389–400.

    PubMed  Google Scholar 

  • American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.

    Google Scholar 

  • Anderson, R. N., & Smith, B. L. (2003). Deaths: Leading causes for 2001. National Vital Statistics Report, 52, 1–85.

    Google Scholar 

  • Asarnow, J. R., Porta, G., Spirito, A., Emslie, G., Clarke, G., Wagner, K. D., et al. (2011). Suicide attempts and nonsuicidal self-injury in the Treatment of Resistant Depression in Adolescents: Findings from the TORDIA study. Journal of the American Academy of Child & Adolescent Psychiatry, 50, 772–781.

    Google Scholar 

  • Bateman, A., & Fonagy, P. (1999). Effectiveness of partial hospitalization in the treatment of borderline personality disorder: A randomized controlled trial. American Journal of Psychiatry, 156, 1563–1569.

    PubMed  Google Scholar 

  • Bateman, A., & Fonagy, P. (2004). Mentalization-based treatment of BPD. Journal of Personality Disorders, 18, 36–51.

    PubMed  Google Scholar 

  • Beauchaine, T. P., Klein, D. N., Crowell, S. E., Derbidge, C., & Gatzke-Kopp, L. (2009). Multifinality in the development of personality disorders: A biology × sex × environment interaction model of antisocial and borderline traits. Development and Psychopathology, 21, 735–770.

    PubMed Central  PubMed  Google Scholar 

  • Bjarehed, J., & Lundh, L. (2008). Deliberate self-harm in 14-year-old adolescents: How frequent is it, and how is it associated with psychopathology, relationship variables, and style of emotional regulation? Cognitive Behaviour Therapy, 37, 26–37.

    PubMed  Google Scholar 

  • Brown, M. Z., Comtois, K. A., & Linehan, M. M. (2002). Reasons for suicide attempts and nonsuicidal self-injury in women with borderline personality disorder. Journal of Abnormal Psychology, 111, 198–202.

    PubMed  Google Scholar 

  • Calkins, S. D. (1994). Origins and outcomes of individual differences in emotional regulation. In N. A. Fox (Ed.), Emotion regulation: Behavioral and biological considerations, Monographs of the Society for Research in Child Development, 59 (Serial No. 240), 53–72.

    Google Scholar 

  • Calkins, S. D. (2004). Early attachment processes and the development of emotional self-regulation. In R. F. Baumeister & K. D. Vohs (Eds.), Handbook of self-regulation: Research, theory, and applications (pp. 324–339). New York: Guilford.

    Google Scholar 

  • Cawood, C. D., & Huprich, S. K. (2011). Late adolescent nonsuicidal self-injury: The roles of coping style, self-esteem, and personality pathology. Journal of Personality Disorders, 25, 765–781.

    PubMed  Google Scholar 

  • Centers for Disease Control and Prevention. (2007). Suicide trends among youths and young adults aged 10–24 years—United States, 1990–2004. Morbidity and Mortality Weekly Report, 56, 905–908.

    Google Scholar 

  • Cerutti, R., Manca, M., Presaghi, F., & Gratz, K. L. (2011). Prevalence and clinical correlates of deliberate self-harm among a community sample of Italian adolescents. Journal of Adolescence, 34, 337–347.

    PubMed  Google Scholar 

  • Cha, C. B., & Nock, M. K. (2009). Emotional intelligence is a protective factor for suicidal behavior. Journal of the American Academy of Child & Adolescent Psychiatry, 48, 422–430.

    Google Scholar 

  • Chapman, A. L., Gratz, K. L., & Brown, M. Z. (2006). Solving the puzzle of deliberate self- harm: The experiential avoidance model. Behaviour Research and Therapy, 44, 371–394.

    PubMed  Google Scholar 

  • Cole, P. M., Michel, M. K., & Teti, L. O. (1994). The development of emotion regulation and dysregulation: A clinical perspective. In N. A. Fox (Ed.), The development of emotion regulation: Biological and behavioral considerations. Monographs of the Society for Research in Child Development, 59 (Serial No. 240), 73–100.

    Google Scholar 

  • Crowell, S. E., Beauchaine, T. P., Hsiao, R. C., Vasilev, C. A., Yaptangco, M., Linehan, M. M., et al. (2012). Differentiating adolescent self-injury from adolescent depression: Possible implications for borderline personality development. Journal of Abnormal Child Psychology, 40, 45–57.

