Maternal Autistic Traits and Mentalization in Adolescent Non-suicidal Self-Injury: A Case-Control Study

Plain Language Summary

Why is this study important? Self-harm among teenage girls is rising and becoming a serious public health issue. While we know family relationships play a role, specific maternal characteristics have not been studied enough. This study looked at “mentalization” skills in mothers of teens who self-harm, their capacity to understand and respond to their child's mental state. What did we do? We compared three groups of teenage girls: (1) those who engaged in self-harm without ever attempting suicide, (2) those who had attempted suicide in addition to self-harming, and (3) healthy teens with no history of self-harm. We asked their biological mothers to complete a questionnaire about their social skills and autistic traits, and to take a test where they had to guess emotions just by looking at photos of people's eyes. We also interviewed the teens to understand the reasons behind their self-harm behaviors. What did we find? We found that mothers of teens who self-harm (in both clinical groups) had significantly more difficulty reading emotions from the eyes compared to mothers of healthy teens. Interestingly, these mothers did not report high levels of general autistic traits in the questionnaires; they specifically struggled with the skill of tuning into emotions in the eye test. Additionally, we found a key difference among the teens: those who had attempted suicide reported that they did so to get a reaction from others much more frequently than those who only engaged in self-harm. What does this mean? Our study suggests a link between a mother's difficulty in reading emotions and her child's self-harm behavior. Although we do not yet know the exact reasons underlying this relationship, it raises the possibility that missed emotional cues between mother and child may contribute to the issue. Therefore, helping mothers improve their skills in understanding emotions could be a valuable addition to the treatment.