(PS9-B48) Is Resiliency Actually Protective? Investigating the Mediating Effect of Resiliency on the Relation Between Personality Factors and Self-injurious Behaviors

Engagement in self-injurious thoughts and behaviors (SITBs) is one of the primary predictors for death by suicide (Marraccini et al., 2020), and age of onset for said behaviors is typically observed in adolescence (Muehlenkamp et al., 2018). Additionally, research has demonstrated that adolescents who score higher on personality measures of impulsivity, sensation seeking, and emotional dysregulation are more likely to engage in SITBs (Fox et al., 2015); thus, increasing their likelihood of dying by suicide. A potential mediating factor for SITB engagement is resilience; with preliminary studies showing that young adults who engage in self-harm reporting lower levels of resilience than peers with no history of self-harm (Watson & Tatnell, 2022). Research also supports the utilization of resilience and family protective factors as treatments of SITBs for youth (e.g., Diamond et al., 2022; Sher, 2019). Few studies investigate how these results vary after accounting for personality factors among adolescents. The present study aimed to investigate the mediating effect of resilience and protective factors on the relation between personality factors (sensation seeking, impulsivity, and difficulties in emotional regulation) and various SITBs (e.g., engaging in SITBs, age at first self-injury, number of suicide attempts in 12 months).

We examined our hypotheses in a diverse sample of 226 Colorado adolescents (M_age = 16.14, SD = 1.04, range = 13-18, 56% female, 71% White, 84% endorsed SITBs at least once in their lifetime) who were patients at an adolescent inpatient psychiatric facility. Preliminary analyses revealed that resilience and protective factors were inconsistent mediators of the relation between personality and SITBs. Individual, family, and community resilience and protective factors were least effective in significantly mediating the relation between difficulties in emotional regulation and SITBs, with only one of 21 possible mediation analyses (family protective factors mediating difficulties with emotion regulation and lifetime endorsement of suicidal ideation) being statistically significant on both the indirect path (B = 0.069, p < 0.01) and total effect (B = 0.154, p < 0.05) paths. Furthermore, individual resilience was only statistically significant as a mediator for sensation seeking with suicidal ideation and suicide attempts at both the indirect path and total effect (p < 0.01) and family protective factors were statistically significant as mediators for impulsivity with non-suicidal self-injury and suicidal ideation at both the indirect path and total effect (p < 0.05).

These findings indicate that efforts to build resilience and protective factors as a prevention or treatment of SITBs among inpatient adolescents may be ineffective for adolescents experiencing difficulties with emotion regulation. These findings highlight the importance of understanding the various unique personality factors of inpatient adolescents to maximize the effectiveness of resilience and protective factors interventions aimed at preventing and reducing SITBs. Future analyses will investigate if the mediating effect of resilience and protective factors is moderated by trauma.