    Google Scholar 

  • Crowell, S. E., Beauchaine, T. P., & Lenzenweger, M. F. (2008). The development of borderline personality disorder and self-injurious behavior. In T. P. Beauchaine & S. P. Hinshaw (Eds.), Child and adolescent psychopathology (pp. 510–539). Hoboken, NJ: Wiley.

    Google Scholar 

  • Crowell, S. E., Beauchaine, T. P., & Linehan, M. M. (2009). A biosocial developmental model of borderline personality: Elaborating and extending Linehan’s theory. Psychological Bulletin, 135, 495–510.

    Google Scholar 

  • Crowell, S. E., Beauchaine, T. P., McCauley, E., Smith, C. J., Stevens, A. L., & Sylvers, P. (2005). Psychological, autonomic, and serotonergic correlates of parasuicide among adolescent girls. Development and Psychopathology, 17, 1105–1127.

    PubMed  Google Scholar 

  • Crumley, F. E. (1979). Adolescent suicide attempts. Journal of the American Medical Association, 241, 2404–2407.

    PubMed  Google Scholar 

  • Daughters, S. B., Reynolds, E. K., MacPherson, L., Kahler, C. W., Danielson, C. K., & Lejuez, C. W. (2009). Negative reinforcement and early adolescent externalizing and internalizing symptoms: The moderating role of gender and ethnicity. Behaviour Research and Therapy, 47, 198–205.

    PubMed Central  PubMed  Google Scholar 

  • Dougherty, D. M., Mathias, C. W., Marsh-Richard, D. M., Prevette, K. N., Dawes, M. A., Hatzis, E. S., et al. (2009). Impulsivity and clinical symptoms among adolescents with non-suicidal self-injury with or without attempted suicide. Psychiatry Research, 169, 22–27.

    PubMed Central  PubMed  Google Scholar 

  • Eisenberg, N., Cumberland, A., & Spinrad, T. L. (1998). Parental socialization of emotion. Psychological Inquiry, 9, 241–273.

    PubMed Central  PubMed  Google Scholar 

  • Eisenberg, N., Spinrad, T. L., & Eggum, N. D. (2010). Emotion-related self-regulation and its relation to children’s maladjustment. Annual Review of Clinical Psychology, 6, 495–525.

    PubMed Central  PubMed  Google Scholar 

  • Esposito, C., Spirito, A., Boergers, J., & Donaldson, D. (2003). Affective, cognitive, and behavioral functioning in adolescents with multiple suicide attempts. Suicide and Life Threatening Behavior, 33, 389–399.

    PubMed  Google Scholar 

  • Evans, E., Hawton, K., Rodham, K., & Deeks, J. (2005). The prevalence of suicidal phenomena in adolescents: A systematic review of population-based studies. Suicide and Life Threatening Behaviors, 35, 239–250.

    Google Scholar 

  • Ferrara, M., Terrinoni, A., & Williams, R. (2012). Non-suicidal self-injury (Nssi) in adolescent inpatients: Assessing personality features and attitude toward death. Child and Adolescent Psychiatry and Mental Health, 6, 12–20.

    PubMed Central  PubMed  Google Scholar 

  • First, M. B., Gibbon, M., Spitzer, R. L., Williams, J. B. W., & Benjamin, L. S. (1997). Structured clinical interview for DSM-IV axis II personality disorders (SCID-II). Washington, DC: American Psychiatric Press.

    Google Scholar 

  • Flesichhaker, C., Böhme, R., Sixt, B., BrĂĽck, C., Schneider, C., & Schulz, E. (2011). Dialectical behavioral therapy for adolescents (DBT-A): A clinical trial for patients with suicidal and self-injurious behavior and borderline symptoms with a one-year follow-up. Child and Adolescent Psychiatry and Mental Health, 5, 1–10.

    Google Scholar 

  • Fliege, H., Lee, J. R., Grimm, A., & Klapp, B. F. (2009). Risk factors and correlates of deliberate self-harm behavior: A systematic review. Journal of Psychosomatic Research, 66, 477–493.

    PubMed  Google Scholar 

  • Giannetta, M. M., Betancourt, L. M., Brodsky, N. L., Wintersteen, M. B., Romer, D., Giannetta, J. M., et al. (2012). Suicidal ideation and self-harm behavior in a community sample of preadolescent youth: A case–control study. Journal of Adolescent Health, 50, 524–526.

    PubMed  Google Scholar 

  • Gnepp, J., & Hess, D. L. R. (1986). Children's understanding of verbal and facial display rules. Developmental Psychology, 22, 103–108.

