Abstract
People who engage in dysregulated behaviours, such as nonsuicidal self-injury (NSSI) and risky drinking, commonly report adverse family environments. We investigated the association between family functioning and NSSI and/or risky drinking, with a focus on the roles of emotional reactivity and dysregulation. A sample of 733 university students (age: 18–33 years; M = 21.54; 76.6% female) completed self-report measures. Of the sample, 35% reported self-injury and 31% risky drinking. NSSI was associated with all variables (family functioning, emotional reactivity, emotional dysregulation) but few predicted risky drinking. Family functioning was indirectly associated with NSSI through emotional reactivity and dysregulation. Additionally, difficulties in emotion regulation moderated the association between family function and NSSI. While people with difficulties regulating emotion are more likely to self-injure, poor family functioning increases risk even among those with no such difficulties. While family context may increase risk of dysregulated behaviours, intervention may also benefit from focusing on emotional reactivity and regulation of emotions.
Highlights
-
We tested the association between family functioning and NSSI and/or risky drinking.
-
Poor family functioning increases risk of NSSI.
-
Family functioning was indirectly associated with NSSI, via emotion regulation.
-
Intervention could focus on the experience and regulation of emotions.
Similar content being viewed by others
References
Adrian, M., Berk, M. S., Korslund, K., Whitlock, K., McCauley, E., & Linehan, M. (2018). Parental validation and invalidation predict adolescent self-harm. Professional Psychology: Research and Practice, 49(4), 274. https://doi.org/10.1037/pro0000200.
Aurora, P., & Klanecky, A. K. (2016). Drinking motives mediate emotion regulation difficulties and problem drinking in college students. American Journal of Drug and Alcohol Abuse, 42, 341–350.
Baetens, I., Claes, L., Onghena, P., Grietens, H., Leeuwen, K. V., Pieters, C., & Griffith, J. W. (2014). Non-suicidal self-injury in adolescence: A longitudinal study of the relationship between NSSI, psychological distress and perceived parenting. Journal of Adolescence, 37, 817–826. https://doi.org/10.1016/j.adolescence.2014.05.010.
Bandura, A. (1986). Social foundations of thought and action: a social cognitive theory. NJ: Prentice Hall.
Bresin, K. (2014). Five indices of emotion regulation in participants with a history of nonsuicidal self-injury: a daily diary study. Behavior Therapy, 45(1), 56–66. https://doi.org/10.1016/j.beth.2013.09.005.
Bruffaerts, R., Mortier, P., Kiekens, G., Auerbach, R. P., Cuijpers, P., Demyttenaere, K., & Kessler, R. (2018). Mental health problems in college freshmen: Prevalence and academic functioning. Journal of Affective Disorders, 225, 97–103. https://doi.org/10.1016/j.jad.2017.07.044.
Buckholdt, K. E., Parra, G. R., Anestis, M. D., Lavendar, J. M., Jobe-shields, L. E., Tull, M. T., & Gratz, K. M. (2015). Emotion regulation difficulties and maladaptive behaviours: examination of deliberate self-harm, disordered eating, and substance misuse in two samples. Cognitive Therapy and Research, 39, 140–152. https://doi.org/10.1007/s10608-014-9655-3.
Campbell, J. M., & Oei, T. P. S. (2010). The intergenerational transference of alcohol use behaviour from parents to offspring: a test of the cognitive model. Addictive Behaviors, 35, 714–716. https://doi.org/10.1016/j.addbeh.2010.02.001.
Cantanzaro, S. J., & Laurent, J. (2004). Perceived family support, negative mood regulation expectancies, coping, and adolescent alcohol use: Evidence of mediation and moderation effects. Addictive Behaviors, 29, 1779–1797. https://doi.org/10.1016/j.addbeh.2004.04.001.
Chapman, A. L., Gratz, K. L., & Brown, M. Z. (2006). Solving the puzzle of deliberate self-harm: the experiential avoidance model. Behaviour Research and Therapy, 44(3), 371–394. https://doi.org/10.1016/j.brat.2005.03.005.
Conrod, P. J., & Nikolaou, K. (2016). Annual research review: on the developmental neuropsychology of substance use disorders. The Journal of Child Psychology & Psychiatry, 57, 371–394. https://doi.org/10.1111/jcpp.12516.
Cooper, M. L., Fropne, M. R., Russell, M., & Mudar, P. (1995). Drinking to regulate positive and negative emotions: a motivational model of alcohol use. Journal of Personality and Social Psychology, 69, 990–1005.
Dawkins, J., Hasking, P., Boyes, M., Greene, D., & Passchier, C. (2019). Applying a Cognitive-Emotional Model to nonsuicidal self-injury. Stress and Healt, 35, 39–48.
