Attachment quality in adolescents with non-suicidal self-injury



Foreign studies reveal a connection between attachment disorders and the occurrence of non-suicidal self-injury (NSSI) in adolescents. Domestic studies, for all the relevance and importance of this topic, are few. It remains unclear which attachment disorders have the greatest impact on the emergence of non-suicidal self-injurious behavior: there are studies that have shown that the occurrence of NSSI is influenced by an attachment disorder to both parents, but there are studies that have revealed that attachment disorders to the father play a more significant role. It also discusses whether attachment to parents or peers has the greatest impact on the occurrence of NSSI and mental well-being in adolescence. The degree of influence of attachment to parents and peers is debated. Described are the targets and methods of psychological treatmentof adolescents with NSSI and their families.

General Information

Keywords: non-suicidal self-injury, adolescents, family, attachment

Journal rubric: Medical Psychology

Article type: review article


For citation: Snegireva T.V., Volikova S.V. Attachment quality in adolescents with non-suicidal self-injury [Elektronnyi resurs]. Sovremennaia zarubezhnaia psikhologiia = Journal of Modern Foreign Psychology, 2020. Vol. 9, no. 4, pp. 66–76. DOI: 10.17759/jmfp.2020090406. (In Russ., аbstr. in Engl.)


  1. Boulbi D. Privyazannost' [Affection]. Moscow: Gardariki, 2003. 477 p. (In Russ.).
  2. Pol'skaya N.A. Psikhologiya samopovrezhdayushchego povedeniya [The psychology of self-harming behavior]. Moscow: Lenand, 2017. 320 p. (In Russ.).
  3. Diamond G.S. et al. A Randomized Controlled Trial: Attachment-Based Family and Nondirective Supportive Treatments for Youth Who Are Suicidal. Journal of the American Academy of Child and Adolescent Psychiatry, 2019. Vol. 58, no. 7, pp. 721–731. DOI:10.1016/j.jaac.2018.10.006
  4. Kaess M. et al. Adverse childhood experiences and their impact on frequency, severity, and the individual function of nonsuicidal self-injury in youth. Psychiatry research, 2013. Vol. 206, no. 2–3, pp. 265–272. DOI:10.1016/j.psychres.2012.10.012
  5. Muris P. et al. Anger and hostility in adolescents: Relationships with self-reported attachment style and perceived parental rearing styles. Journal of Psychosomatic Research, 2004. Vol. 57, no. 3, pp. 257–264. DOI:10.1016/S0022-3999(03)00616-0
  6. Kobak R.R. et al. Attachment and Emotion Regulation during Mother‐Teen Problem Solving: A Control Theory Analysis. Child Development, 1993. Vol. 64, no. 1, pp. 231–245. DOI:10.1111/j.1467-8624.1993.tb02906.x
  7. Kim K.L. et al. Behavioral and emotional responses to interpersonal stress: A comparison of adolescents engaged in non-suicidal self-injury to adolescent suicide attempters. Psychiatry Research, 2015. Vol. 228, no. 3, pp. 899–906. DOI:10.1016/j.psychres.2015.05.001
  8. Bowlby J. A secure base: Clinical applications of attachment theory. London: Routledge, 2005. 204 p.
  9. Brown A.M., Whiteside S.P. Relations among perceived parental rearing behaviors, attachment style, and worry in anxious children. Journal of Anxiety Disorders, 2008. Vol. 22, no. 2, pp. 263–272. DOI:10.1016/j.janxdis.2007.02.002
  10. Cassidy J., Berlin L.J. The Insecure/Ambivalent Pattern of Attachment: Theory and4 Research. Child development, 1994. Vol. 65, no. 4, pp. 971–991. DOI:10.1111/j.1467-8624.1994.tb00796.x
  11. Martin J. et al. Childhood abuse and neglect, attachment states of mind, and non-suicidal self-injury. Attachment and Human Development, 2017. Vol. 19, no. 5, pp. 425–446. DOI:10.1080/14616734.2017.1330832
  12. Deliberto T.L., Nock M.K. An exploratory study of correlates, onset, and offset of non-suicidal self-injury. Archives of Suicide Research, 2008. Vol. 12, no. 3, pp. 219–231. DOI:10.1080/13811110802101096
  13. Diamond G.M. Attachment-based family therapy interventions. Psychotherapy, 2014. Vol. 51, no. 1, pp. 15–19. DOI:10.1037/a0032689
  14. Adrian M. et al. Emotional dysregulation and interpersonal difficulties as risk factors for nonsuicidal self-injury in adolescent girls. Journal of Abnormal Child Psychology, 2011. Vol. 39, no. 3, pp. 389–400. DOI:10.1007/s10802-010-9465-3
