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ABSTRACT: Nonsuicidal self-injury (NSSI), or the purposeful destruction of body tissue occurring without suicidal intent, is a perplexing behavior as it goes against the natural instinct to maximize pleasure and minimize pain. One possible reason that people engage in NSSI is to regulate affect. However, the exact mechanisms that cause NSSI to lead to reduced feelings of negative affect remain unclear. Due to its involvement in the regulation of pain and emotion, the endogenous opioid system has been proposed to mediate the affect regulation effects of NSSI. The authors review evidence from multiple literatures to support this claim. Based on the current research, it is proposed that 1) individuals who engage in NSSI have lower baseline levels of endogenous opioids, 2) NSSI releases endogenous opioids, and 3) opioids released during NSSI regulate affect. These predictions are discussed in terms of previous models and other functions of NSSI.
Neuroscience & Biobehavioral Reviews 01/2013; · 8.65 Impact Factor
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April R Smith,
Erin L Fink,
Michael D Anestis,
Jessica D Ribeiro, Kathryn H Gordon,
Heather Davis,
Pamela K Keel,
Anna M Bardone-Cone,
Carol B Peterson,
Marjorie H Klein,
Scott Crow,
James E Mitchell,
Ross D Crosby,
Stephen A Wonderlich,
Daniel le Grange,
Thomas E Joiner
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ABSTRACT: We conducted four studies to examine the relationship between over-exercise and suicidality. Study 1 investigated whether over-exercise predicted suicidal behavior after controlling for other eating disorder behaviors in a patient sample of 204 women (144 with Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) Bulimia Nervosa [BN]). Study 2 tested the prospective association between over-exercise and acquired capability for suicide (ACS) in a sample of 171 college students followed for 3-4 weeks. Study 3 investigated whether pain insensitivity accounted for the relationship between over-exercise and ACS in a new sample of 467 college students. Study 4 tested whether ACS accounted for the relationship between over-exercise and suicidal behavior in a sample of 512 college students. In Study 1, after controlling for key covariates, over-exercise was the only disordered eating variable that maintained a significant relationship with suicidal behavior. In Study 2, Time 1 over-exercise was the only disordered eating behavior that was associated with Time 2 ACS. In Study 3, pain insensitivity accounted for the relationship between over-exercise and ACS. In Study 4, ACS accounted for the relationship between over-exercise and suicidal behavior. Over-exercise appears to be associated with suicidal behavior, an association accounted for by pain insensitivity and the acquired capability for suicide; notably, this association was found across a series of four studies with different populations.
Psychiatry research. 12/2012;
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ABSTRACT: Theories of nonsuicidal self-injury (NSSI) and impulsivity suggest that individuals with high levels of negative urgency (e.g., those with a propensity to act rashly while experiencing negative affect) should experience the urge to engage in NSSI during negative affect states. However, previous research has not directly tested these predictions. This study used a daily diary methodology in a sample of individuals who engaged in NSSI in the last year. Participants completed self-report measures of trait impulsivity and subsequently made daily ratings of negative affect, sadness, guilt, and urge to engage in NSSI for 14 days. Our results indicated that for individuals high in negative urgency, daily sadness, but not guilt or general negative affect, was a positive predictor of urge to engage in NSSI. Meanwhile, for those low in negative urgency, sadness was unrelated to NSSI urge. Implications for theories of NSSI and treatment are discussed.
Psychiatry research. 10/2012;
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ABSTRACT: Our aim was to investigate two personality traits (i.e., stoicism and sensation seeking) that may account for well-established gender differences in suicide, within the framework of the interpersonal theory of suicide. This theory proposes that acquired capability for suicide, a construct comprised of pain insensitivity and fearlessness about death, explains gender differences in suicide. Across two samples of undergraduates (N = 185 and N = 363), men demonstrated significantly greater levels of both facets of acquired capability than women. Further, we found that stoicism accounted for the relationship between gender and pain insensitivity, and sensation seeking accounted for the relationship between gender and fearlessness about death. Thus, personality may be one psychological mechanism accounting for gender differences in suicidal behavior.
