Psychological correlates of nonsuicidal self-injury in women with borderline personality disorder: a cross-sectional study to inform mindfulness-based interventions

TL;DR

This study explores psychological factors linked to self-harm in women with borderline personality disorder to guide future mindfulness-based treatments.

Contribution

The study identifies specific psychological factors associated with self-injury frequency in BPD patients, offering insights for targeted interventions.

Findings

Higher impulsivity and lower self-compassion are linked to more frequent self-harm.

Mindfulness skills are moderately correlated with self-harm risk factors but not directly linked to frequency.

Adaptive emotion regulation strategies are associated with increased self-harm frequency.

Abstract

Nonsuicidal self-injury (NSSI) is a significant predictor of suicide, particularly among patients with borderline personality disorder (BPD). This study examined modifiable psychological factors associated with NSSI to generate preliminary insights that may inform future intervention research.

In a cross-sectional design, 109 female BPD patients completed self-reported measures assessing NSSI behaviours, mindfulness skills, emotion regulation strategies, depressive symptoms, and self-compassion. Correlational analyses were conducted to investigate the relationships among the psychological variables, NSSI frequency, and the number of NSSI methods used. Ordinal logistic general linear models were used to identify potential predictors of NSSI frequency.

Participants reported low levels of self-compassion, mindfulness skills, and self-esteem, alongside high depression, impulsivity, and frequent self-harming behaviour. The key relevant psychological factors associated with more frequent NSSI included increased impulsivity (95% CI: 1.007–1.199), higher scores on the adaptive cognitive-emotional regulation strategies subscale (95% CI: 1.015–1.082), and reduced self-compassion (95% CI: 0.945–0.999). Although mindfulness skills were not directly linked to the frequency of NSSI or the number of methods used, they were moderately correlated with these risk factors.

These findings underscore the importance of targeted interventions for NSSI in BPD patients. Mindfulness-based approaches may reduce suicide risk and improve treatment engagement by addressing deficits in impulsivity, acceptance, and self-compassion.

Not applicable (this study was a cross-sectional, observational design and does not meet the criteria for a clinical trial). The project and data are publicly registered at: 10.17605/OSF.IO/ZUR84

The online version contains supplementary material available at 10.1186/s12888-025-07740-0.

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