Abstract
Emotion regulation has been specifically linked to both non-suicidal self-injury (NSSI) and attempted suicide. It is also known that self-harm is disproportionally higher (30–68.4%) in forensic samples than in the general population, yet knowledge about the association between emotion regulation and self-harm in forensic settings is scarce. The purpose of this study was to describe emotion regulation in a sample of forensic psychiatric patients, to explore dimensions and levels of emotion regulation between forensic psychiatric patients with and without self-harm, and to explore associations between forensic psychiatric patients’ self-reported emotion regulation and self-reported functions of NSSI. A cohort of forensic psychiatric inpatients (N=98) was consecutively recruited during 2016–2020 from a high-security forensic psychiatric clinic in Sweden. Data were collected through the self-report measures Difficulties in Emotion Regulation Scale (DERS) and Inventory of Statements About Self-injury (ISAS). In relation to the first aim, median total and subscales scores for DERS were reported. Results showed a statistically significant difference in emotion regulation between participants with and without self-harm (p=0.004), with a medium effect size (Cohen’s d=0.65) for the DERS total scale. The DERS subscales returned large differences for Impulse (p=0.001, d=0.86), Goals (p=0.014, d=0.58), and Strategies (p=0.012, d=0.54) between participants with and without self-harm. Finally, DERS scores were correlated with both the interpersonal (rs=0.531, p<0.001, n=43) and intrapersonal factors (rs=0.503, p<0.001, n=43) of NSSI as reported on the ISAS. Participants with self-harm (NSSI and/or suicide attempts) demonstrated significantly more difficulties with emotion regulation than those without self-harm. Emotion dysregulation was associated with both interpersonal and intrapersonal functions of NSSI in the participants. We suggest further studies on forensic psychiatric patients’ maladaptive behaviors that focus on substance abuse, self-harm, and aggressive behaviors in relation to the regulation and expression of emotion.
Highlights
Emotion regulation is the mechanism through which individuals modify their emotions to achieve a certain goal (Aldao et al, 2010) or to enhance and/or inhibit their emotional experiences and expressions (Gross, 2002; Bridges et al, 2004; Rottenberg and Gross, 2007; Calkins and Mackler, 2011)
Participants with self-harm and/or suicide attempts showed higher Difficulties in Emotion Regulation Scale (DERS) scores on subscales measuring their inability to engage in goal-directed behaviors when distressed and limited access to effective emotion regulation strategies
We found moderate to strong associations between the interpersonal functions of non-suicidal self-injury (NSSI) and the dimensions of emotion regulation, regardingability to engage in goal-directed behaviors when distressed, control of impulsive behaviors, and access to effective emotion regulation strategies
Summary
Emotion regulation is the mechanism through which individuals modify their emotions to achieve a certain goal (Aldao et al, 2010) or to enhance and/or inhibit their emotional experiences and expressions (Gross, 2002; Bridges et al, 2004; Rottenberg and Gross, 2007; Calkins and Mackler, 2011). Emotion regulation can generally be described as a continuum ranging from under-regulation, through intermediate adaptive regulation, to over-regulation (Roberton et al, 2012, 2014) Both under-regulation and over-regulation of emotions can be defined as maladaptive, and their expression negatively affects the individual’s functioning and wellbeing. The evidence to date indicates both an association between emotion regulation and NSSI in different samples and a higher prevalence of the behavior in forensic psychiatric patients. Increased knowledge on NSSI and its functions in relation to emotion regulation seems especially important in forensic psychiatric settings, to avoid misconceptions of patients’ intent behind NSSI such that the behavior rather functions to manipulate or control the environment instead of being an expression of psychological dysfunction and suffering
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
