An Investigation of the Mediating Roles of Emotion Regulation Difficulties, Distress Tolerance, Self-Compassion, and Self-Disgust in the Association Between Childhood Trauma and Nonsuicidal Self-Injury.

OBJECTIVE Childhood maltreatment has been associated as a risk factor with the development of nonsuicidal self-injury (NSSI), with difficulty in emotion regulation explaining the association. However, little is known about the potential factors that make some individuals with maltreatment history more vulnerable to difficulties in emotion regulation and, in turn, engage in NSSI. The current study aimed to examine the roles of distress tolerance, self-compassion, and self-disgust in the association between childhood maltreatment types and emotion regulation difficulty, which was expected to predict NSSI. METHOD The sample included 397 university students between the ages of 18 and 30. Participants completed self-report scales assessing childhood maltreatment, emotion regulation difficulty, distress tolerance, self-compassion, self-disgust, and NSSI using the paper-pencil and online methods. The mediation model suggested for the association between childhood maltreatment types and NSSI was tested using path analysis. RESULTS Low distress tolerance, low self-compassion, high self-disgust, and resulting high emotion regulation difficulty mediated the indirect effect of emotional neglect on NSSI. CONCLUSION The current study sheds light on various factors in the development and maintenance of NSSI and reveals three developmental pathways from emotional neglect in childhood to engaging in NSSI.HIGHLIGHTSEmotional neglect may be a distal risk factor for nonsuicidal self-injury (NSSI).Low distress tolerance and self-compassion and high self-disgust may increase the risk of NSSI.Emotion regulation difficulty may make people engage in NSSI to regulate emotions.

[1]  Jodie C. Stevenson,et al.  Self-disgust and the dark triad traits: The role of expressive suppression , 2021, Personality and Individual Differences.

[2]  U. Voderholzer,et al.  Self-compassion and emotion regulation difficulties in obsessive-compulsive disorder. , 2020, Clinical psychology & psychotherapy.

[3]  Self-Injury , 2020, Definitions.

[4]  M. Cunha,et al.  The role of self-disgust in eating psychopathology in overweight and obesity: Can self-compassion be useful? , 2019, Journal of health psychology.

[5]  Richard S. Herrington,et al.  From childhood emotional maltreatment to depressive symptoms in adulthood: The roles of self-compassion and shame. , 2019, Child abuse & neglect.

[6]  P. Overton,et al.  The roles of impulsivity, self-regulation, and emotion regulation in the experience of self-disgust , 2019 .

[7]  P. Overton,et al.  Self-disgust as a potential mechanism explaining the association between loneliness and depression. , 2019, Journal of affective disorders.

[8]  P. McEvoy,et al.  Common Pathways to NSSI and Suicide Ideation: The Roles of Rumination and Self-Compassion , 2018, Archives of suicide research : official journal of the International Academy for Suicide Research.

[9]  A. Reffi,et al.  Examining Pathways of Childhood Maltreatment and Emotional Dysregulation Using Self-Compassion , 2018, Journal of Aggression, Maltreatment & Trauma.

[10]  Jianing You,et al.  Distress Intolerance Mediates the Relationship between Child Maltreatment and Nonsuicidal Self-Injury among Chinese Adolescents: A Three-Wave Longitudinal Study , 2018, Journal of Youth and Adolescence.

[11]  D. Dickstein,et al.  Emotion Dysregulation Mediates the Relationship Between Child Maltreatment and Non-Suicidal Self-Injury , 2018, Journal of aggression, maltreatment & trauma.

[12]  M. Berking,et al.  Adaptive emotion regulation mediates the relationship between self‐compassion and depression in individuals with unipolar depression , 2017, Psychology and psychotherapy.

[13]  Jianjun Zhu,et al.  Brief report: A preliminary comparison of self-compassion between adolescents with nonsuicidal self-injury thoughts and actions. , 2017, Journal of adolescence.

