A nurse is reviewing the medical record of a client who performs self-injury. Which of the following information should the nurse identify as placing the client at risk for self-harm behaviors?

A. A parent with dependent personality disorder does not directly place the client at high risk for self-injury. Although family dynamics can influence mental health, it is not a primary risk factor for self-harm. B. Borderline personality disorder is strongly associated with self-harming behaviors. Individuals with this disorder often experience intense emotional instability and engage in self-injury as a coping mechanism for emotional pain or a way to feel in control. C. While bulimia nervosa involves unhealthy coping behaviors related to body image and control, it is not as strongly linked to self-harm behaviors as borderline personality disorder. However, both conditions may involve maladaptive coping mechanisms. D. Receiving a promotion at work typically does not place someone at risk for self-harm; in fact, positive life changes are often seen as protective factors against self-harm.