Relationship between borderline personality traits, emotion regulation, and non-suicidal self-injury in depressed adolescents: a cross-sectional study

Abstract

Abstract Objective: Non-suicidal self-injury (NSSI) is common among adolescents and has been linked to mental disorders and suicide in addition to physical injuries. According to the empirical avoidance model, adolescents with NSSI have stronger emotional experience and poorer emotional regulation than those without NSSI, which are core features of borderline personality disorder (BPD). The relationship between borderline personality features, emotion regulation, and NSSI in the population is unclear. This study aims to explore these associations and provide theoretical basis for the treatment of NSSI in the future. Methods: Depressed adolescents (n = 1192) were evaluated using Chinese versions of the Function Assessment of Self-mutilation Scale, Emotional Regulation Questionnaire for Children and Adolescents, and Borderline Personality Features Scale for Children. Results: The majority of depressed adolescents (71.3%, 850/1192) had demonstrated NSSI in the past year, with cutting or scratching the most common form (57.4%). Pearson correlation analysis with NSSI as a fixed factor (NSSI=1, no NSSI=2) revealed a negative correlation between NSSI and borderline personality characteristics (r = -0.314, P < 0.01) but a positive correlation between NSSI and emotion regulation capacity (r = 0.159, P < 0.01). This results are statistically significant. Emotion regulation played a mediating role between borderline personality traits and NSSI in adolescents with depression (effect value = 0.151). Conclusion: Borderline personality features and emotional regulation ability were significantly correlated with non-suicidal NSSI in depressed adolescents. Borderline personality symptoms not only directly influence NSSI risk in adolescents with depression, but also indirectly influence NSSI risk through emotional regulation.