Do attachment-related differences in reflective functioning explain associations between expressed emotion and youth...

Area of Science:

• Psychology
• Clinical Psychology
• Developmental Psychology

Background:

• Youth self-harm is a significant public health concern linked to adverse outcomes, including suicide.
• Existing research suggests links between self-harm, expressed emotion (EE), attachment insecurity, and reflective functioning (RF), but these relationships require further elucidation.

Purpose of the Study:

• To evaluate a mediation model examining the indirect effects of perceived caregiver EE (pEE) on youth self-harm via attachment insecurity and RF uncertainty.
• To investigate gender-specific effects of caregiver EE on youth self-harm.

Main Methods:

• Online survey administered to 461 participants aged 16-24 years.
• Statistical analyses employed to test direct and indirect effects within the proposed mediation model.

Main Results:

• Significant direct effects were observed between pEE and attachment insecurity, and between RF uncertainty and self-harm.
• Gender-specific effects were noted, with some associations particularly relevant to female caregivers.
• Indirect effects of pEE on self-harm through attachment anxiety and RF uncertainty were significant only in relation to female caregivers.

Conclusions:

• Findings suggest that caregiver EE, attachment insecurity, and RF uncertainty play crucial roles in youth self-harm, with specific pathways influenced by caregiver gender.
• Recommendations include family-, attachment-, and mentalization-based interventions.
• Emphasizes the importance of providing caregivers with support, education, and skills training following youth self-harm disclosures.