Catherine Glenn | University of Rochester (original) (raw)

Papers by Catherine Glenn

Psychiatry Research

There is debate among researchers regarding the most appropriate conceptual model of non-suicidal... more There is debate among researchers regarding the most appropriate conceptual model of non-suicidal self-injury (NSSI). Some argue that NSSI is best viewed within an addictions framework. Because craving of substances is a key concept in the addictions literature, we sought to compare the nature of craving in NSSI and substance use. Measures of NSSI, substance use, and craving were administered to a sample of adolescents (n=58) receiving psychiatric treatment. It was found that total craving scores were significantly lower for NSSI than for substances. Item-level analyses suggested that substances are craved in a variety of contexts, whereas NSSI is typically craved in the context of negative emotions. The pattern of results remained the same when analyses were limited to patients who engaged in both NSSI and substance use. Thus, findings appear to be due to differences in the nature of the behaviors themselves rather than to individual differences between those who engage in NSSI or ...

Paper presentation at the 47th annual meeting of the American Association of Suicidology, Los Ang... more Paper presentation at the 47th annual meeting of the American Association of Suicidology, Los Angeles, CA.

Paper presentation at the 45th annual meeting of the Association for Behavioral and Cognitive The... more Paper presentation at the 45th annual meeting of the Association for Behavioral and Cognitive Therapies, Toronto, ON.

Suicide & life-threatening behavior, Jan 22, 2014

Suicide and suicidal behavior are major public health problems, especially among adolescents and ... more Suicide and suicidal behavior are major public health problems, especially among adolescents and young adults. Previous research has established links between parental bonding and suicidality; however, it remains unclear whether parental bonding is associated with suicide ideation, the progression from suicide ideation to suicide attempts, or both. This study examined the relation of parental bonding to suicide ideation and suicide attempts in adolescents from two settings: (1) acute psychiatric care (n = 172) and (2) high school (n = 426). All participants were administered validated measures of parental bonding, suicide ideation, and suicide attempts, as well as emotion dysregulation, loneliness, and self-worth. In the psychiatric sample, lower parental care significantly differentiated adolescents with a history of suicide attempts from those with suicide ideation only or without histories of suicidality. This pattern remained even after controlling for other known correlates of ...

American journal of preventive medicine, 2014

Aspirational Goal 3 of the National Action Alliance for Suicide Prevention's Research Priorit... more Aspirational Goal 3 of the National Action Alliance for Suicide Prevention's Research Prioritization Task Force is to predict who is at risk for attempting suicide in the near future. Despite decades of research devoted to the study of risk and protective factors for suicide and suicidal behavior, surprisingly little is known about the short-term prediction of these behaviors. In this paper, we propose several questions that, if answered, could improve the identification of short-term, or imminent, risk for suicidal behavior. First, what factors predict the transition from suicidal thoughts to attempts? Second, what factors are particularly strong predictors of making this transition over the next hours, days, or weeks? Third, what are the most important objective markers of short-term risk for suicidal behavior? And fourth, what method of combining information about risk and protective factors yields the best prediction? We propose that the next generation of research on the as...

Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Académie canadienne de psychiatrie de l'enfant et de l'adolescent, 2013

Although the DSM-IV suggests that dysfunctional personality patterns can be traced back to adoles... more Although the DSM-IV suggests that dysfunctional personality patterns can be traced back to adolescence, there is continued debate about whether borderline personality disorder (BPD) can be reliably and validly diagnosed before age 18. The current study examined the reliability and validity of BPD in a large sample of adolescent psychiatric patients. BPD and Axis I disorders were assessed with validated structured interviews and a series of clinical, emotion, and personality correlates were assessed with validated self-report questionnaires. Consistent with previous studies in adolescent clinical samples, approximately 30% of patients in the current sample met criteria for BPD. The nine BPD criteria demonstrated good internal consistency, equivalent to rates reported in adult samples. In addition, BPD was related to greater clinical severity and impairment as indexed by strong associations with all major Axis I disorders, as well as with dimensional measures of depression, anxiety, d...

