Do attachment-related differences in reflective functioning explain associations between expressed emotion and youth self-harm?

Jamie Kennedy-Turner*, Vilas Sawrikar, Lucy Clark, Helen Griffiths

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Youth self-harm is associated with poor health outcomes and attempted and completed suicide. Associations exist between self-harm and expressed emotion (EE), attachment insecurity, and reflective functioning (RF), but these associations are poorly understood. This study evaluates a mediation model in which perceived caregiver EE (pEE) exerts an indirect effect on youth self-harm through attachment insecurity and RF uncertainty. 461 participants aged 16-24 years completed an online survey. Statistical analyses revealed significant direct effects of pEE on attachment insecurity, and of RF uncertainty on self-harm; however, some direct effects were specific to pEE from female caregivers, and attachment insecurity in youth relationships with female caregivers. A significant direct effect of pEE on self-harm was found for pEE from male caregivers only. Significant indirect effects of pEE on self-harm through attachment anxiety and RF uncertainty were found only in relation to female caregivers. The findings encourage family-, attachment-, and mentalization-based approaches to preventing and treating youth self-harm, with a recommendation that caregivers are given adequate support, education, and skills-based training following youth disclosures of self-harm.
Original languageEnglish
Number of pages39
JournalCurrent psychology
Early online date26 Aug 2022
DOIs
Publication statusE-pub ahead of print - 26 Aug 2022

Keywords

  • youth
  • self-harm
  • reflective functioning
  • expressed emotion
  • attachment

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