A Functional Approach to the Assessment of Self-Mutilative Behavior.

Department of Psychology, Harvard University, Cambridge, MA 02138, USA. .
Journal of Consulting and Clinical Psychology (Impact Factor: 4.85). 11/2004; 72(5):885-90. DOI: 10.1037/0022-006X.72.5.885
Source: PubMed


This study applied a functional approach to the assessment of self-mutilative behavior (SMB) among adolescent psychiatric inpatients. On the basis of past conceptualizations of different forms of self-injurious behavior, the authors hypothesized that SMB is performed because of the automatically reinforcing (i.e., reinforced by oneself; e.g., emotion regulation) and/or socially reinforcing (i.e., reinforced by others; e.g., attention, avoidance-escape) properties associated with such behaviors. Data were collected from 108 adolescent psychiatric inpatients referred for self-injurious thoughts or behaviors. Adolescents reported engaging in SMB frequently, using multiple methods, and having an early age of onset. Moreover, the results supported the structural validity and reliability of the hypothesized functional model of SMB. Most adolescents engaged in SMB for automatic reinforcement, although a sizable portion endorsed social reinforcement functions as well. These findings have direct implications for the understanding, assessment, and treatment of SMB.

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Available from: Mitchell J Prinstein
    • "Examining literature from both the study of men and masculinity as well as self-harm, several lines of research converge to offer a potential explanation. Nock and Prinstein's (2004, 2005) four-factor model (FFM) provides a framework for better understanding the links between adherence to masculine norms and self-harm. The model identifies four functions of selfharm: (1) automatic positive reinforcement, (2) automatic negative reinforcement, (3) social positive reinforcement, and (4) social negative reinforcement. "
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    ABSTRACT: Several known risk factors for nonsuicidal self-injury (NSSI), such as negative emotionality and deficits in emotion skills, are also associated with masculinity. Researchers and clinicians suggest that masculine norms around emotional control and self-reliance may make men more likely to engage in self-harm. Masculinity has also been implicated as a potential risk factor for suicide and other self-damaging behaviors. However, the association between masculinity and NSSI has yet to be explored. In the current study, a sample of 912 emerging adults from two universities in the Northeastern United States completed a web-based questionnaire assessing adherence to masculine norms, engagement in NSSI, and known risk factors for NSSI (demographics and number of self-injurers known). Stronger adherence to masculine norms predicted chronic NSSI (five or more episodes throughout the life span) above and beyond other known risk factors. Adherence to masculine norms was related to methods of NSSI. Clinical implications are discussed, including discussions of masculine norms in treatment settings. Future research should examine what specific masculine norms are most closely linked to NSSI and other self-damaging behaviors.
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    • "Accordingly, there is growing consensus that the primary (but not only) function of NSSI is affect regulation, with people who self-injure reporting being overwhelmed and frustrated before NSSI and relieved and calm afterwards (Klonsky, 2011; Nock & Prinstein, 2004; Wilcox et al., 2012). Ecological momentary assessment studies also demonstrate detectable increases in negative affect prior to NSSI and associated decreases after NSSI, supporting an emotion regulatory function (Armey, Crowther & Miller, 2011). "
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    ABSTRACT: Objectives: This study sought to explore the relationships between depression, anxiety, stress and non-suicidal self-injury (NSSI), and the mediating roles of rumination and emotion regulation in this relationship. Methods: The sample comprised 1,586 Australian university students who completed a self-report questionnaire assessing the relevant variables. Results: Of the sample, 8.9% engaged in NSSI in the four weeks prior to the survey. Depression, anxiety and stress each exerted a direct effect on NSSI, and each relationship was mediated by cognitive reappraisal. The relationship between stress and NSSI was also mediated by expressive suppression. Conclusion: The results imply intervention efforts aimed at teaching adaptive emotion regulation strategies for students experiencing high levels of psychological distress may reduce the frequency of NSSI.
    Full-text · Article · Dec 2015 · Archives of suicide research: official journal of the International Academy for Suicide Research
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    • "Similarly, given that individuals often report engaging in NSSI to regulate very painful emotions and for self-punishment purposes (Nock and Prinstein, 2004), viewing a particular scar might activate negative emotions related to the circumstances that prompted engagement and trigger distressing memories. Thus, it is possible that NSSI scarring may be associated with elevated levels of distress, which in turn, may augment one's vulnerability for exhibiting STBs. "
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    ABSTRACT: Background. Suicide risk is challenging to quantify due to reliance on self-report, which is limited by individuals’ lack of insight and the desire to conceal such intentions. Non-suicidal self-injury (NSSI) is one of the most robust predictors of suicidal ideation (SI) and suicide attempts (SA). Although NSSI often leads to permanent scarring, which can be assessed by objective physical examination, no research has examined whether scarring denotes tangible risk for SI and SA. The present study examined whether NSSI scar presence and number predict current SI and SA history. Further, we examined whether brooding would exacerbate the effects of NSSI scarring on SI or SA. Methods. Young adults (N = 231; M = 21.24 years; 78% female) completed self-report questionnaires assessing SA history, frequency of NSSI, presence/number of NSSI scars, brooding, current depressive symptoms, and SI. Results. NSSI scar presence and number predicted current SI and SA history after controlling for current depressive symptoms. Moreover, scar presence and number predicted current SI over and above the effects of SA history and NSSI frequency, method, and medical severity. Further, NSSI scar presence and number predicted SI more strongly among individuals with greater levels of brooding than among individuals with lower levels of brooding. Conclusions. The presence and number of NSSI scars are objective physical indicators of risk for SI and SAs. Brooding may further heighten the risk of SI for individuals bearing NSSI scars.
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