Journal of Clinical Child & Adolescent Psychology, 2014

The purpose of this study was to review the current evidence base of psychosocial treatments for ... more The purpose of this study was to review the current evidence base of psychosocial treatments for suicidal and nonsuicidal self-injurious thoughts and behaviors (SITBs) in youth. We reviewed major scientific databases (HealthSTAR, MEDLine, PsycINFO, PubMed) for relevant studies published prior to June 2013. The search identified 29 studies examining interventions for suicidal or nonsuicidal SITBs in children or adolescents. No interventions currently meet the Journal of Clinical Child and Adolescent Psychology standards for Level 1: well-established treatments. Six treatment categories were classified as Level 2: probably efficacious or Level 3: possibly efficacious for reducing SITBs in youth. These treatments came from a variety of theoretical orientations, including cognitive-behavioral, family, interpersonal, and psychodynamic theories. Common elements across efficacious treatments included family skills training (e.g., family communication and problem solving), parent education and training (e.g., monitoring and contingency management), and individual skills training (e.g., emotion regulation and problem solving). Several treatments have shown potential promise for reducing SITBs in children and adolescents. However, the probably/possibly efficacious treatments identified each have evidence from only a single randomized controlled trial. Future research should focus on replicating studies of promising treatments, identifying active treatment ingredients, examining mediators and moderators of treatment effects, and developing brief interventions for high-risk periods (e.g., following hospital discharge).

Psychopathology, 2009

Borderline personality disorder (BPD) is a debilitating mental illness that affects approximately... more Borderline personality disorder (BPD) is a debilitating mental illness that affects approximately 6% of the general population and 10-20% of psychiatric patients. The Borderline Symptom List (BSL) is a self-report questionnaire designed to comprehensively assess BPD symptomatology. The present study examined the convergence of the BSL with DSM-IV BPD assessed by semi-structured interview. To ensure variability in BPD symptoms, participants were recruited from a large college sample if they generated either high or low scores on a BPD symptom screening questionnaire. The final sample included 59 participants who completed the BSL, the BPD questions from the Structured Interview for DSM-IV Personality (SIDP-IV), and self-report measures of depression and anxiety. Ten participants (17%) met the full BPD criteria and 29 (49%) met 2 or more criteria. Results indicate strong convergence between the BSL and BPD assessed by semi-structured interview, even when controlling for measures of depression and anxiety. The shortened version of the BSL, the BSL-23, also correlated robustly with BPD assessed by semi-structured interview. Findings support the validity of the BSL (and BSL-23) as a self-report measure of BPD symptomatology. Future research should replicate results in other samples, including those drawn from psychiatric populations.

Psychiatry Research, 2012

There is debate among researchers regarding the most appropriate conceptual model of non-suicidal... more There is debate among researchers regarding the most appropriate conceptual model of non-suicidal self-injury (NSSI). Some argue that NSSI is best viewed within an addictions framework. Because craving of substances is a key concept in the addictions literature, we sought to compare the nature of craving in NSSI and substance use. Measures of NSSI, substance use, and craving were administered to a sample of adolescents (n=58) receiving psychiatric treatment. It was found that total craving scores were significantly lower for NSSI than for substances. Item-level analyses suggested that substances are craved in a variety of contexts, whereas NSSI is typically craved in the context of negative emotions. The pattern of results remained the same when analyses were limited to patients who engaged in both NSSI and substance use. Thus, findings appear to be due to differences in the nature of the behaviors themselves rather than to individual differences between those who engage in NSSI or use substances. We conclude that, while both behaviors have powerful reinforcement contingencies, NSSI appears to be almost exclusively maintained by negative reinforcement (e.g., the reduction of aversive emotions). Findings are more consistent with emotion regulation than addiction models of NSSI.

Personality and Individual Differences, 2009

The link between non-suicidal self-injury (NSSI) and suicide is complex. Previous research indica... more The link between non-suicidal self-injury (NSSI) and suicide is complex. Previous research indicates that self-injurers endorsing automatic/intrapersonal functions (as opposed to social/interpersonal functions) for NSSI are more likely to have considered and attempted suicide. Subsequent research suggests that those endorsing automatic/intrapersonal functions are more likely to self-injure exclusively while alone. Based on these findings, we hypothesized that the social context during NSSI (i.e., the extent to which one self-injures alone versus around others) represents an easily measurable and theoretically meaningful marker for suicide risk among those who self-injure. Participants were 205 young adults who had performed one or more NSSI behaviors and completed several clinical measures. In general, self-injurers scored higher on measures of suicidality and suicide risk factors (i.e., depression, anxiety, borderline personality disorder symptomatology) than a non-injuring control sample (n = 596). In addition, self-injurers who engage in NSSI alone were more likely to report a history of suicide ideation, plans, and attempts compared to other self-injurers. Endorsement of automatic/intrapersonal functions only partially explained the relationship between the social context during NSSI and suicidality. Consistent with the study hypothesis, social context during NSSI appears to be a marker for suicide risk in individuals who engage in NSSI.