    Google Scholar 

  • Goldman, S. J., D’Angelo, E. J., & DeMaso, D. R. (1993). Psychopathology in the families of children and adolescents with borderline personality disorder. American Journal of Psychiatry, 150, 1832–1835.

    PubMed  Google Scholar 

  • Goodman, M., Hazlett, E. A., Avedon, J. B., Siever, D. R., Chu, K., & New, A. S. (2011). Anterior cingulate volume reduction in adolescents with borderline personality disorder and co-morbid major depression. Journal of Psychiatric Research, 45, 803–807.

    PubMed  Google Scholar 

  • Gould, M. S., King, R., Greenwald, S., Fisher, P., Schwab-Stone, M., Kramer, R., et al. (1998). Psychopathology associated with suicidal ideation and attempts among children and adolescents. Journal of the American Academy of Child & Adolescent Psychiatry, 37, 915–923.

    Google Scholar 

  • Graber, J. A., & Brooks-Gunn, J. (1996). Transitions and turning points: Navigating the passage from childhood through adolescence. Developmental Psychology, 32, 768–776.

    Google Scholar 

  • Gratz, K. L. (2001). Measurement of deliberate self-harm: Preliminary data on the Deliberate Self-Harm Inventory. Journal of Psychopathology and Behavioral Assessment, 23, 253–263.

    Google Scholar 

  • Gratz, K. L. (2003). Risk factors for and functions of deliberate self-harm: An empirical and conceptual review. Clinical Psychology: Science and Practice, 10, 192–205.

    Google Scholar 

  • Gratz, K. L. (2006). Risk factors for deliberate self-harm among female college students: The role and interaction of childhood maltreatment, emotional inexpressivity, and affect intensity/reactivity. American Journal of Orthopsychiatry, 76, 238–250.

    PubMed  Google Scholar 

  • Gratz, K. L., Breetz, A., & Tull, M. T. (2010). The moderating role of borderline personality in the relationships between deliberate self-harm and emotion-related factors. Personality and Mental Health, 4, 96–107.

    Google Scholar 

  • Gratz, K. L., Hepworth, C., Tull, M. T., Paulson, A., Clarke, S., Remington, B., et al. (2011). An experimental investigation of emotional willingness and physical pain tolerance in deliberate self-harm: The moderating role of interpersonal distress. Comprehensive Psychiatry, 52, 63–74.

    PubMed  Google Scholar 

  • Gratz, K. L., Latzman, R. D., Tull, M. T., Reynolds, E. K., & Lejuez, C. W. (2011). Exploring the association between emotional abuse and childhood borderline personality features: The moderating role of personality traits. Behavior Therapy, 42, 493–508.

    PubMed Central  PubMed  Google Scholar 

  • Gratz, K. L., Latzman, R. D., Young, J., Heiden, L. J., Damon, J., Tull, M. T., et al. (2012). Deliberate self-harm among underserved adolescents: The moderating roles of gender, race, and school-level and association with borderline personality features. Personality Disorders: Theory, Research, and Treatment, 3, 39–54.

    Google Scholar 

  • Gratz, K. L., & Roemer, L. (2008). The relationship between emotion dysregulation and deliberate self-harm among female undergraduate students at an urban commuter university. Cognitive Behaviour Therapy, 37, 14–25.

    PubMed  Google Scholar 

  • Gratz, K. L., & Tull, M. T. (2010). Emotion regulation as a mechanism of change in acceptance- and mindfulness-based treatments. In R. A. Baer (Ed.), Assessing mindfulness and acceptance: Illuminating the processes of change (pp. 107–134). Oakland, CA: New Harbinger.

    Google Scholar 

  • Gratz, K. L., Tull, M. T., Reynolds, E. K., Bagge, C., Latzman, R. D., Daughters, S. B., et al. (2009). Extending extant models of the pathogenesis of borderline personality disorder to childhood borderline personality symptoms: The roles of affective dysfunction, disinhibition, and self- and emotion-regulation deficits. Development and Psychopathology, 21, 1263–1291.

    Google Scholar 

  • Green, J. M., Wood, A. J., Kerfoot, M. J., Trainor, G., Roberts, C., Rothwell, J., et al. (2011). Group therapy for adolescents with repeated self harm: Randomised controlled trial with economic evaluation. British Medical Journal, 342, 859–961.

