Depresión, desregulación emocional y estrategias de afrontamiento en adolescentes con conductas de autolesión

Abstract

In Mexico, there is little research on the study of self-injury and even less on possible explanatory models. With this in mind, this study aimed to determine the relationship between self-injury and depression, emotional dysregulation, and coping styles, to generate an explanatory model of the problem. The study was carried out using a quantitative, cross-sectional, explanatory scope, design and a sample of 5835 adolescents (Mage = 11-15 years) enrolled in 62 public high schools in the state of Sonora. Logistic regressions were performed for data analysis, and as a result it was found that, for students with severe self-injury (3.54 %), the model explains 61 % of the variance in the data (Nagelkerke’s R2 = .61) and correctly classifies 84.1 % of the participants; whereas, in mild self-injury (5.29 %), the model explains 72 % of the variance in the data (Nagelkerke’s R2 = .72) and correctly classifies 88.2 % of the students. Likewise, the depression dimensions showed the highest explanatory level (cognitive-affective, somatic) and positive correlations with emotional dysregulation and avoidance coping style, as well as negative correlations with approach coping style. At the end, the importance of the independent variables for future research is discussed, as well as anomalous results and other data of interest.

Keywords:

self-injury depression adolescents coping emotional disturbance

References

Albores, L., Méndez, J., García, A., Delgadillo, Y., Chávez, C., & Martínez, O. (2014). Autolesiones sin intención suicida en una muestra de niños y adolescentes de la ciudad de México. Actas Psiquiátricas Españolas 42(4), 159-68. https://www.actaspsiquiatria.es/reposito rio/16/90/ESP/16-90-ESP-159-168-346514.pdf

Beck, A. T., Steer, R. A., & Garbin, M. G. (1988). Psychometric properties of Beck Depression Inventory: Twenty-five years of evaluation. Clinical Psychology Review, 1(8), 77-100. https://doi.org/10.1016/0272-7358(88)90050-5

Beltrán, M., Freyre, M., & Hernández, L. (2012). El Inventario de Depresión de Beck: Su validez en población adolescente. Terapia Psicológica, 30(1), 5-13. http://dx.doi.org/10.4067/S0718-48082012000100001

Brausch, A., & Gutierrez, P. (2010). Differences in NonSuicidal Self-Injury and Suicide Attempts in Adolescents. Journal Youth Adolescence, 39(3), 233-242. https://doi. org/10.1007/s10964-009-9482-0

De la Sancha, V. E., Meraz, M. E., Cervera, D. C., Martí, R. M., & Colorado, H. J. L. (2020). Autolesiones en estudiantes de Secundaria: incidencia y factores circundantes. Apuntes de Psicología, 38(1), 23-33. http://apuntesdepsi cologia.es/index.php/revista/article/view/852/551

De Oliveira Pimentel, F., Della Méa, C. P., & Dapieve Patias, N. (2020). Víctimas de bullying, síntomas depresivos, ansiedad, estrés e ideación suicida en adolescentes. Acta Colombiana de Psicología, 23(2), 205-240. https://doi. org/10.14718/ACP.2020.23.2.9

Dirección General de Planeación, Programación y Estadística Educativa. (2019). Principales Cifras del Sistema Educativo Nacional 2018-2019. SEP.

Duarte Tánori, K. G., Vera Noriega, J. Á., & Fregoso Borrego, D. (2021). Factores contextuales relacionados a las conductas de autolesión no suicidas: una revisión sistemática. Psicología y Salud, 31(1), 51-59. https://doi. org/10.25009/pys.v31i1.2675

Duggan, J., Heath, N., & Hu, T. (2015). Non-suicidal self-injury maintenance and cessation among adolescents: a one-year longitudinal investigation of the role of objectified body consciousness, depression and emotion dysregulation. Child and Adolescent Psychiatry and Mental Health, 9(21). https://doi.org/10.1186/ s13034-015-0052-9

Frías, Á., Vázquez, C. M., Del Real, P, Á., Sánchez, C., & Giné, S. (2012). Conducta autolesiva en adolescentes: prevalencia, factores de riesgo y tratamiento. Cuadernos de Medicina Psicosomática y Psiquiatría de Enlace, 103, 33-48. http://www.editorialmedica.com/download. php?idart=468

Graham, B. M., Denson, T. F., Barnett, J., Calderwood, C., & Grisham, J. R. (2018). Sex hormones are associated with rumination and interact with emotion regulation strategy choice to predict negative affect in women following a sad mood induction. Frontiers in Psychology, 9, 937. https://doi.org/10.3389/fpsyg.2018.00937

Gratz, K., & Roemer, L. (2004). Multidimensional assessment emotion regulation and dysregulation: development, factor structure and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 26(1), 41-54. https://doi. org/10.1023/B:JOBA.0000007455.08539.94

Gratz, K., & Roemer, L. (2008). The relationship between emotion dysregulation and deliberate self-harm among female undergraduate students at an urban commuter university. Cognitive Behaviour Therapy, 37(1), 14-25. https://doi.org/10.1080/16506070701819524