Journal of Psychopathology and Behavioral Assessment, 2009

The present study reports the psychometric properties of the Inventory of Statements About Self-i... more The present study reports the psychometric properties of the Inventory of Statements About Self-injury (ISAS), a measure designed to comprehensively assess the functions of non-suicidal self-injury (NSSI). The ISAS assesses 13 functions of NSSI, as well as the frequency of 12 NSSI behaviors. The ISAS was administered to 235 young adults from a college population who had performed at least one NSSI behavior. Consistent with previous research, ISAS functions comprised two factors representing interpersonal and intrapersonal functions. In addition, the ISAS factors exhibited excellent internal consistency and expected correlations with both clinical constructs (e.g., borderline personality disorder, suicidality, depression, anxiety) and contextual variables (e.g., tendency to self-injure alone). Findings support the reliability and validity of the ISAS. The ISAS may be useful in research and treatment contexts as a comprehensive measure of NSSI functions.

Journal of Personality Disorders, 2013

Suicide-related behaviors are a significant public health concern among adolescents, and research... more Suicide-related behaviors are a significant public health concern among adolescents, and research is greatly needed to identify risk factors for these behaviors in this age group. Borderline personality disorder (BPD) features are one such factor that may help predict suicide risk in adolescents. In adults, BPD features are related to negative outcomes, including suicidal behavior. However, much less is known about this association in adolescents. The current study examined which specific facets of BPD relate to suicidal ideation and attempts in an adolescent psychiatric inpatient sample. Results indicated that the affective instability facet of BPD was uniquely related to suicidal ideation and attempts, even when controlling for general negative emotionality. Moreover, greater affective instability significantly differentiated suicide ideators from attempters. These findings are consistent with adult BPD research and with Linehan's biosocial theory of BPD, suggesting that affective instability is a central BPD feature that leads to the behavioral dysregulation observed in the disorder.

Journal of Personality Disorders, 2009

Borderline personality disorder (BPD) is a debilitating mental illness that affects approximately... more Borderline personality disorder (BPD) is a debilitating mental illness that affects approximately 1-2% of the general population. Researchers have increasingly come to view emotion dysregulation as a core feature of BPD. The present study examines the relationship between BPD symptomatology and emotion dysregulation using the Difficulties in Emotion Regulation Scale (DERS) in two college samples. BPD symptoms were assessed by self-report (MSI-BPD) in sample 1 and by semistructured interview (SIDP-IV) in sample 2. Results suggest that emotion dysregulation accounts for unique variance in BPD even after controlling for traditional indicators of negative emotionality, including depression, anxiety, and negative affect. Findings support theories regarding the role of emotion dysregulation in BPD and provide directions for future research.

Journal of Personality and Social Psychology, 2007

This research examines whether people who experience epistemic motivation (i.e., a desire to acqu... more This research examines whether people who experience epistemic motivation (i.e., a desire to acquire knowledge) came to have implicit attitudes consistent with the apparent beliefs of another person. People had lower implicit prejudice when they experienced epistemic motivation and interacted with a person who ostensibly held egalitarian beliefs (Experiments 1 and 2). Implicit prejudice was not affected when people did not experience epistemic motivation. Further evidence shows that this tuning of implicit attitudes occurs when beliefs are endorsed by another person, but not when they are brought to mind via means that do not imply that person's endorsement (Experiment 3). Results suggest that implicit attitudes of epistemically motivated people tune to the apparent beliefs of others to achieve shared reality.

Journal of Clinical Psychology, 2010

Non-suicidal self-injury (NSSI) is a growing clinical problem, especially among adolescents and y... more Non-suicidal self-injury (NSSI) is a growing clinical problem, especially among adolescents and young adults. Anecdotal accounts, clinical reports, and popular media sources suggest that observing the blood resulting from NSSI often plays an important role in the behavior's reinforcement. However, research to date has not systematically assessed the role of blood in NSSI. The current study examined this phenomenon in 64 young adults from a college population with histories of non-suicidal skin-cutting. Approximately half the participants reported it was important to see blood during NSSI. These individuals reported spending five minutes or less looking at the blood after each instance of NSSI, and that seeing blood served several functions including "to relieve tension" and "makes me feel calm." In addition, wanting to see blood was associated with greater lifetime frequency of skin-cutting and greater endorsement of intrapersonal functions for NSSI (e.g., affect regulation, self-punishment). Finally, participants who reported wanting to see blood were more likely to endorse symptoms of bulimia nervosa and borderline personality disorder. Theoretical and clinical implications are discussed.

