Child Psychiatry & Human Development

, Volume 51, Issue 1, pp 39–47 | Cite as

Invalidating Caregiving Environments, Specific Emotion Regulation Deficits, and Non-suicidal Self-injury

  • Camille Guérin-MarionEmail author
  • Jodi Martin
  • Marie-France Lafontaine
  • Jean-François Bureau
Original Article


This study examined the indirect effects of distinct aspects of invalidating caregiving environments (i.e., paternal maltreatment, maternal maltreatment, and perceived alienation) on non-suicidal self-injury (NSSI) via six specific emotion regulation difficulties. We hypothesized that specific emotion regulation deficits would mediate associations between invalidating environments and NSSI. Participants included 114 young adults (57 self-injurers; 57 age- and sex-matched comparison participants) aged 17–25 years. Three parallel mediation models tested hypotheses. Results showed that maternal maltreatment, paternal maltreatment, and perceived alienation indirectly predicted NSSI through poor emotional clarity. Maternal maltreatment uniquely predicted NSSI through limited access to regulation strategies. Lastly, maternal maltreatment and perceived alienation were both linked to greater difficulties engaging in goal-directed behavior during emotional upsets; however, contrary to hypotheses, this particular deficit was associated with decreased odds of engaging in NSSI. Findings illustrate how different aspects of invalidating environments and specific emotion regulation deficits may be implicated in NSSI engagement.


Non-suicidal self-injury Parent–child relationships Maltreatment Alienation Emotion regulation 



This research was supported by Joseph-Armand Bombardier Canadian Graduate Scholarships (Doctoral) from the Social Sciences and Humanities Research Council awarded to C. Guérin-Marion, and by a Louise and Alan Edwards Postdoctoral Fellowship in Pediatric Pain awarded to J. Martin.

