History Of Non-suicidal Self-injury Research Articles

Self-Critical and Self-Punishment Cognitions Differentiate Those With and Without a History of Nonsuicidal Self-Injury: An Ecological Momentary Assessment Study

The aim of this study was to examine trait, state, and temporal instability measures of self-critical and self-punishment cognitions to evaluate their respective roles in nonsuicidal self-injury (NSSI). Participants were university students with a history of NSSI (n = 64) and those with no history of NSSI (n = 59). At baseline, participants completed measures assessing history of NSSI behavior, as well as trait measures of self-criticism and self-punishment. After completion of baseline procedures, participants subsequently participated in a 10-day ecological momentary assessment protocol in which self-critical and self-punishment cognitions were assessed in real time three times daily. Employing bivariate and multivariate frameworks, our results demonstrate that both trait and state levels of self-critical and self-punishment cognitions robustly differentiate between young adults with and without a lifetime history of NSSI. The present results also confirm that the temporal instability of these cognitive states also meaningfully differentiate between groups, such that those who exhibit greater fluctuations in these cognitive states are more likely to have a history of NSSI. The current findings suggest that trait, state, and temporal instability of negative self-focused cognitions may be vulnerability factors for engagement in NSSI.

Characterizing the choice to disclose nonsuicidal self-injury.

Despite nonsuicidal self-injury (NSSI) being a prevalent and problematic behavior, only approximately half of those who engage in NSSI disclose their behavior. Yet, limited research has explored the choice to disclose. This study sought to identify if NSSI characteristics, emotional distress, and perceived interpersonal obstacles discriminated between NSSI disclosure status. Exploratory aims also investigated reasons for one's disclosure decision and disclosure contextual factors. Participants included 977 undergraduate students (83% female) with a lifetime history of NSSI. Greater NSSI intrapersonal functions, suicide risk, and significant other support, and lower depression symptoms were associated with NSSI disclosure. Exploratory results highlight perceptions of one's NSSI severity and desire to receive support in disclosure choice; intrapersonal functions and peer support were associated with the timing of disclosure. Findings underscore the potential importance of individual attitudes toward NSSI, in addition to traditionally measured risk factors, as potential drivers in NSSI disclosure.

Examining the Time to Transition From Nonsuicidal Self-Injury to Suicide Attempt.

Background: Nonsuicidal self-injury (NSSI) is a strong predictor of suicide attempts (SA). Characteristics of NSSI have been shown to influence the NSSI-SA relationship; however, the temporal nature of this association is understudied. Aims: This study aimed to elucidate the NSSI-SA relationship by examining the association between NSSI characteristics and time lapsed from NSSI onset to first SA. Method: Participants were 111 individuals with a history of NSSI that preceded their first SA who completed a series of self-report measures. Results: NSSI methods of cutting and burning, and the anti-dissociation function, were associated with a shorter transition time from NSSI to SA. Earlier age of NSSI onset and the interpersonal boundaries function were related to a longer time to transition. Limitations: This sample size was limited, and data were collected cross-sectionally. Conclusion: Findings provide foundational knowledge regarding NSSI characteristics to inform theoretical models of the NSSI-SA association. This information can inform suicide risk assessments among those with a history of NSSI.

Assessing Attentional Bias Toward Nonsuicidal Self-Injury Cues in Young Adults with Histories of Engaging in Self-Harm

Nonsuicidal self-injury (NSSI) is a prevalent behavior among young people maintained by complex transdiagnostic processes. This study sought to investigate whether NSSI attentional bias—the preferential allocation of attentional resources to environmental NSSI cues—is one such transdiagnostic process experienced by young adults with histories of NSSI. Participants were 39 young adults who completed a dot probe task designed to measure attentional bias to NSSI cues and negatively-valenced cues. Participants also provided NSSI urge and affect ratings during the task. Paired samples t-tests were conducted to determine if participants exhibited a significant attentional bias to NSSI cues and negatively-valenced cues compared to neutral cues, and to test whether NSSI urge ratings following the dot probe task increased from baseline levels. Participants exhibited a significant attentional bias to NSSI cues presented for 200 ms and a significant attentional bias to negative cues presented for 200 ms. The urge to engage in NSSI was elicited by NSSI cues, but not by negative cues. These findings indicate exposure to NSSI cues elicits both attentional bias and NSSI urge, a unique process that differs from a mere generalized attentional bias to negative affective stimuli known to be exhibited by individuals with other forms of psychopathology, such as anxiety or depressive disorders. These results provide preliminary evidence for possible avenues of intervention as it relates to the role of exposure to NSSI cues in the maintenance of NSSI, including managing cue-elicited urge and tolerating changes in affective states.