Journal of Clinical Child & Adolescent Psychology, 2013

Nonsuicidal self-injury (NSSI) is a growing public health concern, especially among adolescents. ... more Nonsuicidal self-injury (NSSI) is a growing public health concern, especially among adolescents. In the current edition of the Diagnostic and Statistical Manual of Mental Disorders, NSSI is classified as a criterion of borderline personality disorder (BPD). However, a distinct NSSI disorder will now be included in DSM-5 as a "condition requiring further study." It is important to note that, at this time, there is little direct evidence supporting the DSM-5 proposal over the DSM-IV classification. To address this need, the current study examined the extent to which NSSI occurs independently of BPD and has clinical significance beyond a diagnosis of BPD in adolescent psychiatric patients. NSSI disorder was assessed based on the proposed DSM-5 criteria in 198 adolescents ages 12 to 18 (74% female; 64% Caucasian, 14% Hispanic, 10% African American, and 12% mixed/other ethnicity) from a psychiatric hospital. Major Axis I disorders, Axis II BPD, and suicide ideation and attempts were assessed with structured clinical interviews; emotion dysregulation and loneliness were measured with validated self-report questionnaires. First, results indicated that NSSI disorder occurred independently of BPD. Specifically, although there was overlap between the occurrence of BPD and NSSI disorder, this overlap was no greater than that between BPD and other Axis I disorders (e.g., anxiety and mood disorders). Second, NSSI disorder demonstrated unique associations with clinical impairment-indexed by suicide ideation and attempts, emotion dysregulation, and loneliness-over and above a BPD diagnosis. Taken together, findings support the classification of NSSI as a distinct and clinically significant diagnostic entity.

Journal of Clinical Child & Adolescent Psychology, 2014

The recently proposed Research Domain Criteria (RDoC) project has the potential to stimulate new ... more The recently proposed Research Domain Criteria (RDoC) project has the potential to stimulate new research and overcome many of the limitations of the Diagnostic and Statistical Manual of Mental Disorders taxonomy. In the present article we focus, in three main sections, on how theory and research from developmental psychopathology can inform RDoC. First, we discuss the ontology of mental illness and the potential advantages of the RDoC approach to understanding the nature of mental illness. Second, we note potential issues to consider when implementing the RDoC framework, including (a) integrating developmental processes, (b) classifying mental illness within a dimensional approach, and (c) avoiding problems associated with biological reductionism. Third, we describe how a developmental psychopathology perspective may inform each of these potential issues within RDoC. Finally, we highlight the study of emotion and the centrality of affective processes within the RDoC framework. Specifically, we describe how constructionist models of emotion are consistent with developmental psychopathology and how this perspective on emotion can help to guide RDoC research.

Journal of Abnormal Psychology, 2013

Theoretical and empirical literature suggests that nonsuicidal self-injury (NSSI) may represent a... more Theoretical and empirical literature suggests that nonsuicidal self-injury (NSSI) may represent a particularly important risk factor for suicide. The present study examined the associations of NSSI and established suicide risk factors to attempted suicide in four samples: adolescent psychiatric patients (n ϭ 139), adolescent high school students (n ϭ 426), university undergraduates (n ϭ 1,364), and a random-digit dialing sample of United States adults (n ϭ 438). All samples were administered measures of NSSI, suicide ideation, and suicide attempts; the first three samples were also administered measures of depression, anxiety, impulsivity, and borderline personality disorder (BPD). In all four samples, NSSI exhibited a robust relationship to attempted suicide (median Phi ϭ .36). Only suicide ideation exhibited a stronger relationship to attempted suicide (median Phi ϭ .47), whereas associations were smaller for BPD (median r pb ϭ .29), depression (median r pb ϭ .24), anxiety (median r pb ϭ .16), and impulsivity (median r pb ϭ .11). When these known suicide risk factors and NSSI were simultaneously entered into logistic regression analyses, only NSSI and suicide ideation maintained significant associations with attempted suicide. Results suggest that NSSI is an especially important risk factor for suicide. Findings are interpreted in the context of Joiner's interpersonal-psychological theory of suicide; specifically, NSSI may be a uniquely important risk factor for suicide because its presence is associated with both increased desire and capability for suicide.

