Evaluation of the “Reading the Mind in the Eyes Test” with Non-Suicidal Self-Injury (NSSI) adolescents: A pilot study

  • Fiorenzo LaghiEmail author
  • Rita Cerutti
  • Arianna Terrinoni
  • Antonia Lonigro
  • Annarita Pongetti
  • Mauro Ferrara
  • Fiorella Fantini


Traditionally, non-suicidal self-injury (NSSI) has been investigated through the lens of borderline personality disorder. The present study tried to overcome such a limitation, considering new criteria suggested by the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders. Specifically, the aim of the current study was to compare the performance of a clinical sample of adolescent inpatients who engage in self-injurious acts with healthy controls on an emotion recognition task. Results showed that adolescents with NSSI scored worse than healthy controls on the recognition of both positive and negative emotions, as well as on the entire task. Conversely, no differences between the two groups were found when they had to discriminate between neutral facial expressions. Theoretical and clinical implications were discussed.


Non-suicidal self-injury Theory of mind Self-injuring behavior Adolescent inpatients Suicidal ideation 


Compliance with Ethical Standards

Conflict of Interests

On behalf of all authors, the corresponding author states that there is no conflict of interest.

Informed Consent

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


  1. Adrian, M., Berk, M. S., Korslund, K., Whitlock, K., Mccauley, E., & Linehan, M. (2018). Parental validation and invalidation predict adolescent self-harm. Professional Psychology: Research and Practice, (4), 274–281.Google Scholar
  2. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.CrossRefGoogle Scholar
  3. Baron-Cohen, S., Wheelwright, S., Hill, J., Raste, Y., & Plumb, I. (2001). The “Reading the mind in the eyes” test revised version: A study with normal adults, and adults with Asperger syndrome or high-functioning autism. Journal of Child Psychology and Psychiatry, 42, 241–251.CrossRefGoogle Scholar
  4. Bosco, F., Capozzi, F., Colle, L., Marostica, P., & Tirassa, M. (2013). Theory of mind deficit in subjects with alcohol use disorder: An analysis of mindreading processes. Alcohol Alcoholism, 49, 299–307.CrossRefGoogle Scholar
  5. Cerutti, R., Manca, M., Presaghi, F., & Gratz, K. L. (2011). Prevalence and clinical correlates of deliberate self-harm among a community sample of Italian adolescents. Journal of Adolescence, 34, 337–347.CrossRefGoogle Scholar
  6. Cerutti, R., Presaghi, F., Manca, M., & Gratz, K. L. (2012). Deliberate self-harm behavior among Italian young adults: Correlations with clinical and nonclinical dimensions of personality. American Journal of Orthopsychiatry, 82, 298–308.CrossRefGoogle Scholar
  7. Deliberto, T. L., & Nock, M. K. (2008). An exploratory study of correlates, onset, and offset of non-suicidal self-injury. Archives of Suicide Research, 12, 219–231.CrossRefGoogle Scholar
  8. Di Pierro, R., Sarno, I., Gallucci, M., & Madeddu, F. (2014). Nonsuicidal self-injury as an affect-regulation strategy and the moderating role of impulsivity. Child and Adolescent Mental Health, 19, 259–264.CrossRefGoogle Scholar
  9. Ferrara, M., Terrinoni, A., & Williams, R. (2012). Non-suicidal self-injury (Nssi) in adolescent inpatients: Assessing personality features and attitude toward death. Child and Adolescent Psychiatry and Mental Health, 6, 1–12.CrossRefGoogle Scholar
  10. Fliege, H., Kocalevent, R., Walter, O. B., Beck, S., Gratz, K. L., Gutierrez, P. M., et al. (2006). Three assessment tools for deliberate self-harm and suicide behavior: Evaluation and psychopathological correlates. Journal of Psychosomatic Research, 61, 113–121.CrossRefGoogle Scholar
