Are self-injurers impulsive?: Results from two behavioral laboratory studies

Abstract

Common clinical wisdom suggests that people who engage in self-injury are impulsive. However, virtually all prior work in this area has relied on individuals' self-report of impulsiveness, despite evidence that people are limited in their ability to accurately report on cognitive processes that occur outside awareness. To address this knowledge gap, we used performance-based measures of several dimensions of impulsiveness to assess whether people engaging in non-suicidal self-injury (NSSI) demonstrate greater impulsiveness than non-injurers. In Study 1, we compared adolescent selfinjurers (n=64) to age, sex, and race/ethnicity matched, non-injurious controls (n=30) on self-report impulsiveness (Schedule for Affective Disorders and Schizophrenia for School Age Children, Present and Lifetime Version, Kaufman et al., 1997), and on performance-based measures of two dimensions of impulsiveness: behavioral disinhibition (Conners' Continuous Performance Test, Connors, 1995) and risky decision-making (Iowa Gambling Task, Bechara et al., 1994). In Study 2, we compared adult female self-injurers (n=20) to age and race/ethnicity matched, non-injurious controls (n=20) on self-report impulsiveness (Barratt Impulsiveness Scale-11, Patton et al., 1995), and performance-based measures of behavioral disinhibition, risky decision-making, and two measures of delay discounting (Kirby et al., 1999;Richards et al., 1999). In both studies, self-injurers reported greater impulsiveness; however, performance-based measures of impulsiveness failed to detect any between-group differences. We propose several potential explanations for the discrepancies observed between self-report and performance-based measures of impulsiveness and discuss directions for future research on impulsiveness and self-injury.

Avaliação neuropsicológica do processo de tomada de decisões em crianças e adolescentes: uma revisão integrativa da literatura

“…We can see from the findings reported that the evaluation of decision making skills in children and adolescents, besides useful in the clinical characterization of different psychopathologies, has also a potential use as an indicator of function and social adaptation within each disorder 17,27,46,47,48,51, 54 . Additional investigations about this relationship in children and adolescents with psychiatric disorders are needed.…”

“…Among the studies reviewed, only eleven used the Iowa Gambling Task to assess decision-making 11,20,21,26,29,[47][48][49]51,52,54 . Seven of them used variations very similar to the original task in which there were small changes in the amount of the loan, gains and punishments after the choices 17,28,31,32,36,40,44 .…”

O desempenho executivo em pacientes que apresentam automutilação

“…A literatura aponta estudos que avaliam funções executivas (Ohmann et al, 2008;Oldershaw et al, 2009;Janis;Fikke et al, 2010), …”

Non-Suicidal Self-Injury in Swedish Adolescents : Prevalence, Characteristics, Functions and Associations With Childhood Adversities

“…NSSI is often performed only a few minutes after the urge to engage in NSSI has arisen (Favazza & Conterio, 1989;Klonsky & Olino, 2008;, and self-reported impulsivity has shown to be associated with NSSI (Herpertz, