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Motivations for Self-Injury, Affect, and Impulsivity: A Comparison of Individuals with Current Self-Injury to Individuals with a History of Self-Injury
Abstract
Individuals who report nonsuicidal self-injury (NSSI) are characterized by the tendency to act rashly while experiencing distress (negative urgency), the tendency to act without thinking, and endorsement of both social and affect regulation motives for the behavior. However, very little research has identified characteristics that distinguish current self-injurers from those with a history of the behavior. The purpose of this study was to compare individuals with current self-injury to a history of self-injury on impulsivity-related personality traits, motives for self-injury, and distress. Among a sample of 429 undergraduates, 120 reported self-injury. Among these 120 individuals, 33 endorsed self-injury within the past month, with a mean frequency of 4.77 acts of NSSI. Within the self-injury group, current self-injurers reported higher endorsement of affect regulation motives for NSSI, and higher levels of current negative affect than individuals with a history of self-injury. There were no differences between current and former self-injurers on measures of impulsivity, endorsement of social motives for NSSI, or positive affect. We propose that individuals who use NSSI to regulate negative affect may be more likely to repeatedly engage in this behavior over time.
... A PRISMA flowchart recording each stage of the search process is provided in Fig. 1. In a number of cases, the same source studies were included given differentiation in design or outcome measure: in four cases, authors published follow-up studies utilising the same sample [44,45] and [6,46], or a subset of an earlier cohort [41,43] and [47,48], with the subsequent analysis focused on a different research outcome. Five included studies derived from one international survey data set [4]: four analysed separate country-based subsets [5,[49][50][51]; the remaining study provided analysis across the complete data set, but pursued a different research question [52]. ...
... Two studies established self-injury on the basis of single questions that did not specify the absence of intent [55,64]. When analysing the relationship between impulsivity and NSSI, nine studies classified self-injury as the presence or absence of one or more lifetime NSSI behaviours [13,44,48,56,57,59,60,62,64]; four cases compared lifetime to a more recent indication of self-injury [41][42][43]45]. Four studies required at least one [47,63] or two [61] incidents of self-injury in the past year, or one or more incident of cutting in the past 6 months [55]. ...
... The UPPS scale was the most commonly endorsed assessment tool measuring trait impulsivity in 12 examinations. Six cases adopted the 45-item UPPS-R [13,42,44,45,56,62]; three utilised the 59-item UPPS-P [59,60,65]. Both scales have good reliability and validity [27,32]. ...
Research supports an association between impulsivity and self-harm, yet inconsistencies in methodology across studies have complicated understanding of this relationship. This systematic review examines the association between impulsivity and self-harm in community-based adolescents aged 11-25 years and aims to integrate findings according to differing concepts and methods. Electronic searches of EMBASE, MEDLINE, PsychINFO, CINAHL, PubMed and The Cochrane Library, and manual searches of reference lists of relevant reviews identified 4496 articles published up to July 2015, of which 28 met inclusion criteria. Twenty-four of the studies reported an association between broadly specified impulsivity and self-harm. However, findings varied according to the conception and measurement of impulsivity and the precision with which self-harm behaviours were specified. Specifically, lifetime non-suicidal self-injury was most consistently associated with mood-based impulsivity-related traits. However, cognitive facets of impulsivity (relating to difficulties maintaining focus or acting without forethought) differentiated current self-harm from past self-harm. These facets also distinguished those with thoughts of self-harm (ideation) from those who acted on thoughts (enaction). The findings suggested that mood-based impulsivity is related to the initiation of self-harm, while cognitive facets of impulsivity are associated with the maintenance of self-harm. In addition, behavioural impulsivity is most relevant to self-harm under conditions of negative affect. Collectively, the findings indicate that distinct impulsivity facets confer unique risks across the life-course of self-harm. From a clinical perspective, the review suggests that interventions focusing on reducing rash reactivity to emotions or improving self-regulation and decision making may offer most benefit in supporting those who self-harm.
... NSSI vs no NSSI Individuals who engaged in NSSI self-reported greater impulsivity, as assessed by the UPPS (Whiteside & Lynam, 2001), the Barratt Impulsiveness Scale (BIS, Patton et al., 1995), the impulse control subscale of the Difficulties with Emotion Regulation Scale (DERS, Gratz & Roemer, 2004), and the Schedule for Non-Adaptive and Adaptive Personality Impulsivity Subscale (SNAP-IMP, Clark, 1993), compared to individuals who did not engage in NSSI (e.g., Arens, Gaher, & Simons, 2012;Crowell et al., 2012;Dir, Karyadi & Cyders, 2013;Glenn & Klonsky, 2010;Herpertz, Sass, & Favazza, 1997). Undergraduate students with lifetime histories of NSSI significantly differed from individuals without a history of NSSI on impulsivity measures of negative urgency (Arens et al., 2012;Black & Mildred, 2013;Dir, Karyadi, & Cyders, 2013;Ogle & Clements, 2008) and lack of premeditation (Glenn & Klonsky, 2010;Mullins-Sweatt et al., 2013;Taylor, Peterson, & Fischer, 2012). Similarly, individuals who engaged in NSSI from inpatient adolescent and adult samples reported greater impulsivity than individuals who did not engage in NSSI (i.e., motor impulsivity and non-planning as assessed on the BIS; Evren et al., 2012;Herpertz et al., 1997;McCloskey, Look, Chen, Pajoumand, & Berman, 2012). ...
... Among researchers who employed the four subscales of UPPS (i.e., negative urgency, lack of perseverance, lack of premeditation, sensation-seeking), negative urgency, in particular, was associated with NSSI engagement Glenn & Klonsky, 2010;Mullins-Sweatt et al., 2013;Ogle & Clements, 2008;Taylor et al., 2012). In four of these five studies researchers found that individuals who engaged in NSSI also reported greater lack of premeditation than individuals who did not engage in NSSI Glenn & Klonsky, 2010;Mullins-Sweatt et al., 2013;Ogle & Clements, 2008), and in three studies individuals who engaged in NSSI reported greater lack of persistence than individuals who did not engage in NSSI Glenn & Klonsky, 2010;Taylor et al., 2012). ...
... Among researchers who employed the four subscales of UPPS (i.e., negative urgency, lack of perseverance, lack of premeditation, sensation-seeking), negative urgency, in particular, was associated with NSSI engagement Glenn & Klonsky, 2010;Mullins-Sweatt et al., 2013;Ogle & Clements, 2008;Taylor et al., 2012). In four of these five studies researchers found that individuals who engaged in NSSI also reported greater lack of premeditation than individuals who did not engage in NSSI Glenn & Klonsky, 2010;Mullins-Sweatt et al., 2013;Ogle & Clements, 2008), and in three studies individuals who engaged in NSSI reported greater lack of persistence than individuals who did not engage in NSSI Glenn & Klonsky, 2010;Taylor et al., 2012). Individuals who engaged in NSSI also reported more impulsivity as assessed on the BIS, which has been found to be most closely associated with the premeditation factor on the UPPS Scale (Whiteside & Lynam, 2001). ...
Nonsuicidal self-injury (NSSI; direct self-injury without lethal intent) often is thought to be associated with impulse control problems. Recent research, however, offers conflicting results about whether impulsivity is a risk factor for NSSI engagement. To disentangle findings on the link between impulsivity and NSSI, an extensive review of the literature was conducted using several electronic databases (i.e., PsychInfo, PsychArticles, ERIC, CINAHL, and MEDLINE). In total, 27 studies that met the specific inclusion criteria were identified. Results of a meta-analysis revealed that individuals who engaged in NSSI self-reported greater impulsivity than individuals who did not engage in NSSI, and that this effect was most consistent for measures of negative urgency. In contrast, there was little evidence of an association between lab-based measures of impulsivity (e.g., Go/No-Go, Stop/Signal Task) and NSSI. Moreover, the link between impulsivity and NSSI found for self-report measures was sometimes eliminated when other risk factors for NSSI were controlled (e.g., abuse, depression, post-traumatic stress disorder). In addition to integrating findings, the present review provides several explanations for the discrepancies in findings between studies employing self-report versus lab-based measures of impulsivity. To conclude, several specific recommendations for future research directions to extend the literature on impulsivity and NSSI are offered.
Copyright © 2015 Elsevier Ltd. All rights reserved.
... In the present study, we focused especially on the dimensions of negative urgency and (lack of) premeditation. This is because negative urgency, the tendency to act rashly in response to extreme negative emotions, best distinguished self-injurers from non-injurers (Bresin et al., 2013;Dir, Karyadi, & Cyders, 2013;Glenn & Klonsky, 2010;Taylor, Peterson, & Fischer, 2012), and lack of premeditation, the inability to delay action in order to plan, was also found to be associated with NSSI (Glenn & Klonsky, 2010;Lynam, Miller, Miller, Bornovalova, & Lejuez, 2011). Other dimensions of impulsivity, however, were not significantly related to NSSI. ...
... To partly fill in this knowledge gap, the present study aimed to examine the influence of impulsive friendship group contexts on adolescents' NSSI and how peer group impulsivity moderated the individual level relationship between depression and NSSI. Based on past research (Dir et al., 2013;Glenn & Klonsky, 2010;Lynam et al., 2011;Taylor et al., 2012), impulsivity was measured by negative urgency and (lack of) premeditation in this study. ...
This study examined the influence of impulsive friendship group contexts on nonsuicidal self-injury (NSSI) and how peer group impulsivity (i.e. negative urgency and premeditation) moderated the individual level relationship between depression and NSSI among 1701 Chinese secondary school students (1147 females). Participants were assessed twice over a 6-month interval. After controlling for direct socialization effects for NSSI, multilevel analysis indicated that friendship group negative urgency exerted a significant influence on NSSI. Additionally, friendship group premeditation weakened the relation between individual depression and NSSI, while friendship group negative urgency strengthened the relation between depression and NSSI. The results suggest the contribution of indirect peer influence effects to NSSI.
... The lack of differences between recent and past self-injurers is somewhat surprising in light of previous findings. Compared to past self-injurers, recent self-injurers endorse higher levels of negative affect (Taylor, Peterson, & Fischer, 2012), hostility, guilt, and sadness (Brown, Williams, & Collins, 2007), as well as lower levels of self-esteem, resilience, family support, and satisfaction with life (Rotolone & Martin, 2012). Current self-injurers were less likely to employ problem-focused coping behaviors (Wester & Trepal, 2010), reported less acceptance of emotional responses and control over impulses (Anderson & Crowther, 2012), and endorsed greater levels of impulsivity and lack of perseverance (e.g., difficulty persisting in boring or difficult tasks; Glenn & Klonsky, 2010). ...