  11. Fonagy, P., Bateman, A., & Bateman, A. (2011). The widening scope of mentalizing: A discussion. Psychology and Psychoterapy: Theory and Research and Practice, 84, 98–110.CrossRefGoogle Scholar
  12. Fossati, A., Somma, A., Krueger, R. F., Markon, K. E., & Borroni, S. (2017). On the relationships between DSM-5 dysfunctional personality traits and social cognition deficits: A study in a samole of consecutively admitted Italian psychotherapy patients. Clinical Psychology and Psychotherapy, 24, 1421–1434.CrossRefGoogle Scholar
  13. Frith, C. D. (2008). Social cognition. Philosophical Transactions of the Royal Society B, 363, 2033–2039.CrossRefGoogle Scholar
  14. Gibson, C. M., Penn, D. L., Prinstein, M. J., Perkins, D. O., & Belger, A. (2010). Social skill and social cognition in adolescents at genetic risk for psychosis. Schizophrenia Research, 122, 179–184.CrossRefGoogle Scholar
  15. Goldstein, T. R., & Winner, E. (2012). Enhancing empathy and theory of mind. Journal of Cognition and Development, 13, 19–37.CrossRefGoogle Scholar
  16. Gratz, K. L. (2001). Measurement of deliberate self-harm: Preliminary data on the deliberate self-harm inventory. Journal of Psychopathology and Behavioral Assessment, 23, 253–263.CrossRefGoogle Scholar
  17. Hilt, L. M., Nock, M. K., Lloyd-Richardson, E. E., & Prinstein, M. J. (2008). Longitudinal study of nonsuicidal self-injury among young adolescents: Rates, correlates, and preliminary test of an interpersonal model. Journal of Early Adolescence, 28, 455–469.CrossRefGoogle Scholar
  18. Hüunefeldt, T., Laghi, F., Ortu, F., & Olivetti Belardinelli, M. (2013). The relationship between “theory of mind” and attachment-related anxiety and avoidance in Italian adolescents. Journal of Adolescence, 36, 613–621.CrossRefGoogle Scholar
  19. In-Albon, T., Ruf, C., & Schmid, M. (2013). Proposed diagnostic criteria for the DSM-5 of nonsuicidal self-injury in female adolescents: Diagnostic and clinical correlates. Psychiatry Journal, 7, 5–16.Google Scholar
  20. Jacobson, C. M., Muehlenkamp, J. J., Miller, A. L., & Turner, J. B. (2008). Psychiatric impairment among adolescents engaging in different types of deliberate self-harm. Journal of Clinical Child and Adolescent Psychology, 37, 363–375.CrossRefGoogle Scholar
  21. Joiner, T. E., Di Ribeiro, J. D., & Silva, C. (2012). Nonsuicidal self-injury, suicidal behavior, and their co-occurrence as view ed through the lens of the interpersonal theory of suicide. Current Directions in Psychological Science, 21, 342–347.CrossRefGoogle Scholar
  22. Jovev, M., Chanen, A., Green, M., Cotton, S., Proffitt, T., Coltheart, M., & Jackson, H. (2011). Emotional sensitivity in youth with borderline personality pathology. Psychiatry Research, 15, 234–240.CrossRefGoogle Scholar
  23. Kaufman, J., Birmaher, B., Brent, D., Rao, U., Flynn, C., Moreci, P., Williamson, D., & Ryan, N. (1997). Schedule for affective disorders and schizophrenia for school-age children-present and lifetime version (K-SADS-PL): Initial reliability and validity data. Journal of the American Academy of Child and Adolescent Psychiatry, 36, 980–988.CrossRefGoogle Scholar
  24. Klonsky, E. D., May, A. M., & Glenn, C. R. (2013). The relationship between non suicidal self-injury and attempted suicide: Converging evidence from four samples. Journal of Abnormal Psychology, 122, 231–237.CrossRefGoogle Scholar
  25. Laghi, F., Cotugno, A., Cecere, F., Sirolli, A., Palazzoni, D., & Bosco, F. M. (2014). An exploratory assessment of theory of mind and psychological impairment in patients with bulimia nervosa. British Journal of Psychology, 105, 509–523.CrossRefGoogle Scholar
  26. Laghi, F., Terrinoni, A., Cerutti, R., Fantini, F., Galosi, S., Ferrara, M., & Bosco, F. M. (2016a). Theory of mind in non-suicidal self-injury (NSSI) adolescents. Consciousness and Cognition, 43, 38–47.CrossRefGoogle Scholar