Gratz, K. L., Tull, M. T., Dixon-Gordon, K., Turner, B., & Chapman, A. (2018). Is the association of deliberate self-harm with emotional relief stable or dependent on emotional context? Journal of Behavior Therapy and Experimental Psychiatry, 60, 61-68. https://doi.org/10.1016/j.jbtep.2018.03.003

Heath, N., Carsley, D., De Riggi, M. Mills, D., & Mettler, J. (2016). The relationship between mindfulness, depressive symptoms, and non-suicidal self-injury amongst adolescents. International Academy for Suicide Research, 20(4), 635-649. https://doi.org/10.1080/13811118.2016.1162243 Hernández-Sampieri, R., & Mendoza, C. (2018). Metodología de la investigación. Las rutas cuantitativa, cualitativa y mixta (1. ª ed.). Editorial Mc Graw Hill Education.

Howe-Martin, L., Murrell, A., & Guarnaccia, C. (2012). Repetitive nonsuicidal self-injury as experiential avoidance among a community sample of adolescents. Journal of Clinical Psychology, 68(7), 809-829. https:// doi.org/10.1002/jclp.21868

Ibarra, E. P., Laborín, J. F., & Vera, J. A. (2002) Rasgos de masculinidad-feminidad en la población que habita el desierto del Noroeste de México. Avances en Psicología Clínica Latinoamericana, 20, 45-56. https://www.re searchgate.net/publication/289376719_Rasgos_de_mas culinidad-feminidad_en_la_poblacion_que_habita_el_ desierto_del_Noroeste_de_Mexico

Jacobson, C., & Mufson, L. (2012). Interpersonal psychotherapy for depressed adolescents adapted for self-injury (IPT-ASI): rationale, overview, and case summary. American Journal of Psychotherapy, 66(4), 349-74. https://doi.org/10.1176/appi.psychotherapy.2012.66.4.349

Joormann, J., & Gotlib, I. H. (2010). Emotion regulation in depression: relation to cognitive inhibition. Cognition and Emotion, 24(2), 281-298. https://doi. org/10.1080/02699930903407948

Kang, N., Jiang, Y., Ren, Y., Gong, T., Liu, X., & Leung, F. Y. (2018). Distress intolerance mediates the relationship between child maltreatment and nonsuicidal self-injury among chinese adolescents: a three-wave longitudinal study. Journal of Youth and Adolescence, 47(10), 2220- 2230. https://doi.org/10.1007/s10964-018-0877-7

Khazaie, H., Zakiei, A., McCall, W. V., Noori, K., Rostampour, M., Sadeghi Bahmani, D., & Brand, S. (2020). Relationship between sleep problems and self-injury: A systematic review. Behavioral Sleep Medicine, 19(5), 689-704. https://doi.org/10.1080/1540 2002.2020.1822360

Kirchner, T., Ferrer, L., Forns, M., & Zanini, D. (2011). Conducta autolesiva e ideación suicida en estudiantes de Enseñanza Secundaria Obligatoria. Diferencias de género y relación con estrategias de afrontamiento. Actas Españolas de Psiquiatría, 39(4), 226-35. https://actaspsiquiatria.es/repositorio/13/72/ESP/13-72- ESP-226-235-920269.pdf

Klonsky, E. D. (2009). The funtions of self-injury in young adults who cut themselves: Clarifying the evidence for affect-regulation. Psychiatry Research, 166(2-3), 260- 268. https://doi.org/10.1016/j.psychres.2008.02.008

Klonsky, E. D., Muehlenkamp. J. J., Lewis. S. P., & Walsh. B. (2011). Nonsuicidal Self-Injury. Hogrefe. Klonsky, E. D., Oltmanns, T. F., & Turkheimer, E. (2003). Deliberate self-harm in a non-clinical population: Prevalence and psychological correlates. American Journal of Psychiatry, 160(8), 1501-1508. https://doi. org/10.1176/appi.ajp.160.8.1501

Laye-Gindhu, A., & Schonert-Reichl, K. A. (2005). Nonsuicidal self-harm among community adolescents: understanding the “whats” and “whys” of self-harm. Journal Youth Adolescence, 34(5), 447-457. https://doi. org/10.1007/s10964-005-7262-z

Lewis, S., & Arbuthnott, A. (2012). Nonsuicidal self-injury: characteristics, functions, and strategies. Journal of College Student Psychotherapy, 26(3), 185-200 https:// doi.org/10.1080/87568225.2012.685853

Liu, R. T. (2017). Characterizing the course of non-suicidal self-injury: A cognitive neuroscience perspective. Neuroscience and Biobehavioral Reviews, 80, 159-165. https://doi.org/10.1016/j.neubiorev.2017.05.026

Liverant, G. I., Kamholz, B. W., Sloan, D. M., & Brown, T. A. (2011). Rumination in clinical depression: A type of emotional suppression? Cognitive Therapy and Research, 35(3), 253-265. https://doi.org/10.1007/ s10608-010-9304-4

Marín, M. (2013). Desarrollo y evaluación de una terapia cognitivo conductual para adolescentes que se autolesionan (Tesis doctoral). Universidad Nacional Autónoma de México, Ciudad de México.

