Do attachment-related differences in reflective functioning explain associations between expressed emotion and youth self-harm

Bibliographic Data

ID21625518
AuthorsJamie Kennedy-Turner (0000-0002-5851-873X, University of Edinburgh, corresponding author), Vilas Sawrikar (0000-0001-8160-0232, University of Edinburgh), Lucy Clark (0000-0001-7162-0512, NHS Education for Scotland), Helen Griffiths (0000-0001-8680-1682, University of Edinburgh)
Year2023
Volume42
Issue29
Pages25520-25534
Publication date2023-10-01
Open AccessYes
TypeARTICLE
VenueCurrent Psychology (JOURNAL)
Journal identifiersISSN: 1046-1310 • E-ISSN: 1936-4733
PublisherSpringer Science and Business Media LLC (PUBLISHER)
DOI10.1007/s12144-022-03614-w
PMID36043216
OpenAlexW4293095998
LanguageEN
References cited79

Youth self-harm is associated with poor health outcomes and attempted and completed suicide. Associations exist between self-harm and expressed emotion (EE), attachment insecurity, and reflective functioning (RF), but these associations are poorly understood. This study evaluates a mediation model in which perceived caregiver EE (pEE) exerts an indirect effect on youth self-harm through attachment insecurity and RF uncertainty. 461 participants aged 16–24 years completed an online survey. Statistical analyses revealed significant direct effects of pEE on attachment insecurity, and of RF uncertainty on self-harm; however, some direct effects were specific to pEE from female caregivers, and attachment insecurity in youth relationships with female caregivers. A significant direct effect of pEE on self-harm was found for pEE from male caregivers only. Significant indirect effects of pEE on self-harm through attachment anxiety and RF uncertainty were found only in relation to female caregivers. The findings encourage family-, attachment-, and mentalization-based approaches to preventing and treating youth self-harm, with a recommendation that caregivers are given adequate support, education, and skills-based training following youth disclosures of self-harm

Anxiety · Developmental psychology · Harm · Mediation · Mental health · Mentalization · Psychiatry · Child and Adolescent Psychosocial and Emotional Development · Clinical Psychology · Personality Disorders and Psychopathology · Psychology · Social Psychology · Suicide and Self-Harm Studies