Comparing the roles of behaviour-specific beliefs in the associations between alexithymia and both non-suicidal self-injury and risky drinking: A multi-method assessment of expectancies

Abstract

• Alexithymia was indirectly associated with both NSSI and risky drinking through behaviour-specific refusal self-efficacy. • Alexithymia was indirectly associated with NSSI through stronger affect regulation expectancies and weaker communication expectancies. • Alexithymia was not indirectly associated with risky drinking through drinking expectancies. • Lab-based measures of affect regulation (NSSI) and sexual enhancement expectancies were stronger predictors of NSSI and risky drinking respectively than equivalent questionnaire-measured expectancies. • Clinically, the current results support interventions that challenge behaviour specific thoughts and beliefs for individuals with high levels of alexithymia. Introduction Alexithymia, a trait encompassing difficulties identifying and describing one's feelings, and a tendency to focus externally, is positively associated with both non-suicidal self-injury (NSSI) and risky drinking. The relationships between alexithymia and both behaviours are well researched, however, it is unclear whether both associations are explained by similar behaviour-specific expectancies . The primary aim of the present research was to investigate and compare the indirect relationships between alexithymia and both behaviours through NSSI and drinking specific expectancies and refusal self-efficacy. The secondary aim was to compare lab-based and questionnaire-based measures of expectancies. Methods A sample of 259 students (80.31% female, M age =19.98; SD = 1.49) answered a series of questionnaires and completed lab-based expectancy tasks to measure the variables of interest. Results Alexithymia was indirectly associated with both NSSI and risky drinking through behaviour-specific refusal self-efficacy. Thus, students with high levels of alexithymia may believe they are incapable of resisting engaging in self-injury or consuming alcohol in circumstances that warrant them to place attention on and/or appraise their feelings. Further, alexithymia was indirectly associated with NSSI through stronger affect regulation and weaker communication expectancies. However, alexithymia was not indirectly associated with risky drinking through drinking-specific expectancies. Limitations Cross-sectional methods preclude conclusions regarding temporal ordering. Conclusion Theoretically, these findings suggest that anticipated outcomes of NSSI and risky drinking may be different for university students. Clinically, the current results support interventions that challenge behaviour specific thoughts and beliefs for students who have difficulties identifying and describing feelings.