    Google Scholar 

  • Guan, K., Fox, K. R., & Prinstein, M. J. (2012). Nonsuicidal self-injury as a time-invariant predictor of adolescent suicide ideation and attempts in a diverse community sample. Journal of Consulting and Clinical Psychology, 80, 842–849.

    PubMed Central  PubMed  Google Scholar 

  • Guertin, T., Lloyd-Richardson, E., Spirito, A., Donaldson, D., & Boergers, J. (2001). Self-mutilative behavior in adolescents who attempt suicide by overdose. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 1062–1069.

    PubMed  Google Scholar 

  • Gunderson, J. G. (2001). Borderline personality disorder: A clinical guide. Washington, DC: American Psychiatric Press.

    Google Scholar 

  • Halfon, O., Laget, J., & Barrie, M. (1995). An epidemiological and clinical approach to adolescent suicide. European Child and Adolescent Psychiatry, 4, 32–38.

    PubMed  Google Scholar 

  • Hawton, K., Houston, K., & Shepperd, R. (1999). Suicide in young people: A study of 174 cases, aged under 25 years, based on coroners’ and medical records. British Journal of Psychiatry, 175, 271–276.

    PubMed  Google Scholar 

  • Hawton, K., Kingsbury, S., Steinhardt, K., James, A., & Fagg, J. (1999). Repetition of deliberate self-harm by adolescents: The role of psychological factors. Journal of Adolescence, 22, 369–378.

    PubMed  Google Scholar 

  • Hawton, K., Rodham, K., Evans, E., & Weatherall, R. (2002). Deliberate self harm in adolescents: Self-report survey in schools in England. British Medical Journal, 325, 1207–1211.

    PubMed Central  PubMed  Google Scholar 

  • Hazell, P. L., Martin, G., McGIll, K., Kay, T., Wood, A., Trainor, G., et al. (2009). Group therapy for repeated deliberate self-harm in adolescents: Failure of replication of a randomized trial. Journal of the American Academy of Child & Adolescent Psychiatry, 48, 662–670.

    Google Scholar 

  • Hilt, L. M., Cha, C. B., & Nolen-Hoeksema, S. (2008). Nonsuicidal self-injury in young adolescent girls: Moderators of the distress-function relationship. Journal of Consulting and Clinical Psychology, 76, 63–71.

    PubMed  Google Scholar 

  • Horesh, N., Orbach, I., Gothelf, D., Efrati, M., & Apter, A. (2003). Comparison of the suicidal behavior of adolescent inpatients with borderline personality disorder and major depression. Journal of Nervous and Mental Disease, 191, 582–588.

    PubMed  Google Scholar 

  • Horesh, N., Ratner, S., Laor, N., & Toren, P. (2008). A comparison of life events in adolescents with major depression, borderline personality disorder, and matched controls: A pilot study. Psychopathology, 41, 300–306.

    PubMed  Google Scholar 

  • Jacobson, C. M., & Gould, M. (2007). The epidemiology and phenomenology of non-suicidal self-injurious behavior among adolescents: A critical review of the literature. Archives of Suicide Research, 11, 129–147.

    Google Scholar 

  • Jacobson, C. M., Muehlenkamp, J. J., Miller, A. L., & Turner, J. B. (2008). Psychiatric impairment among adolescents engaging in different types of deliberate self-harm. Journal of Clinical Child & Adolescent Psychology, 37, 363–375.

    Google Scholar 

  • Johnson, J., Smailes, E. M., Cohen, P., Brown, J., & Bernstein, D. P. (2000). Associations between four types of childhood neglect and personality disorder symptoms during adolescence and early adulthood: Findings of a community-based longitudinal study. Journal of Personality Disorders, 14, 171–187.

    PubMed  Google Scholar 

  • Joiner, T. E., Jr., Conwell, Y., Fitzpatrick, K. K., Witte, T. K., Schmidt, N. B., Berlin, M. T., et al. (2005). Four studies on how past and current suicidality relate even when “everything but the kitchen sink” is covaried. Journal of Abnormal Psychology, 114, 291–303.

    PubMed  Google Scholar 

  • Jovev, M., Garner, B., Phillips, L., Velakoulis, D., Wood, S. J., Jackson, H. J., et al. (2008). An MRI study of pituitary volume and parasuicidal behavior in teenagers with first-presentation borderline personality disorder. Psychiatry Research: Neuroimaging, 162, 273–277.