... First, individuals assessed were college students with a restricted age, ethnicity, and gender range. While this can reduce generalizability, it should be noted that college students are among those with the highest prevalence and risk for NSSI (Whitlock, Eckenrode, & Silverman, 2006) and thus the targeted population in a number of prior studies (e.g., Brown, Williams, Collins et al., 2007;Gratz, Hepworth, Tull et al., 2011;Heath, Toste, Nedecheva et al., 2008;Hoff & Muehlenkamp, 2009;Taylor, Peterson, & Fischer, 2012). Second, while the current study incorporated a number of characteristics that were determined critical to the study aim, there are likely other variables at play that warrant further attention (e.g., trauma symptoms, emotional dysregulation, Self-Disgust and Self-Injury family environment, coping strategies, etc.). ...
Self-directed disgust, a component of self-criticism, may present an important, yet unexplored emotion in the context of nonsuicidal self-injury (NSSI). The aim of this study was to examine the role of self-disgust in NSSI, specifically as a potential mediator in the relations between depression and NSSI as well as sexual abuse and NSSI, and to also better understand characteristics that might differentiate recent and past self-injurers. A total of 549 college students completed measures assessing NSSI, self-disgust, depression, anxiety sensitivity, and physical and sexual abuse. Results indicated self-disgust fully mediated the relation between depressive symptoms and NSSI status and partially mediated the relation between sexual abuse and NSSI status. Additionally, compared to past self-injurers (4.6%; n = 25), recent self-injurers (6.4%; n = 35) endorsed significantly higher self-disgust and depressive symptoms. Self-disgust may be an important component in NSSI and should be addressed in treatment.
... The UPPS model identified four main components of impulsivity: Negative Urgency (i.e. the individual's tendency to act impulsively when experiencing negative affect); Lack of Perseverance (i.e. the individual's tendency to give up in the face of boredom, fatigue or frustration); Lack of Premeditation (i.e. the individual's tendency to act without consideration of the potential consequences of the behaviour) and Sensation Seeking (i.e. the individual's tendency to pursue activities that are exciting and novel). On the basis of this classification, recent research has clarified the association between impulsivity and NSSI, stating that NSSI behaviours are strongly associated with the impulsivityrelated traits of urgency and the lack of premeditation (Di Pierro et al., 2012;Glenn & Klonsky, 2010;Lynam, Miller, Miller, Bornovalova, & Lejuez, 2011;Taylor, Peterson, & Fischer, 2012). ...
... The results from this study confirmed previous research findings on the affect-regulation function of NSSI, thus suggesting that NSSI may be used to reduce acute negative feelings (Niedtfeld et al., 2010;Taylor et al., 2012;Williams & Hasking, 2010). Indeed, participants predominantly reported experiencing negative high-arousal affect states before NSSI (Claes et al., 2010;Klonsky, 2007Klonsky, , 2009Muehlenkamp et al., 2009). ...
Background
Nonsuicidal self-injury (NSSI) is used to cope with negative affect states. We investigated the association between impulsivity and this affect-regulation process.Method
Affect states associated with NSSI and impulsivity traits were evaluated in 30 Italian adolescent self-injurers (63.3% female, mean age = 16.63, SD = 0.56).ResultsNonsuicidal self-injury was associated with decreases in affective arousal, but impulsivity moderated other affective changes. High impulsivity was associated with increases in negative high-arousal affects after NSSI, whereas low impulsivity was associated with increases in positive affects after NSSI.Conclusion
Impulsivity traits influenced the success or failure of the NSSI affect-regulation process.
... It has been found that adolescence is a high-risk period for self-injurious behavior [17,67]. In general, self-injurious behavior rst appears in early adolescents' self-injurious behavior [53,64]. According to the functional model of self-injury, it can be well explained that self-injury can distract the individual's attention from this high-arousal negative emotion and stop or alleviate the individual's painful feelings [36]. ...
Background
There has been growing scholarly interest in understanding the adverse effects of bullying victimization on adolescents' development. However, it is less clear whether bullying victimization potentially increases adolescents' non-suicidal self-injury, to date, and the understanding of the factors, that may affect this relationship is also limited. The current study, therefore, examined the relationship between bullying victimization and non-suicidal self-injury in adolescents and sought to determine whether parental phubbing and perceived school climate simultaneously moderated this relationship.
Methods
The participants included 704 students (Mage = 15.15, SD = 0.98) from middle schools in China. They completed the questionnaires regarding their experience with bullying victimization, parental phubbing, perceived school climate and non-suicidal self-injury.
Results
The results indicated that adolescents with a high level of bullying victimization were likely to have a high level of non-suicidal self-injury, after controlling for age and gender. High parental phubbing adolescents who experienced higher levels of bullying victimization were more likely to be non-suicidal self-injury than low parental phubbing adolescents. Furthermore, higher levels of bullying victimization significantly predicted increases in adolescents' non-suicidal self-injury when they had high parental phubbing and low perceived school climate. In contrast, this effect became insignificant when parental phubbing was low and perceived school climate was high.
Conclusions
Our findings indicated bullying victimization affects non-suicidal self-injury in adolescents,This relationship is mediated by parental bowing and perceived school climate. Educators who are concerned about adolescents' non-suicidal self-injury should pay closer attention to parental phubbing, as well as their perceived school climate, to provide appropriate interventions.
... LBC who are experiencing puberty and lack self-control are thus more likely to adopt more extreme coping styles to alleviate negative emotions and ultimately implement NSSI. Empirical research also confirms that individuals with strong negative emotional incidents experience NSSI to alleviate their negative emotions (Taylor et al., 2012). Our study showed that the prevention and intervention of NSSI in LBC should consider the influence of peers and personal factors. ...
Left-behind children face peer victimization, which leads to negative mental adaptation. Previous studies have shown that peer victimization profoundly influences left-behind children’s nonsuicidal self-injury. However, the underlying mechanism of nonsuicidal self-injury remains unclear. A total of 832 junior high school students aged 11−16 in this investigation completed the Peer Victimization Scale, Perceived Discrimination Scale, Hardiness Scale and Nonsuicidal Self-Injury Scale. After left-behind children’s sex and left-behind category were controlled, peer victimization significantly contributed to left-behind children’s nonsuicidal self-injury; perceived discrimination played a mediating role in the relationship between peer victimization and left-behind children’s nonsuicidal self-injury. Both the direct and indirect relations between peer victimization and left-behind children’s nonsuicidal self-injury were moderated by hardiness, which is consistent with the stress-buffering model. The current study reveals how and when peer victimization affects left-behind children’s nonsuicidal self-injury, which contributes to the prevention and intervention of nonsuicidal self-injury.
... A longitudinal study revealed that the association between impulsivity and SH may be reciprocal, such that a higher level of impulsivity may lead to an increased risk of SH, whereas more frequent SH behaviors may exacerbate tendencies towards impulsivity [14]. Some established models of impulsivity, such as the UPPS-P model and the Barratt model, suggested that individuals who reported SH were more inclined to act impulsively when experiencing negative emotions or events [14,[35][36][37]. Another possible theory is that impulsivity may increase the likelihood of SH behavior by reinforcing the processes involved in SH ideation or thought: In their previous study, Madge et al. identified a series of prominent dose-response associations between cognitive impulsivity and SH ideation, SH occurrence, and SH events [38]. ...
Background
Parenting styles are significantly associated with self-harm (SH) in adolescents. Nevertheless, little is known about the mechanism underlying this association. This study primarily aimed to evaluate the potential mediating role of impulsivity in the association between parenting styles and SH in Chinese adolescents.
Methods
Self-administered questionnaires were used to conduct a survey among a sample population consisting of 3146 adolescents in southwest China. Logistic regression analyses were performed to evaluate the association between parenting styles, impulsivity, and SH. A path model investigation further examined the mediating role of impulsivity in terms of the association between parenting styles and SH.
Results
The age range of participants was 10 to 17 years old. The prevalence of SH was 47.0% (95% CI: 36.3–58.0%). Impulsivity, less paternal emotional warmth, maternal over-protection, and rejection were significantly associated with SH. The path model identified impulsivity as a salient mediator, accounting for 23.4% of the total association between parenting styles and SH. The hypothesized path model indicated differences in the parenting styles of fathers and mothers: Impulsivity played a significant mediating role, though only in respect to the maternal over-protection and rejection paths.
Conclusions
For Chinese children and adolescents who experience a harsher maternal parenting style, impulsivity-centered intervention measures might be effective in reducing SH related to parenting styles.
... A longitudinal study revealed that the association between impulsivity and SH may be reciprocal, such that a higher level of impulsivity may lead to an increased risk of SH, whereas more frequent SH behaviors may exacerbate tendencies towards impulsivity [14]. Some established models of impulsivity, such as the UPPS-P model and the Barratt model, suggested that individuals who reported SH were more inclined to act impulsively when experiencing negative emotions or events [14,[35][36][37]. Another possible theory is that impulsivity may increase the likelihood of SH behavior by reinforcing the processes involved in SH ideation or thought: In their previous study, Madge et al. identified a series of prominent dose-response associations between cognitive impulsivity and SH ideation, SH occurrence, and SH events [38]. ...
Background: Parenting styles are significantly associated with self-harm (SH) in adolescents. Nevertheless, little is known about the mechanism underlying this association. This study primarily aimed to evaluate the potential mediating role of impulsivity in the association between parenting styles and SH in Chinese adolescents. Methods: Self-administered questionnaires were used to conduct a survey among a sample population consisting of 3,146 adolescents in southwest China. Logistic regression analyses were performed to evaluate the association between parenting styles, impulsivity, and SH. A path model investigation further examined the mediating role of impulsivity in terms of the association between parenting styles and SH. Results: The age range of participants was 10 to 17 years old. The prevalence of SH was 47.0% (95% CI: 36.3%-58.0%). Impulsivity, less paternal emotional warmth, maternal over-protection, and rejection were significantly associated with SH. The path model identified impulsivity as a salient mediator, accounting for 23.4% of the total association between parenting styles and SH. The hypothesized path model indicated differences in the parenting styles of fathers and mothers: Impulsivity played a significant mediating role, though only in respect to the maternal over-protection and rejection paths. Conclusions: For Chinese children and adolescents who experience a harsher maternal parenting style, impulsivity-centered intervention measures might be effective in reducing SH related to parenting styles.
... A longitudinal study revealed that the association between impulsivity and SH may be reciprocal: a higher level of impulsivity may lead to increased risk of SH, meanwhile, more frequent SH would aggravate impulsivity [13]. Some established models of impulsivity, like UPPS-P model and Barratt model, suggested that individuals who reported SH were more inclined to act impulsively when experiencing negative emotions or events [13,[27][28][29]. Another possible theory is that, impulsivity may increase the possibility of SH by promoting the process of SH ideation or thoughts [30,31]. ...
Background: Parenting styles were positively associated with self-harm (SH) in adolescents. Nevertheless, little is known concerning the mechanism behind this association. This study primarily aims to evaluate the potential mediation of impulsivity in the association between parenting styles and SH in Chinese adolescents.
Methods: A population-based sample of 3146 adolescents in southwest China were surveyed by using self-administered questionnaires. Logistic regression analyses were used to measure the association between parenting styles and SH. Path model further examined mediation of impulsivity in this association.
