The Contribution of Dissociation and Interpersonal Sensitivity to Self-Injurious Behavior in Young Women

245

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

  1. 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.).
  2. 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.).
  3. 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.).
  4. 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.).
  5. 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.).
  6. 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.).
  7. 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.).
  8. 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.).
  9. 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.).
  10. 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.)
  11. 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.).
  12. 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.).
  13. 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.).
  14. 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.).
  15. 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.).
  16. 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.).
  17. 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.).
  18. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA: American Psychiatric Association. 2013. P. 291.
  19. Anupansupsai R. A cross-cultural study of self-harm comparing the UK and Thailand: Doctoral dissertation. University of Nottingham, 2019.
  20. 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
  21. 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
  22. 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
  23. 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
  24. 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
  25. 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
  26. 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
  27. 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
  28. 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
  29. 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
  30. 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
  31. 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
  32. 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
  33. 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
  34. 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
  35. 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
  36. 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
  37. 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
  38. 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
  39. 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
  40. 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
  41. 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
  42. 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
  43. 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
  44. 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
  45. 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
  46. 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
  47. 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
  48. 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
  49. Putnam F.W. Diagnosis and treatment of Multiple Personality Disorder. New York, London: Guilford Press, 1989. 351 p.
  50. 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
  51. 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.
  52. 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
  53. 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
  54. 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
  55. 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
  56. 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
  57. 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

Information About the Authors

Natalia A. Polskaya, Doctor of Psychology, Associate Professor, Professor of the Clinical Psychology and Psychotherapy Department, Faculty of Counseling and Clinical Psychology, Moscow State University of Psychology & Education, Leading Researcher, Scientific and Practical Center for Mental Health of Children and Adolescents named after G.E. Sukhareva of the Moscow Department of Public Health, Moscow, Russia, ORCID: https://orcid.org/0000-0002-7305-5577, e-mail: polskayana@yandex.ru

Mariya A. Melnikova, post-graduate student of the Councelling and Clinical Psychology Department, Moscow State University of Psychology & Education, Moscow, Russia, ORCID: https://orcid.org/0000-0003-2729-9877, e-mail: melnikova-ma@mail.ru

Metrics

Views

Total: 646
Previous month: 59
Current month: 31

Downloads

Total: 245
Previous month: 11
Current month: 7