The relationship between early maladaptive schemas and the functions of self-injurious behaviour in youth

Abstract

ABSTRACT Objective There is emerging research demonstrating relationships between specific Early Maladaptive Schemas and self-injurious behaviour (SIB) in young people. Evidence also highlights the importance of conceptualising SIB in terms of its motivating function, differentiating between intrapersonal and interpersonal functions of the behaviour. Despite this, there is a relative absence of evidence linking schemas and functions of SIB. The current study sought to explore the relationship between schemas and motivations for self-injury in a community sample of young people with a history of self-injury. Method 125 Australian secondary and university students aged between 16 and 25 years who reported SIB history completed the Young Schema Questionnaire and the Inventory of Statements about Self-Injury. Results Multiple regression analyses found that the schemas of Abandonment/Instability and Entitlement significantly predicted intrapersonal functions of self-injury. In contrast, Insufficient Self-Control significantly predicted interpersonal functions. Defectiveness/Shame and Entitlement predicted self-injury with suicidal intent. Conclusions We discuss the findings regarding distinct patterns in the associations between schemas and the functions of self-injurious behaviour among youth with self-injury history. The present study also highlights how schemas may help to understand the motivations behind self-injury and assist clinicians in the assessment of risk for self-injury and suicide among youth, as well as to formulate plans for treatment and early intervention. KEY POINTS What is already known about this topic: Young people are motivated to self-injure for a variety of reasons, including to manage internal distress (intrapersonal) and influence their external environment (interpersonal). Alongside these motivating functions, vulnerability factors, such as childhood maltreatment and intense negative emotions, predispose a young person to self-injury when confronted with stress. Early maladaptive schemas are also increasingly being identified as vulnerability factors for self-injury, particularly Defectiveness/Shame and Abandonment/Instability. What this topic adds: Young people’s motivations to self-injure are influenced by their early maladaptive schemas. Young people who self-injure for intrapersonal motivations report schemas of Abandonment/Instability, those who self-injure for interpersonal motivations report an Insufficient self-control schema, and those who self-injure with some suicidal intent report schemas of Defectiveness/Shame. This highlights that the importance of understanding both the function and the schema when working with young people who self-injure. Youth whose self-injurious behaviour is interpersonally motivated may require interpersonal skill-building. For youth who self-injure for intrapersonal or suicidal motivations, a treatment such as schema therapy may be warranted.