Adolescents who self-harm : the role of Early Maladaptive Schemas

• Main Author: Walker, Louise
• Published: University of Lincoln 2014
• Subjects: 150; C840 Clinical Psychology
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.668389

Background: An estimated one in ten adolescents living in the community will engage in deliberately self-harming (DSH) during their lifetime. This perplexing behaviour is of growing clinical concern and appears to be increasing in prevalence, yet continues to be without definitive understanding. There are multiple theories on the underlying mechanisms of DSH, however, there is limited empirical evidence to support these theories. The present study aimed to investigate whether Young’s schema theory could provide a comprehensive framework to understand DSH in adolescents from the general community. This study aimed take a unique perspective on DSH by investigating the theorised unconscious cognitive constructs, known as Early Maladaptive Schema’s (EMS’s), which may underlie this behaviour. It also explored the relationship between EMS’s and psychopathology within this sample. Methodology: 252 adolescents recruited from internet forums and social networking sites completed a series of self-report questionnaires online. DSH was measured using the Deliberate Self-Harm Inventory. Early Maladaptive Schema’s were measured using an age downward version of the Young’s Schema Questionnaire-short form. The Brief Symptoms Inventory was used to measure psychopathology, and a demographics questionnaire was designed to gather pertinent additional information. Results: Correlational analyses indicated positive relationships between frequency of DSH behaviours and intensity of 13 of the 15 EMS’s. Despite no association found between the overall EMS score and general psychological distress, when each EMS was considered individually, relationships were found between the intensity of each of the 15 EMS’s and the general measure of psychological distress. Hierarchical multiple regression, controlling for gender and general psychopathology, indicated that the Emotional Deprivation, Vulnerability to Harm, Subjugation and Self-Sacrifice EMS’s accounted for a unique proportion of the variance in DSH behaviour. Conclusions: These finding are unique in that they extend the research into both DSH and EMS’s in adolescents. From the findings one could broadly conclude that, as Schema Theory states, DSH is a coping strategy used to manage unbearable memories, emotions, cognitions, and bodily sensations associated with EMS’s, with positive correlations between the intensity of the EMS’s and the frequency of DSH, and the intensity of the EMS’s and increased psychological distress. Further, during this time the EMS’s Emotional Deprivation, Vulnerability to Harm, Self-Sacrifice and Subjugation are more predictive of DSH than alternative EMS’s. When comparing these findings to the wider literature, one could conclude that EMS’s are unstable in adolescents, as those EMS’s causing distress in an individual’s adolescence may not continue to do so into their adulthood, yet the coping strategy may remain the same. This highlights the role of social, environmental and biological changes in the stability of EMS’s. The pertinence of these findings to adolescents who DSH, the overlap with broader psychological symptomotology, and its relevance to clinical practice is discussed.