title: An ecological momentary assessment investigation of complex and conflicting emotions in youth with borderline personality disorder.
abstract: Non-suicidal self-injury (NSSI) is a prevalent behaviour among people with borderline personality disorder (BPD) but many aspects of the emotional changes that trigger and maintain this behaviour are unknown. This study examines the relationships between NSSI and the number of negative ('negative complex') and opposing valence ('conflicting') emotions. One hundred and seven youth (aged 15-25 years) with first-presentation BPD were assessed using a combination of self-report and ecological momentary assessment to investigate trait levels of emotional acceptance and in vivo changes in the number of negative complex and conflicting emotions before and after self-injurious thoughts and behaviours. Multilevel modelling revealed that changes in the number of negative complex emotions mirrored distress levels before and after self-injurious thoughts and behaviours, approximating a quadratic curve. Increases in the number of negative complex emotions reported prior to self-injurious thoughts and behaviours were associated with lower acceptance of negative emotions. These findings indicate that the number of negative emotions experienced contributes to distress prior to engagement in NSSI. The relationship between non-acceptance of negative emotions and negative complex emotions prior to NSSI suggests that improved emotional awareness and acceptance should be a focus for early interventions aimed at reducing self-injury.
authors.affiliation: Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia; Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia.
authors.forename: Holly E
authors.initials: HE
authors.lastname: Andrewes
authors.affiliation: Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Australia.
authors.forename: Carol
authors.initials: C
authors.lastname: Hulbert
authors.affiliation: Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.
authors.forename: Susan M
authors.initials: SM
authors.lastname: Cotton
authors.affiliation: Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Betts
authors.affiliation: Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Australia; Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia; Orygen Youth Health, NorthWestern Mental Health, Melbourne, Australia. Electronic address: andrew.chanen@orygen.org.au.
authors.forename: Andrew M
authors.initials: AM
authors.lastname: Chanen
mesh_terms: D000293:Adolescent; D001883:Borderline Personality Disorder / Q000523:psychology*; D000072860:Ecological Momentary Assessment; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D010641:Phenotype; D016728:Self-Injurious Behavior / Q000523:psychology*; D055815:Young Adult
keywords: Borderline personality disorder; Emotional acceptance; Non-suicidal self-injury; Psychiatry; Youth