The Relationship of Emotional Child Abuse, Borderline Personality, and Self-harm Behavior with the Mediating Role of Object Relation in Female Adolescents

Ghamooshi, Fateme; Sobhi, Afsaneh; Kiani, Qamar; Ahmadi, Mohammad Saeed

doi:10.30476/intjsh.2022.93307.1192

Document Type : Research Article (s)

Authors

¹ Department of Educational Psychology, Islamic Azad University, Zanjan Branch, Zanjan, Iran

² Department of Psychology, Islamic Azad University, Zanjan Branch, Zanjan, Iran

³ Department of Psychology, University of Farhangian, Zanjan, Iran

https://doi.org/10.30476/intjsh.2022.93307.1192

Abstract

Background: Today, the borderline personality disorder has become highly prevalent among adolescents. Its relationship with the incidence of self-harm behaviors has augmented its importance. Thus, in the present article, we aimed to answer the question of what the relationship is of emotional abuse, borderline personality, and self-harm behavior with the mediating role of object relation in female adolescents.
Methods: This cross-sectional study was performed on 285 female students in Qazvin, Iran in the academic year of 2020-2021. Seven female middle schools were randomly chosen for sample collection. Child Trauma Questionnaire (CTQ) Scale, Object Relations Inventory, Leichsenring Borderline Personality Disorder Questionnaire, and Klonsky & Glenn Self-injurious Behavior Questionnaire were used to collect data from the participants. Finally, the data were entered into SPSS software version 25, and Pearson correlation coefficient and multiple regression were utilized to analyze them.
Results: The findings indicated the bivariate correlation of emotional abuse, object relations, and borderline personality with self-harm (r=-0.10, P=0.04, r=-0.47, P=0.001, and r=-0.47, P=0.001, respectively). Standardized coefficients of effects, object relations (β=0.47, P=0.001), borderline syndrome (β=0.28, P=0.003), and emotional abuse (β=-0.10, P=0.046) showed the most significant effects. The mediating role of object relations in this study was also confirmed.
Conclusion: Our results revealed a relationship between borderline personality disorder and self-harm behavior in female adolescents. Object relations can also greatly eliminate the effect of borderline personality disorder on self-harm.