Results: The prevalence of SH was 47.0% (95% CI: 36.3%-58.0%). Impulsivity and mother’s over-protection were significantly associated with SH. Impulsivity showed a salient mediation, accounting for 23.4% of the total association. Parenting styles of father and mother showed disparate roles in the hypothesized path model.
Conclusions: Our major findings suggested that, for Chinese adolescents with harsher maternal parenting style, impulsivity-centered intervention measures might be effective in reducing parenting style related SH.
... For example, in a large longitudinal study of college women, negative urgency predicted NSSI onset; however, the only impulsivity facet to predict NSSI maintenance above and beyond covariates was lack of perseverance, or the tendency to quit when tasks are difficult (Riley et al., 2015). Similarly, in another student sample, while negative urgency was higher among those who had a history of NSSI as compared to those without this history, negative urgency did not differ as a function of whether participants currently engaged in NSSI or had ceased to engage in these behaviors (Taylor et al., 2012). These findings highlight the complicated relationship between negative urgency and NSSI and remind us that factors that contribute to the development of problem areas are not necessarily the same factors influencing the maintenance of those problems. ...
Objective
The aim of this study was to examine concurrent and 3‐month prospective associations between a multidimensional measure of psychological inflexibility and nonsuicidal self‐injury (NSSI) among participants with a self‐harm history.
Method
Participants completed measures of NSSI, psychological inflexibility, negative urgency, and depression at baseline (N = 106, Mage = 34.70, SD = 9.43, 66% women), and were again assessed at follow‐up (N = 86).
Results
Participants currently engaging in NSSI reported significantly higher psychological inflexibility as compared to those who have ceased NSSI. After controlling for covariates, psychological inflexibility was concurrently associated with NSSI recency and longitudinally predicted perceived likelihood of future NSSI. Psychological inflexibility was not associated with new NSSI acts after including baseline covariates. Finally, psychological inflexibility subscales demonstrated differential relationships with various NSSI functions.
Conclusion
Results highlight the psychological inflexibility model's utility in understanding NSSI and have implications for future research that may inform clinical practice.
... This is consistent with cross-sectional evidence for the association between NSSI to regulate affect and continued NSSI over time. For instance, a study comparing adolescents who currently versus formerly engaged in NSSI found that those who continued to self-injure endorsed greater use of NSSI for automatic functions compared to those with a history of NSSI (Taylor et al., 2012). This finding is also consistent with prior prospective studies (e.g., Yen et al., 2016) demonstrating stronger predictive validity of automatic (vs. ...
Nonsuicidal self-injury (NSSI) is a prevalent, concerning behavior among adolescents. Importantly, NSSI can serve a variety of functions. Some adolescents engage in NSSI to fulfill automatic or self-oriented functions (e.g., cutting to avoid internal negative states), whereas others engage in NSSI to serve social functions (e.g., cutting to communicate with others). This study tests whether self-reported reasons for engaging in NSSI, hereafter referred to as NSSI functions, predict NSSI thoughts and behaviors during and after hospitalization among adolescent psychiatric inpatients. Endorsement of both automatic and social NSSI functions, as well as positive and negative reinforcement subtypes, was assessed at hospital admission. Results showed that endorsement of overall automatic function predicted which adolescents engaged in NSSI behavior during hospitalization. Moreover, automatic and social functions showed distinct predictive patterns, such that automatic functions corresponded to greater likelihood of NSSI-related thoughts and behaviors whereas social functions mainly corresponded to reduced likelihood of NSSI-related outcomes. Of note, NSSI functions were less predictive of NSSI-related outcomes after hospital discharge. These findings suggest that identifying adolescent inpatients' reasons for NSSI engagement may meaningfully distinguish those at higher risk (and those at lower risk) of NSSI persistence during their hospital stay.
... The results of this study show that difficulty with impulse control is an important predictor of self-injurious behavior, and the severe NSSI group had significantly greater difficulty in impulse control than the moderate NSSI group. Such results are consistent with those of studies that measured impulse control with a self-reporting scale [68,69]. For self-injurious behavior, the process of intention to action may take only a few minutes; therefore, a lack of self-control and limited strategies for emotion regulation may lead to self-injurious behaviors under the drive of impulse. ...
Background: Previous studies revealed that female adolescents are more likely than males to engage in non-suicidal self-injury (NSSI) to regulate negative emotions; however, the dimensions of emotion regulation that are associated with NSSI behavior in adolescents require further examination. The present study aimed to identify Taiwanese female adolescent clusters with NSSI engagement frequency and to evaluate the association of specific forms of emotion dysregulation with NSSI. Methods: The participants were 438 female adolescents (mean age = 15.23 years, SD = 1.24, range between 13 and 18) recruited from 11 high schools. Self-report questionnaires assessing NSSI, difficulties in emotion regulation, and positive and negative affect were administered, and 37% of respondents reported a history of NSSI. Results: The analysis of NSSI frequency yielded three groups: severe, moderate, and non-NSSI. High negative affect, low positive affect, and difficulties in all aspects of emotion regulation differentiated female adolescents in the severe NSSI group from their counterparts in the non-NSSI group. The moderate and severe NSSI groups were further distinguished by age of onset, negative affect, emotion regulation strategies, and impulse control. Adolescents classified in the severe group reported earlier onset of NSSI, higher negative affect, less emotion regulation strategies, and more difficulty with impulse control. Conclusions: The results indicate that assessments of NSSI and emotion regulation should be incorporated in youth mental health screening. The clinical implications of NSSI behavior intervention require further discussion.
... The affect-regulation model is one of the main theories to understand the mechanism by which negative affect influences individuals' self-injury (Chapman et al., 2006;Gratz, 2003). It has been demonstrated that self-injurers often experience negative affect before conducting self-injury (Klonsky, 2009;Taylor et al., 2012;Victor and Klonsky, 2014), and the purpose of conducting self-injury is to release their negative affect (Gratz, 2003;Nock and Prinstein, 2004). In addition, it has been demonstrated that higher impulsivity is related to higher levels of self-injury with studies based on Barratt's definition of impulsivity (Glenn and Klonsky, 2010;Janis and Nock, 2009) and the model of UPPS-P (Glenn and Klonsky, 2010;Lengel et al., 2016;Mullins-Sweatt et al., 2013), respectively. ...
Background:
Self-injury is one of the strongest predictors of suicide. Undergraduates have been recognized as one of the populations with the highest incidence of self-injury. A substantial body of literature has documented the important influence of impulsivity on self-injury. However, few studies have focused on the mediating mechanisms underlying this relationship. Based on the stress generation hypothesis and the affect-regulation model of self-injury, this study constructed a chain mediating model to examine whether stressful life events and negative affect mediated the relationship between impulsivity and self-injury among Chinese undergraduates.
Methods:
A total of 2270 undergraduates (69.8% female, mean age = 19 years) were recruited to participate in this study and completed self-report measures of impulsivity, self-injury, stressful life events and negative affect.
Results:
(1) There were significant positive correlations among impulsivity, stressful life events, negative affect and self-injury. (2) After controlling for the effect of gender, impulsivity still had a significant positive effect on self-injury. (3) Undergraduates' self-injury was affected by impulsivity partly through 3 different pathways: the mediating role of stressful life events, the mediating role of negative affect, and the chain mediating role of both stressful life events and negative affect.
Conclusions:
These findings contribute to a more comprehensive understanding of the risk factors for self-injury. Impulsivity, stressful life events, and negative affect might increase the occurrence of self-injury. In addition, the chain mediating effect of stressful life events and negative affect plays an important role in the occurrence of self-injury.
... Interpersonal influence is a motivation to self-injure with the intent of receiving attention from others or influencing those around an individual. 38,39 It has been suggested that imitation may play a role in self-injury. 40 For example, previous studies have found that approximately 38% of those who self-injure learned it from a friend, and exposure to self-injury increased the likelihood a person would self-injure. ...
Objective: This study seeks to evaluate the psychometric properties of the Ottawa Self-Injury Inventory-Functions (OSI-F) for assessing non-suicidal self-injury (NSSI), a condition for further study in the DSM-5.
Participants: Participants included 345 students who indicated a history of self-injury in a university counseling center over six semesters from August 2009 – May 2012.
Method: Participants completed the OSI-F as a measure on the psychological intake for the university counseling center.
Results: Factor analysis, Cronbach's alpha coefficients, Independent Samples t tests, and correlations were examined and demonstrated adequate reliability and validity.
Conclusions: A three factor solution emerged from the restructured OSI-F relating to Affect Regulation, Exhilaration, and Release. Affect regulation dimensions were predictive of continuing to self-injure and related to depression, anxiety, and overall mental health. Additionally, females were more likely to attribute self-injuring to affect regulation.
... Irritability is associated with histories of suicidal ideation, suicide attempts, and nonsuicidal self-injury (e.g., Conner, Meldrum, Wieczorek, Duberstein, & Welte, 2004;Ernst et al., 2004;Herpertz, 1995;Pendse, Westrin, & Engström, 1999;Stålenheim, 2001). Individuals who repeatedly engage in SII are likely to experience negative/irritable mood states and use self-harm as a coping strategy to mitigate emotional distress (Brown, Comtois, & Linehan, 2002;Crowell et al., 2009;Nixon, Cloutier, & Aggarwal, 2002;Nock, Prinstein, & Sterba, 2009;Taylor, Peterson & Fischer, 2012). Trait irritability may also help to explain the high co-occurrence of self-harm and aggression directed toward others (Leibenluft & Stoddard, 2013;O'Donnell, House, & Waterman, 2015). ...
Trait impulsivity, which is often defined as a strong preference for immediate over delayed rewards and results in behaviors that are socially inappropriate, maladaptive, and short-sighted, is a predisposing vulnerability to all externalizing spectrum disorders. In contrast, anhedonia is characterized by chronically low motivation and reduced capacity to experience pleasure, and is common to depressive disorders. Although externalizing and depressive disorders have virtually nonoverlapping diagnostic criteria in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders, heterotypic comorbidity between them is common. Here, we review common neural substrates of trait impulsivity, anhedonia, and irritability, which include both low tonic mesolimbic dopamine activity and low phasic mesolimbic dopamine responding to incentives during reward anticipation and associative learning. We also consider how other neural networks, including bottom-up emotion generation systems and top-down emotion regulation systems, interact with mesolimbic dysfunction to result in alternative manifestations of psychiatric illness. Finally, we present a model that emphasizes a translational, transdiagnostic approach to understanding externalizing/depression comorbidity. This model should refine ways in which internalizing and externalizing disorders are studied, classified, and treated.
... Rescue = Ability to be rescued. & Fischer, 2012;Wong & Phillips, 2009). The most common trait measures used were the Barratt Impulsiveness Scale (BIS-11), Impulsivity Rating Scale (IRS), the Plutchik Impulsivity Scale, and the UPPS-R Impulsive Behavior Scale ( Lecrubier, Braconnier, Said, & Payan, 1995;Patton, Stanford, & Barratt, 1995;). ...
