Measurement Invariance of the Perceived Invalidation of Emotion Scale: An Examination Across Race/Ethnicity, Gender, Sexual Orientation, and Intersection of Identities.

The Perceived Invalidation of Emotions Scale (PIES), developed to measure emotional invalidation, could aid research efforts on various internalizing disorders and minority mental health. A prerequisite for its use includes its psychometric evaluation in diverse samples; thus, the current study aimed to evaluate the psychometric properties of the PIES in a combined sample of minoritized adults (N = 876). Results supported a unidimensional structure of the PIES that was invariant across the two minoritized samples, race/ethnicity, gender, sexual orientation, and intersections of race/ethnicity and sexual orientation. A reduced 7- and 4-item PIES with improved unidimensionality and consequentially more interpretable total scores were generated using item response theory analyses. Significant correlations observed between theoretically relevant constructs of adverse mental health outcomes and the PIES above and beyond identity-based discrimination supported the construct validity of the PIES. Implications include the disproportionate amount of emotional invalidation experienced by individuals with minoritized sexual orientation, which may reflect the recent increases in discrimination faced by these individuals.

Randomized controlled trial and uncontrolled 9-month follow-up of an adjunctive emotion regulation group therapy for deliberate self-harm among women with borderline personality disorder.

BACKGROUND: Despite the clinical importance of deliberate self-harm (DSH; also referred to as non-suicidal self-injury) within borderline personality disorder (BPD), empirically supported treatments for this behavior among individuals with BPD are difficult to implement in many clinical settings. To address this limitation, a 14-week, adjunctive emotion regulation group therapy (ERGT) for DSH among women with BPD was developed. The current study examined the efficacy of this ERGT in a randomized controlled trial (RCT) and the durability of treatment gains over a 9-month uncontrolled follow-up period. METHOD: Female out-patients with BPD and recent recurrent DSH were randomly assigned to receive this ERGT in addition to their ongoing out-patient therapy immediately (n = 31) or after 14 weeks (n = 30). Measures of DSH and other self-destructive behaviors, psychiatric symptoms, adaptive functioning and the proposed mechanisms of change (emotion dysregulation/avoidance) were administered pre- and post-treatment or -waitlist (to assess treatment efficacy), and 3 and 9 months post-treatment (to assess durability of treatment gains). RESULTS: Intent-to-treat (ITT) analyses (n = 61) revealed significant effects of this ERGT on DSH and other self-destructive behaviors, emotion dysregulation, BPD symptoms, depression and stress symptoms, and quality of life. Analyses of all participants who began ERGT (across treatment and waitlist conditions; n = 51) revealed significant improvements from pre- to post-treatment on all outcomes, additional significant improvements from post-treatment to 9-month follow-up for DSH, emotion dysregulation/avoidance, BPD symptoms and quality of life, and no significant changes from post-treatment to 9-month follow-up on the other measures. CONCLUSIONS: The results support the efficacy of this ERGT and the durability of treatment gains.

Self-injury, psychiatric symptoms, and defense mechanisms: findings in an Italian nonclinical sample.

INTRODUCTION: This study provides data on the rates, characteristics, and correlates of self-injury (SI) in an Italian nonclinical sample, a population previously unexamined within the SI literature. This study examined the associations between SI and defense mechanisms, as well as the differences between self-injurers (episodic and recurrent) and non self-injurers with regard to the severity and variety of their psychiatric symptoms and psychological distress. MATERIALS AND METHODS: Five hundred and seventy-eight university students (82.5% female; mean age=22.3; S.D.=3.4) were administered a battery of self-report questionnaires, including the "Deliberate Self Harm Inventory" for SI, the Response Evaluation Measure-71 for defense mechanisms, and the "Symptom Checklist-90-Revised" for psychological distress and psychiatric symptoms. RESULTS: One hundred and nineteen participants (20.6%) reported having engaged in SI at least once during their lifetime. Individuals with recurrent SI (SI>or=5) reported significantly higher levels of all psychiatric symptoms and many maladaptive defense mechanisms than individuals without SI. Results also provided evidence for differences between individuals with recurrent and episodic SI. CONCLUSION: Results suggest that recurrent self-injurers are distinguished from both episodic self-injurers and non self-injurers by their greater use of maladaptive defense mechanisms, rather than their lesser use of adaptive defenses. Further, results suggest that recurrent self-injurers differ from episodic self-injurers not in terms of the severity of their psychiatric symptoms, but the variety and number of these symptoms.