Self-Harm Reasons, Goal Achievement, and Prediction of Future Self-Harm Intent

Department of Psychology, University of Guelph, Guelph, Ontario, Canada.
The Journal of nervous and mental disease (Impact Factor: 1.69). 05/2010; 198(5):362-9. DOI: 10.1097/NMD.0b013e3181da8500
Source: PubMed


Self-harm may have several reasons, and these reasons may have corresponding implied goals. The current study examined reasons for self-harm and whether the a priori goals intended by these reasons were achieved. Fifty-seven individuals with a history of self-harm were recruited online and volunteered their time to complete a series of online questionnaires assessing past self-harm frequency, self-harm reasons, whether the goal associated with these reasons was achieved, and future self-harm intent. Reasons to reduce tension and dissociation associated with more past self-harm, a higher intent to self-harm again, and it was reported that the goals associated with reasons were achieved (i.e., these internal states were extinguished). Achievement of these goals (i.e., reported reductions in tension and dissociation) mediated the relation between corresponding self-harm reasons and intent to self-harm in the future. Findings support the view that self-harm is a maladaptive coping strategy and the reinforcement component of the experiential avoidance model of self-harm. Results have clinical implications and heuristic value for future research, which are discussed.

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    • "Other self-injury literature too indicates that people report different reasons for NSSI (Klonsky, 2007). Most commonly reported reasons relate to affect regulation, wherein self-injury reduces unwanted emotional states, such as tension and feeling overwhelmed (Briere & Gil, 1998; Lewis & Santor, 2008). Another commonly reported reason is reduction and management of dissociative experiences (Klonsky, 2007). "
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    ABSTRACT: Nonsuicidal self-injury (NSSI) and suicidal self-injury (SSI) co-occur in adults. The purpose of the current study was to examine differences and similarities in NSSI and SSI in adult women with respect to (1) methods used and lethality of methods, (2) intent and impulsivity of act, (3) precipitating events, and (4) consequences. The data consist of variables pertaining to 46 self-injurious acts committed by 16 Finnish female participants and recorded using Suicide Attempt Self-Injury Interviews (SASII). The data were analyzed using variables weighted by the number of acts. This study found several differences as well as similarities between the acts of SSI and those of NSSI: (a) the respective acts differ in the methods used, in the lethality of the methods, and in the expectations of resulting lethality of the acts, (b) they further differ in the functions the respective acts serve and (c) in some of the precipitating events and consequences. The acts were similar in (d) impulsivity of act and (e) some of the precipitating events and consequences. Because both types of behavior can occur within the same individual, and due to the progressing evolution between them, a thorough assessment of both NSSI and SSI needs to be completed. More emphasis needs to be placed on both the assessment of social connections and interpersonal conflict as well as how it informs the treatment. Because the behavior studied is multifunctional and changing, its treatment too needs to be customized to the multiple and changing needs of the individual patients, as opposed to diagnostic tailored treatment.
    Nordic Psychology 02/2015; 67(1):27-45. DOI:10.1080/19012276.2014.997784 · 0.18 Impact Factor
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    • "Excessive threat reactivity accompanied by maladaptive forms of avoidance are prominent features of many forms of psychopathology , such as anxiety [1] [2] [3] [4] [5] [6] [7], and substance abuse disorders [8] [9], which has increased recognition of avoidance as a transdiagnostic factor [6]. Despite its obvious survival advantages, well established, chronic avoidance can embed individuals within a struggle aimed at perseveration of the avoidance behaviors and routine, which only serves to minimize approach opportunities and perpetuate suffering. "
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    ABSTRACT: Many forms of human psychopathology are characterized by sustained negative emotional responses to threat and chronic behavioral avoidance, implicating avoidance as a potential transdiagnostic factor. Evidence from both nonhuman neurophysiological and human neuroimaging studies suggests a distributed frontal-limbic-striatal brain network supports avoidance. However, our understanding of the temporal dynamics of the network to sustained threat that prompts sustained avoidance is limited. To address this issue, seventeen adults were given extensive training on a modified free-operant avoidance task in which button pressing avoided money loss during a sustained threat period. Subsequently, subjects underwent functional magnetic resonance imaging while completing the avoidance task. In our regions of interest, we observed phasic, rather than sustained, activation during sustained threat in dorsolateral and inferior frontal regions, anterior and dorsal cingulate, ventral striatum and regions associated with emotion, including the amygdala, insula, substantia nigra and bed nucleus of the stria terminalis complex. Moreover, trait levels of experiential avoidance were negatively correlated with insula, hippocampal and amygdala activation. These findings suggest knowledge that one can consistently avoid aversive outcomes is not associated with decreased threat-related responses and that individuals with greater experiential avoidance exhibit reduced reactivity to initial threat. Implications for understanding brain mechanisms supporting human avoidance and psychological theories of avoidance are discussed.
    Behavioural brain research 10/2013; 257. DOI:10.1016/j.bbr.2013.09.042 · 3.03 Impact Factor
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    • "Recent conceptualizations of anxiety disorders, particularly post-traumatic stress disorder, propose that dysfunctional avoidance coping emerges from a shift from neural substrates that process reward motivated approach behavior to neural substrates that support aversively motivated avoidance behavior [4]. Similar imbalances have been hypothesized to contribute to nonsuicidal self-harm [5], chronic substance abuse [6] [7] and pediatric anxiety disorders [8]. Nonhuman studies also suggest genetic differences may contribute to imbalances in the form of excessive avoidance behavior [9] [10] [11] [12]. "
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    ABSTRACT: Adaptive functioning is thought to reflect a balance between approach and avoidance neural systems with imbalances often producing pathological forms of avoidance. Yet little evidence is available in healthy adults demonstrating a balance between approach and avoidance neural systems and modulation in avoidance neurocircuitry by vulnerability factors for avoidance. Consequently, we used functional magnetic resonance imaging (fMRI) to compare changes in brain activation associated with human avoidance and approach learning and modulation of avoidance neurocircuitry by experiential avoidance. fMRI tracked trial-by-trial increases in activation while adults learned through trial and error an avoidance response that prevented money loss and an approach response that produced money gain. Avoidance and approach cues elicited similar experience-dependent increases in activation in a fronto-limbic-striatal network. Positive and negative reinforcing outcomes (i.e., money gain and avoidance of loss) also elicited similar increases in activation in frontal and striatal regions. Finally, increased experiential avoidance and self-punishment coping was associated with decreased activation in medial/superior frontal regions, anterior cingulate, amygdala and hippocampus. These findings suggest avoidance and approach learning recruit a similar fronto-limbic-striatal network in healthy adults. Increased experiential avoidance also appears to be associated with reduced frontal and limbic reactivity in avoidance, establishing an important link between maladaptive avoidance coping and altered responses in avoidance neurocircuitry.
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