109 Near-fatal suicide attempts among Canadian Youth: A CPSP Study

Abstract Background Suicide is the second leading cause of death among Canadian adolescents. Youth who make near fatal suicide attempts, such as those requiring intensive care unit (ICU) level care, are the closest proxy to those that die by suicide; however, there is limited data on this group. Objectives To evaluate the minimum incidence rate and patterns of presentation of youth (under 18 years of age) admitted to the ICU for medically serious self-inflicted injury. Design/Methods From January 2017 to December 2018, over 2,700 paediatricians/subspecialist members of the Canadian Paediatric Surveillance Program were electronically surveyed on a monthly basis regarding cases of medically serious self-harm. Participants completed a detailed questionnaire about the reported case and descriptive statistics were used for analyses. Results Ninety-four cases (71 female; mean age 15.2 years) of confirmed (n=87) and suspected/probable (n=7) medically serious self-harm were reported. The majority (87%) of cases were reported from 4 out of 13 provinces and territories in Canada (Alberta, British Columbia, Ontario, Quebec). There were 11 deaths by suicide (M>F; p<.05). Medication ingestion was the most common method of self-harm among females (76% F vs. 52% M; p=.03) compared with hanging among males (14% F vs. 39% M; p=.009). More females than males had a prior suicide attempt (62% F vs. 32% M; p=.07) and a history of non-suicidal self-injury (NSSI) (65% F vs. 14% M; p<.05), although only history of NSSI reached significance. More females than males had a past psychiatric diagnosis (77% F vs. 55% M; p=.05), and past use of mental health services (69% F vs. 30% M; p<.001), although only service use reached significance. Half of the youth left evidence of intent (54%) and 33% of parents of included youth were aware that their child was considering suicide. Family conflict was the most common precipitating factor for suicide attempt in both females and males (46%). Conclusion These Canadian findings are consistent with international epidemiologic data that observe a gender paradox of higher rates of suicide attempts in females and greater mental health care engagement but increased suicide mortality in males with decreased involvement with mental health care. This study suggests that family conflict is a potential target for suicide prevention interventions among youth. Future research focusing on gender-specificity in risk factor identification and effectiveness of primary prevention interventions among youth is warranted.

The relationship of the UPPS model of impulsivity on bulimic symptoms and non-suicidal self-injury in transgender youth

ObjectiveThis brief report examined the relationship of negative urgency (the tendency to act rashly in response to negative emotional states), (lack of) perseverance, (lack of) premeditation, and sensation seeking in association with non-suicidal self-injury (NSSI) and symptoms of bulimia nervosa (BN) in a sample of treatment-seeking transgender (TG) youth. MethodEighty-six TG youth with a mean age of 17 (sd = 3.2) agreed to participate in the study. The majority of our sample identified as TG male (n = 60) with 20 participants identifying as TG female and 6 identifying as non-binary. The racial ethnic breakdown of our sample was 8.2% Black, 8.2% Multi-racial, 1.2% Native American, and 82.4% White. Over ¼ of our sample endorsed at least one episode of objective binge eating in the last 28 days and 62% endorsed a history of NSSI. ResultsNegative urgency was significantly associated with the odds of NSSI, objective binge eating, and general eating disorder symptoms. Lack of premeditation was significantly related to the odds of NSSI only. No other factors were significantly associated with NSSI or symptoms of BN. ConclusionsNegative urgency appears to be an important personality construct in understanding increased risk for NSSI and BN symptoms in transgender youth.

