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The Strengths and Difficulties Questionnaire -Dysregulation Profile, Non-Suicidal Self-Injury Behaviors and the Mediating Role of Stressful Life Events

Published online by Cambridge University Press:  13 June 2018

Irene Caro-Cañizares*
Affiliation:
Hospital Universitario Fundación Jiménez Díaz (Spain).
Mónica Díaz de Neira-Hernando
Affiliation:
Hospital Universitario Fundación Jiménez Díaz (Spain).
Bernadette Pfang
Affiliation:
Hospital Universitario Fundación Jiménez Díaz (Spain).
Enrique Baca-Garcia
Affiliation:
Hospital Universitario Fundación Jiménez Díaz (Spain).
Juan J. Carballo
Affiliation:
Hospital General Universitario Gregorio Marañón (Spain).
*
*Correspondence concerning this article should be addressed to Irene Caro-Cañizares. Servicio de Psiquiatría del Hospital Universitario Fundación Jiménez Díaz. Avenida Reyes Católicos 2. 28040 Madrid (Spain). E-mail: irene.caro@fjd.es

Abstract

Non-suicidal self-injury (NSSI) behaviors are self-injurious behaviors inflicted without intending death. Literature has shown the relationship between stressful life events (SLE) and NSSI behaviors. The Strengths and Difficulties Questionnaire-Dysregulation Profile (SDQ-DP) is defined as an index of self-regulatory problems, related to higher risk for suicidal ideation and attempts in adolescents. In this study the relationship between SDQ-DP and NSSI behaviors, mediated by SLE in a clinical sample of children and adolescents is analyzed. A cross-sectional study was conducted on 239 subjects (aged from 11 to 17) to test the mediation model. SDQ-DP significantly correlates with NSSI behaviors (Wald = 6.5477, p = .0105); SDQ-DP significantly correlates with SLE (T = 5.7229, p < .001); SLE significantly correlates NSSI behaviors, and the relation remains significant whilst controlling for SDQ-DP (Wald = 4.1715, p = .041); the relation between SDQ-DP and NSSI behaviors stops being significant whilst controlling for the potential mediator (SLE) (Wald = 2.9951, p = .0835). Study of indirect effect supports the mediation model (.0585 CI [.0016, .1266]). Findings are compatible with the complete mediation scenario. These results point out the importance of self-regulatory problems in coping strategies with regards to SLE and the development of NSSI behaviors.

Type
Research Article
Copyright
Copyright © Universidad Complutense de Madrid and Colegio Oficial de Psicólogos de Madrid 2018 

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Footnotes

How to cite this article:

Caro-Cañizares, I., Díaz de Neira-Hernando, M., Pfang, B., Baca-García, E., & Carballo, J. J. (2018). The strengths and difficulties questionnaire - dysregulation profile, non-suicidal self-injury behaviors and the mediating role of stressful life events. The Spanish Journal of Psychology, 21. e22. Doi:10.1017/sjp.2018.23