Journal of Research in Personality 08/2012; 46(4):384-392. · 2.00 Impact Factor
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ABSTRACT: Background: Historically, people who die by suicide and those who survive them have been perceived more negatively than those affected by other types of death (e.g., Reynolds & Cimbolic, 1988 ). Yet, it is unclear whether these negative perceptions actually lead to decreased social and emotional support for people bereaved by suicide. Aims: To examine whether specifying suicide as the cause of death in an obituary impacts perceptions of a decedent and willingness to provide support to the decedent's family. Method: A group of 253 participants were randomly assigned to read one of three fictional obituaries that were identical except for the stated cause of death (suicide, cancer, or drug overdose). Participants responded to questions about the decedent and behaviors toward the family. Results: Consistent with our prediction, people depicted as dying by suicide were viewed more negatively than decedents depicted as dying due to cancer. Contrary to our prediction, participants endorsed similar levels of willingness to provide support to the bereaved family regardless of the type of death specified in the obituary. Conclusions: The findings suggest that, even though those who die by suicide are viewed more negatively, their survivors may receive support that is similar to people bereaved by other types of death.
Crisis The Journal of Crisis Intervention and Suicide Prevention 07/2012; · 1.09 Impact Factor
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ABSTRACT: BACKGROUND: The stress generation hypothesis posits that individuals actively contribute to stress in their lives. Although stress generation has been studied frequently in the context of depression, few studies have examined whether this stress generation process is unique to depression or whether it occurs in other disorders. Although evidence suggests that stress contributes to the development of eating disorders, it is unclear whether eating disorders contribute to subsequent stress. METHODS: A prospective design was used to examine the influence of eating disorder symptoms on negative life stressors. Two hundred and ninety female undergraduates completed questionnaires at two time points that examined eating disorder, depressive and anxiety symptoms and the presence of negative life events. RESULTS: Regression analyses found that while eating disorder symptoms (i.e. bulimic symptoms and drive for thinness) were independent, significant predictors of negative life events, they did not predict negative life events above and beyond symptoms of depression. LIMITATIONS: Limitations include the use of self-report measures and a college-based sample, which may limit generalizability of the results. CONCLUSIONS: Findings suggest that if stress generation is present in individuals with symptoms of eating disorders, it is likely attributable to symptoms of depression. Thus, it may be important for clinicians to target depressive symptoms in order to reduce the frequency of negative life stressors among individuals with eating disorders.
Journal of affective disorders 07/2012; · 3.76 Impact Factor
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ABSTRACT: Based upon the escape theory (Baumeister, 1991; Heatherton & Baumeister, 1991) and the emotional cascade model (Selby, Anestis, & Joiner, 2008), it was hypothesized that body dissatisfaction and rumination tendencies would interact to predict concurrent binge eating symptoms. This hypothesis was tested in a sample of 780 undergraduate students. The results conformed to prediction, in that individuals with high levels of body dissatisfaction were most likely to report binge eating behavior when they also had a tendency to ruminate. This interaction had a significant association with binge eating, above and beyond variance accounted for by participant sex, depression symptoms, and body mass index. Moreover, there was evidence of specificity for the model, as the interaction did not predict concurrent problematic drinking. Our findings suggest compatibility between the escape theory and emotional cascade models, and identify two factors that, in combination, may render individuals particularly vulnerable to binge eating.
Body image 05/2012; 9(3):352-7. · 2.19 Impact Factor
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ABSTRACT: In general, organisms are motivated to avoid stimuli that induce pain. However, some individuals intentionally inflict pain
on themselves (e.g., nonsuicidal self-injury) and report doing so for the perceived emotional benefits following the experience
of pain. Two controlled laboratory studies sought to expand upon the relatively limited literature on the effects of pain
on emotion. In Study 1, participants provided momentary affect ratings immediately before and after experiencing physical
pain. Results demonstrated that both positive affect and negative affect (NA) decreased following the experience of pain.
In the Study 2, we examined the effect that individual differences in emotional reactivity had on affective reactions to pain.
Individuals high in emotional reactivity experienced larger decreases in NA following the experience of pain than individuals
who were low in emotional reactivity. Our findings may potentially explain why some individuals intentionally seek out the
experience of pain.