Degenhardt, L. J., Conigrave, K. M., Wutzke, S. E., & Saunders, J. B. (2001). The validity of an Australian modification of the AUDIT questionnaire. Drug and Alcohol Review, 20, 143–154.
Deliberto, T. L., & Nock, M. K. (2008). An exploratory study of correlates, onset, and offset of non-suicidal self-injury. Archives of Suicide Research, 12, 219–231. https://doi.org/10.1080/13811110802101096.
Dutcher, C. D., Vujanovic, A. A., Paulus, D. J., & Bartlett, B. A. (2017). Childhood maltreatment severity and alcohol use in psychiatric inpatients: The mediating role of emotion regulation difficulties. General Hospital Psychiatry, 48, 42–50.
Eisenberg, N., Cumberland, A., & Spinrad, T. L. (1998). Parental socialization of emotion. Psychological Inquiry, 9(4), 241–273. https://doi.org/10.1207/s15327965pli0904_1.
Emery, A. A., Heath, N. L., & Mills, D. J. (2016). Basic psychological need satisfaction, emotion dysregulation, and non-suicidal self-injury engagement in young adults: an application of self-determination theory. Journal of Youth and Adolescence, 45, 612–623. https://doi.org/10.1007/s10964-015-0405-y.
Epstein, N. B., Baldwin, L. M., & Bishop, D. S. (1983). The McMaster family assessment device. Journal of Marital and Family Therapy, 9(2), 171–180. https://doi.org/10.1111/j.1752-0606.1983.tb01497.x.
Evans, B. E., Greaves-Lord, K., Euser, A. S., Thissen, S., Tulen, J. H. M., Franken, I. H. A., & Huizink, A. (2016). Stress reactivity as a prospective predictor of risky substance use during adolescence. Journal of Studies on Alcohol and Drugs, 77, 208–219.
Franklin, J. C., Hessel, E. T., Aaron, R. V., Arthur, M. S., Heilbron, N., & Prinstein, M. J. (2010). The functions of nonsuicidal self-injury: Support for cognitive–affective regulation and opponent processes from a novel psychophysiological paradigm. Journal of Abnormal Psychology, 119(4), 850.
Glenn, C. R., Blumenthal, T. D., Klonsky, E. D., & Hajcak, G. (2011). Emotional reactivity in nonsuicidal self-injury: Divergence between self-report and startle measures. International Journal of Psychophysiology, 80(2), 166–170. https://doi.org/10.1016/j.ijpsycho.2011.02.016.
Glenn, C. R., & Klonsky, E. D. (2011). One-year test-retest reliability of the inventory of statements about self-injury. Assessment, 18, 375–378. https://doi.org/10.1177/1073191111411669.
Gratz, K. L. (2006). Risk factors for deliberate self‐harm among female college students: The role and interaction of childhood maltreatment, emotional inexpressivity, and affect intensity/reactivity. American Journal of Orthopsychiatry, 76(2), 238–250. https://doi.org/10.1037/0002-9432.76.2.238.
Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioural Assessment, 26, 41–54. https://doi.org/10.1023/B:JOBA.0000007455.08539.94.
Gratz, K. L., & Roemer, L. (2008). The relationship between emotion dysregulation and deliberate self‐harm among female undergraduate students at an urban commuter university. Cognitive Behaviour Therapy, 37(1), 14–25. https://doi.org/10.1080/16506070701819524.
Gromatsky, M. A., Waszczuk, M. A., Perlman, G., Salis, K. L., Klein, D. N., & Kotov, R. (2017). The role of parental psychopathology and personality in adolescent non-suicidal self-injury. Journal of Psychiatric Research, 85, 15–23. https://doi.org/10.1016/j.jpsychires.2016.10.013.
Hagan, M. J., Luecken, L. J., Modecki, K. L., Sandler, I. N., & Wolchik, S. A. (2016). Childhood negative emotionality predicts behavioural dysregulation 15 years later. Emotion, 16, 877–885.
Hallett, J., Howat, P. M., Maycock, B. R., McManus, A., Kypri, K., & Dhaliwal, S. S. (2012). Undergraduate student drinking and related harms at an Australian University: Web-based survey of large random sample. BMC Public Health, 12, 37. https://doi.org/10.1186/1471-2458-12-37.
Hamza, C. A., & Willoughby, T. (2016). Nonsuicidal self-injury and suicidal risk among emerging adults. Journal of Adolescent Health, 59, 411–415. https://doi.org/10.1016/j.jadohealth.2016.05.019.
Hayes, A. F. (2009). Beyond Baron and Kenny: statistical mediation analysis in the new millennium. Communication Monographs, 76, 408–420. https://doi.org/10.1080/03637750903310360.