Optimal PAI-A Cutoffs to Determine Risk for Non-Suicidal Self-Injury (NSSI) and Suicide-Related Behavior (SRB) among At-Risk Adolescents

Objective This study examines psychopathology and personality correlates of non-suicidal self-injury (NSSI) and suicide-related behavior (SRB) in an understudied sample of adolescents who have exhibited behaviors (e.g., delinquent acts, premature high school termination) that place them at-risk for poor psychosocial outcomes. Method Participants included a predominantly White male sample of 182 adolescents (Mage = 16.82 years). In addition to information about NSSI and SRB histories, participants self-reported various facets of personality and psychopathology on the Personality Assessment Inventory-Adolescent (PAI-A). Results Logistic regression analyses indicated that the Suicidal Ideation (SUI) scale on the PAI-A was the strongest predictor of both NSSI and SRB history, as it outperformed other relevant PAI-A scales and the Suicide Potential Index (SPI), an aggregate scale that was designed to assess for suicide risk using the PAI for adults. Receiver operating characteristic (ROC) curve analyses were also conducted to determine optimal cutoff scores for significant PAI-A predictors. Conclusions Findings from the current study can be used to identify NSSI and SRB risk and target these life-threatening behaviors when working with at-risk adolescents. Highlights PAI-A SUI outperformed other PAI-A variables in predicting NSSI and SRB risk. PAI SPI did not perform as well in adolescents compared to adult samples. Cutoff scores in the current sample were well below those in the PAI-A manual.

Open to interpretation? Inconsistent reporting of lifetime nonsuicidal self-injury across two common assessments.

Nonsuicidal self-injury (NSSI) is typically assessed using either single-item questionnaires or checklists of common behaviors, but preliminary research suggests that checklists produce higher lifetime prevalence rates. In 2 preregistered studies (combined n = 1,364), we tested whether memory cueing afforded by behavioral checklists accounts for this discrepancy. Participants reported their lifetime NSSI history using both a single-item and a checklist, with presentation order randomized across participants. Nearly a third of participants reported inconsistent NSSI histories on the 2 assessments, with participants 1.57 times more likely to report an NSSI history on a checklist than on a single-item. Counter to the memory account, this discrepancy was evident even when participants completed the checklist first, suggesting that the increased prevalence estimates captured by checklists are unlikely to simply reflect memory facilitation. Across the 2 samples, 12.5% of participants would have been incorrectly screened out in 2-step assessments; these participants were more likely to have engaged in NSSI historically, less likely to self-injure by cutting, and (in Study 2 only) were more likely to be men. These studies suggest that the inconsistencies across 2 of the most common NSSI assessments arise because people dissimilar to the lay conceptualization of self-injury are less likely to endorse a single-item, even when they have affirmed engaging in self-injury behaviors on a checklist. We argue that single-item and checklist assessments capture different aspects of NSSI, such that future research should distinguish between behaviorally identified NSSI assessed with behavioral checklists and self-identified NSSI assessed with single-item assessments. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Online disinhibition and internet communication of non-suicidal self-injury.

Non-suicidal self-injury (NSSI) is of concern given the increased risk for suicide attempt. Prevalence rates of NSSI are highest among adolescents and young adults. These groups also exhibit the highest rates of Internet use. Previous research suggests that online communication of NSSI can serve as both a risk and protective factor related to NSSI engagement. This study explored online disinhibition in the context of NSSI e-communities as a potential factor that could contribute to opposing NSSI outcomes. The study sample consisted of 200 individuals 18years or older (M=21.76, SD=5.24) recruited from social networking sites (i.e., Reddit, LiveJournal). These participants provided self-report of their NSSI histories and degree of online disinhibition. Those who engaged in Internet communication of NSSI at the highest level endorsed more online disinhibition than those less involved with NSSI content. Furthermore, within this group of high communicators, increased toxic disinhibition predicted lower lifetime frequency of NSSI. This study suggests that online behavior, including toxic disinhibition, may contribute to NSSI outcomes. Online disinhibition and its relationship to NSSI should be an area of continued research. Cyberbullying may be an additional construct of interest in future studies of NSSI e-communication.