Psychiatry Research

There is debate among researchers regarding the most appropriate conceptual model of non-suicidal... more There is debate among researchers regarding the most appropriate conceptual model of non-suicidal self-injury (NSSI). Some argue that NSSI is best viewed within an addictions framework. Because craving of substances is a key concept in the addictions literature, we sought to compare the nature of craving in NSSI and substance use. Measures of NSSI, substance use, and craving were administered to a sample of adolescents (n=58) receiving psychiatric treatment. It was found that total craving scores were significantly lower for NSSI than for substances. Item-level analyses suggested that substances are craved in a variety of contexts, whereas NSSI is typically craved in the context of negative emotions. The pattern of results remained the same when analyses were limited to patients who engaged in both NSSI and substance use. Thus, findings appear to be due to differences in the nature of the behaviors themselves rather than to individual differences between those who engage in NSSI or ...

Paper presentation at the 47th annual meeting of the American Association of Suicidology, Los Ang... more Paper presentation at the 47th annual meeting of the American Association of Suicidology, Los Angeles, CA.

Paper presentation at the 45th annual meeting of the Association for Behavioral and Cognitive The... more Paper presentation at the 45th annual meeting of the Association for Behavioral and Cognitive Therapies, Toronto, ON.

Suicide & life-threatening behavior, Jan 22, 2014

Suicide and suicidal behavior are major public health problems, especially among adolescents and ... more Suicide and suicidal behavior are major public health problems, especially among adolescents and young adults. Previous research has established links between parental bonding and suicidality; however, it remains unclear whether parental bonding is associated with suicide ideation, the progression from suicide ideation to suicide attempts, or both. This study examined the relation of parental bonding to suicide ideation and suicide attempts in adolescents from two settings: (1) acute psychiatric care (n = 172) and (2) high school (n = 426). All participants were administered validated measures of parental bonding, suicide ideation, and suicide attempts, as well as emotion dysregulation, loneliness, and self-worth. In the psychiatric sample, lower parental care significantly differentiated adolescents with a history of suicide attempts from those with suicide ideation only or without histories of suicidality. This pattern remained even after controlling for other known correlates of ...

American journal of preventive medicine, 2014

Aspirational Goal 3 of the National Action Alliance for Suicide Prevention's Research Priorit... more Aspirational Goal 3 of the National Action Alliance for Suicide Prevention's Research Prioritization Task Force is to predict who is at risk for attempting suicide in the near future. Despite decades of research devoted to the study of risk and protective factors for suicide and suicidal behavior, surprisingly little is known about the short-term prediction of these behaviors. In this paper, we propose several questions that, if answered, could improve the identification of short-term, or imminent, risk for suicidal behavior. First, what factors predict the transition from suicidal thoughts to attempts? Second, what factors are particularly strong predictors of making this transition over the next hours, days, or weeks? Third, what are the most important objective markers of short-term risk for suicidal behavior? And fourth, what method of combining information about risk and protective factors yields the best prediction? We propose that the next generation of research on the as...

Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Académie canadienne de psychiatrie de l'enfant et de l'adolescent, 2013

Although the DSM-IV suggests that dysfunctional personality patterns can be traced back to adoles... more Although the DSM-IV suggests that dysfunctional personality patterns can be traced back to adolescence, there is continued debate about whether borderline personality disorder (BPD) can be reliably and validly diagnosed before age 18. The current study examined the reliability and validity of BPD in a large sample of adolescent psychiatric patients. BPD and Axis I disorders were assessed with validated structured interviews and a series of clinical, emotion, and personality correlates were assessed with validated self-report questionnaires. Consistent with previous studies in adolescent clinical samples, approximately 30% of patients in the current sample met criteria for BPD. The nine BPD criteria demonstrated good internal consistency, equivalent to rates reported in adult samples. In addition, BPD was related to greater clinical severity and impairment as indexed by strong associations with all major Axis I disorders, as well as with dimensional measures of depression, anxiety, d...