Marín, M., Robles, R., González, C., & Andrade, P. (2012). Propiedades psicométricas de la escala “Dificultades en la Regulación Emocional” en español (DERS-E) para adolescentes mexicanos. Salud Mental, 35(6), 521-526. http://www.revistasaludmental.mx/index.php/ salud_mental/article/view/1510/1508

Marshall, S., Tilton-Weaver, L., & Stattin, H. (2013). Nonsuicidal self-injury and depressive symptoms during middle adolescence: a longitudinal analysis. Journal of Youth & Adolescence, 42(8), 1234-1242. https://doi. org/10.1007/s10964-013-9919-3

Moos, R. (1993). Coping Responses Inventory. Adult Form Professional Manual. Editorial Psychological Assessment Resources (PAR Inc.)

Muehlenkamp, J. J., & Gutiérrez, P. M. (2004). An investigation of differences between self-injurious behavior and suicide attempts in a sample of adolescents. Suicide and Life Threatening Behavior, 34(1), 12-23. https://doi. org/10.1521/suli.34.1.12.27769

Oyanadel, C., Carrasco-Correa, H., Latorre-Nanjarí, J., Peñate-Castro, W., & Sepúlveda-Queipul, C. (2021). Reduciendo la ideación suicida en adolescentes con terapia de perspectiva temporal. Un estudio experimental. Acta Colombiana de Psicología, 24(1), 63-71. https:// doi.org/10.14718/ACP.2021.24.1.6

Peh, C., Shahwan, S., Fauziana, R., Mahesh, M., Sambasivam, R., Zhang, Y., & Subramaniam, M. (2017). Emotion dysregulation as a mechanism linking child maltreatment exposure and self-harm behaviors in adolescents. Child Abuse & Neglect, 67, 383-390. https://doi.org/10.1016/j. chiabu.2017.03.013

Plener, P., Schumacher, T., Munz, L., & Groschwitz, R. (2015). The longitudinal course of non-suicidal self-injury and deliberate self-harm: a systematic review of the literature. Borderline Personality Disorder and Emotion Dysregulation, 2(2). https://doi.org/10.1186/ s40479-014-0024-3 Robles, R., & Garibay, S., & Páez, F. (2006).

Evaluación de trastornos disociativos en población psiquiátrica mexicana: prevalencia, comorbilidad y características psicométricas de la Escala de Expariencias Disociativas. Salud Mental, 29(2), 38-43. http://www.revistasaludmental. mx/index.php/salud_mental/article/view/1099/1097

Ross, S., & Heath, N. (2002). A Study of the frequency of self-mutilation in a community sample of adolescents. Journal of Youth and Adolescence, 31(1), 67-77. https:// doi.org/10.1023/A:1014089117419 Santos, D. (2008). Reporte del proyecto: quiénes se autolesionan en México: Estudio Exploratorio. Documento interno.

Alía. Santos, D. (2012). Autolesión, que es y cómo ayudar (1. ª ed.). Edición de Autor. Sociedad Mexicana de Psicología. (2007). Código ético del psicólogo (4. ª ed.). Editorial Trillas.

Vallejo, A. R., & Granados, B. E. (2017). Autoagresión y autoconcepto en adolescentes violentadas sexualmente: Una mirada descriptiva. Psicoperspectivas, 16(1), 80-90. http:// dx.doi.org/10.5027/Psicoperspectivas-vol16-issue1 -fulltext-903

Vallejo, A., Osorno, J., Mazadiego, T., & Segura, B. (2007). Evaluación psicométrica del Inventario de Respuestas de Afrontamiento de Moos para adolescentes (CRI-Y Form), en una muestra mexicana. Revista de Educación y Desarrollo, 7, 35-40. http://www.cucs.udg.mx/revistas/ edu_desarrollo/anteriores/7/007_Vallejo.pdf

Vera, J., Bautista, G., & Machado, F. (2018). Cultura y socialización escolar: Autolesión y género. En R. DíazLoving, I. Reyes-Lagunes y F. López-Rosales (eds.). La Psicología Social en México Vol. XVII (pp. 543-557). AMEPSO.

Walsh, B. (2006). Treating self-injury: a practical guide. The Guilford press. Whitlock, J. L. Eckenrode, J., & Silverman, D. (2006). Self injury behavior in a college population. Pediatrics, 117(6), 1939-1948. https://doi.org/10.1542/peds.2005-2543

Wu, R., Huang, J., Ying, J., Gao, Q., Guo, J., & You, J. (2021). Behavioral inhibition/approach systems and adolescent nonsuicidal self-injury: The chain mediating effects of difficulty in emotion regulation and depression. Personality and Individual Differences, 175, 110718. https://doi.org/10.1016/j.paid.2021.110718

You, J., Lin, M., Xu, S., & Hu, W. (2016). Big Five personality traits in the occurrence and repetition of nonsuicidal self-injury among adolescents: The mediating effects of depressive symptoms. Personality and Individual Differences, 101, 227-231. https://doi.org/10.1016/j. paid.2016.05.057

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