Clinical Psychology and Special Education
2023. Vol. 12, no. 1, 150–179
doi:10.17759/cpse.2023120107
ISSN: 2304-0394 (online)
The Contribution of Dissociation and Interpersonal Sensitivity to Self-Injurious Behavior in Young Women
Abstract
The article presents the results of an empirical study of the relationship between dissociative symptoms, interpersonal sensitivity and self-injurious behavior. The study was conducted on a Russian-speaking female sample (N=968, Mean age — 21.29, SD=4.30) in online communities of psychological support for mental health disturbances. The following measures were used: Reasons for Self-Injury (Polskaya, 2017); Peritraumatic Dissociation Questionnaire (Agarkov, Tarabrina, 1998); Somatoform Dissociation Questionnaire (Nijenhuis, 1998); Interpersonal Sensitivity Measure (Razvaliaeva, Polskaya, 2021). The frequency of self-injuries decreases with age. Recent self-injuries are more strongly associated with dissociative symptomatology. Interpersonal functions of self-injurious behavior are typical for 18-19-year-olds, and intrapersonal functions – for 20-21-year-olds. Somatoform (b=0.50, p<0.001, R2=0.25) and peritraumatic dissociation (b=0.41, p<0.001, R2=0.17) significantly predict self-injurious behavior. Fear of Rejection, one of the scales of Interpersonal Sensitivity Measure, mediates the relationship between somatoform (indirect effect — 0.06 [0.03; 0.10], p<0.05) and peritraumatic dissociation (indirect effect — 0.07 [0.04; 0.11], p<0.05) and self-injurious behavior.
General Information
Keywords: self-injurious behavior, dissociation, interpersonal sensitivity, fear of rejection, young women, mental health disturbances
Journal rubric: Empirical Research
Article type: scientific article
DOI: https://doi.org/10.17759/cpse.2023120107
Received: 30.09.2022
Accepted:
For citation: Polskaya N.A., Melnikova M.A. The Contribution of Dissociation and Interpersonal Sensitivity to Self-Injurious Behavior in Young Women [Elektronnyi resurs]. Klinicheskaia i spetsial'naia psikhologiia = Clinical Psychology and Special Education, 2023. Vol. 12, no. 1, pp. 150–179. DOI: 10.17759/cpse.2023120107. (In Russ., аbstr. in Engl.)
References
- Abramova A., Enikolopov S.N., Efremov A.G. et al. Autoagressivnoe nesuitsidal'noe povedenie kak sposob sovladaniya s negativnymi emotsiyami [Autoaggressive Non-suicidal behavior as the way of coping with negative emotions]. Klinicheskaia i spetsial'naia psikhologiia = Clinical Psychology and Special Education, 2018, vol. 7, no. 2, pp. 21–40. DOI: 10.17759/cpse.2018070202. (In Russ., abstr. in Engl.).
- Agarkov V.A. Dissotsiatsiya kak mekhanizm psikhologicheskoi zashchity v kontekste posledstvii psikhicheskoi travmy: diss. kand. psikhol. nauk. [Dissociation as defense mechanism in context of consequences of psychological trauma. PhD. (Psychology) diss.]. Moscow, 2002. 187 p. (In Russ.).
- Agarkov V.A., Tarabrina N.V. Oprosnik peritravmaticheskoi dissotsiatsii. Materialy III nauchno-prakticheskoi konferentsii “Posttravmaticheskii i postvoennyi stress. Problemy reabilitatsii i sotsial'noi adaptatsii uchastnikov chrezvychainykh situatsii: mezhdistsiplinarnyi podkhod” [Proceedings of the Third Scientific and Practical Conference “Posttraumatic and postwar stress. The concerns of rehabilitation and solder adaptation by participants of emergency situations”]. Perm', 1998. P. 17–19 (In Russ.).
- Antropov Yu.F., Shevchenko Yu.S. Psikhosomaticheskie rasstroistva i patologicheskie privychnye deistviya u detei i podrostkov [Psychosomatic disorders and pathological habits in children and adolescents]. Moscow: Inst. Psikhoterapii Publ., NGMA Publ., 2000. 320 p. (In Russ.).
