Patterns of emotion in response to parasuicide imagery in borderline personality disorder

• Main Author: Welch, Stacy Shaw
• Format: Dissertation
• Language: English
• Published: ProQuest Dissertations & Theses 01-01-2004
• Subjects: Clinical psychology; Psychotherapy
• ISBN: 9780496881963; 0496881965

Parasuicide is an extremely costly behavior on a societal level. It is a difficult clinical problem for both therapists, who have few efficacious treatments to draw upon, and the parasuicidal individuals themselves, whose lives are characterized by intense suffering. Parasuicide is especially prevalent in borderline personality disorder (BPD), and the public health/clinical costs incurred by the behavior in this population alone are enormous. Among the many theories of parasuicide from diverse theoretical orientations, very few are supported by empirical data, and even fewer provide evidence for the mechanisms by which parasuicide is reinforced and maintained. One promising theory of parasuicide is Linehan's Integrative Emotion Regulation theory, which suggests that parasuicide in BPD is maintained by its emotion-regulatory qualities. However, there is very little data to support the idea beyond retrospective self-report. The main aim of the proposed study is to test the hypotheses that within a borderline population, both non-suicidal self-injurious behaviors as well as non-fatal suicide attempts are maintained (i.e., negatively reinforced) by immediate reductions in negative emotions. Multi-component indicators of negative emotions associated with parasuicide imagery were examined in 42 BPD individuals with histories of parasuicide. Imagery “scripts” involving suicide attempts, non-suicidal self-injury, a high-stress event followed by accidental death and control scenes (a neutral event and accidental self-injury) were created for use in the four-stage methodology outlined by Haines, Williams, Brain and Wilson (1995). The method guides the subject through imagery involving the “setting” (the circumstances and scene of the event), “approach” (the moments prior to the event), “incident” (the experience of the event itself) and “consequences” (the moments following the event). Results supported an escape conditioning model of non-suicidal self-injury and suicide ideation (as indexed by the accidental death script). Results were less clear for suicide attempts.