Keywords

References

1. Dubovsky AN, Kiefer MM. Borderline personality disorder in the primary care setting. Med Clin North Am. 2014;98(5):1049-64. doi: 10.1016/j.mcna.2014.06.005. PubMed PMID: 25134872. ## 2. Blum K, Gold M, Demetrovics Z, Archer T, Thanos PK, Baron D, et al. Substance use disorder a bio-directional subset of reward deficiency syndrome. Front Biosci. 2017;22(9):1534–48. doi: 10.2741/4557. PubMed PMID: 28410131. ## 3. Kapur N, Cooper J, O'Connor RC, Hawton K. Non-suicidal self-injury v. attempted suicide: new diagnosis or false dichotomy? Br J Psychiatry. 2013;202(5):326-8. doi: 10.1192/bjp.bp.112.116111. PubMed PMID: 23637107. ## 4. Bentley KH, Nock MK, Barlow DH. The Four-Function Model of Nonsocial Self-harm: Key Directions for Future Research. Clinical Psychological Science. 2014;2(5):638-56. ## 5. Hawton K, Bergen H, Kapur N, Cooper J, Steeg S, Ness J, et al. Repetition of self‐harm and suicide following self‐harm in children and adolescents: Findings from the Multicentre Study of Self‐harm in England. J Child Psychol Psychiatry. 2012;53(12):1212-9. doi: 10.1111/j.1469-7610.2012.02559.x. PubMed PMID: 22537181. ## 6. Murphy CM, Hoover SA. Measuring emotional abuse in dating relationships as a multifactorial construct. Violence Vict. 1999;14(1):39-53. PubMed PMID: 10397625. ## 7. Ngai F-W, Chan SW-C. Learned resourcefulness, social support, and perinatal depression in Chinese mothers. Nurs Res. 2012;61(2):78-85. doi: 10.1097/NNR.0b013e318240dd3f. PubMed PMID: 22307141. ## 8. McEvoy PM, Nathan P, Norton PJ. Efficacy of transdiagnostic treatments: A review of published outcome studies and future research directions. Journal of Cognitive Psychotherapy. 2009;23(1):20-33. doi: 10.1891/0889-8391.23.1.20. ## 9. Mesgarian F, Azad Fallah P, Farahani H, Ghorbani N. Object Relations and defense mechanisms in social anxiety. 2017;14(53):3-14. Persian. ## 10. Handelzalts JE, Fisher S, Naot R. Object relations and real life relationships: A cross method assessment. Scand J Psychol. 2014;55(2):160-7. doi: 10.1111/sjop.12102. PubMed PMID: 24506278. ## 11. Metzger JA. Adaptive defense mechanisms: function and transcendence. J Clin Psychol. 2014;70(5):478-88. doi: 10.1002/jclp.22091. PubMed PMID: 24677248. ## 12. PourHosein R, Ezzati N, Gholamali Lavasani M. Study of the efficacy of" self-review method" of suicidal thoughts and anger on female delinquent adolescents. Journal of Psychological Science. 2016;15(57):6-19. Persian. ## 13. Sansone RA, Gaither GA, Songer DA. The relationships among childhood abuse, borderline personality, and self-harm behavior in psychiatric inpatients. Violence Vict. 2002;17(1):49-55. doi: 10.1891/vivi.17.1.49.33636. PubMed PMID: 11991156. ## 14. Bernstein DP, Stein JA, Newcomb MD, Walker E, Pogge D, Ahluvalia T, et al. Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse Negl. 2003;27(2):169-90. doi: 10.1016/s0145-2134(02)00541-0. PubMed PMID: 12615092. ## 15. Bell MD. Bell Object Relations and Reality Testing Inventory: BORRTI: Western Psychological Services; 2007. ## 16. Leichsenring F. Development and first results of the Borderline Personality Inventory: A self-report instrument for assessing borderline personality organization. J Pers Assess. 1999;73(1):45-63. doi: 10.1207/S15327752JPA730104. PubMed PMID: 10497801. ## 17. Klonsky ED, Glenn CR. Assessing the functions of non-suicidal self-injury: Psychometric properties of the Inventory of Statements About Self-injury (ISAS). J Psychopathol Behav Assess. 2009;31(3):215-219. doi: 10.1007/s10862-008-9107-z. PubMed PMID: 29269992; PubMed Central PMCID: PMC5736316. ## 18. Pourshahriar H, Alizade H, Rajaeinia K. Childhood Emotional Abuse and Borderline Personality Disorder Features: The Mediating Roles of Attachment Style and Emotion Regulation. IJPCP. 2018;24(2):148-63. Persian. ## 19. C Chegeni M, Haghdoost A, Shahrbabaki ME, Shahrbabaki PM, Nakhaee N. Validity and reliability of the Persian version of the Adverse Childhood Experiences Abuse Short Form. J Educ Health Promot. 2020;9:140. doi: 10.4103/jehp.jehp_15_20. PubMed PMID: 32766325; PubMed Central PMCID: PMC7377151. ## 20. Mikaeili N, Zamanloo Kh. A Study Of The Prevalence Of Child Abuse And Its Prediction From Parents’ Depression And Anxiety, Attachment Styles And Mental Health Of Their Adolescent Boys. Psychology of Exceptional Individuals. 2012;2(5):145-66. Persian. ## 21. Enayat N, Yaghoubi Doust M. Relationship Between Marital Conflict And Domestic Violence Against Girls. Sociology of Women. 2012;3(11):1-29. Persian. ## 22. Mesgarian F, Azadfallah P, Farahani H, Ghorbani N. Psychometric properties of Bell object relations inventory (BORI). Clinical Psychology and Personality. 2020;15(2):193-204. doi: 10.22070/cpap.2020.2828. Persian. ## 23. Robenzadeh SH, Rasoolzadeh Tabatabaei K, Ghorbani N, Abedin AR. Investigation of the Role of Self-Knowledge, Commitment, and Object Relations in Adolescents’ Identity Formation. Sadra Medical Sciences. 