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Psychopathology and Borderline Personality Pathology Associated with Lifetime Self-Injurious Behavior in Adolescent Psychiatric Inpatients and Detainees

Published Online:https://doi.org/10.1024/1422-4917/a000549

Abstract.Objective: Self-injurious behavior (SIB) is a widespread phenomenon among adolescent psychiatric inpatients. It is also reported among delinquent adolescents detained in correctional facilities. While previous studies have addressed different functions of SIB within offender populations, here we investigate particular patterns of borderline personality pathology and psychopathology underlying SIB in both adolescent psychiatric inpatients and detainees. Method: Adolescent psychiatric inpatients and detainees were recruited consecutively. Participants completed self-reports on SIB, suicidal thoughts and behavior, borderline personality pathology, and general psychopathology. Predictors of lifetime SIB by group were analyzed. Results: Psychiatric inpatients (n = 77) and detainees (n = 50) did not differ with respect to lifetime SIB (57.14 % versus 54.00 %), whereas SIB within the past year did (67.53 % versus 14 %; χ2(1) = 6.158, p = .013). Psychiatric inpatients reported greater emotional problems (t(125) = 5.109, p < .0001) and greater borderline personality pathology. Those with lifetime SIB were characterized by greater emotional problems and borderline personality pathology, independent of their group. Results from regression analyses suggest no group-specific predictors of lifetime SIB. Conclusions: Although psychiatric inpatients endorse greater psychopathological distress, lifetime SIB among adolescent psychiatric inpatients and detainees is associated with similar patterns of psychopathology and borderline personality pathology.


Die Psychopathologie und Borderline-Persönlichkeitspathologie lebenslangen Selbstverletzungsverhaltens bei jugendlichen psychiatrischen PatientInnen und Häftlingen

Zusammenfassung. Hintergrund: Selbstverletzendes Verhalten (SVV) ist ein häufiges Phänomen bei Jugendlichen, insbesondere im Kontext der psychiatrischen Versorgung. SVV wird häufig auch von Jugendlichen im Jugendarrest berichtet. Während vorhergehende Studien die Funktionen von SVV im Strafvollzug untersuchten, war das Ziel der vorliegenden Studie, potentielle Unterschiede hinsichtlich der mit SVV assoziierten, psychopathologischen Belastung und Borderline-Persönlichkeits-Pathologie von Jugendlichen im Kontext der psychiatrischen Versorgung und dem Jugendarrest zu identifizieren. Methodik: Jugendliche Patienten und Inhaftierte im Jugendarrest wurden konsekutiv für eine Teilnahme an der Studie rekrutiert. Alle Teilnehmer füllten Fragebögen zu SVV, Suizidalität, Borderline-Persönlichkeits-Pathologie und Psychopathologie aus. Prädiktoren von Lebenszeit SVV wurden in Abhängigkeit der Gruppenzugehörigkeit analysiert. Ergebnisse: Jugendliche Patienten (n = 77) und Inhaftierte im Jugendarrest (n = 50) unterscheiden sich nicht hinsichtlich der Lebenszeitprävalenz von SVV (57.1 % versus 54.0 %), jedoch bezüglich der Häufigkeit von SVV im letzten Jahr (67.5 % versus 14.0 %;χ2(1) = 6.158, p = .013). Patienten berichten im Vergleich zu Inhaftierten im Jugendarrest von vermehrt emotionalen Problemen t(125) = 5.109, p < .0001) und stärker ausgeprägter Borderline-Persönlichkeits-Pathologie. Jugendliche mit Lebenszeit SVV berichten unabhängig von der Gruppenzugehörigkeit vermehrt von emotionalen Problemen und stärker ausgeprägter Borderline-Persönlichkeits-Pathologie. Schlussfolgerung: Während jugendliche Patienten vermehrt psychopathologische Auffälligkeiten zeigen, ist Lebenszeit SVV bei psychiatrischen Patienten und Inhaftierten im Jugendarrest dieser Altersklasse mit vergleichbaren Mustern psychopathologischer Belastung und Borderline-Persönlichkeits-Pathologie assoziiert.

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