Page 112 - Personality disorders and insecure attachment among adolescents
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Nemar: p < .001). No significant difference was found comparing the frequency of self-reported NSSI on NSSI-BQ between patients with BPD, patients with other personality disorders, and patients with no personality disorder according to the SCID-II.
Method of NSSI in the NSSI group and NSSI starters group
In the NSSI group, scratching and cutting were the methods used most frequently for self-
harm at pre-treatment (cutting 69.8%, scratching 66.0%, other method 34.0%, pills 32.1%, drinking 29.2%, head banging 29.2%, burning 16%). For all the patients who admitted to another method of NSSI than those listed, self-punching was the most frequent (see appendix 3 for a list of categories of potential NSSI behaviours). The NSSI starters group used methods of NSSI that were not listed more often (e.g. self-punching, hair pulling, bumping, substance misuse, physical neglect, eating problems, and sexual activities). Furthermore, patients with BPD used the methods of scratching (Pearson Chi2: 5.515, df 1, p = .019), drinking (Pearson Chi2: 4.824, df 1, p = .028), and pills (Pearson Chi2: 8.564, df 1, p = .003) significantly more often than patients with other personality disorders. Function of NSSI in the NSSI group
At pre-treatment 80.7% (N = 106) of the NSSI group understood (see appendix 1, question 4) why they performed NSSI behaviour. These participants designated their NSSI behaviour as follows: 64.0% designated it to affect regulation, 22.7% to self-punishment, 0.0% to influencing other people, 18.7% to anti-dissociation, 0.0% to anti-suicide, and 0.0% to thrill seeking. At post-treatment, 88.8% (N = 71) of the participants understood why they performed NSSI behaviour. They labelled their NSSI behaviour at t-2 as follows: 71.8% attributed it to affect regulation, 29.6% to self-punishment, 1.4% to influencing other people, 12.7% to anti-dissociation, 1.4% to anti-suicide, and 0.0% to thrill seeking.
Discussion
The aim of this study was to examine the occurrence, frequency, contagiousness, method, and function of NSSI in a high-risk adolescent sample in clinical practice in association with personality disorders, symptoms of distress, and coping skills. At the start of treatment, in light with our first hypothesis, 12-month NSSI was common (66.4%) among inpatient adolescents as was lifetime NSSI (79.1%). In addition, in line with our second hypothesis, NSSI was related to the number of personality disorders and not to a specific personality disorder. Moreover, the frequency of NSSI was found not to significantly differ between patients with BPD, patients with other personality disorders, and patients with no personify disorder. Patients with NSSI (n = 93) disclosed significantly more psychological symptoms of distress at the start of treatment. They also reported using more the negative coping skill self-blame, and less positive refocusing and positive reappraisal as coping skills than the no NSSI group and NSSI starters group. Girls were more than five times more likely to perform NSSI behaviour than boys. Self blame increased the change of NSSI with a third, while positive reappraisal reduced the probability by a fifth. Then, concerning the third hypothesis, with
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