Hayes, A. F. (2018). Introduction to mediation, moderation, and conditional process analysis: a regression-based approach. 2nd Ed. New York: The Guildford Press.
Hu, L. T., & Bentler, P. M. (1995). Evaluating model fit. In R.H. Hoyle (Ed.), Structural equation modeling: concepts, issues, and applications (p. 76–99). Sage Publications, Inc.
International Society for the Study of Self-Injury. (2018, May). What is self-injury? https://itriples.org/about-self-injury/what-is-self-injury.
Jarvi, S., Jackson, B., Swenson, L., & Crawford, H. (2013). The impact of social contagion on non-suicidal self-injury: a review of the literature. Archives of Suicide Research, 17, 1–19.
Kabacoff, R. I., Miller, I. W., Bishop, D. S., Epstein, N. B., & Keitner, G. I. (1990). A psychometric study of the mcmaster family assessment device in psychiatric, medical, and nonclinical samples. Journal of Family Psychology, 3(4), 431. https://doi.org/10.1037/h0080547.
Kaess, M., Hille, M., Parzer, P., Maser-Gluth, C., Resch, F., & Brunner, R. (2012). Alterations in the neuroendocrinological stress response to acute psychosocial stress in adolescents engaging in nonsuicidal self-injury. Psychoneuroendocrinology, 37(1), 157–161. https://doi.org/10.1016/j.psyneuen.2011.05.009.
Keane, C., Magee, C. A., & Lee, J. K. (2015). Childhood trauma and risky alcohol consumption: a study of Australian adults with low housing stability. Drug and Alcohol Review, 34, 18–26.
Kelada, L., Hasking, P., & Melvin, G. (2016). The relationship between nonsuicidal self-injury and family functioning: adolescent and parent perspectives. Journal of Marital and Family Therapy, 42(3), 536–549. https://doi.org/10.1111/jmft.12150.
Kiekens, G., Claes, L., Demyttenaere, K., Auerbach, R. P., Green, J., Kessler, R., & Bruffaerts, R. (2016). Lifetime and 12-month nonsuicidal self-injury and academic performance in college freshmen. Suicide and Life-Threatening Behavior, 46, 563–576. https://doi.org/10.1111/sltb.12237.
Kiekens, G., Hasking, P., Boyes, M., Claes, L., Mortier, P., Auerbach, R. P., & Bruffaerts, R. (2018). The associations between non-suicidal self-injury and first onset suicidal thoughts and behaviours. Journal of Affective Disorders, 239, 171–179. https://doi.org/10.1016/j.jad.2018.06.033.
Klanecky, A. K., Woolman, E. O., & Becker, M. M. (2015). Child abuse exposure, emotion regulation, and drinking refusal self-efficacy: an analysis of problem drinking in college students. The American Journal of Drug and Alcohol Abuse, 41, 188–196.
Klonsky, E. D., & Glenn, C. R. (2009). Assessing the functions of non-suicidal self-injury: psychometric properties of the Inventory of Statements About Self-injury (ISAS). Journal of Psychopathology and Behavioral Assessment, 31(3), 215–219. https://doi.org/10.1007/s10862-008-9107-z.
Klonsky, E. D., & Olino, T. M. (2008). Identifying clinically distinct subgroups of self-injurers among young adults: a latent class analysis. Journal of Consulting and Clinical Psychology, 76(1), 22. https://doi.org/10.1037/0022-006X.76.1.22.
Linehan, M. M. (1993). Cognitive-behavioural treatment of borderline personality disorders. Cognitive-behavioral treatment of borderline personality disorder. New York: Guilford Press.
Martin, G., Thomas, H., Andrews, T., Hasking, P., & Scott, J. G. (2015). Psychotic experiences and psychological distress predict contemporaneous and future non-suicidal self-injury and suicide attempts in a sample of Australian school-based adolescents. Psychological Medicine, 45, 429–437. https://doi.org/10.1017/S0033291714001615.
McKenzie, K. C., & Gross, J. J. (2015). Nonsuicidal self-injury: an emotion regulation perspective. Psychopathology, 47, 207–219. https://doi.org/10.1159/000358097.
Muthén, L. K., & Muthén, B. O. (1998–2017). Mplus User’s Guide. 8th ed. Los Angeles, CA: Muthén & Muthén .
Nock, M. K. (2009). Why do people hurt themselves? new insights in to the nature and functions of self-injury. Current Directions in Psychological Science, 18, 78–83.
Nock, M. K., Wedig, M. M., Holmberg, E. B., & Hooley, J. M. (2008). The emotion reactivity scale: development, evaluation, and relation to self-injurious thoughts and behaviors. Behavior Therapy, 39(2), 107–116. https://doi.org/10.1016/j.beth.2007.05.005.