  15. You J. et al. Emotional Dysregulation and Nonsuicidal Self-Injury: A Meta-Analytic Review [Elektronnyi resurs]. Neuropsychiatry, 2018. Vol. 8, no. 2, pp. 733–748. (Accessed 09.12.2020).
  16. Glazebrook K., Townsend E., Sayal K. The Role of Attachment Style in Predicting Repetition of Adolescent Self-Harm: A Longitudinal Study. Suicide and Life-Threatening Behavior, 2015. Vol. 45, no. 6, pp. 664–678. DOI:10.1111/sltb.12159
  17. Gorrese A. Peer Attachment and Youth Internalizing Problems: A Meta-Analysis. Child and Youth Care Forum, 2016. Vol. 45, no. 2, pp. 177–204. DOI:10.1007/s10566-015-9333-y
  18. Gratz K.L., Conrad S.D., Roemer L. Risk factors for deliberate self-harm among college students. American Journal of Orthopsychiatry, 2002. Vol. 72, no. 1, pp. 128–140. DOI:10.1037//0002-9432.72.1.128
  19. Hallab L., Covic T. Deliberate self-harm: The interplay between attachment and stress. Behaviour Change, 2010. Vol. 27, no. 2, pp. 93–103. DOI:10.1375/bech.27.2.93
  20. Hankin B.L., Abela J.R.Z. Nonsuicidal self-injury in adolescence: Prospective rates and risk factors in a 2 1/2 year longitudinal study. Psychiatry Research, 2011. Vol. 186, no. 1, pp. 65–70. DOI:10.1016/j.psychres.2010.07.056
  21. Martin J. et al. Heterogeneity of Relational Backgrounds is Associated With Variation in Non-Suicidal Self-Injurious Behavior. Journal of Abnormal Child Psychology, 2016. Vol. 44, no. 3, pp. 511–522. DOI:10.1007/s10802-015-0048-1
  22. Corcoran P. et al. Hospital-treated deliberate self-harm in the Western Area of Northern Ireland. Crisis: The Journal of Crisis Intervention and Suicide Prevention, 2015. Vol. 36, no. 2, pp. 83–90. DOI:10.1027/0227-5910/a000301
  23. Kelada L., Hasking P., Melvin G. Adolescent NSSI and Recovery: The Role of Family Functioning and Emotion Regulation. Youth and Society, 2018. Vol. 50, no. 8, pp. 1056–1077. DOI:10.1177/0044118X16653153
  24. Kobak R., Duemmler S. Attachment and conversation: Toward a discourse analysis of adolescent and adult security. In Bartholomew K., Perlman D. (eds.), Attachment processes in adulthood. Advances in personal relationships, vol. 5. Jessica Kingsley Publishers, 1994, pp. 121–149.
  25. Kullik A., Petermann F. Attachment to parents and peers as a risk factor for adolescent depressive disorders: The mediating role of emotion regulation. Child Psychiatry and Human Development, 2013. Vol. 44, no. 4, pp. 537–548. DOI:10.1007/s10578-012-0347-5
  26. Tatnell R. et al. Longitudinal analysis of adolescent NSSI: The role of intrapersonal and interpersonal factors. Journal of Abnormal Child Psychology, 2014. Vol. 42, pp. 885–896. DOI:10.1007/s10802-013-9837-6
  27. Kobak R. et al. Maternal Attachment Strategies and Emotion Regulation With Adolescent Offspring. Journal of Research on Adolescence, 1994. Vol. 4, no. 4, pp. 553–566. DOI:10.1207/s15327795jra0404_7
  28. Jones J.D. et al. Maternal Attachment Style and Responses to Adolescents’ Negative Emotions: The Mediating Role of Maternal Emotion Regulation. Parenting, 2014. Vol. 14, no. 3–4, pp. 235–257. DOI:10.1080/15295192.2014.972760
  29. Wolff J.C. et al. Negative cognitive style and perceived social support mediate the relationship between aggression and NSSI in hospitalized adolescents. Journal of Adolescence, 2014. Vol. 37, no. 4, pp. 483–491. DOI:10.1016/j.adolescence.2014.03.016
  30. Nock M.K. Actions speak louder than words: An elaborated theoretical model of the social functions of self-injury and other harmful behaviors. Applied and Preventive Psychology, 2008. Vol. 12, no. 4, pp. 159–168. DOI:10.1016/j.appsy.2008.05.002
  31. Allroggen M. et al. Nonsuicidal self-injury and its relation to personality traits in medical students. Journal of Nervous and Mental Disease, 2014. Vol. 202, no. 4, pp. 300–304. DOI:10.1097/NMD.0000000000000122
  32. Chesin M.S. et al. Nonsuicidal Self-Injury Is Predictive of Suicide Attempts Among Individuals with Mood Disorders. Suicide and Life-Threatening Behavior, 2017. Vol. 47, no. 5, pp. 567–579. DOI:10.1111/sltb.12331
  33. Victor S.E. et al. Parent and peer relationships as longitudinal predictors of adolescent non-suicidal self-injury onset. Child and Adolescent Psychiatry and Mental Health, 2019. Vol. 13, no. 1. 13 p. DOI:10.1186/s13034-018-0261-0
  34. Pollock L.R., Williams J.M.G. Problem-solving in suicide attempters. Psychological Medicine, 2004. Vol. 34, no. 1, pp. 163–167. DOI:10.1017/S0033291703008092
