Department of Psychiatry, Faculty of Medicine, Chiang Mai University, Chiang Mai 50200, Thailand.
Medicina (Kaunas). 2024 Oct 30;60(11):1776. doi: 10.3390/medicina60111776.
: Fifty percent of individuals with borderline personality disorder (BPD) experience self-harm. One of the crucial factors related to self-harm is feelings of emptiness. While inner strengths, such as the Five Precepts, meditation, and equanimity, have been identified as potential buffers against negative mental health outcomes in BPD, their role in mediating the relationship between feelings of emptiness and self-harm is not well-documented. This study aimed to explore how these inner strengths mediate the relationship between feelings of emptiness and self-harm in individuals exhibiting BPD symptoms. : A total of 302 Thai participants exhibiting BPD symptoms completed several assessments: the SCID-II Personality Disorder Questionnaire for BPD to assess feelings of emptiness and self-harm, the Inner-Strength-Based Inventory (i-SBI) to evaluate the Five Precepts, meditation, and equanimity, and the Outcome Inventory Depression (OI-Depression) to assess depression. Mean and standard deviation were used for continuous variables, such as age and OI-Depression. A -test assessed mean differences in continuous variables between the self-harm group and the non-self-harm group. Chi-square tests examined differences in categorical variables with three or more levels, such as education. Pearson's correlation and linear regression analyzed relationships between continuous variables, including i-SBI and OI-Depression scores. Mediation analysis was performed using IBM SPSS and AMOS, with self-harm as the outcome variable, feelings of emptiness as the predictor, and inner strengths as mediators. : The participants had a mean age of 36.56, with 65.4% being female. The analysis showed that the Five Precepts, meditation, and equanimity significantly mediated the relationship between feelings of emptiness and self-harm, with a standardized coefficient of β = 0.534 (95% CI = 0.417 to 0.647, < 0.001). The indirect effect of feelings of emptiness through these inner strengths was significant (β = 0.034, 95% CI = 0.009 to 0.075, = 0.005). The mediation model explained 38% of the variance in self-harm with a 3% increase, albeit small but significant. : This study highlights that inner strengths negatively mediate the relationship between feelings of emptiness and self-harm, indicating that as these inner strengths increase, the direct impact of feelings of emptiness on self-harm decreases. These findings suggest that targeting inner strengths as protective factors could be a valuable strategy in developing interventions aimed at reducing self-harm by addressing the underlying emotional challenges associated with BPD.
：50%的边缘型人格障碍（BPD）患者有自伤行为。与自伤行为相关的一个关键因素是空虚感。虽然内在力量，如五戒、冥想和不动心，已被确定为 BPD 患者负面心理健康结果的潜在缓冲因素，但它们在调节空虚感和自伤行为之间的关系方面的作用尚未得到充分记录。本研究旨在探讨这些内在力量如何在表现出 BPD 症状的个体中调节空虚感和自伤行为之间的关系。：共有 302 名泰国 BPD 症状患者完成了几项评估：SCID-II 人格障碍问卷 BPD 评估空虚感和自伤行为、内在力量基础量表（i-SBI）评估五戒、冥想和不动心、以及结局量表抑郁（OI-Depression）评估抑郁。年龄和 OI-Depression 等连续变量采用均值和标准差表示。t 检验评估自伤组和非自伤组之间连续变量的均值差异。卡方检验用于检验具有三个或更多水平的分类变量，如教育。Pearson 相关和线性回归分析连续变量之间的关系，包括 i-SBI 和 OI-Depression 评分。使用 IBM SPSS 和 AMOS 进行中介分析，以自伤为结果变量，空虚感为预测变量，内在力量为中介变量。：参与者的平均年龄为 36.56 岁，其中 65.4%为女性。分析表明，五戒、冥想和不动心显著调节了空虚感和自伤行为之间的关系，标准化系数β=0.534（95%置信区间为 0.417 至 0.647，<0.001）。空虚感通过这些内在力量的间接效应是显著的（β=0.034，95%置信区间为 0.009 至 0.075，=0.005）。中介模型解释了自伤行为方差的 38%，增加了 3%，虽然很小但很显著。：本研究强调，内在力量负向调节空虚感和自伤行为之间的关系，表明随着这些内在力量的增强，空虚感对自伤行为的直接影响会降低。这些发现表明，将内在力量作为保护因素作为目标，可能是针对 BPD 相关情绪挑战开发干预措施以减少自伤行为的一种有价值策略。
