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Research on Child and Adolescent Psychopathology

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01-01-2012

Differentiating Adolescent Self-Injury from Adolescent Depression: Possible Implications for Borderline Personality Development

Auteurs: Sheila E. Crowell, Theodore P. Beauchaine, Ray C. Hsiao, Christina A. Vasilev, Mona Yaptangco, Marsha M. Linehan, Elizabeth McCauley

Gepubliceerd in: Research on Child and Adolescent Psychopathology | Uitgave 1/2012

Abstract

Self-inflicted injury (SII) in adolescence marks heightened risk for suicide attempts, completed suicide, and adult psychopathology. Although several studies have revealed elevated rates of depression among adolescents who self injure, no one has compared adolescent self injury with adolescent depression on biological, self-, and informant-report markers of vulnerability and risk. Such a comparison may have important implications for treatment, prevention, and developmental models of self injury and borderline personality disorder. We used a multi-method, multi-informant approach to examine how adolescent SII differs from adolescent depression. Self-injuring, depressed, and typical adolescent females (n = 25 per group) and their mothers completed measures of psychopathology and emotion regulation, among others. In addition, we assessed electrodermal responding (EDR), a peripheral biomarker of trait impulsivity. Participants in the SII group (a) scored higher than depressed adolescents on measures of both externalizing psychopathology and emotion dysregulation, and (b) exhibited attenuated EDR, similar to patterns observed among impulsive, externalizing males. Self-injuring adolescents also scored higher on measures of borderline pathology. These findings reveal a coherent pattern of differences between self-injuring and depressed adolescent girls, consistent with theories that SII differs from depression in etiology and developmental course.

vorige artikel Adolescent Disruptive Behavior and Borderline Personality Disorder Symptoms in Young Adult Men

volgende artikel Parental Behaviors During Family Interactions Predict Changes in Depression and Anxiety Symptoms During Adolescence

Although this study is cross sectional and does not provide for direct inferences about borderline personality development, self-inflicted injury (SII) is a fruitful criterion to examine as a potential precursor to BPD (Crowell et al. 2009). As stated previously, most who self-injure are both impulsive and dysregulated emotionally—core features of BPD (e.g., Trull et al. 2003; Zlotnick et al. 1997). Self-injury also emerges in adolescence, often before other BPD criteria (Kessler et al. 1999; Yen et al. 2004). Moreover, although SII is observed without BPD, their high co-occurrence likely results from shared biological vulnerabilities (e.g., genetic, neural), contextual risk factors (e.g., early adversity), and acquired coping strategies (e.g., self-injury) (see Beauchaine et al. 2009). Rates of SII among adults with BPD are also extremely high, with 40–90% attempting suicide or engaging in non-suicidal self-injury at some point in their lifetimes (APA 2004), and nearly two-thirds first initiating self-injury before age 18. Moreover, about 50% of adolescent self-injurers can be diagnosed with BPD, with no adjustment to adult criteria (Nock et al. 2006). Finally, there is an increasing literature linking adolescent SII to personality disorders, especially borderline and antisocial pathologies (Brent et al. 1994; Clarkin et al. 1984; Johnson et al. 1999; Linehan, Rizvi et al. 2006; Marton et al. 1989; Marttunen et al. 1994; Pfeffer et al. 1991; Runeson and Beskow 1991).

At the time of the assessment, 20 SII and 15 depressed adolescents met full diagnostic criteria for depression on the Youth’s Inventory. This difference was not significant, Mann–Whitney U, p = .085.

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Titel: Differentiating Adolescent Self-Injury from Adolescent Depression: Possible Implications for Borderline Personality Development
Auteurs: Sheila E. Crowell
Theodore P. Beauchaine
Ray C. Hsiao
Christina A. Vasilev
Mona Yaptangco
Marsha M. Linehan
Elizabeth McCauley
Publicatiedatum: 01-01-2012
Uitgeverij: Springer US
Gepubliceerd in: Research on Child and Adolescent Psychopathology / Uitgave 1/2012
Print ISSN: 2730-7166
Elektronisch ISSN: 2730-7174
DOI: https://doi.org/10.1007/s10802-011-9578-3

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