Journal of Clinical Child & Adolescent Psychology, 2014

The purpose of this study was to review the current evidence base of psychosocial treatments for ... more The purpose of this study was to review the current evidence base of psychosocial treatments for suicidal and nonsuicidal self-injurious thoughts and behaviors (SITBs) in youth. We reviewed major scientific databases (HealthSTAR, MEDLine, PsycINFO, PubMed) for relevant studies published prior to June 2013. The search identified 29 studies examining interventions for suicidal or nonsuicidal SITBs in children or adolescents. No interventions currently meet the Journal of Clinical Child and Adolescent Psychology standards for Level 1: well-established treatments. Six treatment categories were classified as Level 2: probably efficacious or Level 3: possibly efficacious for reducing SITBs in youth. These treatments came from a variety of theoretical orientations, including cognitive-behavioral, family, interpersonal, and psychodynamic theories. Common elements across efficacious treatments included family skills training (e.g., family communication and problem solving), parent education and training (e.g., monitoring and contingency management), and individual skills training (e.g., emotion regulation and problem solving). Several treatments have shown potential promise for reducing SITBs in children and adolescents. However, the probably/possibly efficacious treatments identified each have evidence from only a single randomized controlled trial. Future research should focus on replicating studies of promising treatments, identifying active treatment ingredients, examining mediators and moderators of treatment effects, and developing brief interventions for high-risk periods (e.g., following hospital discharge).

Psychopathology, 2009

Borderline personality disorder (BPD) is a debilitating mental illness that affects approximately... more Borderline personality disorder (BPD) is a debilitating mental illness that affects approximately 6% of the general population and 10-20% of psychiatric patients. The Borderline Symptom List (BSL) is a self-report questionnaire designed to comprehensively assess BPD symptomatology. The present study examined the convergence of the BSL with DSM-IV BPD assessed by semi-structured interview. To ensure variability in BPD symptoms, participants were recruited from a large college sample if they generated either high or low scores on a BPD symptom screening questionnaire. The final sample included 59 participants who completed the BSL, the BPD questions from the Structured Interview for DSM-IV Personality (SIDP-IV), and self-report measures of depression and anxiety. Ten participants (17%) met the full BPD criteria and 29 (49%) met 2 or more criteria. Results indicate strong convergence between the BSL and BPD assessed by semi-structured interview, even when controlling for measures of depression and anxiety. The shortened version of the BSL, the BSL-23, also correlated robustly with BPD assessed by semi-structured interview. Findings support the validity of the BSL (and BSL-23) as a self-report measure of BPD symptomatology. Future research should replicate results in other samples, including those drawn from psychiatric populations.

Psychiatry Research, 2012

There is debate among researchers regarding the most appropriate conceptual model of non-suicidal... more There is debate among researchers regarding the most appropriate conceptual model of non-suicidal self-injury (NSSI). Some argue that NSSI is best viewed within an addictions framework. Because craving of substances is a key concept in the addictions literature, we sought to compare the nature of craving in NSSI and substance use. Measures of NSSI, substance use, and craving were administered to a sample of adolescents (n=58) receiving psychiatric treatment. It was found that total craving scores were significantly lower for NSSI than for substances. Item-level analyses suggested that substances are craved in a variety of contexts, whereas NSSI is typically craved in the context of negative emotions. The pattern of results remained the same when analyses were limited to patients who engaged in both NSSI and substance use. Thus, findings appear to be due to differences in the nature of the behaviors themselves rather than to individual differences between those who engage in NSSI or use substances. We conclude that, while both behaviors have powerful reinforcement contingencies, NSSI appears to be almost exclusively maintained by negative reinforcement (e.g., the reduction of aversive emotions). Findings are more consistent with emotion regulation than addiction models of NSSI.

Personality and Individual Differences, 2009

The link between non-suicidal self-injury (NSSI) and suicide is complex. Previous research indica... more The link between non-suicidal self-injury (NSSI) and suicide is complex. Previous research indicates that self-injurers endorsing automatic/intrapersonal functions (as opposed to social/interpersonal functions) for NSSI are more likely to have considered and attempted suicide. Subsequent research suggests that those endorsing automatic/intrapersonal functions are more likely to self-injure exclusively while alone. Based on these findings, we hypothesized that the social context during NSSI (i.e., the extent to which one self-injures alone versus around others) represents an easily measurable and theoretically meaningful marker for suicide risk among those who self-injure. Participants were 205 young adults who had performed one or more NSSI behaviors and completed several clinical measures. In general, self-injurers scored higher on measures of suicidality and suicide risk factors (i.e., depression, anxiety, borderline personality disorder symptomatology) than a non-injuring control sample (n = 596). In addition, self-injurers who engage in NSSI alone were more likely to report a history of suicide ideation, plans, and attempts compared to other self-injurers. Endorsement of automatic/intrapersonal functions only partially explained the relationship between the social context during NSSI and suicidality. Consistent with the study hypothesis, social context during NSSI appears to be a marker for suicide risk in individuals who engage in NSSI.