    PubMed  Google Scholar 

  • Kaess, M., Hille, M., Parzer, P., Maser-Gluth, C., Resch, F., & Brunner, R. (2012). Alterations in the neuroendocrinological stress response to acute psychosocial stress in adolescents engaging in nonsuicidal self-injury. Psychoneuroendocrinology, 37, 157–161.

    PubMed  Google Scholar 

  • Kingsbury, S., Hawton, K., Steinhardt, K., & James, A. (1999). Do adolescents who take overdoses have specific psychological characteristics? A comparative study with psychiatric and community controls. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 1125–1131.

    PubMed  Google Scholar 

  • Kirchner, T., Ferrer, L., Forns, M., & Zanini, D. (2011). Self-harm behavior and suicidal ideation among high school students: Gender differences and relationships with coping strategies. Actas Españolas de PsiquiatrĂ­a, 39, 226–235.

    PubMed  Google Scholar 

  • Klein, D. A., & Miller, A. L. (2011). Dialectical behavior therapy for suicidal adolescents with borderline personality disorder. Child and Adolescent Psychiatric Clinics of North America, 20, 205–216.

    Google Scholar 

  • Klonsky, E. D., & Olino, T. M. (2008). Identifying clinically distinct subgroups of self-injurers among young adults: A latent class analysis. Journal of Consulting and Clinical Psychology, 76, 22–27.

    PubMed  Google Scholar 

  • Kopp, C. (1989). Regulation of distress and negative emotions: A developmental view. Developmental Psychology, 25, 343–354.

    Google Scholar 

  • Kreitman, N. (1977). Parasuicide. London, England: Wiley.

    Google Scholar 

  • Larson, R., Moneta, G., Richards, M. H., & Wilson, S. (2002). Continuity, stability, and change in daily emotional experience across adolescence. Child Development, 73, 1151–1165.

    PubMed  Google Scholar 

  • Larson, R., & Richards, M. H. (1991). Daily companionship in late childhood and early adolescence: Changing developmental contexts. Child Development, 62, 284–300.

    PubMed  Google Scholar 

  • Lejuez, C. W., Aklin, W., Daughters, S., Zvolensky, M., Kahler, C., & Gwadz, M. (2007). Reliability and validity of the youth version of the Balloon Analogue Risk Task (BART-Y) in the assessment of risk-taking behavior among inner-city adolescents. Journal of Clinical Child and Adolescent Psychology, 36, 106–111.

    PubMed  Google Scholar 

  • Lewinsohn, P. M., Rohde, P., & Seeley, J. R. (1993). Psychosocial characteristics of adolescents with a history of suicide attempt. Journal of American Academy of Child & Adolescent Psychiatry, 32, 60–68.

    Google Scholar 

  • Linehan, M. M. (1993). The cognitive-behavioral treatment of borderline personality disorder. New York: Guilford.

    Google Scholar 

  • Links, P. S., Gould, B., & Ratnayake, R. (2003). Assessing suicidal youth with antisocial, borderline, or narcissistic personality disorder. The Canadian Journal of Psychiatry, 48, 301–310.

    Google Scholar 

  • Muehlenkamp, J. J., & Brausch, A. M. (2012). Body image as a mediator of non-suicidal self-injury in adolescents. Journal of Adolescence, 35, 1–9.

    PubMed  Google Scholar 

  • Muehlenkamp, J. J., Ertelt, T. W., Miller, A. L., & Claes, L. (2011). Borderline personality symptoms differentiate non-suicidal and suicidal self-injury in ethnically diverse adolescent outpatients. Journal of Child Psychology and Psychiatry, 52, 148–155.

    PubMed  Google Scholar 

  • Muehlenkamp, J. J., & Gutierrez, P. M. (2004). An investigation of differences between self-injurious behavior and suicide attempts in a sample of adolescents. Suicide and Life-Threatening Behavior, 34, 12–23.

    PubMed  Google Scholar 

  • Nock, M. K., Borges, G., Bromet, E. J., Cha, C. B., Kessler, R. C., & Lee, S. (2008). Suicide and suicidal behaviors. Epidemiologic Reviews, 30, 133–154.

    PubMed Central  PubMed  Google Scholar 

  • Nock, M. K., Joiner, T. E., Gordon, K. H., Lloyd-Richardson, E., & Prinstein, M. J. (2006). Non-suicidal self-injury among adolescents: Diagnostic correlates and relation to suicide attempts. Psychiatry Research, 144, 65–72.

