The Relationship Between Borderline Personality Features,emotion Regulation Strategies,and Non-suicidal Self-injury In Depressed Adolescents:A Cross-sectional Study

Objective: Non-suicidal self-injury is common among adolescents and adversely affects their physical and mental health.It is not only inherently dangerous,but also associated with many other negative effects in the future,including higher risk of mental disorders and suicide.Therefore,the identification of risk factors for NSSI in adolescents will provide valuable clues for in-depth understanding of the mechanism of NSSI and intervention treatment.According to the empirical avoidance model,adolescents with NSSI have stronger emotional experience and less ability to regulate emotions than those without NSSI,and deficits in emotional regulation are the characteristics of BPD.However,the relationship between borderline personality features,emotional regulation and NSSI behavior remains unclear.This study aims to understand the current situation of self-injury in adolescents with depression,analyze the relationship between borderline personality features,emotional regulation and non-suicidal self-injury in adolescents with depression,and provide theoretical basis for future treatment and intervention.Methods: In this study,the NSSI Functional Assessment Scale,the Chinese version of the Emotional Regulation Questionnaire for Children and Adolescents,and the Chinese version of the Borderline Features Scale for Children and Adolescents were used to evaluate and analyze the NSSI behaviors and functions,borderline personality traits,emotional regulation strategies and their sub-dimensions in 1192 adolescents with depression.Results:(1)71.3%(850/1192)of adolescents with depression had self-injury behavior in the past year;The most common way of self-injury was cutting or scratching their own skin(57.4%).(2)The attention-seeking factor in NSSI was positively correlated with borderline personality features(r=0.252,P<0.01),but had no significant correlation with cognitive reappraisal(r=0.007,P > 0.05)and expression inhibition strategies(P > 0.05).Emotion regulation factors were positively correlated with borderline personality features(r=0.464,P<0.01)expression inhibition(r=0.191,P<0.01),and negatively correlated with cognitive reappraisal(r=0.156,P<0.01).Social avoidance factors were positively correlated with borderline personality features(r=0.335,P<0.01)expression inhibition(r=0.091,p<0.01),but not with cognitive reappraisal strategies(r=-0.040,P > 0.05).(3)Using self-injury(1 with self-injury,2 without self-injury)as the fixed factor analysis,Pearson correlation analysis showed that borderline personality features of depressed adolescents were negatively correlated with self-injury(r=-0.314,P < 0.01),but significantly positively correlated with cognitive reappraisal strategies,while there was no significant correlation between cognitive reappraisal and surface inhibition(r=0.022,P>0.05);Nssi was positively correlated with borderline personality(r=0.314,P<0.01).(4)Based on this analysis,cognitive reappraisal and expression inhibition were used as mediating factors respectively.The results showed that cognitive reappraisal played a mediating role in the relationship between borderline personality features and NSSI in adolescents with depression.Conclusion: Borderline personality features not only directly affect NSSI behavior in adolescents with depression,but also indirectly affect NSSI through cognitive reappraisal.