Impulsivity is inconsistently defined in the literature. While there are some clear operationalizations of the trait of impulsivity, there is no consensus about the impulsivity of a specific suicidal behavior. Using a sample of 131 suicide attempters identified in a county emergency room, we used interviewer ratings from the Suicide Attempt Self-Injury Interview (SASII) and the Borderline Personality Disorder (BPD) trait impulsivity criterion from the Structured Clinical Interview for the DSM-IV Axis-II (SCID-II) to examine seven core constructs most commonly used in the literature on impulsivity of suicidal behavior. These constructs are resisting the urge/delaying, planning, trait impulsivity, communication to others, leaving a suicide note, the ability to be rescued, and intoxication. Comparison of these constructs shows relatively small relationships between them, and they clearly do not represent the same underlying concept. The ability of these constructs to predict intent and lethality of the index attempt and a future attempt in the following 6 months varied as well. Planning predicted greater suicidal intent of the index attempt. Chance of rescue predicted lower lethality and less suicidal intent of the index attempt. The presence of a suicide note at the index attempt decreased the odds of a re-attempt in the next 6 months. This study demonstrates that the conceptualization of impulsivity of suicide attempts needs further consideration, and perhaps underlying constructs such as delay, planning, ability to be rescued, and the presence of a suicide note should be studied separately.
... While negative urgency has emerged as a correlate in several studies, other impulsivity-related traits have emerged less consistently. Lack of planning, lack of perseverance, sensation-seeking, and positive urgency correlated with NSSI in some studies but not others, and some studies have found no relationships between any of the traits and NSSI (Claes & Muehlenkamp, 2014;Lynam et al., 2011;Taylor, Peterson & Fischer, 2012). However, consistent with our proposed model, Glenn and Klonsky (2010) found that lack of perseverance significantly differentiated between current self-injurers and past self-injurers. ...
Many researchers have identified impulsivity-related personality traits as correlates of and risk factors for nonsuicidal self-injury (NSSI). Using a longitudinal design, we tested the hypothesis that one such trait, negative urgency (the tendency to act rashly when distressed), predicts the onset of NSSI during the first year of college and a different trait, lack of perseverance (the disposition to fail to maintain focus on tasks that are difficult or boring), predicts the maintenance of NSSI during the first year of college. In a sample of n=1,158 college women (mean age=18.04, 95% of participants were 18 at Time 1), we found support for these hypotheses. Negative urgency, measured prior to college entry, predicted the onset of NSSI behavior across the first year of college (odds ratio=1.58). Lack of perseverance predicted the maintenance of NSSI status across the first year of college, controlling for prior NSSI behavior (odds ratio=1.73). These findings indicate that different impulsivity-related personality traits may play different roles in the risk process for NSSI.
Copyright © 2015. Published by Elsevier Ltd.
... Additionally, future studies should include other variables that are considered to play an important role in the etiology of NSSI and ED symptoms , such as borderline personality features, emotional dysregulation , and impulsivity (e.g. Taylor, Peterson, & Fischer, 2012), to examine how these may interact with identity problems. Despite these limitations, the present study adds to the existing literature by expanding insight into the possible role of developmental processes such as identity formation in patients with NSSI and ED. ...
In the present study, we investigated the association between non-suicidal self-injury (NSSI) and problems in identity formation among patients with eating disorder (ED). NSSI is highly prevalent in ED, and problems with identity formation are characteristic of both NSSI and ED. Few studies, however, have investigated identity formation in patients with ED with and without NSSI while taking into account comorbid psychopathology (e.g. anxiety and depression). Therefore, we investigated the relationships between NSSI characteristics, identity confusion/synthesis, and anxiety/depression in 99 female patients with ED by means of self-report questionnaires. The results showed that 58.6% of the patients with ED engaged in at least one type of NSSI (most frequently cutting), with no significant differences in rates of NSSI or identity problems among ED subtypes. Presence, versatility and automatic negative reinforcement functions of NSSI were each significantly and positively related to identity confusion and negatively related to identity synthesis. Even after controlling for age, anxiety, and depression, lack of identity synthesis remained a significant predictor of NSSI in patients with ED. Given that NSSI may constitute an effort to deal with identity confusion/synthesis in patients with ED, therapists should take this developmental task into account while treating patients with ED with NSSI.
... Some women in this study offered insight that they needed to be ready to change before a change in their nutrition-related behaviors would be possible. Research suggests that readiness to change is strongly correlated with treatment outcomes, particularly with clients in treatment for chronic, recurrent conditions such as eating disorders, self-injurious behavior (e.g., "cutting"), and substance abuse (Delinsky et al., 2011;Taylor, Peterson, & Fischer, 2012;Pollini, O'Toole, Ford, & Bigelow, 2006). While "hitting rock bottom" is generally no longer held as a necessary factor to effect change, personal readiness or motivation remains an area of concern. ...
The aim of this multi-method qualitative study was to explore the eating behaviors and food choices of nine purposively sampled low-income women aged 29 to 40 years who were engaged in a residential substance use disorders recovery program. Findings were limited to photo-elicitation interviews with the women that focused on nutritional choices and issues outside their family context. Consensual data analysis revealed a recovery process that began with cognitive reawakening and an increased focus on and desire for healthier nutrition-related decisions and lifestyle, particularly in the area of weight gain that many of the women experienced.
Keywords: Substance use disorder, women, residential recovery program, photo-elicitation, qualitative,
nutrition
... Individuals engaging in NSSI tend to experience greater levels of state negative affect, including feelings of sadness or depression, on a daily and weekly basis as compared with those without NSSI (Fliege, Lee, Grimm, & Klapp, 2009;Taylor, Peterson, & Fischer, 2012). Depression, feeling all alone and negative thoughts towards the self were most commonly cited as reasons for engaging in NSSI in a sample of adolescents (Laye-Gindhu, & Schonert-Reichl, 2005), and a recent ecological momentary assessment study demonstrated that for individuals high on trait NU, daily ratings of sadness predicted urges to engage in NSSI (Bresin, Carter, & Gordon, 2012). ...
Negative affect often precedes non-suicidal self-injury (NSSI). Negative urgency (NU) and distress tolerance (DT) are associated with NSSI yet represent different trait-like pathways to maladaptive affect regulation. This study examined the role of NU, (lack of) premeditation, depression and DT on NSSI in a sample of 884 undergraduates. Main effects for depression and NU emerged, with no main effects of DT. There was a significant three-way interaction of NU, DT and depression, whereas no interaction was found for (lack of) premeditation. The influence of NU and depression on NSSI is enhanced when individuals have low perceived ability to tolerate distress. Copyright © 2014 John Wiley & Sons, Ltd.
Objective:
The current study aimed to investigate the sociodemographic and psychological variables as well as the function of NSSI related to the cessation of NSSI by analyzing the difference between those currently engaged in nonsuicidal self-injury (NSSI) and those who have stopped NSSI behaviors.
Methods:
A total of 490 adults with a history of NSSI (359 females) were assigned to one of two groups: NSSI engagement within the last 12 months or "current NSSI" (n = 402) vs. no episode of NSSI in the previous 12 months or "lifetime NSSI" (n = 88).
Results:
There were no significant group differences in sex or socioeconomic status, while individuals with current NSSI were slightly younger than those who had ceased NSSI behavior. Regarding the functions of NSSI, the current NSSI group endorsed more intrapersonal functions. Moreover, the participants who had ceased NSSI behavior reported significantly less perceived stress, dysfunctional attitudes, alexithymia, emotion reactivity, and suicidal ideation. On the other hand, the lifetime NSSI group showed greater psychological resources such as self-esteem, distress tolerance, and resilience.
Conclusions:
We revealed apparent differences in NSSI functions, clinical symptoms, and psychological resources depending on the maintenance and cessation of NSSI. This study highlights the need for a better understanding of the factors that stop as well as those that continue NSSI behaviors.HIGHLIGHTSThe lifetime NSSI group reported more intrapersonal NSSI functions.The current NSSI group suffered from more clinical symptoms.Individuals who ceased NSSI had more psychological resources.
Background and aims:
Self-injurious behaviors (SIBs) and problematic shopping (PS) are both prevalent in adolescents. These behaviors have been proposed as behavioral addictions and linked to impulsivity (Imp) and sensation-seeking (SS). They are also associated with negative mental health and psychosocial measures. This study examined relationships between PS and SIB in adolescents. It also examined how PS and SIB relate to Imp and SS, and interactions between PS and SIB in relation to health/functioning measures.
Methods:
Survey data from 2,624 Connecticut high-school students were evaluated using chi-square analyses. Next, logistic regression models were used to assess relationships between PS and measures of SIB. T-tests compared Imp and SS in adolescents with and without PS and SIB. Interaction analyses assessed effects of PS on relationships between SIB and health/functioning measures.
Results:
Adolescents with PS had 3.43-fold higher odds of endorsing lifetime SIB than those without PS, and were more likely to exhibit severe SIB and disruption due to SIB. PS and SIB were associated with elevated Imp and SS. Interaction analyses revealed that in adolescents with PS, the relationships between SIB and substance use was weaker than in adolescents without PS. This suggests PS accounts for variance in relationships between SIB and substance use.
Discussion and conclusions:
PS is strongly related to SIB prevalence, severity, and impairment in adolescents, and weakens associations between SIB and substance use. PS should therefore be considered for prevention efforts for SIB. Further research should investigate mechanisms connecting PS and SIB and explore possible interventions targeting associated features like Imp and SS.
Introduction:
Nonsuicidal self-injury (e.g., self-cutting without lethal intent) is a widely occurring behavior among adolescents and emerging adults. Heightened impulsivity during the adolescent and emerging adult years may contribute to an increased risk for nonsuicidal self-injury onset and engagement during these developmental periods; however, longitudinal research on impulsivity and nonsuicidal self-injury among young persons is lacking.
Method:
To extend previous research, and elucidate the direction of effects between impulsivity and nonsuicidal self-injury, 782 emerging adults (75% female) completed assessments of impulsivity and nonsuicidal self-injury annually for three years.
Results:
Path analysis revealed a bidirectional relation, such that higher impulsivity predicted greater nonsuicidal self-injury frequency over time, and greater nonsuicidal self-injury frequency predicted higher impulsivity over time, even after taking into account past scores on these variables as well as other participant factors (e.g., age, sex, depressive symptoms, anxiety). Gender did not moderate the pattern of associations.
Conclusions:
The present findings indicate that impulsivity may not only lead to nonsuicidal self-injury, but that frequent engagement in nonsuicidal self-injury may undermine regulatory skill development and lead to greater impulsivity over time during the emerging adult years.
World Health Organization reports underlie that, among western populations, violence toward the self or toward others is one of the most frequent cause of death. Aggression, both in its self-directed and others-directed expressions is now considered a very central topic by the scientific community. However, in spite of diverse contributions it lacks an integrated overview of empirical evidences able to shed light on the common matrix and on the peculiar aspects that determine the enactment of such different forms of aggression. In this paper, this topic is discussed in relation to individuals' capacity to regulate emotional states, and in relation to the possible specific role of negative emotions, i.e. anger and shame, in the genesis of these two forms of aggression.