  35. Martin J. et al. Preoccupied but not dismissing attachment states of mind are associated with nonsuicidal self-injury. Development and Psychopathology, 2017. Vol. 29, no. 2, pp. 379–388. DOI:10.1017/S0954579417000050
  36. Swannell S.V. et al. Prevalence of nonsuicidal self-injury in nonclinical samples: Systematic review, meta-analysis and meta-regression. Suicide and Life-Threatening Behavior, 2014. Vol. 44, no. 3, pp. 273–303. DOI:10.1111/sltb.12070
  37. Franklin J.C. et al. Risk factors for suicidal thoughts and behaviors: A meta-analysis of 50 years of research. Psychological Bulletin, 2017. Vol. 143, no. 2, pp. 187–232. DOI:10.1037/bul0000084
  38. Rosenstein D.S., Horowitz H.A. Adolescent attachment and psychopathology. Journal of Consulting and Clinical Psychology, 1996. Vol. 64, no. 2, pp. 244–253. DOI:10.1037/0022-006X.64.2.244
  39. Ryan R.M., Lynch J.H. Emotional autonomy versus detachment: revisiting the vicissitudes of adolescence and young adulthood. Child development, 1989. Vol. 60, no. 2, pp. 340–356. DOI:10.1111/j.1467-8624.1989.tb02720.x
  40. Schade L.C. Non-suicidal Self-Injury (NSSI): A Case for Using Emotionally Focused Family Therapy. Contemporary Family Therapy, 2013. Vol. 35, no. 3, pp. 568–582. DOI:10.1007/s10591-013-9236-8
  41. Seiffge-Krenke I. Coping with relationship stressors: The impact of different working models of attachment and links to adaptation. Journal of Youth and Adolescence, 2006. Vol. 35, no. 1, pp. 24–38. DOI:10.1007/s10964-005-9015-4
  42. Shaver P.R., Mikulincer M. Adult attachment strategies and the regulation of emotion. In Gross J. (ed.), Handbook of Emotion Regulation. New York: The Guilford Press, 2007, pp. 446–465.
  43. Tatnell R., Hasking P., Newman L. Multiple mediation modelling exploring relationships between specific aspects of attachment, emotion regulation, and non-suicidal self-injury. Australian Journal of Psychology, 2018. Vol. 70, no. 1, pp. 48–56. DOI:10.1111/ajpy.12166
  44. Baetens I. et al. The association between family functioning and NSSI in adolescence: The mediating role of depressive symptoms. Family Science, 2015. Vol. 6, no. 1, pp. 330–337. DOI:10.1080/19424620.2015.1056917
  45. Plener P.L. et al. The longitudinal course of non-suicidal self-injury and deliberate self-harm: A systematic review of the literature. Borderline Personality Disorder and Emotion Dysregulation, 2015. Vol. 2, no. 1. 11 p. DOI:10.1186/s40479-014-0024-3
  46. Baetens I. et al. The relationship between non-suicidal self-injury and temperament in male and female adolescents based on child- and parent-report. Personality and Individual Differences, 2011. Vol. 50, no. 4, pp. 527–530. DOI:10.1016/j.paid.2010.11.015
  47. Turner B.J. et al. The role of interpersonal conflict and perceived social support in nonsuicidal self-injury in daily life. Journal of Abnormal Psychology, 2016. Vol. 125, no. 4, pp. 588–598. DOI:10.1037/abn0000141
  48. Groh A.M. et al. The significance of attachment security for children’s social competence with peers: A meta-analytic study. Attachment and Human Development, 2014. Vol. 16, no. 2, pp. 103–136. DOI:10.1080/14616734.2014.883636
  49. Tschan T., Schmid M., In-Albon T. Parenting behavior in families of female adolescents with nonsuicidal self-injury in comparison to a clinical and a nonclinical control group. Child and Adolescent Psychiatry and Mental Health, 2015. Vol. 9, no. 1, pp. 17. DOI:10.1186/s13034-015-0051-x
  50. Wedig M.M., Nock M.K. Parental Expressed Emotion and Adolescent Self-Injury. Journal of the American Academy of Child & Adolescent Psychiatry, 2007. Vol. 46, no. 9, pp. 1171–1178. DOI:10.1097/chi.0b013e3180ca9aaf

Information About the Authors

Tatiana V. Snegireva, Junior Research Associate, Moscow Research Institute of Psychiatry – Branch of The Serbsky Federal Medical Research Center of Psychiatry and Narcology, Moscow, Moscow, Russia, ORCID:, e-mail:

Svetlana V. Volikova, PhD in Psychology, psychologist, Russian University of Transport (MIIT), Assistant Professor at the Clinical Psychology and Psychotherapy Chair, Moscow State University of Psychology and Education, Moscow, Russia, ORCID:, e-mail:



Total: 858
Previous month: 27
Current month: 11


Total: 909
Previous month: 12
Current month: 4