    PubMed  Google Scholar 

  • Nock, M. K., & Kessler, R. C. (2006). Prevalence of and risk factors for suicide attempts versus suicide gestures: Analysis of the National Comorbidity Survey. Journal of Abnormal Psychology, 115, 616–623.

    PubMed  Google Scholar 

  • O’Carroll, P. W., Berman, A. L., Maris, R. W., Moscicki, E. K., Tanney, B. L., & Silverman, M. M. (1996). Beyond the tower of Babel: A nomenclature for suicidology. Suicide and Life-Threatening Behavior, 26, 237–252.

    PubMed  Google Scholar 

  • O’Connor, R., & Sheehy, N. (2000). Understanding suicidal behaviour. Leicester, England: BPS Blackwell.

    Google Scholar 

  • Paris, J. (2005). The development of impulsivity and suicidality in borderline personality disorder. Development and Psychopathology, 17, 1091–1104.

    PubMed  Google Scholar 

  • Pattison, E., & Kahan, M. (1983). The deliberate self-harm syndrome. American Journal of Psychiatry, 140, 867–872.

    PubMed  Google Scholar 

  • Perepletchikova, F., Axelrod, S. R., Kaufman, J., Rounsaville, B. J., Douglas-Palumber, H., & Miller, A. L. (2011). Adapting dialectical behavior therapy for children: Towards a new research agenda for pediatric suicidal and non-suicidal self-injurious behaviors. Child and Adolescent Mental Health, 16, 116–121.

    PubMed Central  PubMed  Google Scholar 

  • Perez, J., Venta, A., Garnaat, S., & Sharp, C. (2012). The difficulties in Emotion Regulation Scale: Factor structure and association with nonsuicidal self-injury in adolescent inpatients. Journal of Psychology and Behavioral Assessment, 34, 393–404.

    Google Scholar 

  • Plutchik, R., & van Praag, H. (1989). The measurement of suicidality, aggressivity and impulsivity. Progress in Neuropsychopharmacology and Biological Psychiatry, 13, S23–S34.

    Google Scholar 

  • Rathus, J. H., & Miller, A. L. (2002). Dialectical behavior therapy adapted for suicidal adolescents. Suicide and Life Threatening Behaviors, 32, 146–157.

    Google Scholar 

  • Robinson, J., Hetrick, S. E., & Martin, C. (2011). Preventing suicide in young people: Systematic review. Australian and New Zealand Journal of Psychiatry, 45, 3–26.

    PubMed  Google Scholar 

  • Rossouw, T. I., & Fonagy, P. (2012). Mentalization-based treatment for self-harm in adolescents: A randomized controlled trial. Journal of the American Academy of Child & Adolescent Psychiatry, 51, 1304–1313.

    Google Scholar 

  • Rothbart, M. K., Ziaie, H., & O’Boyle, C. G. (1992). Self-regulation and emotion in infancy. In N. Eisenberg & R. Fabes (Eds.), Emotion and its regulation in early development (pp. 7–24). San Francisco, CA: Jossey-Bass.

    Google Scholar 

  • Runeson, B., & Beskow, J. (1991). Borderline personality disorder in young Swedish suicides. Journal of Nervous and Mental Disease, 179, 153–156.

    PubMed  Google Scholar 

  • Saarni, C. (1979). Children's understanding of display rules for expressive behavior. Developmental Psychology, 15, 424–429.

    Google Scholar 

  • Sabo, A. N., Gunderson, J. G., Najavits, L. M., Chauncey, D., & Kisiel, C. (1995). Changes in self-destructiveness of borderline patients in psychotherapy: A prospective follow-up. Journal of Nervous and Mental Disease, 183, 370–376.

    PubMed  Google Scholar 

  • Safer, D. L., Telch, C. F., & Chen, E. Y. (2009). Dialectical behavior therapy for binge eating and bulimia. New York: Guilford Press.

    Google Scholar 

  • Sapyta, J., Goldston, D. B., Erkanli, A., Daniel, S. S., Heilbron, N., Mayfield, A., et al. (2012). Evaluating the predictive validity of suicidal intent and medical lethality in youth. Journal of Consulting and Clinical Psychology, 80, 222–231.

    PubMed Central  PubMed  Google Scholar 

  • Shafii, M., Carrigan, S., Whittinghill, J. R., & Derrick, A. (1985). Psychological autopsy of completed suicide in children and adolescents. American Journal of Psychiatry, 142, 1061–1064.