References

Achenbach, T. M. (1991). Manual for the Child Behavior Checklist/4–18 and 1991 profile. Burlington, VT: University of Vermont.Google Scholar
Althoff, R. R., Ayer, L. A., Crehan, E. T., Rettew, D. C., Baer, J. R., & Hudziak, J. J. (2012). Temperamental profiles of Dysregulated Children. Child Psychiatry & Human Development, 43(4), 511522. https://doi.org/10.1007/s10578-012-0280-7Google Scholar
Althoff, R. R., Rettew, D. C., Ayer, L. A., & Hudziak, J. J. (2010). Cross-informant agreement of the Dysregulation Profile of the Child Behavior Checklist. Psychiatry Research, 178(3), 550555. https://doi.org/10.1016/j.psychres.2010.05.002CrossRefGoogle ScholarPubMed
Althoff, R. R., Verhulst, F. C., Rettew, D. C., Hudziak, J. J., & van der Ende, J. (2010). Adult outcomes of childhood dysregulation: A 14-year follow-up study. Journal of the American Academy of Child and Adolescent Psychiatry, 49(11), 1105–1116. e1 https://doi.org/10.1016/j.jaac.2010.08.006Google Scholar
Ayer, L., Althoff, R., Ivanova, M., Rettew, D., Waxler, E., Sulman, J., & Hudziak, J. (2009). Child Behavior Checklist Juvenile Bipolar Disorder (CBCL-JBD) and CBCL Posttraumatic Stress Problems (CBCL-PTSP) scales are measures of a single dysregulatory syndrome. Journal of Child Psychology & Psychiatry, 50(10), 12911300. https://doi.org/10.1111/j.1469-7610.2009.02089.xGoogle Scholar
Baron, R. M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 11731182. https://doi.org/10.1037/0022-3514.51.6.1173Google Scholar
Bateman, A., & Fonagy, P. (2010). Mentalization based treatment for borderline personality disorder. World Psychiatry, 9(1), 1115. https://doi.org/10.1002/j.2051-5545.2010.tb00255.xGoogle Scholar
Biederman, J., Wozniak, J., Kiely, K., Ablon, S., Faraone, S., Mick, E., … Kraus, I. (1995). CBCL Clinical scales discriminate prepubertal children with structured interview-derived diagnosis of mania from those with ADHD. Journal of the American Academy of Child and Adolescent Psychiatry, 34, 464471. https://doi.org/10.1097/00004583-199504000-00013Google Scholar
Bornovalova, M. A., Gratz, K. L., Daughters, S. B., Nick, B., Delany-Brumsey, A., Lynch, T., … Lejuez, C. W. (2008). A multimodal assessment of the relationship between emotion dysregulation and borderline personality disorder among inner-city substance users in residential treatment. Journal of Psychiatric Research, 42(9), 717726. https://doi.org/10.1016/j.jpsychires.2007.07.014Google Scholar
Brown, M. Z., Comtois, K. A., & Linehan, M. M. (2002). Reasons for suicide attempts and nonsuicidal self-injury in women with borderline personality disorder. Journal of Abnormal Psychology, 111(1), 198202. https://doi.org/10.1037/0021-843X.111.1.198Google Scholar
Carballo, J. J., Serrano-Drozdowskyj, E., García, R., Díaz, M., Pérez-Fominaya, M., Molina-Pizarro, C. A., … Baca-García, E. (2014). Prevalence and correlates of psychopathology in children and adolescents evaluated with the Strengths and Difficulties Questionnaire Dysregulation Profile in a Clinical Setting. Psychopathology, 47(5), 303311. https://doi.org/10.1159/000360822Google Scholar
Cerutti, R., Manca, M., Presaghi, F., & Gratz, K. L. (2011). Prevalence and clinical correlates of deliberate self-harm among a community sample of Italian adolescents. Journal of Adolescence, 34(2), 337347. https://doi.org/10.1016/j.adolescence.2010.04.004Google Scholar
Chartrand, H., Bhaskaran, J., Sareen, J., Katz, L. Y., & Bolton, J. M. (2015). Correlates of nonsuicidal self-injury and suicide attempts among tertiary care, emergency department patients. The Canadian Journal of Psychiatry, 60(6), 276283. https://doi.org/10.1177/070674371506000606Google Scholar
Claes, L., Klonsky, E. D., Muehlenkamp, J., Kuppens, P., Vandereycken, W. (2010). The affect-regulation function of nonsuicidal self-injury in eating-disordered patients: Which affect states are regulated? Comprehensive Psychiatry, 51(4), 386392. https://doi.org/10.1016/j.comppsych.2009.09.001Google Scholar