Background:
The present study compared sociodemographic characteristics, comorbidities with substance use, and impulsivity features in three groups of psychiatric patients - suicide attempters, nonsuicidal self-injury, and nonsuicidal without self-injury - to determine the predictive factors for nonsuicidal self-injury or suicide behavior.
Patients and methods:
Demographic features and self-reported substance use were assessed in 384 Mexican psychiatric patients. Impulsivity features were evaluated using the Plutchik Impulsivity Scale. Comparison analyses between groups were performed and a logistic regression model used to determine the factors associated with nonsuicidal with self-injury behavior and suicidal behavior.
Results:
Different predictive factors were observed for nonsuicidal self-injury and suicidal behavior. Females were more likely to present nonsuicidal self-injury behaviors (odds ratio [OR] 0.42, 95% confidence interval [CI] 0.18-0.93; P=0.03). For suicide attempters, the factors associated were younger age (OR 0.89, 95% CI 0.85-0.93; P<0.001), less than 6 years of schooling (OR 0.2, 95% CI 0.06-0.6; P=0.004), and higher impulsivity traits, such as self-control (OR 1.19, 95% CI 1.03-1.36; P=0.01), planning of future actions (OR 0.79, 95% CI 0.66-0.95; P=0.01), and physiological behavior (OR 1.34, 95% CI 1.01-1.78; P=0.03).
Conclusion:
Our results show that in a Mexican population, impulsivity features are predictors for suicide attempts, but not for self-injury. Other factors related to sociocultural background and individual features (such as personality) may be involved in this behavioral distinction, and should be studied in future research aimed at better understanding of both self-harmful behaviors.
We sought to identify factors associated with current versus lifetime nonsuicidal self-injury (NSSI) and factors that show consonant and distinct relationships with current NSSI for adolescents and young adults. Data came from a population-based survey of high school students (n = 9,985) and a national survey of college students (n = 7,801). Among both samples, factors associated with current NSSI included male gender, younger age, greater depressive symptoms, more hopelessness, and being the victim of a verbal or physical assault. For high school students, greater anxiety, and for college students, identifying as non-White, negative perceptions of one's weight, a same-sex sexual experience, and involvement in dating violence also distinguished the groups. Findings suggest that clinical and research assessments of lifetime NSSI might not extend to current behavior, and some differences exist in the factors associated with current behavior between adolescents and young adults. Clinical practice and prevention programming efforts should target certain intrapersonal and interpersonal factors associated with current NSSI among younger students during stressful transition periods in their lives, such as entering high school or college, when they might consider initiating or continuing this behavior.
Prior studies of nonsuicidal self-injury (NSSI) suggest the existence of multiple NSSI typologies. Using data from 2,101 university students, this study employed latent class analysis to investigate NSSI typologies. Results show a good fitting 3-class solution with distinct quantitative and qualitative differences. Class 1 was composed largely of women using 1 form to engage in superficial tissue damage with moderate (<11) lifetime incidents. Class 2 was composed predominately of men using 1 to 3 forms to engage in self-battery and light tissue damage, with low (2–10) lifetime incidents. Class 3 was composed largely of women using more than 3 self-injury forms and engaging in behaviors with the potential for a high degree of tissue damage with moderate to high numbers of lifetime incidents. All 3 classes were at elevated risk for adverse conditions when compared to no-NSSI respondents. We conclude that NSSI typologies exist and may warrant
differential clinical assessment and treatment.
In recent studies of the structure of affect, positive and negative affect have consistently emerged as two dominant and relatively independent dimensions. A number of mood scales have been created to measure these factors; however, many existing measures are inadequate, showing low reliability or poor convergent or discriminant validity. To fill the need for reliable and valid Positive Affect and Negative Affect scales that are also brief and easy to administer, we developed two 10-item mood scales that comprise the Positive and Negative Affect Schedule (PANAS). The scales are shown to be highly internally consistent, largely uncorrelated, and stable at appropriate levels over a 2-month time period. Normative data and factorial and external evidence of convergent and discriminant validity for the scales are also presented. (PsycINFO Database Record (c) 2010 APA, all rights reserved)
The present research broadens the understanding of the multidimensional nature of impulsivity by investigating the validity of a German adaptation of the UPPS scale of impulsivity (Whiteside & Lynam, 2001). Two studies utilizing paper-pencil and computerized administration replicated the internal structure of the UPPS, provided evidence for convergent and discriminant validity utilizing self- and peer-reports, demonstrated incremental validity for the UPPS scale over the respective personality facets, and investigated the relationships between self-reported impulsivity and behavioral measures including perceptual speed and response latencies. Taken together, results not only confirm the reliability and validity of the German UPPS scale but also prove its benefit in predicting relevant criteria beyond well-established personality questionnaires. Significant but weak correlations with behavioral measures of cognitive aspects of impulsivity were particularly observed for (lack of) Premeditation and (lack of) Perseverance.
This study examines self-harm in a community sample of adolescents. More specifically, the study identifies the prevalence
and types of self-harm, elucidates the nature and underlying function of self-harm, and evaluates the relation of psychological
adjustment, sociodemographic, and health-risk variables to self-harm. Self-report questionnaires assessing self-harm, adjustment,
health behaviors, suicide history, and social desirability were completed by 424 school-based adolescents. Overall, 15% of
the adolescents reported engaging in self-harm behavior. Analyses revealed gender differences across behaviors and motivations.
Adolescents who indicated harming themselves reported significantly increased antisocial behavior, emotional distress, anger
problems, health risk behaviors, and decreased self-esteem. Results provide support for the coping or affect regulation model
of self-harm. Findings suggest that self-harm is associated with maladjustment, suicide, and other health behaviors indicative
of risk for negative developmental trajectories.
The present study reports the psychometric properties of the Inventory of Statements About Self-injury (ISAS), a measure designed
to comprehensively assess the functions of non-suicidal self-injury (NSSI). The ISAS assesses 13 functions of NSSI, as well
as the frequency of 12 NSSI behaviors. The ISAS was administered to 235 young adults from a college population who had performed
at least one NSSI behavior. Consistent with previous research, ISAS functions comprised two factors representing interpersonal
and intrapersonal functions. In addition, the ISAS factors exhibited excellent internal consistency and expected correlations
with both clinical constructs (e.g., borderline personality disorder, suicidality, depression, anxiety) and contextual variables
(e.g., tendency to self-injure alone). Findings support the reliability and validity of the ISAS. The ISAS may be useful in
research and treatment contexts as a comprehensive measure of NSSI functions.
The present project utilized the Five Factor Model of personality (FFM; McCrae & Costa, 1990) to clarify the multi-faceted nature of impulsivity. The NEO-PI-R and a number of commonly used impulsivity measures were administered to over 400 young adults. Exploratory factor analyses identified four distinct personality facets associated with impulsive-like behavior which were labeled urgency, (lack of) premeditation, (lack of) perseverance, and sensation seeking. Each of these traits was marked by a different facet of the FFM. Following the initial factor identification, scales to measure each of the personality facets were created and combined to form the UPPS Impulsive Behavior scale. Implications for the understanding of impulsive behavior and the FFM are discussed, as are future applications of the UPPS impulsive behavior scale.
Despite increasing research on the correlates and functions of deliberate self-harm (DSH) among community youth, less is known about the subsets of youth most at-risk for DSH or the relevance of borderline personality (BP) pathology to DSH within this population. This study sought to extend research on the characteristics associated with DSH by examining the ways in which gender, racial/ethnic background, and school-level interact to influence DSH among ethnically diverse youth in a relatively poor and underserved area, as well as the extent to which levels of BP features account for differences in rates of DSH across subsets of youth. Middle- and high-school students (N = 1931) from six public schools in Mississippi completed self-report measures of DSH and BP features. Consistent with past research, 39% of the youth in our sample reported engaging in DSH. However, rates of DSH varied as function of gender, racial/ethnic background, and school-level (as well as their interactions), with African American boys reporting higher rates of most DSH behaviors than their peers (particularly in middle-school). One notable exception to this pattern pertains to the specific behavior of cutting, for which both White girls and African American boys reported the highest rates. Further, although BP features were reliably associated with DSH status (above and beyond these demographic characteristics), they did not account for the interactive effect of gender and race on rates of DSH. Findings highlight the importance of continuing to examine DSH and its correlates among more diverse groups of youth.
Impulsivity has been proposed as an important construct in nonsuicidal self-injury (NSSI). Yet, research on the relationship of impulsivity to NSSI has been mixed. The present study clarified this relationship using a multifaceted measure of impulsivity (i.e., UPPS Impulsive Behavior Scale), and a computer-based behavioral measure of inhibitory control (i.e., a stop-signal task). Participants were 82 confirmed self-injurers and 86 controls recruited from a college population. Self-injurers and controls performed similarly on the stop-signal task. On the UPPS, self-injurers were best distinguished by Urgency (committing rash decisions when faced with negative emotions), and distinguished to a lesser degree by lack of Premeditation (inability to delay action in order to plan) and Sensation Seeking (seeking excitement and adventure). Among self-injurers, lack of Perseverance (inability to stay with a task through completion) predicted more recent and frequent NSSI. Conceptual and clinical implications are discussed. (PsycINFO Database Record (c) 2011 APA, all rights reserved).
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.
Deliberate self-harm (DSH) occurs with high frequency among clinical and nonclinical youth populations. Although depression has been consistently linked with the behavior, not all depressed individuals engage in DSH.
The current study examined maladaptive coping strategies (i.e., self-blame, distancing, and self-isolation) as mediators between depression and DSH among undergraduate students.
202 students from undergraduate psychology courses at a private university in Southern California (77.7% women) completed anonymous self-report measures.
A hierarchical regression model found no differences in DSH history across demographic variables. Among coping variables, self-isolation alone was significantly related to DSH. A full meditational model was supported: Depressive symptoms were significantly related to DSH, but adding self-isolation to the model rendered the relationship nonsignificant.
The cross-sectional study design prevents determination of whether a casual relation exists between self-isolation and DSH, and obscures the direction of that relationship.
Results suggest targeting self-isolation as a means of DSH prevention and intervention among nonclinical, youth populations.
Borderline personality disorder (BPD) has received significant attention as a predictor of suicidal behavior (SB) and nonsuicidal self-injury (NSSI). Despite significant promise, trait impulsivity has received less attention. Understanding the relations between impulsivity and SB and NSSI is confounded, unfortunately, by the heterogeneous nature of impulsivity. This study examined the relations among 4 personality pathways to impulsive behavior studied via the UPPS model of impulsivity and SB and NSSI in a residential sample of drug abusers (N = 76). In this study, we tested whether these 4 impulsivity-related traits (i.e., Negative Urgency, Sensation Seeking, Lack of Premeditation, and Lack of Perseverance) provide incremental validity in the statistical prediction of SB and NSSI above and beyond BPD; they do. We also tested whether BPD symptoms provide incremental validity in the prediction of SB and NSSI above and beyond these impulsivity-related traits; they do not. In addition to the main effects of Lack of Premeditation and Negative Urgency, we found evidence of a robust interaction between these 2 personality traits. The current results argue strongly for the consideration of these 2 impulsivity-related domains--alone and in interaction--when attempting to understand and predict SB and NSSI.