[14]  C. Peh,et al.  Emotion dysregulation as a mechanism linking child maltreatment exposure and self-harm behaviors in adolescents. , 2017, Child abuse & neglect.

[15]  François Ric,et al.  Psychology of Emotion , 2017 .

[16]  M. Barlow,et al.  Trauma appraisals, emotion regulation difficulties, and self-compassion predict posttraumatic stress symptoms following childhood abuse. , 2017, Child abuse & neglect.

[17]  S. Herpertz,et al.  Pain-mediated affect regulation is reduced after dialectical behavior therapy in borderline personality disorder: a longitudinal fMRI study , 2017, Social cognitive and affective neuroscience.

[18]  S. Barnow,et al.  Emotion dysregulation mediates the relationship between child maltreatment and psychopathology: A structural equation model. , 2016, International Journal of Child Abuse & Neglect.

[19]  Amber R. Madden,et al.  Specificity of childhood maltreatment and emotion deficit in nonsuicidal self-injury in an inpatient sample of youth , 2016, Psychiatry Research.

[20]  K. Neff The Self-Compassion Scale is a Valid and Theoretically Coherent Measure of Self-Compassion , 2016 .

[21]  A. Meyer-Lindenberg,et al.  Incision and stress regulation in borderline personality disorder: Neurobiological mechanisms of self-injurious behaviour , 2015, British Journal of Psychiatry.

[22]  A. Meuret,et al.  Investigating the Role of Self-Disgust in Nonsuicidal Self-Injury , 2015, Archives of suicide research : official journal of the International Academy for Suicide Research.

[23]  J. Simons,et al.  Child Maltreatment and Deliberate Self-Harm , 2014, Child maltreatment.

[24]  Andrew Page,et al.  Prevalence of nonsuicidal self-injury in nonclinical samples: systematic review, meta-analysis and meta-regression. , 2014, Suicide & life-threatening behavior.

[25]  P. Overton,et al.  The revolting self: an interpretative phenomenological analysis of the experience of self-disgust in females with depressive symptoms. , 2014, Journal of clinical psychology.

[26]  A. Schienle,et al.  Self-disgust in mental disorders -- symptom-related or disorder-specific? , 2014, Comprehensive psychiatry.

[27]  Meghan E McDevitt-Murphy,et al.  Differences in Features of Non-Suicidal Self-Injury According to Borderline Personality Disorder Screening Status , 2014, Archives of suicide research : official journal of the International Academy for Suicide Research.

[28]  K. Neff,et al.  Self-compassion in clinical practice. , 2013, Journal of clinical psychology.

[29]  Amit Bernstein,et al.  Tolerance of Negative Affective States (TNAS): Development and Evaluation of a Novel Construct and Measure , 2013, Cognitive Therapy and Research.

[30]  J. Muehlenkamp,et al.  Nonsuicidal self-injury as a gateway to suicide in young adults. , 2013, The Journal of adolescent health : official publication of the Society for Adolescent Medicine.

[31]  Elizabeth K. Reynolds,et al.  An Examination of the Association of Distress Intolerance and Emotion Regulation with Avoidance , 2013, Cognitive Therapy and Research.

[32]  T. Joiner,et al.  Evaluating Distress Tolerance Measures: Interrelations and Associations with Impulsive Behaviors , 2012, Cognitive Therapy and Research.

[33]  Michael F. Armey,et al.  Changes in ecological momentary assessment reported affect associated with episodes of nonsuicidal self-injury. , 2011, Behavior therapy.

[34]  W. Li,et al.  Does Self-Compassion Mitigate the Association Between Childhood Maltreatment and Later Emotion Regulation Difficulties? A Preliminary Investigation , 2011, International Journal of Mental Health and Addiction.

[35]  G. Can,et al.  Self-harm, suicidal ideation and suicide attempts among college students , 2011, Psychiatry Research.

[36]  J. Jackson,et al.  Child Maltreatment, Emotion Regulation, and Posttraumatic Stress: The Impact of Emotional Abuse , 2010 .