Cohen, J. N., Stange, J. P., Hamilton, J. L., Burke, T. A., Jenkins, A., Ong, M.-L., … Alloy, L. B. (2015). The interaction of affective states and cognitive vulnerabilities in the prediction of non-suicidal self-injury. Cognition & Emotion, 29(3), 539547. https://doi.org/10.1080/02699931.2014.918872Google Scholar
De Caluwé, E., Decuyper, M., & De Clercq, B. (2013). The Child Behavior Checklist Dysregulation Profile predicts adolescent DSM–5 pathological personality traits 4 years later. European Child & Adolescent Psychiatry, 22(7), 401411. https://doi.org/10.1007/s00787-013-0379-9Google Scholar
de Tychey, C., Garnier, S., Lighezzolo-Alnot, J., Claudon, P., & Rebourg-Roesler, C. (2010). An accumulation of negative life events and the construction of alexithymia: A longitudinal and clinical approach. Journal of Personality Assessment, 92(3), 189206. https://doi.org/10.1080/00223891003670125Google Scholar
García-Nieto, R., Blasco-Fontecilla, H., Paz, M., & Baca-García, E. (2013). Traducción y validación de la Self-Injurious Thoughts and Behaviors Interview en población española con conducta suicida [Translation and validation of the “Self-Injurious Thoughts and Behaviors Interview” in a Spanish population with suicidal behavior]. Revista de Psiquiatrí́a y Salud Mental, 6(3), 101108. https://doi.org/10.1016/j.rpsm.2012.07.001Google Scholar
Gastaminza, X., Herreros, O., Ortiz, V., & Sánchez, F. (2005). Suicidio e intento de suicidio en niños y adolescentes: Revisión e intervenciones terapéuticas [Suicide and suicide attempts in children and adolescents: Review and therapeutic interventions]. Revista de Psiquiatría Infanto-Juvenil, 22(3), 110117.Google Scholar
Goodman, R. (1997). The Strengths and Difficulties Questionnaire: A research note. The Journal of Child Psychology and Psychiatry , 38(5), 581586. https://doi.org/10.1111/j.1469-7610.1997.tb01545.xGoogle Scholar
Gratz, K. L. (2007). Targeting emotion dysregulation in the treatment of self-injury. Journal of Clinical Psychology, 63(11), 10911103. https://doi.org/10.1002/jclp.20417Google Scholar
Gratz, K. L., Tull, M. T., & Gunderson, J. G. (2008). Preliminary data on the relationship between anxiety sensitivity and borderline personality disorder: The role of experiential avoidance. Journal of Psychiatric Research, 42(7), 550559. https://doi.org/10.1016/j.jpsychires.2007.05.011Google Scholar
Hayes, S. C. (2004). Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies. Behavior Therapy, 35(4), 639665. https://doi.org/10.1016/S0005-7894(04)80013-3Google Scholar
Holmbeck, G. N. (2002). Post-hoc probing of significant moderational and mediational effects in studies of pediatric populations. Journal of Pediatric Psychology, 27(1), 8796. https://doi.org/10.1093/jpepsy/27.1.87Google Scholar
Holtmann, M., Becker, A., Banaschewski, T., Rothenberger, A., & Roessner, V. (2011). Psychometric validity of the Strengths and Difficulties Questionnaire-Dysregulation Profile. Psychopathology, 44(1), 5359. https://doi.org/10.1159/000318164Google Scholar
Holtmann, M., Buchmann, A. F., Esser, G., Schmidt, M. H., Banaschewski, T., & Laucht, M. (2011). The Child Behavior Checklist-Dysregulation Profile predicts substance use, suicidality, and functional impairment: A longitudinal analysis. The Journal of Child Psychology & Psychiatry, 52(2), 139147. https://doi.org/10.1111/j.1469-7610.2010.02309.xGoogle Scholar
Jucksch, V., Salbach-Andrae, H., Lenz, K., Goth, K., Döpfner, M., Poustka, F., … Holtmann, M. (2011). Severe affective and behavioral dysregulation is associated with significant psychosocial adversity and impairment. Journal of Child Psychology & Psychiatry, 52(6), 686695. https://doi.org/10.1111/j.1469-7610.2010.02322.xGoogle Scholar