    PubMed  Google Scholar 

  • Sharp, C., Ha, C., Michonski, J., Venta, A., & Carbone, C. (2012). Borderline personality disorder in adolescents: Evidence in support of the Childhood Interview for DSM-IV Borderline Personality Disorder in a sample of adolescent inpatients. Comprehensive Psychiatry, 53, 765–774.

    PubMed  Google Scholar 

  • Skegg, K. (2005). Self-harm. The Lancet, 366, 1471–1483.

    Google Scholar 

  • Slee, N., Garnefski, N., van der Leeden, R., Arensman, E., & Spinhoven, P. (2008). Cognitive-behavioural intervention for self-harm: Randomised controlled trial. British Journal of Psychiatry, 192, 202–211.

    PubMed  Google Scholar 

  • Southam-Gerow, M. A., & Kendall, P. C. (2002). Emotion regulation and understanding: Implications for child psychopathology and therapy. Clinical Psychology Review, 22, 189–222.

    PubMed  Google Scholar 

  • Steinberg, L., Dahl, R., Keating, D., Kupfer, D. J., Masten, A., & Pine, D. (2006). The study of developmental psychopathology in adolescence: Integrating affective neuroscience with the study of context. In D. Cicchetti & D. Cohen (Eds.), Developmental psychopathology (Vol. 2, pp. 710–741). New York: Wiley.

    Google Scholar 

  • Tamás, Z., Kovacs, M., Gentzler, A. L., Tepper, P., Gádoros, J., Kiss, E., et al. (2007). The relations of temperament and emotion self-regulation with suicidal behaviors in a clinical sample of depressed children in Hungary. Journal of Abnormal Child Psychology, 35, 640–652.

    PubMed  Google Scholar 

  • Taylor, J., James, L. M., Reeves, M. D., & Kistner, J. A. (2009). Borderline personality traits are associated with poor clinical and psychosocial functioning in delinquent boys. Journal of Psychopathology and Behavioral Assessment, 31, 94–103.

    Google Scholar 

  • Taylor, L. M. W., Oldershaw, A., Richards, C., Davidson, K., Schmidt, U., & Simic, M. (2011). Development and pilot evaluation of a manualized cognitive-behavioural treatment package for adolescent self-harm. Behavioural and Cognitive Psychotherapy, 39, 619–625.

    PubMed  Google Scholar 

  • Thompson, R. A. (1994). Emotion regulation: A theme in search of definition. In N. A. Fox (Ed.), The development of emotion regulation: Biological and behavioral considerations, Monographs of the Society for Research in Child Development, 59 (Serial No. 240), 25–52.

    Google Scholar 

  • Tull, M. T., Weiss, N. H., Adams, C. E., & Gratz, K. L. (2012). The contribution of emotion regulation difficulties to risky sexual behavior within a sample of patients in residential substance abuse treatment. Addictive Behaviors, 37, 1084–1092.

    PubMed Central  PubMed  Google Scholar 

  • Tyrer, P., Tom, B., Byford, S., Schmidt, U., Jones, V., Davidson, K., et al. (2004). Differential effects of manual assisted cognitive behavior therapy in the treatment of recurrent deliberate self-harm and personality disturbance: The POPMACT Study. Journal of Personality Disorders, 18, 102–116.

    PubMed  Google Scholar 

  • Venta, A., Kenkel-Mikelonis, R., & Sharp, C. (2012). A preliminary study of the relation between trauma symptoms and emerging BPD in adolescent inpatients. Bulletin of the Menninger Clinic, 76, 130–146.

    PubMed  Google Scholar 

  • Walsh, B. W., & Rosen, P. M. (1988). Self-mutilation: Theory, research and treatment. New York: Guilford Press.

    Google Scholar 

  • Washburn, J. J., Richardt, S. L., Styer, D. M., Gebhardt, M., Juzwin, K. R., Yourek, A., et al. (2012). Psychotherapeutic approaches to non-suicidal self-injury in adolescents. Child and Adolescent Psychiatry and Mental Health, 6, 14–21.

    PubMed Central  PubMed  Google Scholar 

  • Wetzler, S., Asnis, G. M., Hyman, R. B., Virtue, C., Zimmerman, J., & Rathus, J. H. (1996). Characteristics of suicidality among adolescents. Suicide and Life-Threatening Behavior, 26, 37–45.

    PubMed  Google Scholar 

  • Wood, A., Trainor, G., Rothwell, J., Moore, A., & Harrington, R. (2001). Randomized trial of group therapy for repeated deliberate self-harm in adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 40(11), 1245–1253.

