Self-harm and Lifespan Emotion Regulation Strategies in EUPD traits V1
Research type
Research Study
Full title
Differing Self-harm in Younger versus Older Adults with Emotionally Unstable Personality Disorder Traits; Implications for Cognitive Emotion Regulation Strategies Throughout the Lifespan
IRAS ID
304357
Contact name
Jenny Lisshammar
Contact email
Sponsor organisation
Oxford Health NHS Foundation Trust
Duration of Study in the UK
1 years, 0 months, 22 days
Research summary
Summary of Research
Individuals with high levels of Emotionally Unstable Personality Traits (EUPTs) often experience difficulties managing emotions and are at high risk of self-harm. High level EUPTs are also closely related to a diagnosis of Emotionally Unstable Personality Disorder which, until recently, was thought to be an extremely uncommon in older adults (65+). Recent evidence now suggests it may be more common than previously thought, albeit with modified clinical presentation.Central to EUPTs is difficulty developing and adapting cognitive-emotional regulation strategies (C-ERS, e.g. different thinking strategies to manage difficult emotions). Instead, individuals may use alternative ways to manage emotions, such as self-harm. Self-harm is believed to present differently in older adults from younger individuals, and may thus be missed at clinical assessment. However, this remains to be scientifically established.
The current study has two main research questions. It seeks to explore whether there is a difference in type of self-harm behaviours employed by younger (18-26) and older (65+) adults with a high degree EUPTs. Secondly, it explores whether C-ERS employed differ between younger and older self-harming adults, versus those who do not, and whether this impacts type of self-harm. It is hypothesised that a contributing maintenance factor for high trait EUPTs in older adults is an incongruence between C-ERS and expectations of their lifespan stage.
The study employs a cross-sectional survey design, and collects data using three questionnaires: Borderline Symptom List (to identify high degrees of EUPTs), Cognitive Emotion Regulation Questionnaire (to establish C-ERS employed), and the Self-harm inventory (measuring types of self-harm behaviours. We are collecting data from individuals (18-26 and 65+) with high degree EUPTs (as established on the BSL) accessing Community Mental health Teams in OHFT, regardless of diagnosis. Participants will complete the three questionnaires in a 1-2-1 setting with the student researcher. Data collection is planned
Summary of Results
We need more research on Emotionally Unstable Personality Disorder (EUPD) - which is also known as Borderline Personality Disorder (BPD). We wanted to know more about how older people aged over 65 years, who fulfilled the criteria for a diagnosis of EUPD/BPD, coped with difficulties managing their emotions (so-called "emotional regulation strategies"). Some research says that older people who find it difficult to manage their emotions, manage these difficulties in different ways from younger adults. For this reason, older people might not get a diagnosis of EUPD/BPD when they fulfill the criteria for diagnosis, and they feel that such a diagnosis is right for them.Our study aimed to explore emotional regulation strategies across the adult lifespan by establishing differences in self-harm behaviours that younger adults and older adults used. All the people in the study had high degrees of "Emotionally unstable personality traits"; which are the type of personality traits that may be relevant for a diagnosis of EUPD/BPD. We also wanted to see whether younger and older people used different thinking strategies to manage these difficult emotions - and whether these different thinking strategies changed the way they self-harmed.
18 younger and 18 older participants took part. They completed two questionnaires for the study. These were the Self-Harm Inventory and Cognitive Emotional Regulation Questionnaire.We found that younger adults were more likely to self-harm by physically hurting themselves, compared to older people. Both younger and older people self-harmed by "self-neglecting" methods, such as not taking their medication as they should, or starving themselves. Their thinking skills to manage emotions were not related to their age group or their self-harm behaviours.
From this, we suggested that non-violent self-harm is common for both younger and older people who may fulfill the criteria for EUPD/BPD. When older people self-harm, it might be less obvious. Health professionals, such as doctors, nurses, and psychologists, might not realise they are self-harming. We suggest that health professionals should keep in mind that self-harm can be lots of different types of things, and think about this when asking questions about self-harm.for 24 weeks.
REC name
East of England - Essex Research Ethics Committee
REC reference
22/EE/0004
Date of REC Opinion
22 Mar 2022
REC opinion
Further Information Favourable Opinion