Abstract
In the present study, we investigated the association between Non-Suicidal Self-Injury (NSSI) and the UPPS-P impulsivity facets in eating disorder patients and healthy controls. The prevalence of NSSI in eating disorder (ED) patients ranged from 17% in restrictive anorexia nervosa (AN-R) patients to 43% in patients with bulimia nervosa (BN). In healthy controls (HC), the prevalence of NSSI was 19%. Eating disorder patients from the binge eating/purging type showed significantly more NSSI compared to restrictive ED and HC participants. Binge-eating/purging ED patients also scored significantly higher on Negative/Positive Urgency, Lack of Premeditation and Lack of Perseverance compared to HC and restrictive ED patients. Comparable findings were found between ED patients and HC with and without NSSI; ED patients and HC with NSSI scored significantly higher in four of the five UPPS-P dimensions compared to participants without NSSI; Sensation Seeking was the exception. Finally, the presence of NSSI in HC/ED patients was particularly predicted by low levels of Perseverance. Therefore, the treatment of ED patients with NSSI certainly needs to focus on the training of effortful control.
Highlights
Non-suicidal self-injury (NSSI) refers to the deliberate and direct injury of one’s own body tissue without suicidal intent [1], such as scratching, cutting, hitting and burning oneself
Post-hoc comparison between diagnostic subtypes indicated that prevalence of NSSI in the healthy controls (HC) group was not significantly different from the anorexia nervosa restrictive subtype (AN-R) group (OR = 1.15, p =. 774), but the NSSI prevalence was lower in HC when compared to anorexia nervosa binge eating/purging subtype (AN-BP) (OR = 2.65, p =. 046), bulimia nervosa (BN) (OR = 3.24, p
For the rest of the UPPS-P scales (Lack of Premeditation, Sensation Seeking and Positive Urgency), the interaction NSSI×group achieved a significant result, indicating that the mean differences based on the presence of the NSSI behavior was related to the diagnostic subtype: a) the UPPS-P Lack of Premeditation mean was higher for participants who reported the presence of NSSI behavior compared to those without NSSI only in the AN-BP subtype and b) mean scores for the UPPS-P Positive Urgency scale were higher for patients with NSSI as compared to those without NSSI into the AN-BP, BN and EDNOS subtypes
Summary
Non-suicidal self-injury (NSSI) refers to the deliberate and direct injury of one’s own body tissue without suicidal intent [1], such as scratching, cutting, hitting and burning oneself. According to Peterson and Fischer [5], the link between NSSI and BN in community and clinical samples, can be the desire to quickly reduce negative affect. Recent developments in the study of impulsivity theoretically clarify the role of reactivity to negative affect in impulsive action [5] One of these models, the UPPS model of Whiteside and Lynam [9], originally described four distinct personality pathways to impulsive behavior: Negative Urgency, Lack of Perseverance, Lack of Premeditation and Sensation Seeking. In 2007, Cyders et al [10] have identified an important additional dimension, Positive Urgency, which refers to the tendency to act impulsively when experiencing positive affect To assess these five pathways of impulsive behavior Whiteside and Lynam [9] developed the UPPS-P Impulsive Behavior Scale
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