KeywordsEmotional reactivity-Negative affect-Positive affect-Pain-Nonsuicidal self-injury
Motivation and Emotion 04/2012; 34(3):280-287. · 1.23 Impact Factor
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ABSTRACT: BackgroundIn past research, anxiety sensitivity (AS) has been identified as a risk factor for anxiety, mood, and alcohol problems. Little
work, however, has examined the relationship between AS and eating pathology. We predicted that individuals high in AS would
have elevated rates of eating disorder symptoms as measured by the Eating Disorder Inventory (EDI).
MethodsParticipants in two studies—one undergraduate sample (N=88) and one clinical sample (N=96)—were assessed for anxiety sensitivity and eating disorder symptoms.
ResultsIn both samples, AS was significantly related to EDI-Bulimia scores, controlling for depressive symptoms, trait anxiety symptoms,
and impulsivity. In the clinical sample, AS was also significantly related to EDI-Drive for Thinness, controlling for the
same covariates. A follow-up analysis suggested that the relationship between AS and EDI eating disorder symptoms was mediated
by EDI-Interoceptive Awareness.
LimitationsBoth studies were cross-sectional, which prohibits causal interpretations. The follow-up mediational analysis must be interpreted
with caution due to overlap between the measures of AS and interoceptive awareness. Because of a small sample size and significant
comorbidity, the exploratory results analyzing diagnostic categories in Study 2 must be interpreted with caution.
ConclusionsAS has a statistically significant relationship to certain eating disorder symptoms measured by the EDI. Future research should
investigate whether high AS individuals utilize certain eating behaviors in an effort to regulate somatic symptoms of anxiety.
Cognitive Therapy and Research 04/2012; 32(3):370-385. · 1.33 Impact Factor
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ABSTRACT: Two studies examined the predictions of a of the catharsis theory of aggression, which suggests that aggressing towards the source of frustration should reduce aggressive drive (e.g., anger), and lead to the increased likelihood of future aggression (Hokanson, 1974; Verona & Sullivan, 2008). Across the two studies, predictions from this theory were generally supported. Using a laboratory paradigm, Study 1 found that provoked participants allowed to evaluate the source of frustration reported a non-zero decrease in anger, while individuals who evaluated an unrelated source showed no significant change. Using daily diary methods, Study 2 results demonstrated that individuals who had a decrease in anger following aggression in Study 1 were more likely to aggress on high anger days. In contrast, among individuals who had an increase in anger after aggressing, there was no relationship between daily anger and aggression. Implications for the adaptive aspects of aggression are discussed.
Journal of Social and Clinical Psychology 01/2012; · 1.36 Impact Factor
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ABSTRACT: Suicide is a major public health concern and, as such, research that elucidates potential mechanisms contributing to suicide risk is highly important. along these lines, prior research has linked high levels of distress tolerance with elevations in a specific component of suicide risk: the acquired capability for suicide. The fol-lowing two studies aimed to examine whether sensation seeking—the tendency to seek out activities involving risk or thrill—moderates the previously established relationship between distress tolerance and the acquired capability, such that a heightened ability to tolerate emotional distress was more strongly related to the acquired capability amongst people with greater risk taking tendencies. Study 1 examined this possibility using self-report measures in an undergraduate popula-tion. results indicated that individuals reporting high levels of both distress toler-ance and sensation seeking exhibited the highest level of the acquired capability.
Journal of Social and Clinical Psychology 01/2012; 31(1):81-100. · 1.36 Impact Factor
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ABSTRACT: Theoretical models of nonsuicidal self-injury (NSSI; i.e., purposeful destruction of body tissue without suicidal intent) suggest that individuals engage in NSSI in order to regulate negative affect (NA). One limitation of the current research is that most studies using pain as a proxy of NSSI have failed to include a nonpainful stimuli control group. This study attempted to address this limitation by comparing the emotional response to painful (vs. nonpainful) heat stimulation in individuals with a history of NSSI (vs. no history of NSSI) following a negative mood induction. It was predicted that among individuals with a history of NSSI, pain would lead to larger reductions in NA than warm stimulation. Furthermore, it was predicted that this reduction would be larger than that of controls regardless of condition. The hypotheses received partial support, such that pain led to greater reductions in negative affect for individuals with a history of NSSI, but not compared to controls. Future research directions are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved).