    Google Scholar 

  • You, J., Leung, F., Fu, K., & Lai, C. M. (2011). The prevalence of nonsuicidal self-injury and different subgroups of self-injurers in Chinese adolescents. Archives of Suicide Research, 15, 75–86.

    PubMed  Google Scholar 

  • You, J., Leung, F., Lai, C. M., & Fu, K. (2012). The associations between non-suicidal self-injury and borderline personality disorder features among Chinese adolescents. Journal of Personality Disorders, 26, 226–237.

    PubMed  Google Scholar 

  • Young, R., Sweeting, H., & Ellaway, A. (2011). Do schools differ in suicide risk? The influence of school and neighbourhood on attempted suicide, suicidal ideation and self-harm among secondary school pupils. Biomed Central Public Health, 11, 874–889.

    PubMed Central  PubMed  Google Scholar 

  • Young, R., van Beinum, M., Sweeting, H., & West, P. (2007). Young people who self-harm. British Journal of Psychiatry, 191, 44–49.

    PubMed  Google Scholar 

  • Zaitsoff, S. L., & Grilo, C. M. (2010). Eating disorder psychopathology as a marker of psychosocial distress and suicide risk in female and male adolescent psychiatric inpatients. Comprehensive Psychiatry, 51, 142–150.

    PubMed Central  PubMed  Google Scholar 

  • Zanarini, M. C., Frankenburg, F. R., Ridolfi, M. E., Jager-Hyman, S., Hennen, J., & Gunderson, J. G. (2006). Reported childhood onset of self-mutilation among borderline patients. Journal of Personality Disorders, 20, 9–15.

    PubMed  Google Scholar 

  • Zanarini, M. C., Frankenburg, F. R., Sickel, A. E., & Young, L. (1996). Diagnostic interview for DSM-IV personality disorders. Boston, MA: McLean Hospital.

    Google Scholar 

Suggested Reading

  • Crowell, S. E., Beauchaine, T. P., Hsiao, R. C., Vasilev, C. A., Yaptangco, M., Linehan, M. M., et al. (2012). Differentiating adolescent self-injury from adolescent depression: Possible implications for borderline personality development. Journal of Abnormal Child Psychology, 40, 45–57.

    Google Scholar 

  • Crowell, S. E., Beauchaine, T. P., & Linehan, M. M. (2009). A biosocial developmental model of borderline personality: Elaborating and extending Linehan’s theory. Psychological Bulletin, 135, 495–510.

    Google Scholar 

  • Gratz, K. L., Tull, M. T., Reynolds, E. K., Bagge, C., Latzman, R. D., Daughters, S. B., et al. (2009). Extending extant models of the pathogenesis of borderline personality disorder to childhood borderline personality symptoms: The roles of affective dysfunction, disinhibition, and self- and emotion-regulation deficits. Development and Psychopathology, 21, 1263–1291.

    Google Scholar 

  • Jacobson, C. M., & Gould, M. (2007). The epidemiology and phenomenology of non-suicidal self-injurious behavior among adolescents: A critical review of the literature. Archives of Suicide Research, 11, 129–147.

    Google Scholar 

  • Klein, D. A., & Miller, A. L. (2011). Dialectical behavior therapy for suicidal adolescents with borderline personality disorder. Child and Adolescent Psychiatric Clinics of North America, 20, 205–216.

    Google Scholar 

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Acknowledgment

The authors wish to thank Michael Anestis for his assistance with the review of the literature on impulsivity in suicidal behaviors.

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Authors and Affiliations

  1. Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, 2500 North State Street, Jackson, MS, USA

    Kim L. Gratz

  2. Department of Psychiatry and Human Behavior, University of Mississippi Medical Center, Jackson, MS, USA

    Katherine L. Dixon-Gordon & Matthew T. Tull

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  1. Kim L. Gratz
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  2. Katherine L. Dixon-Gordon
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  3. Matthew T. Tull
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Correspondence to Kim L. Gratz .

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Editors and Affiliations

  1. Dept. Psychology, University of Houston, Houston, Texas, USA

    Carla Sharp

  2. Dept. Psychology, University of Houston, Houston, Texas, USA

    Jennifer L. Tackett

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Gratz, K.L., Dixon-Gordon, K.L., Tull, M.T. (2014). Self-Injurious Behaviors in Adolescents with Borderline Personality Disorder. In: Sharp, C., Tackett, J. (eds) Handbook of Borderline Personality Disorder in Children and Adolescents. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-0591-1_14

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