Expressed Emotion, Shame, and Non-Suicidal Self-Injury

Int J Environ Res Public Health. 2018 Apr 30;15(5):890. doi: 10.3390/ijerph15050890.

Abstract

A cross-sectional study examining relationships between perceived family Expressed Emotion and shame, emotional involvement, depression, anxiety, stress and non-suicidal self-injury, in 264 community and online adults (21.6% male). We compared self-injurers with non-self-injurers, and current with past self-injurers. Self-injurers experienced more family Expressed Emotion (EE) than non-injurers (t(254) = &minus;3.24, p = 0.001), linear contrasts explaining 6% of between-groups variability (F(2, 254) = 7.36, p = 0.001, &eta;² = 0.06). Differences in EE between current and past self-injurers were not significant. Overall shame accounted for 33% of between-groups variance (F(2, 252) = 61.99, p < 0.001, &eta;² = 0.33), with linear contrasts indicating self-injurers experienced higher levels compared to non-injurers (t(252) = &minus;8.23, p < 0.001). Current self-injurers reported higher overall shame than past self-injurers (t(252) = 6.78, p < 0.001). In further logistic regression, emotional involvement and overall shame were the only significant predictors of self-injury status. With every one-unit increase in emotional involvement, odds of currently engaging in self-injury decreased by a factor of 0.860. Conversely, a one-unit increase in overall shame was associated with an increase in the odds of being a current self-injurer by a factor of 1.05. The findings have important treatment implications for engaging key family members in intervention and prevention efforts.

Keywords: Shame; adults; anxiety; depression; emotion dysregulation; expressed emotion; non-suicidal self-injury; stress.

MeSH terms

  • Adolescent
  • Adult
  • Anxiety / epidemiology
  • Anxiety / psychology
  • Cross-Sectional Studies
  • Depression / epidemiology
  • Depression / psychology
  • Expressed Emotion*
  • Family
  • Female
  • Humans
  • Male
  • Middle Aged
  • Self-Injurious Behavior / psychology*
  • Shame*
  • Surveys and Questionnaires
  • Young Adult