  27. Laghi, F., Federico, F., Lonigro, A., Levanto, S., Ferraro, M., Baumgartner, E., & Baiocco, R. (2016b). Peer and tecacher-selected peer buddies for adolescents with autism spectrum disorders: The role of social, emotional, and mentalizing abilities. Journal of Psychology, 150, 469–484.CrossRefGoogle Scholar
  28. Muehlenkamp, J. J. (2005). Self-injurious behavior as a separate clinical syndrome. American Journal of Orthopsychiatry, 75, 324–333.CrossRefGoogle Scholar
  29. Muehlenkamp, J.J., & Gutierrez, P. M. (2004). An investigation of differences between self-injurious behavior and suicide attempts in a sample of adolescents. Suicide and Life-Threatening Behavior, 34, 12–23.Google Scholar
  30. Nock, M. K., Joiner, T. E., Gordon, K. H., Lloyd-Richardson, E., & Prinstein, M. J. (2006). Non-suicidal self-injury among adolescents: Diagnostic correlates and relation to suicide attempts. Psychiatry Research, 144, 65–72.CrossRefGoogle Scholar
  31. Quintana, D. S., Guastella, A. J., Outhred, T., Hickie, I. B., & Kemp, A. H. (2012). Heart variability is associated with emotion recognition: Direct evidence for a relationship between the autonomic nervous system and social cognition. International Journal of Psychopathology, 86, 168–172.Google Scholar
  32. Scherzer, P., Leveillé, E., Achim, A., Boisseau, E., & Stip, E. (2012). A study of theory of mind in paranoid schizophrenia: A theory or many theories? Frontiers in Psychology, 14, 432–443.Google Scholar
  33. Vellante, M., Baron-Cohen, S., Melis, M., Marrone, M., Petretto, D. R., Masala, C., & Preti, A. (2013). The “Reading the mind in the eyes” test: Systematic review of psychometric properties and a validation study in Italy. Cognitive Neuropsychiatry, 18, 326–354.CrossRefGoogle Scholar
  34. Von Ceumern-Lindenstjerna, I. A., Brunner, R., Parzer, P., Frey, M., Fiedler, P., & Resch, F. (2007). Wahrnehmung und Bewertung von emotionalen Gesichtsausdrücken bei weiblichen Jugendlichen mit einer Borderline-Persönlichkeitsstörung. Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie, 35, 333–340.CrossRefGoogle Scholar
  35. Whitlock, J. L., & Selekman, M. (2014). Non-suicidal self-injury (NSSI) across the lifespan. In M. Nock (Ed.), Oxford handbook of suicide and self-injury. Oxford Library of Psychology: Oxford University Press.Google Scholar
  36. Zanarini, M. C., Frankenburg, F. R., Reich, D. B., Fitzmaurice, G., Weinberg, I., & Gunderson, J. G. (2008). The 10-year course of physically self-destructive acts reported by borderline patients and axis II comparison subjects. Acta Psychiatrica Scandinavia, 117, 177–184.CrossRefGoogle Scholar
  37. Zetterqvist, M. (2017). Nonsuicidal self-injury in adolescents: Characterization of the disorder and the issue of distress and impairment. Suicide and Life-threatening Behavior, 47, 321–335.CrossRefGoogle Scholar
  38. Zetterqvist, M., Lundh, L. G., Dahlström, O., & Svedin, C. G. (2013). Prevalence and function of non-suicidal self-injury (NSSI) in a community sample of adolescents, using suggested DSM-5 criteria for a potential NSSI disorder. Journal of Abnormal Child Psychology, 41, 759–773.CrossRefGoogle Scholar

Copyright information

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

Authors and Affiliations

  1. 1.Department of Developmental and Social and Psychology, Faculty of Medicine and Psychology, SapienzaUniversity of RomeRomeItaly
  2. 2.Department of Dynamic and Clinical Psychology, Faculty of Medicine and Psychology, SapienzaUniversity of RomeRomeItaly
  3. 3.Department of Pediatrics and Child and Adolescent Neurology and Psychiatry SapienzaUniversity of RomeRomeItaly
  4. 4.Department of Human Sciences, Faculty of PsychologyUniversità Europea di RomaRomeItaly

Personalised recommendations