The Positive and Negative Affect Schedule (PANAS) is a widely used inventory for the assessment of affect in psychology and other applied sciences. Despite its popularity, the structure of the PANAS is still under debate. On the one hand, there is evidence of the traditional 2-factor model with Positive Affect (PA) and Negative Affect (NA) as uncorrelated factors. On the other hand, a more complex structure of the PANAS has been discussed. To shed further light on the core dimensions of the PANAS, 2 studies investigated the structure of the PANAS in 2 German samples (N = 354 and N = 364, respectively) by means of confirmatory factor analysis. The factor analysis results of Study 1 for a traitlike time frame instruction suggested a suboptimal model fit for the uncorrelated 2-factor model and the 3-factor model with PA, Afraid, and Upset as factors, whereas a superior model fit occurred for a bifactor model with traitlike PA, NA, and a general 3rd factor named Affective Polarity. In Study 2, the bifactor model was replicated for a statelike PANAS time frame instruction and evidence of criterion validity was provided for PA, NA, and Affective Polarity factors in 2 sex offender subgroups and in a community sample. With Affective Polarity, we introduce an affect dimension that captures additional variance beyond PA and NA. Because of the adjectives with relevant loadings on Affective Polarity, this general factor represents an individual's orientation toward approach and withdrawal, respectively.
Suicide is the second-leading cause of death among college students in the U.S. and is preventable. Approximately 1100 college students die by suicide each year. This study examined the prevalence and predictors of one-time and persistent suicide ideation, plans, and attempts reported during college.
Data were gathered prospectively over four years. Face-to-face interviews were conducted with 1253 first-year college students at one large mid-Atlantic university. Risk factors were measured in Year 1.
An estimated 12%(wt) of individuals experienced suicide ideation at some point during college, and of those individuals, 25% had more than one episode of ideation (persistent ideation; 2.6%(wt) of the overall sample). Ten individuals had a plan or attempt during college (0.9%(wt) of the sample). Risk factors for persistent suicide ideation included low social support, childhood or adolescent exposure to domestic violence, maternal depression, and high self-reported depressive symptoms. Persistent ideators differed from one-time ideators only by higher levels of depression (p=.027). Persistent ideators were no more likely than one-time ideators to have made a suicide plan or attempt during college (8% vs. 9%, respectively).
Although the sample size is large, only a small percentage of participants had persistent ideation, suicide plans or attempts during college.
These results have implications for programs aimed at identifying college students at risk for suicide. The accurate identification of college students at risk for suicide is an important step toward suicide prevention.
This study provides evidence that an Italian version of the Positive and Negative Affect Schedule (PANAS) is a reliable and valid self-report measure. In an Italian sample (N = 600), the PANAS showed solid psychometric properties, and several American findings with the PANAS were replicated. The replicability of the PANAS factor structure was confirmed by high congruence coefficients between the American and Italian varimax solutions. Alternative models were tested with Confirmatory Factor Analysis; as in previous studies, the two-factor model achieved the best fit, but absolute fit indices varied with the estimation methods used. The independence/bipolarity issue was also explored: Positive and negative affect scales remain substantially independent after accounting for measurement error and acquiescence. Some predictions from the tripartite model of anxiety and depression were confirmed, and external correlates of the PANAS replicated those found in other languages and cultures. These analyses offer strong support for the construct validity of the Italian PANAS.
Self-injurious behaviors are among the leading causes of death worldwide. However, the basic nature of self-injurious thoughts and behaviors (SITBs) is not well understood because prior studies have relied on long-term, retrospective, aggregate, self-report assessment methods. The authors used ecological momentary assessment methods to measure suicidal and nonsuicidal SITBs as they naturally occur in real time. Participants were 30 adolescents and young adults with a recent history of self-injury who completed signal- and event-contingent assessments on handheld computers over a 14-day period, resulting in the collection of data on 1,262 thought and behavior episodes. Participants reported an average of 5.0 thoughts of nonsuicidal self-injury (NSSI) per week, most often of moderate intensity and short duration (1-30 min), and 1.6 episodes of NSSI per week. Suicidal thoughts occurred less frequently (1.1 per week), were of longer duration, and led to self-injurious behavior (i.e., suicide attempts) less often. Details are reported about the contexts in which SITBs most often occur (e.g., what participants were doing, who they were with, and what they were feeling before and after each episode). This study provides a first glimpse of how SITBs are experienced in everyday life and has significant implications for scientific and clinical work on self-injurious behaviors.
The interpersonal-psychological theory of suicidal behavior (T. E. Joiner, 2005) makes 2 overarching predictions: (a) that perceptions of burdening others and of social alienation combine to instill the desire for death and (b) that individuals will not act on the desire for death unless they have developed the capability to do so. This capability develops through exposure and thus habituation to painful and/or fearsome experiences and is posited by the theory to be necessary for overcoming powerful self-preservation pressures. Two studies tested these predictions. In Study 1, the interaction of (low) family social support (cf. social alienation or low belonging) and feeling that one does not matter (cf. perceived burdensomeness) predicted current suicidal ideation, beyond depression indices. In Study 2, the 3-way interaction among a measure of low belonging, a measure of perceived burdensomeness, and lifetime number of suicide attempts (viewed as a strong predictor of the level of acquired capability for suicide) predicted current suicide attempt (vs. ideation) among a clinical sample of suicidal young adults, again beyond depression indices and other key covariates. Implications for the understanding, treatment, and prevention of suicidal behavior are discussed.
To determine the prevalence of deliberate self harm in adolescents and the factors associated with it.
Cross sectional survey using anonymous self report questionnaire.
41 schools in England.
6020 pupils aged 15 and 16 years.
Deliberate self harm.
398 (6.9%) participants reported an act of deliberate self harm in the previous year that met study criteria. Only 12.6% of episodes had resulted in presentation to hospital. Deliberate self harm was more common in females than it was in males (11.2% v 3.2%; odds ratio 3.9, 95% confidence interval 3.1 to 4.9). In females the factors included in a multivariate logistic regression for deliberate self harm were recent self harm by friends, self harm by family members, drug misuse, depression, anxiety, impulsivity, and low self esteem. In males the factors were suicidal behaviour in friends and family members, drug use, and low self esteem.
Deliberate self harm is common in adolescents, especially females. School based mental health initiatives are needed. These could include approaches aimed at educating school pupils about mental health problems and screening for those at risk.
Adolescent self-mutilative behavior (SMB) is a pervasive and dangerous problem, yet factors influencing the performance of SMB are not well understood. The authors examined the contextual features and behavioral functions of SMB in a sample of 89 adolescent psychiatric inpatients. SMB typically was performed impulsively, in the absence of physical pain, and without the use of alcohol or drugs. Moreover, analyses supported the construct validity of a functional model in which adolescents reported engaging in SMB for both automatic and social reinforcement. Considering the functions of SMB clarified the relations between SMB and other clinical constructs reported in previous studies such as suicide attempts, posttraumatic stress, and social concerns and has direct implications for the assessment and treatment of SMB.
The goal was to assess the prevalence, forms, demographic and mental health correlates of self-injurious behaviors in a representative college sample.
A random sample of undergraduate and graduate students at 2 northeastern US universities were invited to participate in an Internet-based survey in the spring of 2005. Thirty-seven percent of the 8300 invited participants responded.
The lifetime prevalence rate of having > or =1 self-injurious behavior incident was 17.0%. Seventy-five percent of those students engaged in self-injurious behaviors more than once. Thirty-six percent reported that no one knew about their self-injurious behaviors and only 3.29% indicated that a physician knew. Compared with non-self-injurers, those with repeat self-injurious behavior incidents were more likely to be female, bisexual or questioning their sexual orientation. They were less likely to be Asian/Asian American and >24 years of age. When controlling for demographic characteristics, those with repeat self-injurious behavior incidents were more likely to report a history of emotional abuse or sexual abuse, ever having considered or attempted suicide, elevated levels of psychological distress, and > or =1 characteristic of an eating disorder. A dose-response gradient was evident in each of these areas when single-incident self-injurious behaviors were compared with repeat-incident self-injurious behaviors.
A substantial number of college students reported self-injurious behaviors in their lifetimes. Many of the behaviors occurred among individuals who had never been in therapy for any reason and who only rarely disclosed their self-injurious behaviors to anyone. Single self-injurious behavior incidents were correlated with a history of abuse and comorbid adverse health conditions but less strongly than were repeat self-injurious behavior incidents. The reticence of these clients to seek help or advice renders it critical that medical and mental health providers find effective strategies for detecting and addressing self-injurious behaviors.
Few studies have investigated non-suicidal self-injury (NSSI), or the deliberate, direct destruction of body tissue without conscious suicidal intent, and the motivations for engaging in NSSI among adolescents. This study assessed the prevalence, associated clinical characteristics, and functions of NSSI in a community sample of adolescents.
A total of 633 adolescents completed anonymous surveys. NSSI was assessed with the Functional Assessment of Self-Mutilation (FASM).
Some form of NSSI was endorsed by 46.5% (n=293) of the adolescents within the past year, most frequently biting self, cutting/carving skin, hitting self on purpose, and burning skin. Sixty per cent of these, or 28% of the overall sample, endorsed moderate/severe forms of NSSI. Self-injurers reported an average of 12.9 (s.d.=29.4) incidents in the past 12 months, with an average of 2.4 (s.d.=1.7) types of NSSI used. Moderate/severe self-injurers were more likely than minor self-injurers, who in turn were more likely than non-injurers, to have a history of psychiatric treatment, hospitalization and suicide attempt, as well as current suicide ideation. A four-factor model of NSSI functions was indicated, with self-injurers likely to endorse both reasons of automatic reinforcement and social reinforcement. The most common reasons for NSSI were 'to try to get a reaction from someone', 'to get control of a situation', and 'to stop bad feelings'.
Community adolescents reported high rates of NSSI, engaged in to influence behaviors of others and to manage internal emotions. Intervention efforts should be tailored to reducing individual issues that contribute to NSSI and building alternative skills for positive coping, communication, stress management, and strong social support.
This study examined characteristics associated with mildly injurious (fingernail biting, skin picking, etc.) and more injurious (cutting, burning, etc.) self-harm (SH) in an undergraduate sample (N = 280); 31% reported mildly injurious SH within the past 3 years with no more injurious SH, whereas 20% reported more injurious SH within the past 3 years. SH was not associated with significant general negative affect or history of physical or sexual abuse, although more injurious SH was associated with a history of emotional abuse. A portion of both groups reported negative affect regarding their histories of SH. Both types of SH were associated with other impulsive and disordered eating behaviors, some obsessive-compulsive characteristics, and more somatic symptoms. Similarities and differences with clinical SH are discussed, as well as implications for further research and treatment. Arguments for and against a continuum view of self-harm, as ranging from mild to severe in injuriousness or clinical significance, are also discussed.
