Deficits in Affect Regulation and Coping Among Adolescents with Self-Injurious Behavior and Ideation (pp. 141-166)
Authors: (Alison L. Bocquee, Melanie J. Zimmer-Gembeck & Shirley Morrissey)
Abstract: In multiple theories (e.g., Briere & Gil, 1998; Cicchetti, Ganiban, & Barnett, 1991; Yates, 2004), affect dysregulation has been proposed as a direct correlate of adolescent self-injury. In the first of two studies reported here, this was tested by comparing the negative and positive affect, affect regulation, and regulation when under stress (coping) reported by adolescent (aged 16 to 18) self-injurers (SI, n = 86) to self-injury ideators who do not engage in behaviors (SID, n = 66) and to adolescents who reported neither (NSI; n = 381). In a second study, a diary methodology was used to expand the findings of the first study. This second study included 55 adolescents recruited at their first contacts with a mental health clinic. In the larger community study, support was found for the roles of affect, affect regulation, stress and coping in both self-injurious behavior and ideation. Compared to NSIís, SIís reported more negative affect, less affect recognition and feeling repair (i.e., regulation), more daily hassles, and more use of distraction and avoidance to cope with recent stressors. SI's also used more social support to cope with stress but reported that adaptive coping strategies (active coping and social support) were less helpful to them. SIDís had many of these same difficulties compared to NSIís, but also differed from SIís in some ways. Although many of these differences were not found in the second study when SI's were compared to other adolescents seeking mental health services, the results of both studies showed that clarity of feelings was the most prominent challenge of SIís compared to other adolescents. These findings point to the need to focus on SI's difficulties with clarity and repair of feelings and
whether their use of adaptive coping strategies, such as problem-solving and seeking social support, could be improved to make these responses more helpful to them when coping with stress. It also could be useful to identify adolescents who engage in self-injury ideation in order to address emotion recognition and regulation deficits as well as to encourage appropriate help-seeking behaviors.