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Open AccessArticle

Expressed Emotion, Shame, and Non-Suicidal Self-Injury

Provisional Psychologist, Newcastle Mental Health Service, Newcastle, NSW 2300, Australia
Department of Psychiatry, The University of Queensland, Royal Brisbane and Women’s Hospital, Herston, Brisbane, QLD 4066, Australia
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2018, 15(5), 890;
Received: 14 March 2018 / Revised: 15 April 2018 / Accepted: 26 April 2018 / Published: 30 April 2018
(This article belongs to the Special Issue Advances in Suicide Research)
PDF [372 KB, uploaded 3 May 2018]


A cross-sectional study examining relationships between perceived family Expressed Emotion and shame, emotional involvement, depression, anxiety, stress and non-suicidal self-injury, in 264 community and online adults (21.6% male). We compared self-injurers with non-self-injurers, and current with past self-injurers. Self-injurers experienced more family Expressed Emotion (EE) than non-injurers (t(254) = −3.24, p = 0.001), linear contrasts explaining 6% of between-groups variability (F(2, 254) = 7.36, p = 0.001, η2 = 0.06). Differences in EE between current and past self-injurers were not significant. Overall shame accounted for 33% of between-groups variance (F(2, 252) = 61.99, p < 0.001, η2 = 0.33), with linear contrasts indicating self-injurers experienced higher levels compared to non-injurers (t(252) = −8.23, p < 0.001). Current self-injurers reported higher overall shame than past self-injurers (t(252) = 6.78, p < 0.001). In further logistic regression, emotional involvement and overall shame were the only significant predictors of self-injury status. With every one-unit increase in emotional involvement, odds of currently engaging in self-injury decreased by a factor of 0.860. Conversely, a one-unit increase in overall shame was associated with an increase in the odds of being a current self-injurer by a factor of 1.05. The findings have important treatment implications for engaging key family members in intervention and prevention efforts. View Full-Text
Keywords: non-suicidal self-injury; adults; Shame; expressed emotion; emotion dysregulation; depression; anxiety; stress non-suicidal self-injury; adults; Shame; expressed emotion; emotion dysregulation; depression; anxiety; stress
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Hack, J.; Martin, G. Expressed Emotion, Shame, and Non-Suicidal Self-Injury. Int. J. Environ. Res. Public Health 2018, 15, 890.

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