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Self-harm, early emotional neglect and alexithymia in young Italian help seekers

Published online by Cambridge University Press:  26 August 2025

S. Mammarella*
Affiliation:
Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
L. Giusti
Affiliation:
Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
S. Del Vecchio
Affiliation:
Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
A. Salza
Affiliation:
Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
M. Casacchia
Affiliation:
Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
R. Roncone
Affiliation:
Department of Life, Health and Environmental Sciences, University of L’Aquila, L’Aquila, Italy
*
*Corresponding author.

Abstract

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Introduction

Recent studies showed that non-suicidal Self-Injury (NSSI) is a transdiagnostic behavior with multiple functions and motivational factors. More specifically, two key functions have been identified: the first is an interpersonal function (hurting/punishing others, influencing others’ behavior); the second involves personal goals (emotions regulation, dissociation, self-punishment). Some distal factors may contribute to the onset of this behavior (e.g., childhood abuse, emotional neglect), resulting in emotional dysregulation and alexithymia. Alexithymia, also called emotional blindness, a coping strategy to reduce emotional pain following trauma traumatic life events, emerged as a predictor of NSSI.

Objectives

The study aimed to investigate in a sample of young Italian help seekers referred to an early intervention service and a university counseling and consultation service (1) the prevalence of NSSI behaviors; (2) their correlation to early traumatic life experiences and alexithymia symptoms.

Methods

From March 2023, the young adults participating in this study filled a standardized battery (through a QR code). In this preliminary analysis, only data concerning the Deliberate Self-Harm Inventory (DSHI), Childhood Trauma Questionnaire – Short Form (CTQ-SF), and the Toronto Alexithymia Scale (TAS – 20) were considered.

Results

Nowadays, 73 young adults participated in the study (60% women; mean age 26 years, SD 4.2). A third of the sample reported NSSI behavior lifetime, with a higher distribution among women (χ2= 9.425 p=0.002). By comparing the NSSI and No-NSSI groups, only the emotional neglect dimension exceed the clinical cut-off even if statistically significant differences emerged in all the early traumatic dimensions, with higher scores in the NSSI group as regard the emotional abuse (F= 18.321; p=0.000), physical abuse (F= 17.556; p=0.000), sexual abuse (F= 5.200; p=0.026), emotional neglect (F= 20.053; p=0.000), physical neglect (F= 12.134; p=0.001), minimization/denial (F= 13.384; p=0.000). The alexithymia symptoms, assessed with the TAS-20 scale, the NSSI group showed higher scores with a statistically significant difference compared to the No-NSSI group (F= 15.842; p=0.000) and, specifically, in the “difficulty describing feelings” (F= 10.351; p=0.002) and “difficulty in identifying emotions” (F= 13.543; p=0.000).

Conclusions

According to the social neuroscience model, these preliminary results suggested that young adults that practice self-harm behaviors may have experienced early emotional neglect, determining a vulnerability to recognize and regulate emotions in response to stressful events. It is therefore crucial to assess and monitor this behavior in all young people help seekers from mental health services, concerning the history of traumatic events and emotional difficulties, to plan personalized evidence-based interventions.

Disclosure of Interest

None Declared

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Abstract
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of European Psychiatric Association
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