@article{ref1,
title="Do attachment-related differences in reflective functioning explain associations between expressed emotion and youth self-harm?",
journal="Current psychology",
year="2022",
author="Kennedy-Turner, Jamie and Sawrikar, Vilas and Clark, Lucy and Griffiths, Helen",
volume="ePub",
number="ePub",
pages="ePub-ePub",
abstract="Youth self-harm is associated with poor health outcomes and attempted and completed suicide. Associations exist between self-harm and expressed emotion (EE), attachment insecurity, and reflective functioning (RF), but these associations are poorly understood. This study evaluates a mediation model in which perceived caregiver EE (pEE) exerts an indirect effect on youth self-harm through attachment insecurity and RF uncertainty. 461 participants aged 16-24 years completed an online survey. Statistical analyses revealed significant direct effects of pEE on attachment insecurity, and of RF uncertainty on self-harm; however, some direct effects were specific to pEE from female caregivers, and attachment insecurity in youth relationships with female caregivers. A significant direct effect of pEE on self-harm was found for pEE from male caregivers only. Significant indirect effects of pEE on self-harm through attachment anxiety and RF uncertainty were found only in relation to female caregivers. The findings encourage family-, attachment-, and mentalization-based approaches to preventing and treating youth self-harm, with a recommendation that caregivers are given adequate support, education, and skills-based training following youth disclosures of self-harm. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s12144-022-03614-w.<p /> <p>Language: en</p>",
language="en",
issn="1046-1310",
doi="10.1007/s12144-022-03614-w",
url="http://dx.doi.org/10.1007/s12144-022-03614-w"
}