[37]  P. Kirsch,et al.  Affect Regulation and Pain in Borderline Personality Disorder: A Possible Link to the Understanding of Self-Injury , 2010, Biological Psychiatry.

[38]  T. Gençöz,et al.  Psychometric properties of a Turkish version of the Difficulties in Emotion Regulation Scale. , 2010, Journal of clinical psychology.

[39]  J. Muehlenkamp,et al.  Abuse Subtypes and Nonsuicidal Self-Injury: Preliminary Evidence of Complex Emotion Regulation Patterns , 2010, The Journal of nervous and mental disease.

[40]  M. Nock,et al.  Revealing the form and function of self-injurious thoughts and behaviors: A real-time ecological assessment study among adolescents and young adults. , 2009, Journal of abnormal psychology.

[41]  G. Flett,et al.  Personality, child maltreatment, and substance use: Examining correlates of deliberate self-harm among university students. , 2009 .

[42]  C. Glenn,et al.  Assessing the Functions of Non-suicidal Self-injury: Psychometric Properties of the Inventory of Statements About Self-injury (ISAS) , 2009, Journal of psychopathology and behavioral assessment.

[43]  J. Zeman,et al.  Adolescent Deliberate Self-Harm: Linkages to Emotion Regulation and Family Emotional Climate , 2009 .

[44]  J. Muehlenkamp,et al.  Self-injury: a research review for the practitioner. , 2007, Journal of clinical psychology.

[45]  C. Lejuez,et al.  A laboratory-based study of the relationship between childhood abuse and experiential avoidance among inner-city substance users: the role of emotional nonacceptance. , 2007, Behavior therapy.

[46]  A. Chapman,et al.  Solving the puzzle of deliberate self-harm: the experiential avoidance model. , 2006, Behaviour research and therapy.

[47]  J. Simons,et al.  The Distress Tolerance Scale: Development and Validation of a Self-Report Measure , 2005 .

[48]  S. Paivio,et al.  Alexithymia as a mediator between childhood trauma and self-injurious behaviors. , 2004, Child abuse & neglect.

[49]  Tuppett M. Yates The developmental psychopathology of self-injurious behavior: compensatory regulation in posttraumatic adaptation. , 2004, Clinical psychology review.

[50]  K. Neff The Development and Validation of a Scale to Measure Self-Compassion , 2003 .

[51]  K. Neff Self-Compassion: An Alternative Conceptualization of a Healthy Attitude Toward Oneself , 2003 .

[52]  V. Şar,et al.  Suicide attempt and self‐mutilation among Turkish high school students in relation with abuse, neglect and dissociation , 2003, Psychiatry and clinical neurosciences.

[53]  S. Kaplan,et al.  Child and adolescent abuse and neglect research: a review of the past 10 years. Part I: Physical and emotional abuse and neglect. , 1999, Journal of the American Academy of Child and Adolescent Psychiatry.

[54]  J. Gross The Emerging Field of Emotion Regulation: An Integrative Review , 1998 .

[55]  J. Gross,et al.  Emotion Regulation and Mental Health , 1995 .

[56]  J Foote,et al.  Initial reliability and validity of a new retrospective measure of child abuse and neglect. , 1994, The American journal of psychiatry.

[57]  M. Bakermans-Kranenburg,et al.  The Prevalence of Child Maltreatment across the Globe: Review of a Series of Meta‐Analyses , 2015 .

[58]  Matthias Berking,et al.  Affect Regulation Training , 2014 .

[59]  V. Şar,et al.  Validity and reliability of the Turkish version of Childhood Trauma Questionnaire , 2012 .

[60]  M. Nock Understanding nonsuicidal self-injury : origins, assessment, and treatment , 2009 .

[61]  A. Sumer,et al.  The ValidiTy and ReliabiliTy of The TuRkish VeRsion of The self-Compassion sCale , 2008 .

[62]  Dante Cicchetti,et al.  Child maltreatment. , 2005, Annual review of clinical psychology.