High rates of nonsuicidal self-injury (NSSI; 14%-17%) in adolescents and young adults suggest that some self-injurers may exhibit more or different psychiatric problems than others. In the present study, the authors utilized a latent class analysis to identify clinically distinct subgroups of self-injurers. Participants were 205 young adults with a history of 1 or more NSSI behaviors. Latent classes were identified on the basis of method (e.g., cutting vs. biting vs. burning), descriptive features (e.g., self-injuring alone or with others), and functions (i.e., social vs. automatic). The analysis yielded 4 subgroups of self-injurers, which were then compared on measures of depression, anxiety, borderline personality disorder, and suicidality. Almost 80% of participants belonged to 1 of 2 latent classes characterized by fewer or less severe NSSI behaviors and fewer clinical symptoms. A 3rd class (11% of participants) performed a variety of NSSI behaviors, endorsed both social and automatic functions, and was characterized by high anxiety. A 4th class (11% of participants) cut themselves in private, in the service of automatic functions, and was characterized by high suicidality. Clinical and research implications are discussed.
Objective: To determine the prevalence of deliberate self harm in adolescents and the factors associated with it. Design: Cross sectional survey using anonymous self report questionnaire. Setting: 41 schools in England. Participants: 6020 pupils aged 15 and 16 years. Main outcome measure: Deliberate self harm. Results: 398 (6.9%) participants reported an act of deliberate self harm in the previous year that met study criteria. Only 12.6% of episodes had resulted in presentation to hospital. Deliberate self harm was more common in females than it was in males (11.2% v 3.2%; odds ratio 3.9, 95% confidence interval 3.1 to 4.9). In females the factors included in a multivariate logistic regression for deliberate self harm were recent self harm by friends, self harm by family members, drug misuse, depression, anxiety, impulsivity, and low self esteem. In males the factors were suicidal behaviour in friends and family members, drug use, and low self esteem. Conclusions: Deliberate self harm is common in adolescents, especially females. School based mental health initiatives are needed. These could include approaches aimed at educating school pupils about mental health problems and screening for those at risk. What is already known on this topic What is already known on this topic Deliberate self harm is a common reason for presentation of adolescents to hospital Community studies from outside the United Kingdom have shown much greater prevalence of self harm in adolescents than hospital based studies
The present research broadens the understanding of the multidimensional nature of impulsivity by investigating the validity of a German adaptation of the UPPS scale of impulsivity (Whiteside & Lynam, 2001). Two studies utilizing paper-pencil and computerized administration replicated the internal structure of the UPPS, provided evidence for convergent and discriminant validity utilizing self- and peer-reports, demonstrated incremental validity for the UPPS scale over the respective personality facets, and investigated the relationships between self-reported impulsivity and behavioral measures including perceptual speed and response latencies. Taken together, results not only confirm the reliability and validity of the German UPPS scale but also prove its benefit in predicting relevant criteria beyond well-established personality questionnaires. Significant but weak correlations with behavioral measures of cognitive aspects of impulsivity were particularly observed for (lack of) Premeditation and (lack of) Perseverance.
Recent theory suggests that people may engage in dysregulated behaviors, such as non-suicidal self-injury (NSSI), as a way
to distract from rumination and emotional cascades (Selby et al. 2008); similarly, another theory suggests that people may not engage in self-injurious behavior without habituation to fear through
repeated exposure to painful events (Joiner 2005). We hypothesized that both high rumination and habituation to the fear of pain may strongly influence NSSI because those
who lack a fear of pain and ruminate intensely will not be afraid to inflict physical pain as a way to distract from negative
affect. Participants were undergraduate students (N=94), a large portion of whom reported engaging in NSSI. These participants were given measures of past painful experiences,
rumination, and frequency of recent self-injury. Using hierarchical linear regression, evidence was found to support the interaction
effect of rumination and painful/provocative experiences on the frequency of NSSI, even after controlling for important variables
such as age, gender, and sensation seeking. Although the interaction significantly predicted NSSI, it did not predict dysregulated
eating behaviors or drinking to cope.
KeywordsRumination-Self-injury-Self-harm-Emotional cascades-Acquired capability
Deliberate self-harm has recently begun to receive more systematic attention from clinical researchers.
However, there remains a general lack of consensus as to how to define and measure this important
clinical construct. There is still no standardized, empirically validated measure of deliberate selfharm,
making it more difficult for research in this area to advance. The present paper provides an
integrative, conceptual definition of deliberate self-harm as well as preliminary psychometric data on a
newly developed measure of self-harm, the Deliberate Self-Harm Inventory (DSHI). One hundred and
fifty participants from undergraduate psychology courses completed research packets consisting of the
DSHI and other measures, and 93 of these participants completed the DSHI again after an interval of
2–4 weeks (M D3:3 weeks). Preliminary findings indicate that the DSHI has high internal consistency;
adequate construct, convergent, and discriminant validity; and adequate test-retest reliability.
Bulimia nervosa and non-suicidal self-injury (NSSI) co-occur at high rates, and both have been conceptualized as maladaptive emotion regulation strategies. Treatments focusing on emotion regulation have been designed for both problem behaviors, yet, there exists very little research examining the temporal emotional states surrounding acts of NSSI. Using ecological momentary assessment (EMA) methodology, the current study examined the temporal association between positive and negative emotional states prior to and consequent to acts of NSSI within a subset of bulimia nervosa patients. Results indicate significant increases in negative affect, and decreases in positive affect, prior to an NSSI act. Post-NSSI, positive affect significantly increased while negative affect remained unchanged. The findings offer partial support for an emotion regulation paradigm to understanding NSSI within bulimic populations and implications for treatment are discussed.
Understanding the functions of nonsuicidal self-injury (NSSI) has important implications for the development and refinement of theoretical models and treatments of NSSI. Emotional and social vulnerabilities associated with five common functions of NSSI-emotion relief (ER), feeling generation (FG), self-punishment (SP), interpersonal influence (II), and interpersonal communication (IC)-were investigated to clarify why individuals use this behavior in the service of different purposes. Female participants (n = 162) with a history of NSSI completed online measures of self-injury, emotion regulation strategies and abilities, trait affectivity, social problem-solving styles, and interpersonal problems. ER functions were associated with more intense affectivity, expressive suppression, and limited access to emotion regulation strategies. FG functions were associated with a lack of emotional clarity. Similar to ER functions, SP functions were associated with greater affective intensity and expressive suppression. II functions were negatively associated with expressive suppression and positively associated with domineering/controlling and intrusive/needy interpersonal styles. IC functions were negatively associated with expressive suppression and positively associated with a vindictive or self-centered interpersonal style. These findings highlight the specific affective traits, emotional and social skill deficits, and interpersonal styles that may render a person more likely to engage in NSSI to achieve specific goals.
Attitudes towards the body have been largely overlooked as a potential risk factor for adolescent non-suicidal self-injury (NSSI) despite theorizing that a negative body image may play a critical role in the development of this behavior. The current study used structural equation modeling to evaluate the fit of a theoretical model specifying body image as a mediator between negative affect and NSSI in a combined clinical and non-clinical sample of 284 adolescents. The data supported the model, accounted for 21.6% of the variance in NSSI, and body image significantly mediated the relationship between negative affect and NSSI. These findings provide essential preliminary evidence that body image may represent a necessary but not sufficient risk factor for NSSI in adolescents and that treatment for NSSI should consider targeting body-related pathology in addition to emotion regulation. The findings also support including body image within developing etiological models of NSSI.
Joiner's (2005) interpersonal-psychological theory of suicidal behavior posits that an individual must exhibit elevations on three variables--perceived burdensomeness, thwarted belongingness, and the acquired capability for suicide--in order to enact lethal self-harm. Thus far, however, no research has examined the role of emotion in this process or whether the interaction of these three variables is more problematic for certain populations than for others. We sought to address these voids by examining the role of negative urgency as an amplifier of the relationship between the components of the theory and lifetime number of suicide attempts. Results indicated that the four-way interaction of negative urgency and the three components of the theory predicted lifetime number of suicide attempts, controlling for depression symptoms and sex. Additionally, the three-way interaction of the theory components significantly predicted lifetime number of suicide attempts in the full sample. Furthermore, for individuals with negative urgency scores at or above the median, the three-way interaction of the theory components significantly predicted lifetime number of suicide attempts whereas, for individuals with negative urgency scores below the median, the interaction was non-significant. These findings indicate that, although elevations on the three components of the theory may be dangerous for anyone, this is particularly true for individuals exhibiting high levels of negative urgency, as they might be more likely to quickly develop suicidal ideation and resort to painful self-harming behaviors while experiencing negative affective states.
Nonsuicidal self-injury (NSSI) is a prevalent but perplexing behavior problem in which people deliberately harm themselves without lethal intent. Research reveals that NSSI typically has its onset during early adolescence; most often involves cutting or carving the skin; and appears equally prevalent across sexes, ethnicities, and socioeconomic statuses. Less is known about why people engage in NSSI. This article presents a theoretical model of the development and maintenance of NSSI. Rather than a symptom of mental disorder, NSSI is conceptualized as a harmful behavior that can serve several intrapersonal (e.g., affect regulation) and interpersonal (e.g., help-seeking) functions. Risk of NSSI is increased by general factors that contribute to problems with affect regulation or interpersonal communication (e.g., childhood abuse) and by specific factors that influence the decision to use NSSI rather than some other behavior to serve these functions (e.g., social modeling). This model synthesizes research from several different areas of the literature and points toward several lines of research needed to further advance the understanding of why people hurt themselves.
Researchers have reported similar prevalence rates for non-suicidal self-injury (NSSI) among men and women, yet few studies have investigated gender differences in NSSI. This study describes and compares basic NSSI characteristics among a nonclinical sample by gender. Forty-eight individuals reporting a history of NSSI were interviewed (M = 18.52 years old, SD = 1.18 years). NSSI characteristics, including frequency, age of onset, method of NSSI, pain and control during NSSI, and degree of medical injury were compared between men (n = 19) and women (n = 29). Men and women differed significantly on age of onset, degree of medical injury, and NSSI methods. This study supports previous findings of gender differences in NSSI and suggests that further investigation of gender differences in NSSI is warranted.
Impulsivity is a multifaceted construct central to several forms of psychopathology. Recently, Lynam, Smith, Whiteside, and Cyders (2006) developed the UPPS-P scale, a multidimensional inventory that assesses 5 personality pathways contributing to impulsive behavior: negative urgency, lack of perseverance, lack of premeditation, sensation seeking, and positive urgency. In this study, we aimed (a) to analyze the psychometric properties of a Spanish version of the UPPS-P scale and (b) to explore the relationship between the different dimensions of the UPPS-P scale and conceptually related constructs including trait measures derived from different models of impulsive personality (the Gray's [1987] and Plutchik's [1984] models) and a state measure of cognitive impulsivity, the Delay-Discounting Test (Kirby, Petry, & Bickel, 1999). We administered the UPPS-P scale along with the Sensitivity to Punishment and Sensitivity to Reward Questionnaire (Torrubia, Avila, Molto, & Caseras, 2001), the Plutchik Impulsivity Scale (Plutchik & Van Praag, 1989), and the Delay-Discounting Test to a sample of 150 undergraduate students. Results showed that the Spanish adaptation of the UPPS-P scale have appropriate psychometric properties. Different dimensions of the UPPS-P were differentially associated with predicted conceptually related constructs. We conclude that the Spanish adaptation of the UPPS-P scale is a useful instrument for fine-grained assessment of impulsivity in Spanish-speaking adult population.