- Van der Hart O., Nijenhuis E.R.S., Steele K. Prizraki proshlogo. Strukturnaya teoriya dissotsiatsii i terapiya posledstvii khronicheskoi psikhicheskoi travmy [The haunted self. Structural dissociation and the treatment of chronic traumatization]. Moscow: Kogito-Tsentr, 2013. 496 p. (In Russ.).
- Zinchuk M.S., Avedisova A.S., Guekht A.B. Nesuitsidal'noe samopovrezhdayushchee povedenie pri psikhicheskikh rasstroistvakh nepsikhoticheskogo urovnya: epidemiologiya, sotsial'nye i klinicheskie faktory riska [Nonsuicidal self-injury behavior in non-psychotic disorders: epidemiology, social and clinical risk factors]. Zhurnal Nevrologii i Psikhiatrii imeni S.S. Korsakova = Korsakov’s Journal of Neurology and Psychiatry, 2019, vol. 119, no. 3, pp. 108–119. DOI: 10.17116/jnevro2019119031108 (In Russ., abstr. in Engl.).
- Medvedeva T., Enikolopov S., Vorontsova O. et al. Psikhologicheskie osobennosti zhenshchin s depressiei i samopovrezhdayushchim povedeniem [Psychological characteristics of women with depression and self-harming behavior]. Psikhologicheskie issledovaniya = Psychological Studies, 2020, vol. 13, no. 69. DOI: 10.54359/ps.v13i69.206 (In Russ., abstr. in Engl.).
- Mezhdunarodnaya klassifikatsiya boleznei (10-i peresmotr). Klassifikatsiya psikhicheskikh i povedencheskikh rasstroistv. Klinicheskie opisaniya i ukazaniya po diagnostike. Vsemirnaya organizatsiya zdravookhraneniya. Rossiya [International Classification of Diseases 10th Revision. The ICD-10 Classification of Mental and Behavioural Disorders. Diagnostic criteria for research. World Health Organization. Russia]. Saint Petersburg: Adis, 1994. 304 p. (In Russ.).
- Padun M.A. Narusheniya regulyatsii emotsii posle psikhicheskoi travmy [Disturbances of emotion regulation after psychological trauma]. Psikhologicheskii zhurnal = Psychological Journal, 2016, vol. 37, no. 4, pp. 74–84. (In Russ., abstr. in Engl.).
- Petrikov S.S., Kholmogorova A.B., Suroegina A.Yu. et al. Professional'noe vygoranie, simptomy emotsional'nogo neblagopoluchiya i distressa u meditsinskikh rabotnikov vo vremya epidemii COVID-19 [Professional burnout, symptoms of emotional disorders and distress among healthcare professionals during the COVID-19 epidemic]. Konsul'tativnaya psikhologiya i psikhoterapiya = Counseling Psychology and Psychotherapy, 2020, vol. 28, no. 2, pp. 8–45. DOI: 10.17759/cpp.2020280202. (In Russ., аbstr. in Engl.)
- Polskaya N.A. Fenomenologiya i funktsii samopovrezhdayushchego povedeniya pri normativnom i narushennom psikhicheskom razvitii: diss… dokt. psikhol. nauk. [Phenomenology and functions of self-injurious behavior in normative and impaired psychological development. Dr. Sc. (Psychology) diss.]. Moscow, 2017. 423 p. (In Russ.).
- Polskaya N.A., Melnikova M.A. Dissotsiatsiya, travma i samopovrezhdayushchee povedenie [Dissociation, trauma and self-harm]. Konsul'tativnaya psikhologiya i psikhoterapiya = Counseling Psychology and Psychotherapy, 2020, vol. 28, no. 1, pp. 25–48. DOI: 10.17759/cpp.2020280103 (In Russ., abstr. in Engl.).
- Polskaya N.A., Razvalyaeva A.Yu. Mezhlichnostnaya chuvstvitel'nost' v period samoizolyatsii: rol' v vybore mer sotsial'nogo distantsirovaniya [Interpersonal sensitivity in the period of self-isolation and its role in the choice of social distancing measures]. Psikhologicheskaya nauka i obrazovanie = Psychological Science and Education, 2020, vol. 25, no. 6, pp. 63–76. DOI: 10.17759/pse.2020250606 (In Russ., аbstr. in Engl.).
