Page 112 - Personality disorders and insecure attachment among adolescents

adolescence is the period when NSSI, personality disorders (Amoss, Lynch, & Bratley, 2016; Tyrer, Reed, & Crawford, 2015) and several major mental health disorders develop (Kessler, Chiu, Demler, & Walters, 2005). Prevention and treatment interventions can target these coping skills to prevent NSSI behaviour. The findings from this study should be interpreted in relation to limitations. Since the NSSI- BQ is a self-developed, self-report questionnaire for studying adolescents in a clinical psychotherapy facility and not in another target group, the psychometric properties remain unclear. Also, the generalizability of our results is limited due to the use of an inpatient sample of one facility. Another limitation is the amount of dropouts in this study despite attempts to reach and motivate them. Only a part of the adolescents that were included could be followed from the start until the end of treatment. Presumably, there was a lack of motivation to participate in this research project without reward. Furthermore, the small number of the NSSI starters group is a limitation due to which it would be premature to come to conclusions concerning contagiousness of NSSI based on these findings. Finally, not all Axis-II disorders and no Axis-I disorders were examined in this study to avoid overloading patients with assessment instruments. In conclusion, this study provided preliminary support that NSSI behaviour could be contagious among adolescents in clinical practice. Important prevention and treatment targets seem to improve positive copings skills, such as positive refocusing and positive reappraisal, and reduce the negative coping skill self blame. Since this negative coping strategy self blame was related to NSSI, it could be a marker bearing clinical relevance. References Amoss, S., Lynch, M., & Bratley, M. (2016). Bringing forth stories of blame and shame in dialogues with families affected by adolescent self-harm. Journal of Family Therapy(38), 189-205. doi:10.1111/1467-6427.12101 APA. (2013). Diagnostic and statistical manual of mental disorders (5th ed.) (5th ed.). Washington, DC: Author. Arrindell, W. A., & Ettema, J. H. M. (2003). SCL-90: Manual for a Multidimensional Psychopathology Indicator (2nd ed. ed.). Amsterdam, The Netherlands: Pearson. Bateman, A., & Fonagy, P. (2006). Mentalization based treatment for borderline personality disorder: A practical guide. Oxford, UK: Oxford University Press. Brunner, R., Kaess, M., Parzer, P., Fischer, G., Carli, V., Hoven, C. W., . . . Wasserman, D. (2013). 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 & Psychiatry, 54(12). doi:10.1111/jcpp.12166 Cassels, M., van Harmelen, A.-L., Neufeld, S., Goodyer, I., Jones, P. B., & Wilkinson, P. (2018). Poor family functioning mediates the link between childhood adversity and adolescent nonsuicidal self-injury. Journal of Child Psychology and Psychiatry, 59(8), 881-887. doi:10.1111/jcpp.12866 Cawood, C. D., & Huprich, S. K. (2011). Late adolescent nonsuicidal self-injury: the roles of coping style, self-esteem, and personality pathology. Journal of Personality Disorders, 25(6), 765- 781. doi:10.1521/pedi.2011.25.6.765 Chiesa, M., Cirasola, A., Williams, R., Nassisi, V., & Fonagy, P. (2017). Categorical and dimensional approaches in the evaluation of the relationship between attachment and personality disorders: 108