Journal of Psychopathology and Behavioral Assessment, 2009

The present study reports the psychometric properties of the Inventory of Statements About Self-i... more The present study reports the psychometric properties of the Inventory of Statements About Self-injury (ISAS), a measure designed to comprehensively assess the functions of non-suicidal self-injury (NSSI). The ISAS assesses 13 functions of NSSI, as well as the frequency of 12 NSSI behaviors. The ISAS was administered to 235 young adults from a college population who had performed at least one NSSI behavior. Consistent with previous research, ISAS functions comprised two factors representing interpersonal and intrapersonal functions. In addition, the ISAS factors exhibited excellent internal consistency and expected correlations with both clinical constructs (e.g., borderline personality disorder, suicidality, depression, anxiety) and contextual variables (e.g., tendency to self-injure alone). Findings support the reliability and validity of the ISAS. The ISAS may be useful in research and treatment contexts as a comprehensive measure of NSSI functions.

Journal of Personality Disorders, 2013

Suicide-related behaviors are a significant public health concern among adolescents, and research... more Suicide-related behaviors are a significant public health concern among adolescents, and research is greatly needed to identify risk factors for these behaviors in this age group. Borderline personality disorder (BPD) features are one such factor that may help predict suicide risk in adolescents. In adults, BPD features are related to negative outcomes, including suicidal behavior. However, much less is known about this association in adolescents. The current study examined which specific facets of BPD relate to suicidal ideation and attempts in an adolescent psychiatric inpatient sample. Results indicated that the affective instability facet of BPD was uniquely related to suicidal ideation and attempts, even when controlling for general negative emotionality. Moreover, greater affective instability significantly differentiated suicide ideators from attempters. These findings are consistent with adult BPD research and with Linehan's biosocial theory of BPD, suggesting that affective instability is a central BPD feature that leads to the behavioral dysregulation observed in the disorder.

Journal of Personality Disorders, 2009

Borderline personality disorder (BPD) is a debilitating mental illness that affects approximately... more Borderline personality disorder (BPD) is a debilitating mental illness that affects approximately 1-2% of the general population. Researchers have increasingly come to view emotion dysregulation as a core feature of BPD. The present study examines the relationship between BPD symptomatology and emotion dysregulation using the Difficulties in Emotion Regulation Scale (DERS) in two college samples. BPD symptoms were assessed by self-report (MSI-BPD) in sample 1 and by semistructured interview (SIDP-IV) in sample 2. Results suggest that emotion dysregulation accounts for unique variance in BPD even after controlling for traditional indicators of negative emotionality, including depression, anxiety, and negative affect. Findings support theories regarding the role of emotion dysregulation in BPD and provide directions for future research.

Journal of Personality and Social Psychology, 2007

This research examines whether people who experience epistemic motivation (i.e., a desire to acqu... more This research examines whether people who experience epistemic motivation (i.e., a desire to acquire knowledge) came to have implicit attitudes consistent with the apparent beliefs of another person. People had lower implicit prejudice when they experienced epistemic motivation and interacted with a person who ostensibly held egalitarian beliefs (Experiments 1 and 2). Implicit prejudice was not affected when people did not experience epistemic motivation. Further evidence shows that this tuning of implicit attitudes occurs when beliefs are endorsed by another person, but not when they are brought to mind via means that do not imply that person's endorsement (Experiment 3). Results suggest that implicit attitudes of epistemically motivated people tune to the apparent beliefs of others to achieve shared reality.

Journal of Clinical Psychology, 2010

Non-suicidal self-injury (NSSI) is a growing clinical problem, especially among adolescents and y... more Non-suicidal self-injury (NSSI) is a growing clinical problem, especially among adolescents and young adults. Anecdotal accounts, clinical reports, and popular media sources suggest that observing the blood resulting from NSSI often plays an important role in the behavior's reinforcement. However, research to date has not systematically assessed the role of blood in NSSI. The current study examined this phenomenon in 64 young adults from a college population with histories of non-suicidal skin-cutting. Approximately half the participants reported it was important to see blood during NSSI. These individuals reported spending five minutes or less looking at the blood after each instance of NSSI, and that seeing blood served several functions including "to relieve tension" and "makes me feel calm." In addition, wanting to see blood was associated with greater lifetime frequency of skin-cutting and greater endorsement of intrapersonal functions for NSSI (e.g., affect regulation, self-punishment). Finally, participants who reported wanting to see blood were more likely to endorse symptoms of bulimia nervosa and borderline personality disorder. Theoretical and clinical implications are discussed.

