Validation, emotion dysregulation and self-harm Results from an anonymous large-scale Internet-based study of young people

Abstract Background: Self-harm is a major public healh concern and it is particularly prevalent among adolescents. The functions of self-harm are diverse, but can be devided into interpersonal and intrapersonal. Linehan’s Biosocial Theory suggests that there is a transaction between the indivduals’ emotional vulnurablity and an invalidating environment, which in turn results in maladptive and often self-destructive behaviors. This paper examines the associations between self-harm, emotion dysregulation and percieved validation/invalidation. Methods: A total of 1910 (M age = 17.2, 86.9% female gender identity) respondents completed questionnaires in an anonymous Web-based survey. We used well-established questionnairs for assessing self-harm and emotion dysregulation, and for the assessment of perceived validation/invalidation we used a novel instrument “Responses to my Emotion, Thoghts and Actions, REMTA”. Results: Validation/invalidation correlated with self-harm and to an even larger extent to emotional dysregulation. A lagre and significat part of the association between self-harm and perceived validation/inavldiation was also mediated by emotion regulation. Validation/invalidation from family members had a higher impact on both self-harm and emotion dysregulation than from non-relatives. Those reporting high levels of invalidation also reported significantly more difficulties in emotion regulation. Conclusions: The present study contributes to the understanding validation in the ethiology of self-harm. The results also provide additional support for the Biosocial Theory and has implication assessment and treatment of self-harm. Trial registration: The study was approved by the Regional Ethics Board in Stockholm (Dnr. 2015/815-31/5).