Personality characteristics, defense styles, borderline symptoms, and non-suicidal self-injury in first-episode major depressive disorder

Bo Peng; Jiwu Liao; Yang Li; Guangbo Jia; Jihui Yang; Zhiwei Wu; Jian Zhang; Yingjia Yang; Xinxin Luo; Yao Wang; Yingli Zhang; Jiyang Pan

doi:10.3389/fpsyg.2023.989711

Personality characteristics, defense styles, borderline symptoms, and non-suicidal self-injury in first-episode major depressive disorder

Front Psychol. 2023 Jan 26:14:989711. doi: 10.3389/fpsyg.2023.989711. eCollection 2023.

Authors

Bo Peng^{1

2

3}, Jiwu Liao¹, Yang Li⁴, Guangbo Jia³, Jihui Yang³, Zhiwei Wu³, Jian Zhang³, Yingjia Yang³, Xinxin Luo³, Yao Wang^{2

3}, Yingli Zhang^{2

3}, Jiyang Pan¹

Affiliations

¹ Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China.
² Department of Depressive Disorder, Shenzhen Kangning Hospital, Shenzhen, Guangdong, China.
³ Shenzhen Mental Health Center, Shenzhen, Guangdong, China.
⁴ Teachers College, Columbia University, New York, NY, United States.

Abstract

Background: Non-suicidal self-injury (NSSI) is commonly seen in adolescents with depression and is a high-risk factor leading to suicide. The psychological mechanisms underlying depression with NSSI are still unclear. The purpose of this study was to explore the differences in personality traits, defensive styles, and borderline symptoms among first-episode youth patients with depression and self-injury compared with patients with depression without self-injury and healthy populations.

Methods: The current study recruited 188 participants, including 64 patients with depression and NSSI, 60 patients with depression without NSSI, and 64 healthy control subjects. Eysenck Personality Questionnaire, the Defense Style Questionnaire, the short version of the Borderline Symptom List, the Beck Depression Inventory, and the Ottawa Self-Injury Inventory were used to assess all participants.

Results: Patients with depression and NSSI showed more psychoticism than patients with depression without NSSI and healthy control subjects. Patients with depression and NSSI presented more intermediate defense styles than healthy control subjects. In the patients with depression and NSSI group, the frequency of self-injury in the last week was negatively correlated with mature defense styles and positively correlated with depressive symptoms and borderline symptoms. Further regression analysis showed that EPQ-psychoticism and depressive symptoms were independent risk factors for NSSI in patients with depression.

Conclusion: This study found that patients with depression and self-injury presented more neuroticism, introversion, EPQ-psychoticism, immature defenses, intermediate defenses, and borderline symptoms. Self-injury frequency was negatively correlated with mature defense styles and positively correlated with depressive symptoms and borderline symptoms. EPQ-Psychoticism and depressive symptoms are risk factors for predicting non-suicidal self-injury in patients with depression.

Keywords: borderline; defensive mechanisms; depression; non-suicidal self-injury; personality; traits.