Parents' Attitudes Toward and Experience of Non-Suicidal Self-Injury in Adolescents: A Qualitative Study.

BackgroundNon-suicidal self-injury (NSSI) is prevalent in adolescents and brings a series of serious consequences to their well-being. However, little is known about parents’ attitude toward NSSI in Chinese adolescents. The study aims to investigate the parents’ attitudes toward and perceptions of adolescents who have engaged in NSSI behaviors, and the impact of NSSI on their parents.MethodsPurposive sampling was used in the study. The biological parents of adolescents with NSSI were recruited from the psychiatric ward of a tertiary hospital in China. Semi-structured interviews were conducted which contained three aspects, that is the history of NSSI, the process of seeking or maintaining help and the impacts on the family. Each interview typically lasted 40–50 min. All of the interviews were audio-recorded. Their responses were analyzed by the thematic analysis.ResultsTwenty participants completed the interview, consisting of 16 mothers and 4 fathers. Three themes and eight sub-themes were extracted: (1) the attitudes to children’s NSSI behaviors (ignorance, shame, and stereotype); (2) coping strategies of parents (the initial response to adolescents’ NSSI, and the way of help-seeking); (3) the impacts on family (altered parenting and communication styles, limited personal lives, and increased psychological pressure).ConclusionThe results showed that parents lack the knowledge about NSSI and its treatment and are suffering great emotional stress. It is recommended to expand the popularization of knowledge of NSSI in adolescents and more interventions adapted to China’s sociocultural climate are required for the well-being of parents and NSSI in adolescents.

Characteristics of nonsuicidal self-injury among veterans.

The current study aimed to (a) assess basic nonsuicidal self-injury (NSSI) characteristics using a validated clinical interview among a sample of veterans not recruited for specific diagnostic or environmental criteria and (b) examine the relation between NSSI and medical severity of prior suicide attempts (SAs) among veterans. We conducted secondary data analyses among a combined sample of veterans (N = 165) from two parent studies conducted at a large VA Medical Center that implemented identical recruitment protocols. No psychiatric criteria were utilized for inclusion or exclusion purposes. Approximately 16% of participants reported NSSI history and almost 21% reported SA history. NSSI history was associated with probability of prior SA but not the medical severity of prior SA. NSSI is a prevalent concern among veterans and is associated with probability of SA. It remains unclear whether prior NSSI is associated with more medically serious SA in this population.

Do styles of emotion dysregulation differentiate adolescents engaging in non-suicidal self-injury from those attempting suicide?

Emotion dysregulation is implicated in both suicide attempts (SA) and non-suicidal self-injury (NSSI). However, little is known about how emotion dysregulation may differ between adolescents who have made an SA from those engaged in NSSI. We sought to address this gap by comparing emotion dysregulation profiles across three homogenous groups of adolescents (1) SA-only (2) NSSI-only (3) and typically developing controls (TDCs). Mean comparisons suggest that adolescents with a history of NSSI reported significantly lower distress tolerance and higher emotional reactivity when compared to adolescents who made an SA. After controlling for shared variance across emotion dysregulation measures, parent report of affective lability was the only scale to uniquely distinguish between NSSI and SA groups. Accurately distinguishing emotion dysregulation patterns across self-injurious groups has practical implications towards assessment, treatment, course of illness, and prevention.

An exploratory mixed methods approach to implicit and explicit identification with non-suicidal self-injury

Background and objectivesIdentification with non-suicidal self-injury (NSSI) is uniquely related to NSSI behavior and predicts future NSSI. This exploratory, mixed methods study used implicit and explicit approaches to further understanding of NSSI identity. Methods: Participants included 15 treatment-seeking adults (60% female, 87% Caucasian) with lifetime NSSI. Participant age ranged from 19 to 38 years (M = 25.33, SD = 6.10). Implicit tasks were completed at two time points in a test-retest design, followed by a qualitative interview. ResultsQualitative data suggest that explicit NSSI identity is relevant to some individuals with NSSI history. Mixed methods analyses indicate that individuals who explicitly identify with NSSI have stronger implicit NSSI identities than those who do not, and report more methods of NSSI on average. LimitationsResults are novel, although exploratory in nature due to the sample size, and may not be generalizable to non-clinical samples or individuals currently engaging in NSSI. ConclusionsIndividuals with stronger explicit identity evidence higher implicit identity scores, suggesting a potential higher risk profile for future NSSI. This study offers further support for the value of including both implicit and explicit assessment of NSSI identity in risk assessment.