- Polskaya N.A., Razvaliaeva A.Yu. Osnovy diagnostiki i profilaktiki samopovrezhdayushchego povedeniya [Foundations of diagnostics and prevention of self-injurious behavior]. Moscow: publ. of MSUPE, 2022. 220 p. (In Russ.).
- Razvalyaeva A.Yu., Pol'skaya N.A. Psikhometricheskie svoistva russkoyazychnoi trekhfaktornoi versii oprosnika mezhlichnostnoi chuvstvitel'nosti [Psychometric properties of the Russian three-factor Interpersonal Sensitivity Measure]. Konsul'tativnaya psikhologiya i psikhoterapiya = Counseling Psychology and Psychotherapy, 2021, vol. 29, no. 4, pp. 73–94. DOI: 10.17759/cpp.2021290405 (In Russ., abstr. in Engl.).
- Tkhostov A.Sh., Rasskazova E.I. Psikhologicheskoe soderzhanie trevogi i profilaktiki v situatsii infodemii: zashchita ot koronavirusa ili “porochnyi krug” trevogi? [Psychological Contents of Anxiety and the Prevention in an Infodemic Situation: Protection against Coronavirus or the “Vicious Circle” of Anxiety?]. Konsul'tativnaya psikhologiya i psikhoterapiya = Counseling Psychology and Psychotherapy, 2020, vol. 28, no. 2, pp. 70–89. DOI: 10.17759/cpp.2020280204 (In Russ., аbstr. in Engl.).
- Kharlamenkova N.E., Bykhovets Yu.V., Dan M.V., et al. Perezhivanie neopredelennosti, trevogi, bespokoistva v usloviyakh COVID-19 [Experiencing uncertainty, anxiety, and worry during COVID-19]. Moscow: IP of RAS, 2020. URL: https://www.ipras.ru/cntnt/rus/institut_p/covid-19/kommentariieksp/har-1.html (Accessed: 15.03.2020). (In Russ.).
- American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA: American Psychiatric Association. 2013. P. 291.
- Anupansupsai R. A cross-cultural study of self-harm comparing the UK and Thailand: Doctoral dissertation. University of Nottingham, 2019.
- Bentley K.H., Nock M.K., Barlow D.H. The four-function model of nonsuicidal self-injury: Key directions for future research. Clinical Psychological Science, 2014, vol. 2 (5), pp. 638–656. DOI: 10.1177/2167702613514563
- Boyce P., Parker G. Development of a scale to measure interpersonal sensitivity. Australian and New Zealand Journal of Psychiatry, 1989, vol. 23 (3), pp. 341–351. DOI: 10.1177/000486748902300320
- Brown S.A., Williams K., Collins A. Past and recent deliberate self‐harm: Emotion and coping strategy differences. Journal of Clinical Psychology, 2007, Vol. 63 (9), pp. 791–803. DOI: 10.1002/jclp.20380
- Brunner R., Kaess M., Parzer P. et al. Life-time prevalence and psychosocial correlates of adolescent direct self-injurious behavior: a comparative study of findings in 11 European countries. Journal of Child Psychology and Psychiatry, 2014, vol. 55 (4), pp. 337–348. DOI: 10.1111/jcpp.12166
- Buser T.J., Buser J.K. Conceptualizing nonsuicidal self-injury as a process addiction: Review of research and implications for counselor training and practice. Journal of Addictions & Offender Counseling, 2013, vol. 34 (1), pp. 16–29. DOI: 10.1002/j.2161-1874.2013.00011.x
- Calati R., Bensassi I., Courtet P. The link between dissociation and both suicide attempts and non-suicidal self-injury: Meta-analyses. Psychiatry Research, 2017, vol. 251, pp. 103–114. DOI: 10.1016/j.psychres.2017.01.035
- Černis E., Chan C., Cooper M. What is the relationship between dissociation and self‐harming behaviour in adolescents? Clinical Psychology & Psychotherapy, 2019, vol. 26 (3), pp. 328–338. DOI: 10.1002/cpp.2354
- Chaplo S.D., Kerig P.K., Bennett D.C. et al. The roles of emotion dysregulation and dissociation in the association between sexual abuse and self-injury among juvenile justice–involved youth. Journal of Trauma & Dissociation, 2015, vol. 16 (3), pp. 272–285. DOI: 10.1080/15299732.2015.989647
