The Relationship Between Parental Expressed Emotions and Non-suicidal Self-injury: The Mediating Roles of Self-criticism and Depression

Perceived parental expressed emotions have a substantial effect on adolescents' well-being and non-suicidal self-injury (NSSI). The present study examines the mediating effects of self-criticism and depression in the relationship between perceived parental expressed emotions and NSSI. In total, 358 adolescents between the ages of twelve and twenty were examined. The brief NSSI assessment tool was used to assess NSSI. Depressive symptoms and self-criticism were examined with the Children's Depression Inventory (CDI-NL) and the Self Rating Scale. Finally, the self-report questionnaire of the level of expressed emotions was used to assess perceived parental expressed emotions. The lifetime prevalence of NSSI in the current study was 13.41 %. Results of a mediation analysis show the relationship between self-criticism and NSSI is mediated by depressive symptoms. Furthermore, results of a path model analysis, explaining 20 % of the variance in NSSI frequency, show a direct effect of perceived parental environment (perceived lack of emotional support and perceived parental criticism) on NSSI frequency, as well as indirect paths via adolescent risk factors (depressive symptoms and self-criticism). Perceived lack of parental emotional support had a direct effect on frequency of NSSI, as well as an indirect effect via depressive symptoms. Perceived parental criticism on the other hand, had no direct effect on frequency of NSSI, but showed an indirect effect through self-criticism. This study improves our understanding of the underlying mechanisms involved in NSSI by interrelating significant family and adolescent risk factors. Limitations and clinical implications of these findings are discussed.