School-Based Prevention Targeting Non-Suicidal Self-injury: A Pilot Study.

Non-suicidal self-injury (NSSI) is prevalent in adolescence and is associated with increased risk for a variety of subsequent negative mental health outcomes, necessitating an evidence-based preventive approach. This pilot study examines the potential iatrogenic effects and feasibility of an evidence-based school program for the prevention of NSSI. Differences are examined between a general in-classroom prevention program (Happyles) and this program combined with a 1-h in-classroom psychoeducation module on NSSI (HappylesPLUS) in terms of primary (e.g., delay in NSSI onset and decrease in NSSI frequency, urges, probability of future engagement) and secondary outcomes (e.g., psychological distress, emotion regulation, help-seeking, and stigma) using a mixed-method design. A total of 651 secundary school pupils (Mage = 12.85 years; 49.8% female versus 50.2% male) were assigned to the Happyles program and HappylesPLUS. Participants filled out validated self-report questionnaires pre (T0) and post (T1, 6 weeks after T0) the school prevention program, including the Youth Outcome Questionnaire (YOQ), the Brief Non-Suicidal Self-Injury Assessment Test (BNSSI-AT), the Difficulties in Emotion Regulation Scale (DERS), the Attitudes Toward Seeking Professional Psychological Help Scale—Short Form (ATSPPH-SF), and the Peer Mental Health Stigmatization Scale (PMHSS). Qualitative semi-structured interviews (at T2,6 weeks after T1) were conducted with participants with and without a history of NSSI. Overall, results show no iatrogenic effects of the NSSI-focused psychoeducation module. In terms of our primary outcome, both groups reported a reduced likelihood of future NSSI engagement from T0 to T1. Regarding secondary outcome measures, we also observed increased emotional awareness in both groups. The qualitative data suggest that the addition of the NSSI-specific module to the Happyles program may have direct benefits to some students with lived experience, such as increased help-seeking behavior for NSSI. Findings of this pilot study show that incorporating NSSI-specific modules into evidence-based school prevention programs is feasible and does not lead to iatrogenic effects. Future work is needed to evaluate the potential (longer-term) benefits of incorporating NSSI-focused modules to evidence-based mental health programs in the prevention of NSSI.

Self-Stigma Toward Nonsuicidal Self-Injury: An Examination of Implicit and Explicit Attitudes.

Evidence suggests that individuals without a history of nonsuicidal self-injury (NSSI) are likely to view NSSI as a stigmatized behavior. However, there is limited evidence evaluating the presence of self-stigma among individuals who have engaged in NSSI. We recruited a university sample (n=351) and employed implicit and explicit measures to examine the degree of stigmatization toward those with NSSI scarring, as compared to nonintentional disfigurement (i.e., accidental scarring) and to tattoos (i.e., a culturally sanctioned form of intentional tissue alteration). We examined the extent to which bias is related to indicators of NSSI severity among those with a history of NSSI. We provide evidence that negative biases toward NSSI may represent the effects of self-stigma. However, findings suggest that biases were generally attenuated among participants with a history of NSSI as compared to those without. Participants who had lower levels of NSSI explicit bias were more likely to have a history of more severe engagement in NSSI; however, no significant relationships were found between implicit bias and NSSI severity indicators. We present a theoretical rationale for attenuated biases among individuals with a history of NSSI and discuss implications of this research for NSSI recovery.