Keenan, K., Hipwell, A. E., Stepp, S. D., & Wroblewski, K. (2014). Testing an equifinality model of nonsuicidal self-injury among early adolescent girls. Development and Psychopathology, 26(3), 851862. https://doi.org/10.1017/S0954579414000431Google Scholar
Kokkevi, A., Richardson, C., Olszewski, D., Matias, J., Monshouwer, K., & Bjarnason, T. (2012). Multiple substance use and self-reported suicide attempts by adolescents in 16 European countries. European Child & Adolescent Psychiatry, 21(8), 443450. https://doi.org/10.1007/s00787-012-0276-7Google Scholar
Lacina, R. M., Staub-Ghielmini, S., Bircher, U., Bianchi, F., Schmeck, K., & Schmid, M. (2014). Survey of problematic behavior of adolescents and their self-reported psychopathology. Praxis Der Kinderpsychologie Und Kinderpsychiatrie, 63(1), 3662.Google Scholar
Ledesma, R. (2008). Introduccion al Bootstrap. Desarrollo de un ejemplo acompañado de software de aplicación. Tutorials in Quantitative Methods for Psychology, 4(2), 5160.Google Scholar
Lundh, L.-G., Wångby-Lundh, M., & Bjärehed, J. (2011). Deliberate self-harm and psychological problems in young adolescents: Evidence of a bidirectional relationship in girls. Scandinavian Journal of Psychology, 52(5), 476483. https://doi.org/10.1111/j.1467-9450.2011.00894.xGoogle Scholar
Mandelli, L., Nearchou, F. A., Vaiopoulos, C., Stefanis, C. N., Vitoratou, S., Serretti, A., & Stefanis, N. C. (2015). Neuroticism, social network, stressful life events: Association with mood disorders, depressive symptoms and suicidal ideation in a community sample of women. Psychiatry Research, 226(1), 3844. https://doi.org/10.1016/j.psychres.2014.11.001Google Scholar
Mbekou, V., Gignac, M., MacNeil, S., Mackay, P., & Renaud, J. (2014). The CBCL Dysregulated Profile: An indicator of pediatric bipolar disorder or of psychopathology severity? Journal of Affective Disorders, 155, 299302. https://doi.org/10.1016/j.jad.2013.10.033Google Scholar
Meyer, S. E., Carlson, G. A., Youngstrom, E., Ronsaville, D. S., Martinez, P. E., Gold, P. W., … Radke-Yarrow, M. (2009). Long-term outcomes of youth who manifested the CBCL-Pediatric Bipolar Disorder phenotype during childhood and/or adolescence. Journal of Affective Disorders, 113(3), 227235. https://doi.org/10.1016/j.jad.2008.05.024Google Scholar
Nock, M. K., Holmberg, E. B., Photos, V. I., & Michel, B. D. (2007). Self-Injurious Thoughts and Behaviors Interview: Development, reliability, and validity in an adolescent sample. Psychological Assessment, 19(3), 309317. https://doi.org/10.1037/1040-3590.19.3.309Google Scholar
Nock, M. K., & Kessler, R. C. (2006). Prevalence of and risk factors for suicide attempts versus suicide gestures: Analysis of the National Comorbidity Survey. Journal of Abnormal Psychology, 115(3), 616623. https://doi.org/10.1037/0021-843X.115.3.616Google Scholar
Oliva, A., Jiménez, J., Parra, A., & Sánchez-Queija, I. (2008). Acontecimientos vitales estresantes, resiliencia y ajuste adolescente [Stressful life events, resilience and adolescent adjustment]. Revista de Psicopatología y Psicología Clínica, 13, 5362.Google Scholar
Pardo, A., & Román, M. (2013). Reflections on the Baron and Kenny model of statistical mediation. Anales de Psicología, 29(2).Google Scholar
Preacher, K. J., & Hayes, A. F. (2004). SPSS and SAS procedures for estimating indirect effects in simple mediation models. Behavior Research Methods, Instruments, & Computers, 36(4), 717731. https://doi.org/10.3758/BF03206553Google Scholar
Shaffer, D., Gould, M. S., Brasic, J., Ambrosini, P., Fisher, P., Bird, H., & Aluwahlia, S. (1983). A Children’s Global Assessment Scale (CGAS). Archives of General Psychiatry 40(11), 12281231.Google Scholar
Stein, D. J., Chiu, W. T., Hwang, I., Kessler, R. C., Sampson, N., Alonso, J., … Nock, M. K. (2010). Cross-national analysis of the associations between traumatic events and suicidal behavior: Findings from the WHO World Mental Health Surveys. PLoS ONE, 5(5), e10574. https://doi.org/10.1371/journal.pone.0010574Google Scholar