Personality disorders. 10/2011;
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ABSTRACT: Non-suicidal self-injury (NSSI) disorder has been suggested for inclusion into the Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, in preparation), yet there is concern that NSSI is primarily a function of high borderline personality disorder (BPD) symptoms. The purpose of this study was to examine the characteristics of NSSI disorder and compare it to BPD and other DSM Axis I diagnoses commonly seen in clinical practice to aid in the determination of whether NSSI should be considered a separate, valid diagnostic entity. Chart data were analyzed from the screening, intake, and termination information of 571 treatment-seeking patients in a general practice clinic. Patients were classified into one of three groups: NSSI without BPD, BPD (with and without NSSI) or a comparison condition for those who did not meet criteria for the first 2 groups. Participants in these 3 groups were compared on functioning at intake, psychopathology, and diagnostic co-occurrence. Results indicated important group differences regarding diagnostic co-occurrence rates, patient history of associated features, and impairment at intake. The NSSI group displayed similar levels of functional impairment as the BPD group, including on indices of suicidality. The BPD group reported increased experiences with abuse and fewer men relative to the NSSI group. Most in the NSSI group did not exhibit subthreshold BPD symptoms or personality disorder not otherwise specified. In conclusion, a potential NSSI disorder may be characterized by high levels of depressive symptoms, anxiety, suicidality, and low functioning relative to other Axis I diagnoses.
Personality disorders. 07/2011; 3(2):167-75.
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ABSTRACT: Multiple studies have reported a link between high levels of impulsivity and suicidal behavior. Joiner's (2005) explanation for this link is that impulsive individuals have a greater tendency to experience painful and provocative events that habituate them to fear and pain, which leads to an acquired capability for engaging in suicidal behavior.
Study 1 tested Joiner's (2005) hypothesis in a sample of 182 undergraduate students who completed self-report questionnaires on impulsivity, frequency of painful and provocative events, and acquired capability for suicide. In addition to self-report, pain tolerance (an aspect of acquired capability for suicide) was measured with a pressure algometer. Study 2 sought to replicate our findings from Study 1 in a sample of 516 clinical outpatients using a multi-faceted measure of impulsivity.
Consistent with prediction, product of coefficients tests for mediation (MacKinnon et al., 2002) revealed that impulsivity has an indirect relationship with acquired capability for suicidal behavior, and that this relationship is mediated by painful and provocative events.
Data from our studies are cross-sectional in nature, which does not allow for conclusions about the temporal ordering of our variables. In addition, self-report was used to measure most variables. Future research may benefit from a longitudinal design and the inclusion of other modes of assessment (e.g., behavioral measures of impulsivity).
Our findings suggest that the link between impulsivity and suicidal behavior occurs because impulsive people tend to have a greater capability for suicidal behavior, which they have acquired through experiencing painful and provocative events.
Journal of affective disorders 03/2011; 129(1-3):301-7. · 3.76 Impact Factor
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ABSTRACT: Psychodynamic and social cognitive approaches to personality assessment converge now more so than at any time in the history of experimental psychology. This contribution seeks to make this point. First, the trait of neuroticism predisposes one to multiple adverse outcomes, a point not sufficiently captured by the current version of the Diagnostic and Statistical Manual of Mental Disorders (4th ed. [DSM-IV]; American Psychiatric Association, 1994). Second, though, self-reported levels of neuroticism are insufficient in understanding problematic outcomes for multiple reasons. Third, there are ways of experimentally modeling the many processes of interest to psychodynamic theorists such as unconscious affective biases, implicit representations of self and other, and underlying deficits in self- and emotion regulation. Implicit approaches to assessment also provide clues to interventions targeting the processes of interest, a point that will be made as well.
Journal of Personality Assessment 03/2011; 93(2):161-76. · 1.29 Impact Factor
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ABSTRACT: The purpose of the current study was to evaluate the relationship between social support, negative life events, and disordered eating using a longitudinal design. More specifically, we examined whether the interaction between perceived social support and occurrence of negative life events would predict symptoms of eating disorders.
Two hundred seventy female undergraduate students completed self-report questionnaires at two time points to assess perceived social support, negative life events experienced, and current psychopathology.
Low social support and a greater number of negative life events interacted to predict increased bulimic symptoms, but not restrictive eating tendencies or symptoms of depression or anxiety.
Low perceived social support in the face of negative events may exacerbate bulimic symptoms. Management of interpersonal problems and the enhancement of social skills may be important targets in the treatment of eating disorders.