- Chapman A.L., Gratz K.L., Brown M.Z. Solving the puzzle of deliberate self-harm: The experiential avoidance model. Behaviour Research and Therapy, 2006, vol. 44 (3), pp. 371–394. DOI: 10.1016/j.brat.2005.03.005
- Chiu C.D., Ho H.L., Tollenaar M.S. Relational self-evaluations in dissociation: Implicit self-rejection? Psychological Trauma: Theory, Research, Practice, and Policy, 2021, vol. 14 (1), pp. 99–106. DOI: 10.1037/tra0001017
- Cipriano A., Cella S., Cotrufo P. Nonsuicidal self-injury: A systematic review. Frontiers in Psychology, 2017, vol. 8, article 1946. DOI: 10.3389/fpsyg.2017.01946
- Daukantaitė D., Lundh L.G., Wångby-Lundh M. et al. What happens to young adults who have engaged in self-injurious behavior as adolescents? A 10-year follow-up. European Child & Adolescent Psychiatry, 2021, vol. 30 (3), pp. 475–492. DOI: 10.1007/s00787-020-01533-4
- Dorahy M.J., Carrell J.M., Thompson N. Assessing the validity of the quartile risk model of dissociation for predicting deliberate self-harm. Journal of Trauma & Dissociation, 2019, vol. 20 (5), pp. 548–563. DOI: 10.1080/ 15299732.2019.1597812
- Ford J.D., Gómez J.M. The relationship of psychological trauma and dissociative and posttraumatic stress disorders to nonsuicidal self-injury and suicidality: A review. Journal of Trauma & Dissociation, 2015, vol. 16 (3), pp. 232–271. DOI: 10.1080/15299732.2015.989563
- Franzke I., Wabnitz P., Catani C. Dissociation as a mediator of the relationship between childhood trauma and nonsuicidal self-injury in females: A path analytic approach. Journal of Trauma & Dissociation, 2015, vol. 16 (3), pp. 286–302. DOI: 10.1080/15299732.2015.989646
- Gardner K.J., Paul E., Selby E.A. et al. Intrapersonal and interpersonal functions as pathways to future self-harm repetition and suicide attempts. Frontiers in Psychology, 2021, vol. 12, article 688472. DOI: 10.3389/fpsyg.2021.688472
- Gratz K.L., Roemer L. The relationship between emotion dysregulation and deliberate self‐harm among female undergraduate students at an urban commuter university. Cognitive Behaviour Therapy, 2008, vol. 37 (1), pp. 14–25. DOI: 10.1080/16506070701819524
- Hielscher E., Whitford T.J., Scott J.G. et al. When the body is the target –Representations of one’s own body and bodily sensations in self-harm: A systematic review. Neuroscience & Biobehavioral Reviews, 2019, vol. 101, pp. 85–112. DOI: 10.1016/j.neubiorev.2019.03.007
- Holmes E.A., Brown R.J., Mansell W. et al. Are there two qualitatively distinct forms of dissociation? A review and some clinical implications. Clinical Psychology Review, 2005, vol. 25 (1), pp. 1–23. DOI: 10.1016/j.cpr.2004.08.006
- Horowitz S., Stermac L. The relationship between interpersonal trauma history and the functions of non-suicidal self injury in young adults: An experience sampling study. Journal of Trauma & Dissociation, 2018, vol. 19 (2), pp. 232–246. DOI: 10.1080/15299732.2017.1330228
- Hoyos C., Mancini V., Furlong Y. et al. The role of dissociation and abuse among adolescents who self-harm. Australian & New Zealand Journal of Psychiatry, 2019, vol. 53 (10), pp. 989–999. DOI: 10.1177/0004867419851869
- Klonsky E.D. The functions of self-injury in young adults who cut themselves: Clarifying the evidence for affect-regulation. Psychiatry Research, 2009, vol. 166 (2), pp. 260–268. DOI: 10.1016/j.psychres.2008.02.008
- Leary M.R., Twenge J.M., Quinlivan E. Interpersonal rejection as a determinant of anger and aggression. Personality and Social Psychology Review, 2006, vol. 10 (2), pp. 111–132. DOI: 10.1207/s15327957pspr1002_2