The current study investigated the association between non-suicidal self-injury (NSSI), self-concept and acquaintance with NSSI peers in a sample of 150 high school students (60% female) with a mean age of 15.56 (SD=2.00) years. Analyses showed that students with NSSI rated themselves lower on academic intelligence, physical attractiveness, social skills and emotional stability than their non-NSSI peers. The self-injurers also had more friends who engaged in NSSI, and having more NSSI acquaintances was negatively related to self-esteem. It could be that adolescents with lower self-esteem are more attracted to self-injuring peers, or that adolescents with low self-esteem are more vulnerable to copy NSSI to deal with their problems or to gain a certain identity in their peer group. Future studies must test these possible NSSI pathways.
Although self-mutilation has been studied from medical and individual perspectives, it has rarely been examined within a social stress context. As such, we use a social stress framework to examine risk factors for self-mutilation to determine whether status strains that are often associated with poorer health outcomes in the general population are also associated with self-mutilation among a sample of young adults in the United States who have a history of homelessness. Data are drawn from the Homeless Young Adult Project which involved interviews with 199 young adults in 3 Midwestern United States cities. The results of our path analyses revealed that numerous stressors including running away, substance use, sexual victimization, and illegal subsistence strategies were associated with more self-mutilation. In addition, we found that certain social statuses exacerbate the risk for self-mutilation beyond the respondents' current situation of homelessness. We discuss the implications of our findings for the social stress framework and offer suggestions for studying this unique population within this context.
The question of why some people do things that are intentionally harmful to themselves continues to puzzle scientists, clinicians, and the public. Prior studies have demonstrated that one fairly extreme, direct form of self-harm, non-suicidal self-injury (NSSI), is maintained by both automatic (i.e., intrapersonal) as well as social (i.e., interpersonal) reinforcement. However, the majority of theoretical and empirical papers on this topic focus almost exclusively on the automatic functions. The purpose of this paper is to provide a more comprehensive analysis of the social functions of NSSI. Evidence is presented supporting the notion that NSSI is maintained by social reinforcement in at least a substantial minority of instances. Moreover, an elaborated theoretical model of the social functions of NSSI is outlined that proposes that this behavior represents a high intensity social signal used when less intense communication strategies fail (e.g., speaking, yelling, crying). The model further proposes that NSSI can serve not only as a signal of distress that is reinforced primarily by the caregiving behavior it elicits from others, but that it also can serve as a signal of strength and fitness that is reinforced by warding off potential threats (e.g., peer victimization), and in some cases can strengthen affiliation with others. Support for this theoretical model is drawn from diverse literatures including psychology, evolutionary biology, and cultural anthropology. The paper concludes with specific recommendations for empirical tests of the proposed model of the social functions of NSSI, as well as other harmful behaviors such as alcohol and drug use.
In recent studies of the structure of affect, positive and negative affect have consistently emerged as two dominant and relatively independent dimensions. A number of mood scales have been created to measure these factors; however, many existing measures are inadequate, showing low reliability or poor convergent or discriminant validity. To fill the need for reliable and valid Positive Affect and Negative Affect scales that are also brief and easy to administer, we developed two 10-item mood scales that comprise the Positive and Negative Affect Schedule (PANAS). The scales are shown to be highly internally consistent, largely uncorrelated, and stable at appropriate levels over a 2-month time period. Normative data and factorial and external evidence of convergent and discriminant validity for the scales are also presented.
This paper examines impulsivity as a central factor in moderate/superficial self-mutilation such as skin-cutting and burning. A sample of 165 subjects were divided into four groups, namely self-mutilators, patients with any modes of impulsive behavior other than self-mutilation, patients without any impulsive behavior, and normal probands. All were administered the 10th version of the Barratt Impulsiveness Scale, the State-Trait Anger Expression Inventory, and the Inventory for the Assessment of Factors of Aggressiveness. They also were interviewed carefully in regards to both impulsive and self-mutilative behavior. A d-fenfluramine challenge test was administered to 36 females and prolactin levels were measured. On the whole results implicate impulsive personality functioning as a major factor in subjects with moderate/superficial self-mutilative behavior whose trait pathology is similar to personality disordered patients with other modes of self-harming impulsive behavior.
To evaluate the reliability and validity of the PANAS (Watson, Clark, & Tellegen, 1988b) and provide normative data.
Cross-sectional and correlational.
The PANAS was administered to a non-clinical sample, broadly representative of the general adult UK population (N = 1,003). Competing models of the latent structure of the PANAS were evaluated using confirmatory factor analysis. Regression and correlational analysis were used to determine the influence of demographic variables on PANAS scores as well as the relationship between the PANAS with measures of depression and anxiety (the HADS and the DASS).
The best-fitting model (robust comparative fit index = .94) of the latent structure of the PANAS consisted of two correlated factors corresponding to the PA and NA scales, and permitted correlated error between items drawn from the same mood subcategories (Zevon & Tellegen, 1982). Demographic variables had only very modest influences on PANAS scores and the PANAS exhibited measurement invariance across demographic subgroups. The reliability of the PANAS was high, and the pattern of relationships between the PANAS and the DASS and HADS were consistent with tripartite theory.
The PANAS is a reliable and valid measure of the constructs it was intended to assess, although the hypothesis of complete independence between PA and NA must be rejected. The utility of this measure is enhanced by the provision of large-scale normative data.
The aims of this study are to adapt two validated self-report questionnaires of deliberate self-harm and suicidal behavior to German, to investigate their psychometric properties and agreement with clinician-administered ratings, and to examine their psychopathological correlates.
The Deliberate Self-Harm Inventory [Gratz KL. Measurement of deliberate self-harm: preliminary data on the deliberate self-harm inventory. J Psychopathol Behav 2001;23:253-263] and the Self-Harm Behavior Questionnaire [Guttierez PM, Osman A, Barrios FX, Kopper BA. Development and initial validation of the self-harm behavior questionnaire. J Pers Assess 2001;77:475-490] were completed by 361 patients hospitalized for depressive, anxiety, adjustment, somatoform, and/or eating disorders. A clinician-administered rating scale of self-destructive behavior was included. Psychopathological variables were assessed by standardized questionnaires.
The self-report questionnaires demonstrated good reliability (alpha=.81-.96, split-half r=.78-.98, test-retest r=.65-.91). Reliability of the clinician-administered ratings was acceptable (interrater kappa=.46-.77, test-retest kappa=.35-.48). Intraclass correlations (ICC=.68) for all three instruments were satisfactory. Rates of self-harm and associations between self-harm and suicidal behaviors are reported. The findings support the hypotheses of a higher degree of psychiatric symptomatology in patients with self-harm behavior compared to those without.
The two questionnaire adaptations are reliable and valid self-report scales for the assessment of self-harm and past suicidal behavior.
Deliberate self-injury is defined as the intentional, direct injuring of body tissue without suicidal intent. The present article reviews the empirical research on the functions of self-injury. This literature includes self-reports of reasons for self-injuring, descriptions of the phenomenology of self-injury, and laboratory studies examining the effects of self-injury proxies on affect and physiological arousal. Results from 18 studies provide converging evidence for an affect-regulation function. Research indicates that: (a) acute negative affect precedes self-injury, (b) decreased negative affect and relief are present after self-injury, (c) self-injury is most often performed with intent to alleviate negative affect, and (d) negative affect and arousal are reduced by the performance of self-injury proxies in laboratory settings. Studies also provide strong support for a self-punishment function, and modest evidence for anti-dissociation, interpersonal-influence, anti-suicide, sensation-seeking, and interpersonal boundaries functions. The conceptual and empirical relationships among the different functions remain unclear. Future research should address the measurement, co-variation, clinical correlates, and treatment implications of different functions.
The ability to make precise distinctions among related personality constructs helps clarify theory and increases the utility of clinical assessment. In three studies, the authors evaluated the validity of distinctions among four impulsivity-like traits: sensation seeking, lack of planning, lack of persistence, and urgency (acting rashly when distressed). Factor analyses indicated that lack of planning and lack of persistence are two distinct facets of one broader trait, whereas urgency and sensation seeking are both very modestly related to each other and to the planning/persistence measures. The authors developed interview assessments of each, and multitrait, multimethod matrix results indicated clear convergent and discriminant validity among the constructs. The distinctions among them were useful: The traits accounted for different aspects of risky behaviors. Sensation seeking appeared to relate to the frequency of engaging in risky behaviors, and urgency appeared to relate to problem levels of involvement in those behaviors.
This study examined the relationship between parental expressed emotion (EE) and adolescent self-injurious thoughts and behaviors (SITB), as well as potential mediators and moderators of this relationship.
Thirty-six adolescents ages 12 to 17 years recruited from the community (2004-2005) provided data. Parents of the adolescents completed the Five-Minute Speech Sample, a performance-based measure of EE, and adolescents completed interviews and rating scales assessing SITB, mental disorders, and related constructs.
Analyses revealed that high parental EE was associated with each type of SITB assessed: suicide ideation, suicide plans, suicide attempts, and non-suicidal self-injury. Analyses also revealed that one specific component of EE (i.e., parental criticism) was strongly associated with SITB, whereas the other (i.e., emotional overinvolvement) was not and that the relationship between EE and SITB was not explained by the presence of mental disorders. Finally, a moderation model was supported in which the relationship between parental criticism and SITB was especially strong among adolescents with a self-critical cognitive style.
This study indicates that parental criticism is significantly associated with SITB and suggests one specific pathway through which the family may influence adolescent SITB. Future research is needed to replicate these findings and examine the direction of these relationships.
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- K L Croyle
- J Waltz
- H Fliege
- R D Kocalevent
- O B Walter
- S Beck
- K L Gratz
- P M Gutierrez
The Positive and Negative Affect Schedule
(PANAS): Construct validity, measurement properties and normative data in a large non-clinical
sample. British Journal of Clinical Psychology, 43,
245-265.
CROYLE, K. L., & WALTZ, J. (2007). Subclinical self-harm: Range of behaviors, extent and
associated characteristics. American Journal of
Orthopsychiatry, 77, 332-342.
FLIEGE, H., KOCALEVENT, R. D., WALTER,
O. B., BECK, S., GRATZ, K. L., GUTIERREZ, P. M.,
et al. (2006). Three assessment tools for self harm
and suicide behavior: Evaluation and psychopathological correlates. Journal of Psychosomatic
Research, 61, 113-121.