2016;4(4):267-76. Persian. ## 24. Ahmadi F, Sarafraz MR, Rezaei AK. The Diagnostic Role of Object Relations and Defensive Mechanisms in Patients with Opioid abuse, Stimulant Users and Normal Individuals. etiadpajohi. 2020;14(55):169-92. Persian. ## 25. Levy KN. The implications of attachment theory and research for understanding borderline personality disorder. Dev Psychopathol. 2005;17(4):959-86. doi: 10.1017/s0954579405050455. PubMed PMID: 16613426. ## 26. Shadara Z, Dehghani M, Heidari M, Mahmoud Aliloo M. Distress Tolerance, Impulsivity and Aggression: the Role of Emotional Dysregulation and Reward Sensitivity in Individuals with Borderline Personality Disorder Features. PCP. 2021;9(1):37-50. doi: 10.32598/jpcp.9.1.727.1. ## 27. Ataei J, Shamshirgaran SM, Iranparvar M, Safaeian A, Malek A. Reliability and validity of the Persian version of the Kessler psychological distress scale among patients with type 2 diabetes. J Anal Res Clin Med. 2015;3(2):99-106. doi: 10.15171/jarcm.2015.015. ## 28. Saffarinia M, Nikoogoftar M, Damavandian A. The Effectiveness of Dialectical Behavior Therapy (DBT) on Reducing Self-Harming Behaviors in Juvenile Offenders in Tehran's Juvenile Correction and Rehabilitation Centre. Clinical Psychology Studies. 2014;4(15):141-58. Persian. ## 29. Peymannia B, Hamid N, Mehrabizadehhonarmand M, Mahmoudalilu M. The Effectiveness of Dialectic Behavioral Therapy-Family and child Skills Training (DBT-FST) on Impulsivity and quality of life in girls with self-harm behaviors. Iranian Journal of Rehabilitation Research. 2018;4(3):8-17. Persian. ## 30. Khanipour H, Borjali A, Falsafinejad MR. Non-suicidal Self-injury in delinquent adolescents and adolescents with history of childhood maltreatment: motivation and suicide probability. Psychology of Exceptional Individuals. 2016;6(21):59-79. Persian. ## 31. Zaki LF, Coifman KG, Rafaeli E, Berenson KR, Downey G. Emotion differentiation as a protective factor against nonsuicidal self-injury in borderline personality disorder. Behav Ther. 2013;44(3):529-40. doi: 10.1016/j.beth.2013.04.008. PubMed PMID: 23768678. ## 32. Mahmoud Alilou M, Hashemi T, Bairami M, Bakhshipour A, Sharifi MA. Investigating the Relationship between Childhood Abuse, Primary Loss and Separation, and Emotional Disorder with Borderline Personality Disorder. Journal of Psychological Achievements. 2014;21(2):65-88. Persian. ## 33. Stern BL, Caligor E, Hörz-Sagstetter S, Clarkin JF. An Object-Relations Based Model for the Assessment of Borderline Psychopathology. Psychiatr Clin North Am. 2018;41(4):595-611. doi: 10.1016/j.psc.2018.07.007. PubMed PMID: 30447727. ## 34. Huh HJ, Kim KH, Lee H-K, Chae J-H. The relationship between childhood trauma and the severity of adulthood depression and anxiety symptoms in a clinical sample: The mediating role of cognitive emotion regulation strategies. J Affect Disord. 2017;213:44-50. doi: 10.1016/j.jad.2017.02.009. PubMed PMID: 28189964. ## 35. Mojahed A, Rajabi M, Khanjani S, Basharpoor S. Prediction of self-injury behavior in men with borderline personality disorder based on their symptoms of borderline personality and Alexithymia. Int J High Risk Behav Addict. 2018;7(3):e67693. doi: 10.5812/ijhrba.67693. ## 36. Tang X, Tang S, Ren Z, Wong DFK. Prevalence of depressive symptoms among adolescents in secondary school in mainland China: A systematic review and meta-analysis. J Affect Disord. 2019;245:498-507. doi: 10.1016/j.jad.2018.11.043. PubMed PMID: 30439677. ## 37. Griffin DW, Bartholomew K. Models of the self and other: Fundamental dimensions underlying measures of adult attachment. Journal of Personality and Social Psychology. 1994;67(3):430-445. doi: 10.1037/0022-3514.67.3.430. ## 38. Goldstein CP. Suicide attempts in traumatized children and adolescents: An implicit investigation of affect regulation and object relations: Adelphi University; 2016. ## 39. Zarrati I, Bermas H, Sabet M. Correlation between Childhood Trauma and Suicidal Ideation by Mediation of Mental Pain and Object Relations. Journal of Health Promotion Management. 2020;9(3):34-48. Persian. ## 40. Stead VE, Boylan K, Schmidt LA. Longitudinal associations between non-suicidal self-injury and borderline personality disorder in adolescents: A literature review. Borderline Personality Disorder and Emotion Dysregulation. 2019;6(1):1-12. ##

International Journal of School Health

The Relationship of Emotional Child Abuse, Borderline Personality, and Self-harm Behavior with the Mediating Role of Object Relation in Female Adolescents

References

References

Volume 9, Issue 1 - Serial Number 32
January 2022
Pages 26-35

The Relationship of Emotional Child Abuse, Borderline Personality, and Self-harm Behavior with the Mediating Role of Object Relation in Female Adolescents

References

References

Volume 9, Issue 1 - Serial Number 32January 2022Pages 26-35

Volume 9, Issue 1 - Serial Number 32
January 2022
Pages 26-35