- Lyssenko L., Schmahl C., Bockhacker L. et al. Dissociation in psychiatric disorders: A meta-analysis of studies using the dissociative experiences scale. American Journal of Psychiatry, 2018, vol. 175 (1), pp. 37–46. DOI: 10.1176/appi.ajp.2017.17010025
- McManus S., Gunnell D., Cooper C. et al. Prevalence of non-suicidal self-harm and service contact in England, 2000–14: Repeated cross-sectional surveys of the general population. The Lancet Psychiatry, 2019, vol. 6 (7), pp. 573–581. DOI: 10.1016/S2215-0366(19)30188-9
- Menninger K. A psychoanalytic study of the significance of self-mutilations. The Psychoanalytic Quarterly, 1935, vol. 4, pp. 408–466. DOI: 10.1080/21674086.1935.11925248
- Morey C., Corcoran P., Arensman E. et al. The prevalence of self-reported deliberate self harm in Irish adolescents. BMC Public Health, 2008, vol. 8 (1), p. 79. DOI: 10.1186/1471-2458-8-79
- Nijenhuis E.R.S., Spinhoven P., Van Dyck R. et al. The development and psychometric characteristics of the Somatoform Dissociation Questionnaire (SDQ-20). Journal of Nervous and Mental Disease, 1996, vol. 184 (11), pp. 688–694. DOI: 10.1097/00005053-199611000-00006
- Nock M.K., Prinstein M.J., Sterba S.K. Revealing the form and function of self-injurious thoughts and behaviors: A real-time ecological assessment study among adolescents and young adults. Journal of Abnormal Psychology, 2009, vol. 118 (4), pp. 816–827. DOI: 10.1037/a0016948
- Putnam F.W. Diagnosis and treatment of Multiple Personality Disorder. New York, London: Guilford Press, 1989. 351 p.
- Quarshie E.N.B., Waterman M.G., House A.O. Self-harm with suicidal and non-suicidal intent in young people in sub-Saharan Africa: a systematic review. BMC Psychiatry, 2020, vol. 20, p. 234. DOI: 10.1186/s12888-020-02587-z
- Rossi R., Longo L., Fiore D. et al. Dissociation in stress-related disorders and self-harm: A review of the literature and a systematic review of mediation models. Journal of Psychopathology, 2019, vol. 25, pp. 162–171.
- Shahbaz G., Bakhtiari M., Davazdahemami M. et al. Explaining the effects of psychological factors: Trauma exposure, dissociation, emotion dysregulation and alexithymia on deliberate self-harm with the mediating roles of dissociation and emotion dysregulation. Prensa Medica Argentina, 2019, vol. 105 (3). DOI: 10.41720032-745X.1000366
- Turner B.J., Layden B.K., Butler S.M. et al. How often, or how many ways: Clarifying the relationship between non-suicidal self-injury and suicidality. Archives of Suicide Research, 2013, vol. 17 (4), pp. 397–415. DOI: 10.1080/13811118.2013.802660
- Turner B.J., Yiu A., Claes L. et al. Occurrence and co-occurrence of nonsuicidal self-injury and disordered eating in a daily diary study: Which behavior, when? Psychiatry Research, 2016, vol. 246, pp. 39–47. DOI: 10.1016/j.psychres.2016.09.012
- Victor S.E., Scott L.N., Stepp S.D. et al. I want you to want me: Interpersonal stress and affective experiences as within‐person predictors of nonsuicidal self‐injury and suicide urges in daily life. Suicide and Life‐Threatening Behavior, 2019, vol. 49 (4), pp. 1157–1177. DOI: 10.1111/sltb.12513
- Whitlock J., Muehlenkamp J., Eckenrode J. Variation in nonsuicidal self-injury: Identification and features of latent classes in a college population of emerging adults. Journal of Clinical Child & Adolescent Psychology, 2008, vol. 37 (4), pp. 725–735. DOI: 10.1080/15374410802359734
- Willoughby T., Heffer T., Hamza C.A. The link between nonsuicidal self-injury and acquired capability for suicide: A longitudinal study. Journal of Abnormal Psychology, 2015, vol. 124 (4), pp. 1110–1115. DOI: 10.1037/abn0000104
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