Journal of Clinical Child & Adolescent Psychology, 2013

Nonsuicidal self-injury (NSSI) is a growing public health concern, especially among adolescents. ... more Nonsuicidal self-injury (NSSI) is a growing public health concern, especially among adolescents. In the current edition of the Diagnostic and Statistical Manual of Mental Disorders, NSSI is classified as a criterion of borderline personality disorder (BPD). However, a distinct NSSI disorder will now be included in DSM-5 as a "condition requiring further study." It is important to note that, at this time, there is little direct evidence supporting the DSM-5 proposal over the DSM-IV classification. To address this need, the current study examined the extent to which NSSI occurs independently of BPD and has clinical significance beyond a diagnosis of BPD in adolescent psychiatric patients. NSSI disorder was assessed based on the proposed DSM-5 criteria in 198 adolescents ages 12 to 18 (74% female; 64% Caucasian, 14% Hispanic, 10% African American, and 12% mixed/other ethnicity) from a psychiatric hospital. Major Axis I disorders, Axis II BPD, and suicide ideation and attempts were assessed with structured clinical interviews; emotion dysregulation and loneliness were measured with validated self-report questionnaires. First, results indicated that NSSI disorder occurred independently of BPD. Specifically, although there was overlap between the occurrence of BPD and NSSI disorder, this overlap was no greater than that between BPD and other Axis I disorders (e.g., anxiety and mood disorders). Second, NSSI disorder demonstrated unique associations with clinical impairment-indexed by suicide ideation and attempts, emotion dysregulation, and loneliness-over and above a BPD diagnosis. Taken together, findings support the classification of NSSI as a distinct and clinically significant diagnostic entity.

Journal of Clinical Child & Adolescent Psychology, 2014

The recently proposed Research Domain Criteria (RDoC) project has the potential to stimulate new ... more The recently proposed Research Domain Criteria (RDoC) project has the potential to stimulate new research and overcome many of the limitations of the Diagnostic and Statistical Manual of Mental Disorders taxonomy. In the present article we focus, in three main sections, on how theory and research from developmental psychopathology can inform RDoC. First, we discuss the ontology of mental illness and the potential advantages of the RDoC approach to understanding the nature of mental illness. Second, we note potential issues to consider when implementing the RDoC framework, including (a) integrating developmental processes, (b) classifying mental illness within a dimensional approach, and (c) avoiding problems associated with biological reductionism. Third, we describe how a developmental psychopathology perspective may inform each of these potential issues within RDoC. Finally, we highlight the study of emotion and the centrality of affective processes within the RDoC framework. Specifically, we describe how constructionist models of emotion are consistent with developmental psychopathology and how this perspective on emotion can help to guide RDoC research.

Journal of Abnormal Psychology, 2013

Theoretical and empirical literature suggests that nonsuicidal self-injury (NSSI) may represent a... more Theoretical and empirical literature suggests that nonsuicidal self-injury (NSSI) may represent a particularly important risk factor for suicide. The present study examined the associations of NSSI and established suicide risk factors to attempted suicide in four samples: adolescent psychiatric patients (n ϭ 139), adolescent high school students (n ϭ 426), university undergraduates (n ϭ 1,364), and a random-digit dialing sample of United States adults (n ϭ 438). All samples were administered measures of NSSI, suicide ideation, and suicide attempts; the first three samples were also administered measures of depression, anxiety, impulsivity, and borderline personality disorder (BPD). In all four samples, NSSI exhibited a robust relationship to attempted suicide (median Phi ϭ .36). Only suicide ideation exhibited a stronger relationship to attempted suicide (median Phi ϭ .47), whereas associations were smaller for BPD (median r pb ϭ .29), depression (median r pb ϭ .24), anxiety (median r pb ϭ .16), and impulsivity (median r pb ϭ .11). When these known suicide risk factors and NSSI were simultaneously entered into logistic regression analyses, only NSSI and suicide ideation maintained significant associations with attempted suicide. Results suggest that NSSI is an especially important risk factor for suicide. Findings are interpreted in the context of Joiner's interpersonal-psychological theory of suicide; specifically, NSSI may be a uniquely important risk factor for suicide because its presence is associated with both increased desire and capability for suicide.