Eating behaviors 01/2011; 12(1):44-8.
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ABSTRACT: Natural disasters are frequently associated with increases in risk factors for suicide, yet research indicates that suicide rates tend to stay the same or decrease in the wake of disasters (e.g., Krug et al., 1999).
The present research sought to shed light on this counterintuitive phenomenon by testing hypotheses derived from Joiner's (2005) interpersonal-psychological theory of suicidal behavior, which proposes that the desire to die by suicide is the result of feeling like one does not belong and feeling like one is a burden on others. During natural disasters, community members often pull together in volunteering efforts, and it was predicted that such behaviors would boost feelings of belonging and reduce feelings that one is a burden.
The present study tested these predictions in a sample of 210 undergraduate students in Fargo, North Dakota, following the 2009 Red River Flood.
Consistent with prediction, greater amounts of time spent volunteering in flood efforts were associated with increased feelings of belongingness and decreased feelings of burdensomeness.
The findings in the current study are consistent with the notion that communities pulling together during a natural disaster can reduce interpersonal risk factors associated with the desire for suicide.
Crisis The Journal of Crisis Intervention and Suicide Prevention 01/2011; 32(1):52-5. · 1.09 Impact Factor
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ABSTRACT: Oquendo and colleagues (Oquendo, Baca-García, Mann, & Giner, 2008; Oquendo & Currier, 2009) recommend that DSM-V emphasize suicide risk assessment on a sixth axis, thereby increasing regularity of suicide risk assessments.
We propose that evidence of nonredundancy with Axis V - Global Assessment of Functioning (GAF) is one piece of data that can serve as a starting point for a line of research establishing incremental predictive utility for a separate suicide risk assessment in the DSM framework.
A standardized suicide risk assessment protocol, measures of depressive, anxious, and eating disordered symptomatology, as well as an index of comorbidity were administered to a sample of 412 adult outpatients.
Our data indicate that data from standardized suicide risk assessments are associated with indices of symptomatology severity as well as comorbidity, controlling for GAF.
These results support the nonredundancy of the assessments and suggest the utility of longitudinal investigations of the predictive utility of a sixth DSM axis in the assessment of suicide risk.
Crisis The Journal of Crisis Intervention and Suicide Prevention 01/2011; 32(2):110-3. · 1.09 Impact Factor
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ABSTRACT: The current study tested hypotheses derived from Joiner's (2005) interpersonal theory of suicide, which proposes that deliberate self-harm (DSH) becomes increasingly more reinforcing with repetition. One hundred six participants with a history of DSH completed questionnaires about their emotions and experience of physical pain during their most recent DSH episode. Consistent with prediction, people with more numerous past DSH episodes felt more soothed, more relieved, and calmer following their most recent episode of DSH. Contrary to prediction, greater numbers of past DSH episodes were associated with more intense physical pain during the most recent episode. The findings suggest that the emotion regulation functions of DSH may become more reinforcing with repetition.
Archives of suicide research: official journal of the International Academy for Suicide Research 10/2010; 14(4):329-41.
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ABSTRACT: Previous studies have reported inconsistent relationships between body image, eating disorder symptoms, and acculturation-relevant variables. The current study examined these variables in a sample of White, Latina, and Black college women (N = 276). White and Latina participants selected slimmer personal body shape ideals than Black women. Among Black women, the discrepancy between perceived body shape and perceived ideal body shape for the United States was predictive of Eating Disorder Inventory Body Dissatisfaction (EDI-BD) and Drive for Thinness (EDI-DFT) scores. The discrepancy between perceived body shape and perceived ideal for their ethnic group also predicted EDI-BD scores. Among Latinas, the discrepancy between perceived body shape and perceived body shape ideal for their ethnic group was predictive of EDI-BD and EDI-DFT scores, whereas a discrepancy between perceived body shape and perceived ideal for the United States was not predictive of eating disorder symptoms. Finally, higher levels of acculturative stress, but not acculturation, were associated with EDI-BD scores among Black women and EDI-DFT scores among Latinas. Findings underscore the importance of considering cultural variables such as acculturative stress when conducting clinical work with ethnic minority women.
Cultural Diversity and Ethnic Minority Psychology 04/2010; 16(2):135-43. · 1.36 Impact Factor