Park, C. L., Aremeli, S., & Tennen, H. (2004). The daily stress and coping process and alcohol use among college students. Journal of Studies on Alcohol, 65, 126–135.
Perez, J., Venta, A., Garnaat, S., & Sharp, C. (2012). The difficulties in emotion regulation scale: Factor structure and association with nonsuicidal self-injury in adolescent inpatients. Journal of Psychopathology and Behavioral Assessment, 34, 393–404. https://doi.org/10.1007/s10862-012-9292-7.
Reboussin, B. A., Song, E., & Wolfson, M. (2012). Social influences on the clustering of underage risky drinking and its consequences in communities. Journal of Studies on Alcohol and Drugs, 73, 890–898.
Richter, K. P., & Bammer, G. (2000). A hierarchy of strategies heroin-using mothers employ to reduce harm to their children. Journal of Substance Abuse Treatment, 19, 403–413.
Roche, A. M., & Watt, K. (1999). Drinking and university students: from celebration to inebriation. Drug and Alcohol Review, 18, 389–399.
Selby, E. A., & Joiner, T. E. (2009). Cascades of emotion: the emergence of borderline personality disorder from emotional and behavioural dysregulation. Review of General Psychology, 13, 219–229. https://doi.org/10.1037/a0015687.
Shenk, C. E., & Fruzzetti, A. E. (2011). The impact of validating and invalidating responses on emotional reactivity. Journal of Social and Clinical Psychology, 30(2), 163–183. https://doi.org/10.1521/jscp.2011.30.2.163.
Sinha, R. (2012). How does stress lead to risk of alcohol relapse? Alcohol Research Current Reviews, 34, 432–440.
Smith, K. E., Hayes, N. A., Styer, D. M., & Washburn, J. J. (2017). Emotional reactivity in a clinical sample of patients with eating disorders and nonsuicidal self-injury. Psychiatry Research, 257, 519–525. https://doi.org/10.1016/j.psychres.2017.08.014.
Swannell, S., Martin, G., Page, A., Hasking, P., Hazell, P., Taylor, A., & Protani, M. (2012). Child maltreatment, subsequent non-suicidal self-injury and the mediating roles of dissociation, alexithymia and self-blame. Child Abuse & Neglect, 36, 572–584. https://doi.org/10.1016/j.chiabu.2012.05.005.
Swannell, S., Martin, G., Page, A., Hasking, P., & St John, N. (2014). Prevalence of non-suicidal self-injury (NSSI) in non-clinical samples; systematic review, meta-analysis and meta-regression. Suicide and Life-Threatening Behavior, 44, 273–303.
Tatnell, R., Kelada, L., Hasking, P., & Graham, M. (2014). Longitudinal analysis of adolescent NSSI: the role of intrapersonal and interpersonal factors. Journal of Abnormal Child Psychology, 42(6), 885–896. https://doi.org/10.1007/s10802-013-9837-6.
Taylor, P. J., Jomar, K., Dhingra, K., Forrester, R., Shahmalak, U., & Dickson, J. M. (2018). A meta-analysis of the prevalence of different functions of non-suicidal self-injury. Journal of Affective Disorders, 227, 759–769. https://doi.org/10.1016/j.jad.2017.11.073.
Turner, B. J., Chapman, A. L., & Layden, B. K. (2012). Intrapersonal and interpersonal functions of non suicidal self‐injury: Associations with emotional and social functioning. Suicide and Life‐Threatening Behavior, 42(1), 36–55. https://doi.org/10.1111/j.1943-278X.2011.00069.x.
Van Der Mijl, R. C. W., & Vingerhoets, A. J. J. M. (2017). The positive effects of parentification: an exploratory study among students. Psihologiske Teme, 26, 417–430. https://doi.org/10.31820/pt.26.2.8.
Author Contributions
PH and MB conceptualised and designed the study, assisted with data analysis, analysed data and assisted with manuscript preparation; JD collected data and prepared the manuscript for publication; NG and PW collected data and assisted with manuscript preparation.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of Interest
The authors declare that they have no conflict of interest.
Ethical Approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Curtin University HRE2018-0536) and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed Consent
All participants provided informed consent to participate in the study and for use of their data for research publications.
Additional information
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Hasking, P., Dawkins, J., Gray, N. et al. Indirect Effects of Family Functioning on Non-Suicidal Self-Injury and Risky Drinking: The Roles of Emotion Reactivity and Emotion Regulation. J Child Fam Stud 29, 2070–2079 (2020). https://doi.org/10.1007/s10826-020-01722-4
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10826-020-01722-4