Coercion, Invalidation, and Risk for Self-Injury and Borderline Personality Traits
Self-inflicted injury (SII) is defined as a deliberate act in which a person seeks to cause bodily harm or death. The etiology and developmental course of SII are unclear. Converging evidence suggests coercive family processes may heighten risk for SII and related clinical problems among vulnerable youth. This chapter outlines a developmental theory of SII with particular attention to contextual risk factors. It proposes that risk for SII is highest when vulnerable youth are exposed repeatedly to coercive and invalidating family environments. Evidence in support of this theory is drawn from longitudinal studies of SII and borderline personality traits. The chapter also reviews data involving conflict discussion tasks with self-injuring and depressed adolescents and their mothers. Accumulating evidence suggests that coercive processes are a leading contextual mechanism that shapes behavioral and physiological dysregulation, ultimately heightening risk for self-injury and borderline personality disorder.