Measurement Invariance of Two Measures of Alexithymia in Students Who Do and Who Do Not Engage in Non-suicidal Self-Injury and Risky Drinking

Non-Suicidal Self-Injury (NSSI) and risky drinking have a shared emotion regulatory function. Alexithymia is an important risk factor for both behaviors. However, it is conceivable that the emotional processing difficulties thought to underlie both behaviors may contribute to differences between people who self-injure or drink in a risky fashion, and those who do not, when interpreting alexithymia items on self-report questionnaires. Therefore, measurement invariance should be established before attributing scale score differences between groups to true differences in alexithymia. We examined the validity, factor structure, and measurement invariance of the Toronto Alexithymia Scale (TAS-20) and the Perth Alexithymia Questionnaire (PAQ) among 640 university students (Mage = 20.39, SD = 1.86) with and without histories of NSSI and risky drinking. The original factor structure of the TAS-20 was not supported; however, the addition of a reverse-scored item method factor improved fit. The intended five-factor model of the PAQ was supported. We found configural, full metric, and full scalar invariance for the PAQ and a revised-TAS-20. Both the PAQ and TAS-20 demonstrated good concurrent, convergent, and discriminate validity. Our results suggest that all subscales of the PAQ and the difficulties identifying feelings and difficulties describing feelings subscales of the TAS-20 can be used confidently to discern differences in alexithymia in the context of NSSI and risky drinking. However, the externally orientated thinking subscale of the TAS-20 had poor internal consistency and several inadequate factor loadings. We discuss the utility of the externally orientated thinking subscale (TAS-20).

The Differences Between Individuals Engaging in Nonsuicidal Self-Injury and Suicide Attempt Are Complex (vs. Complicated or Simple).

BackgroundWhy do some people engage in nonsuicidal self-injury (NSSI) while others attempt suicide? One way to advance knowledge about this question is to shed light on the differences between people who engage in NSSI and people who attempt suicide. These groups could differ in three broad ways. First, these two groups may differ in a simple way, such that one or a small set of factors is both necessary and sufficient to accurately distinguish the two groups. Second, they might differ in a complicated way, meaning that a specific set of a large number of factors is both necessary and sufficient to accurately classify them. Third, they might differ in a complex way, with no necessary factor combinations and potentially no sufficient factor combinations. In this scenario, at the group level, complicated algorithms would either be insufficient (i.e., no complicated algorithm produces good accuracy) or unnecessary (i.e., many complicated algorithms produce good accuracy) to distinguish between groups. This study directly tested these three possibilities in a sample of people with a history of NSSI and/or suicide attempt.MethodA total of 954 participants who have either engaged in NSSI and/or suicide attempt in their lifetime were recruited from online forums. Participants completed a series of measures on factors commonly associated with NSSI and suicide attempt. To test for simple differences, univariate logistic regressions were conducted. One theoretically informed multiple logistic regression model with suicidal desire, capability for suicide, and their interaction term was considered as well. To examine complicated and complex differences, multiple logistic regression and machine learning analyses were conducted.ResultsNo simple algorithm (i.e., single factor or small set of factors) accurately distinguished between groups. Complicated algorithms constructed with cross-validation methods produced fair accuracy; complicated algorithms constructed with bootstrap optimism methods produced good accuracy, but multiple different algorithms with this method produced similar results.ConclusionsFindings were consistent with complex differences between people who engage in NSSI and suicide attempts. Specific complicated algorithms were either insufficient (cross-validation results) or unnecessary (bootstrap optimism results) to distinguish between these groups with high accuracy.

Decreased Amygdalar Activation to NSSI-Stimuli in People Who Engage in NSSI: A Neuroimaging Pilot Study.

In healthy individuals, stimuli associated with injury (such as those depicting blood or wounds) tend to evoke negative responses on both self-report and psychophysiological measures. Such an instinctive aversion makes sense from an evolutionary perspective. However, to engage in nonsuicidal self-injury (NSSI), this natural barrier must be overcome. The Benefits and Barriers model of NSSI predicts that people who engage in NSSI will show diminished aversion to NSSI-related stimuli compared to controls who do not engage in NSSI. We tested this hypothesis in a pilot study assessing 30 adults, 15 of whom reported current skin cutting and 15 of whom had no history of NSSI. Functional magnetic resonance imaging (fMRI) data were collected while participants viewed neutral, positive, and negative images selected from the International Affective Picture System. Participants also viewed NSSI images depicting razors, scalpels, or wounds caused by cutting. Compared to healthy control (HC) participants, the NSSI group showed decreased amygdala and increased cingulate cortex (CC) and orbitofrontal cortex (OFC) activation to NSSI and negative images. They also showed increased amygdalar and OFC activation to positive images. Neither the control group nor the NSSI group demonstrated significant activation within regions more typically associated with reward during any of the conditions; however, positive and negative affect ratings collected throughout the course of the task suggested that none of the affective conditions were viewed as rewarding. Although preliminary, these findings are suggestive of reduced limbic and greater cortical processing of NSSI stimuli in those with a history of this behavior. This has potentially important implications for current models of NSSI as well as for its treatment.