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Nock MK, Favazza AR (2009) Nonsuicidal self-injury: definition and classification. In: Nock MK (ed) Understanding non-suicidal self-injury: origins, assessment and treatment. American Psychological Association, Washington, DC, pp 9–18CrossRefGoogle Scholar
  2. 2.
    Swannell S, Martin G, Page A, Hasking P, St John NJ (2014) Prevalence of nonsuicidal self-injury in nonclinical samples: systematic review, meta-analysis and meta-regression. Suicide Life Threat Behav 44:273–303CrossRefGoogle Scholar
  3. 3.
    Klonsky ED, May AM, Glenn CR (2013) The relationship between nonsuicidal self-injury and attempted suicide: converging evidence from four samples. J Abnorm Child Psychol 122:231–237CrossRefGoogle Scholar
  4. 4.
    Olfson M, Gameroff MJ, Marcus SC, Greenberg T, Shaffer D (2005) Emergency treatment of young people following deliberate self-harm. Arch Gen Psychiatry 62:1122–1128CrossRefGoogle Scholar
  5. 5.
    Hamza C, Willoughby T (2015) Nonsuicidal self-injury and affect regulation: recent findings from experimental and ecological momentary assessment studies and future directions. J Clin Psychol 71:561–574CrossRefGoogle Scholar
  6. 6.
    McKenzie KC, Gross JJ (2014) Nonsuicidal self-injury: an emotion regulation perspective. Psychopathology 47:207–219CrossRefGoogle Scholar
  7. 7.
    Sim L, Adrian M, Zeman J, Cassano M, Friedrich WN (2009) Adolescent deliberate self-harm: linkages to emotion regulation and family emotional climate. J Res Adolesc 19:75–91CrossRefGoogle Scholar
  8. 8.
    Swannell S, Martin G, Page A, Hasking P, Hazell P, Taylor A et al (2012) Child maltreatment, subsequent non-suicidal self-injury and the mediating roles of dissociation, alexithymia and self-blame. Child Abuse Negl 36:572–584CrossRefGoogle Scholar
  9. 9.
    Yurkowski K, Martin J, Levesque C, Bureau J-F, Lafontaine M-F, Cloutier P (2015) Emotion dysregulation mediates the influence of relationship difficulties on non-suicidal self-injury behavior in young adults. Psychiatry Res 228:871–878CrossRefGoogle Scholar
  10. 10.
    Liu RT, Scopelliti KM, Pittman SK, Zamora AS (2018) Childhood maltreatment and non-suicidal self-injury: a systematic review and meta-analysis. Lancet Psychiatry 5:51–64CrossRefGoogle Scholar
  11. 11.
    Linehan M (1993) Cognitive-behavioral treatment of borderline personality disorder. Guilford Press, New YorkGoogle Scholar
  12. 12.
    Thompson RA (1994) Emotion regulation: a theme in search of definition. Monogr Soc Res Child Dev 59:25–52CrossRefGoogle Scholar
  13. 13.
    Klonsky ED (2007) The functions of deliberate self-injury: a review of the evidence. Clin Psychol Rev 27:226–239CrossRefGoogle Scholar
  14. 14.
    Nock MK, Prinstein MJ (2004) A functional approach to the assessment of self-mutilative behavior. J Consult Clin Psychol 72:885–890CrossRefGoogle Scholar
  15. 15.
    Paivio SC, McCulloch CR (2004) Alexithymia as a mediator between childhood trauma and self-injurious behaviors. Child Abuse Negl 28:339–354CrossRefGoogle Scholar
  16. 16.
    Thomassin K, Shaffer A, Madden A, Londino DL (2016) Specificity of childhood maltreatment and emotion deficit in nonsuicidal self-injury in an inpatient sample of youth. Psychiatry Res 244:103–108CrossRefGoogle Scholar
  17. 17.
    Gratz KL, Roemer L (2004) Multidimensional assessment of emotion regulation and dysregulation: development, factor structure, and initial validation of the Difficulties in Emotion Regulation Scale. J Psychopathol Behav Assess 26:41–54CrossRefGoogle Scholar
  18. 18.
    Gratz KL, Roemer L (2008) The relationship between emotion dysregulation and deliberate self-harm among female undergraduate students at an urban commuter university. Cogn Behav Ther 37:14–25CrossRefGoogle Scholar
  19. 19.
    Plener PL, Libal G, Keller F, Fegert JM, Muehlenkamp JJ (2009) An international comparison of adolescent non-suicidal self-injury (NSSI) and suicide attempts: Germany and the USA. Psychol Med 39:1549–1558CrossRefGoogle Scholar
  20. 20.
    Muehlenkamp JJ, Kerr PL, Bradley AR, Adams Larsen M (2010) Abuse subtypes and nonsuicidal self-injury: preliminary evidence of complex emotion regulation patterns. J Nerv Ment Dis 198:258–263CrossRefGoogle Scholar
  21. 21.
    Gratz KL, Conrad SD, Roemer L (2002) Risk factors for deliberate self-harm among college students. Am J Orthopsychiatry 72:128–140CrossRefGoogle Scholar
  22. 22.
    Martin J, Bureau J-F, Yurkowski K, Fournier TR, Lafontaine M-F, Cloutier P (2016) Family-based risk factors for non-suicidal self-injury: considering influences of maltreatment, adverse family-life experiences, and parent–child relational risk. J Adolesc 49:170–180CrossRefGoogle Scholar
  23. 23.
    Tatnell R, Hasking P, Newman L (2017) Multiple mediation modelling exploring relationships between specific aspects of attachment, emotion regulation, and non-suicidal self-injury. Aust J Psychol 70:1–9Google Scholar
  24. 24.
    Guérin-Marion C, Martin J, Deneault A-A, Lafontaine M-F, Bureau J-F (2018) The functions and addictive features of non-suicidal self-injury: a confirmatory factor analysis of the Ottawa self-injury inventory in a community sample of young adults. Psychiatry Res 264:316–321CrossRefGoogle Scholar
  25. 25.
    Adrian M, Zeman J, Erdley C, Lisa L, Sim L (2011) Emotional dysregulation and interpersonal difficulties as risk factors for nonsuicidal self-injury in adolescent girls. J Abnorm Child Psychol 39:389–400CrossRefGoogle Scholar
  26. 26.
    Bureau J-F, Martin J, Freynet N, Poirier AA, Lafontaine M-F, Cloutier P (2010) Perceived dimensions of parenting and non-suicidal self-injury in young adults. J Youth Adolesc 39:484–494CrossRefGoogle Scholar
  27. 27.
    Yates TM, Tracy AJ, Luthar SS (2008) Nonsuicidal self-injury among ‘privileged’ youths: longitudinal and cross-sectional approaches to developmental process. J Consult Clin Psychol 76:52–62CrossRefGoogle Scholar
  28. 28.
    Higgins DJ, McCabe MP (2001) The development of the comprehensive child maltreatment scale. J Fam Stud 7:7–28CrossRefGoogle Scholar
  29. 29.
    Armsden GC, Greenberg MT (1987) The inventory of parent and peer attachment: individual differences and their relationship to psychological well-being in adolescence. J Youth Adolesc 16:427–454CrossRefGoogle Scholar
  30. 30.
    Cloutier PF, Nixon MK (2003) The Ottawa Self-Injury Inventory: a preliminary evaluation. Abstracts to the 12th International congress European Society for Child and Adolescent Psychiatry. Eur Child Adolesc Psychiatry 12(Suppl. 1):1–94Google Scholar
  31. 31.
    Martin J, Cloutier PF, Levesque C, Bureau J-F, Lafontaine M-F, Nixon MK (2013) Psychometric properties of the functions and addictive features scales of the Ottawa Self-Injury Inventory: a preliminary investigation using a university sample. Psychol Assess 25:1013–1018CrossRefGoogle Scholar
  32. 32.
    Hayes AF (2017) Introduction to mediation, moderation, and conditional process analysis: a regression-based approach. Guilford Publications, New YorkGoogle Scholar
  33. 33.
    McFadden D (1974) Conditional logit analysis of qualitative choice behavior. In: Zarembka P (ed) Frontiers in econometrics. Academic Press, New York, pp 104–142Google Scholar
  34. 34.
    Morris AS, Silk JS, Steinberg L, Myers SS, Robinson LR (2007) The role of the family context in the development of emotion regulation. Soc Dev 16:361–388CrossRefGoogle Scholar
  35. 35.
    Flett GL, Goldstein AL, Hewitt PL, Wekerle C (2012) Predictors of deliberate self-harm behavior among emerging adolescents: an initial test of a self-punitiveness model. Curr Psychol 31:49–64CrossRefGoogle Scholar
  36. 36.
    Whitlock J, Eckenrode J, Silverman D (2006) Self-injurious behaviors in a college population. Pediatrics 117:1939–1948CrossRefGoogle Scholar
  37. 37.
    Bresin K, Gordon KH (2013) Endogenous opioids and nonsuicidal self-injury: a mechanism of affect regulation. Neurosci Biobehav Rev 37:374–383CrossRefGoogle Scholar
  38. 38.
    Muehlenkamp JJ (2012) Body regard in nonsuicidal self-injury: theoretical explanations and treatment directions. J Cogn Psychother 26:331–347CrossRefGoogle Scholar
  39. 39.
    Buser TJ, Pitchko A, Buser JK (2014) Naturalistic recovery from nonsuicidal self-injury: a phenomenological inquiry. J Couns Dev 92:438–444CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.School of PsychologyUniversity of OttawaOttawaCanada
  2. 2.Department of PsychologyYork UniversityTorontoCanada

Personalised recommendations