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. 2023 Aug 29;23(1):632.
doi: 10.1186/s12888-023-05127-7.

Early maladaptive schemas are associated with self-injury thoughts and behavior in adolescents

Pauliina Saarijärvi  1   2   3   4 , Christina Salmivalli  1   4 , Saija Helmi  5 , Max Karukivi  6   7
Affiliations

Early maladaptive schemas are associated with self-injury thoughts and behavior in adolescents

Pauliina Saarijärvi et al. BMC Psychiatry. .

Abstract

Background: Early maladaptive schemas (EMSs) and self-harm have been firmly linked in adults, but research on these associations in adolescents remains scarce. Additionally, the links between EMSs and functions of self-injury has not been previously studied in this age group. Thus, the aim of the present study was to investigate the associations of EMSs with self-harm thoughts and behavior, as well as with self-harm functions, among adolescents in specialized health care.

Methods: The participants were recruited from first-visit 12-22-year-old adolescent patients entering specialized mental health care or pediatric care. For 118 participants, complete data were available for the Young Schema Questionnaire Short Form 2-Extended (YSQ) when entering care and the Ottawa Self-Injury Inventory Functions scale (OSI-F) one year later. YSQ was used to measure the participants' EMSs and OSI-F their self-harm thoughts and behavior. The associations of EMSs and self-harm were investigated in three groups: no self-harm, self-harm thoughts only, and both self-harm thoughts and behavior. The associations of EMSs with self-injury behavior functions were assessed in four categories: Internal Emotional Regulation, External Emotional Regulation, Social Influence, and Sensation Seeking. Additionally, EMSs' associations with addictive features of self-injury behavior were assessed. The magnitudes of effect sizes of differences between the self-harm groups were evaluated with Cliff's Delta. The associations of EMSs with self-injury functions were analyzed with general linear modeling and with self-injury addictive features using logistic regression.

Results: The differences between the self-harm groups were significant for the majority of the EMSs. The stronger the EMSs were, the more severe the manifestations of self-harm. The effect sizes ranged from small to large depending on the EMS. Considering self-injury functions, Internal Emotional Regulation was associated with Self-Sacrifice EMS (p = 0.021), and External Emotional Regulation both with Abandonment (p = 0.040) and Unrelenting Standards (p = 0.012) EMSs. Being addicted to self-injury was associated with Abandonment (p = 0.043) and Dependence (p = 0.025) EMSs.

Conclusions: The present study shows that significant associations between EMSs and both self-harm thoughts and behavior exist also in adolescents. Stronger EMSs are linked to more severe self-harm. Knowledge of these associations may help to improve the understanding and treatment of adolescents suffering from self-harm.

Keywords: Adolescents; Early maladaptive schemas; Ottawa Self-Injury Inventory; Self-harm; Self-injury; Young Schema Questionnaire.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Recruitment of the participants in the whole research project and in the present study. YSQ = Young Schema Questionnaire-Short Form 2-Extended, OASIS = Overall Anxiety Severity and Impairment Scale, OSI-F = the Ottawa Self-Injury Inventory – Functions - v3.1
See this image and copyright information in PMC

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