Emotional Response Inhibition: A Shared Neurocognitive Deficit in Eating Disorder Symptoms and Nonsuicidal Self-Injury.

Eating disorder (ED) symptoms often co-occur with non-suicidal self-injury (NSSI). This comorbidity is consistent with evidence that trait negative urgency increases risk for both of these phenomena. We previously found that impaired late-stage negative emotional response inhibition (i.e., negative emotional action termination or NEAT) might represent a neurocognitive mechanism for heightened negative urgency among people with NSSI history. The current study evaluated whether relations between negative urgency and ED symptoms similarly reflect deficits in this neurocognitive process. A total of 105 community adults completed an assessment of ED symptoms, negative urgency, and an emotional response inhibition task. Results indicated that, contrary to predictions, negative urgency and NEAT contributed independent variance to the prediction of ED symptoms, while controlling for demographic covariates and NSSI history. Worse NEAT was also uniquely associated with restrictive eating, after accounting for negative urgency. Our findings suggest that difficulty inhibiting ongoing motor responses triggered by negative emotional reactions (i.e., NEAT) may be a shared neurocognitive characteristic of ED symptoms and NSSI. However, negative urgency and NEAT dysfunction capture separate variance in the prediction of ED-related cognitions and behaviors, distinct from the pattern of results we previously observed in NSSI.

Mental images, entrapment and affect in young adults meeting criteria of nonsuicidal self-injury disorder (NSSID) \u2013 a daily diary study

BackgroundIncidents of nonsuicidal self-injury (NSSI) are often accompanied by mental images which could be perceived as distressing and/or soothing; yet existing data is derived from participants with a history of NSSI using retrospective methods. This study investigated mental images related to NSSI (“NSSI-images”), and their relationship to the proposed Nonsuicidal Self-Injury Disorder (NSSID).MethodsAn e-mail was sent to all female students of the local University providing the link to an online screening and 201 students with a history of repetitive NSSI responded. Nineteen eligible participants meeting criteria of NSSID (mean age = 25; 32% with migrant background) further completed a baseline interview and a ten-day-diary protocol.ResultsAmong the sample of N = 201, 83.6% reported NSSI-images. In the subsample of n = 19 diagnosed with NSSID, the frequencies of NSSI and NSSI-images were correlated; about 80% of the most significant NSSI-images were either of NSSI or of an instrument associated with NSSI (i.e., a razorblade). In the diary, 53% of the sample self-injured. NSSI-images were reported on 94% of NSSI-days, and on days with NSSI and NSSI-images, the images almost always occurred first; the images were overall perceived as twice more distressing than comforting. Images on NSSI-days were characterized by more comfort, intrusiveness and compellingness yet less vividness, and increased subsequent positive and negative affect compared to non-NSSI days. NSSI-days were further marked by increased entrapment beliefs and increased negative yet decreased positive affect at night. These results were non-significant.LimitationsDue to non-significant results among a small sample size and a low rate of NSSI among the NSSID-group, results remain preliminary.ConclusionsThe study provides information on feasibility and methodological challenges such as intervention effects of the diary. NSSI-images may be common among individuals who engage in NSSI; they may capture ambivalent (positive and negative) appraisals of NSSI and thus play a role in NSSI and possibly a disorder such as NSSID. The preoccupation with NSSI (Criterion C of NSSID in DSM-5) may as well be imagery-based.RegistrationThe study was retrospectively registered with the DRKS under the number DRKS00011854.