The Role of Difficulty in Identifying and Describing Feelings in Non-Suicidal Self-Injury Behavior (NSSI): Associations With Perceived Attachment Quality, Stressful Life Events, and Suicidal Ideation.

Rita Cerutti,Valentina Spensieri,Antonio Zuffianò

doi:10.3389/fpsyg.2018.00318

Rita Cerutti, Valentina Spensieri + Show 1 more

Open Access

https://doi.org/10.3389/fpsyg.2018.00318

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Abstract

Objective: Core alexithymic features, such as the difficulty in identifying and describing feelings, are associated with poor attachment styles and emotional trauma, which influence the capacity to regulate affect. Additionally, emotional regulation has been found to be the most commonly identified function associated with non-suicidal self-injury behavior (NSSI) in adolescents as they attempt to modulate strong emotions. However, few studies have examined the link between difficulty in identifying and describing feelings (core components of alexithymia), NSSI behaviors, quality of attachment, life stressors and suicidal ideation in healthy early adolescents. Consequently, this study aims to investigate these constructs and the relationship among them in a large non-clinical sample of adolescents.Methods: Seven hundred and nine middle school students (50.4% males), aged 10–15 years (M = 12.6; SD = 1.06) were involved in this study. In order to investigate the variables considered in the study, the following measures were administered: the Deliberate Self-Harm Inventory exploring non-suicidal self-injurious behaviors; the Alexithymia Questionnaire for Children examining difficulty in identifying and describing feelings; the Inventory of Parent and Peer Attachment assessing the quality of parental and peer attachment; the Life Stressor Checklist-Revised outlining stressful/traumatic events and the Children’s Depression Inventory evaluating suicidal ideation.Results: We found significantly positive relationships among difficulty in identifying and describing feelings, NSSI behaviors, stressful events, and suicidal ideation. Data indicated a significant negative association of difficulty in identifying and describing feelings with quality of attachment to parents and peers. Further findings highlighted that difficulty in identifying and describing feelings significantly mediated the effect of quality of attachment (parent and peer) on NSSI and suicidal ideation.Conclusion: The ability to identify and describing feelings is important to managing emotional expression and understanding the feelings of others, both crucial in attaining successful interpersonal relationships. Our data revealed that, while controlling for stressful life events, low levels of attachment may increase adolescents’ difficulty in identifying and describing their own feelings, which in turn may increase the risk of both NSSI and suicidal ideation.

Highlights

In recent years, there has been growing interest in research on alexithymia, as documented by a series of major systematic reviews in the international literature
The following clinical features have been considered as dimensions of alexithymia: difficulty in identifying and describing emotions, difficulty in distinguishing between subjective emotional states and the somatic components of emotional activation, poverty of imaginative processes, and cognitive style oriented toward external reality
In line with previous investigation of healthy adults (Paivio and McCulloch, 2004), difficulties in identifying and describing inner feelings have been conceptualized as core components of alexithymia which may be associated with problems in building and maintaining close relationships with others and using social support to protect themselves against the potentially pathological influences of stressful events (Kojima et al, 2003)

Summary

Introduction

There has been growing interest in research on alexithymia, as documented by a series of major systematic reviews in the international literature. The literature is not always unanimous about the definition of “alexithymia,” research suggests that alexithymia is a multi-dimensional deficit in affect recognition and regulation (Timoney and Holder, 2013). For some authors, it refers to a personality construct normally distributed in the population (Parker et al, 2008) whilst others use the term to denote a limited ability to identify, describe and communicate one’s feelings, which in turn reflects difficulties in affective self-regulation (Taylor et al, 1997). The difficulty in “identifying and describing ones’ own inner feelings” may make people reluctant to participate in social activities (Kojima, 2012)

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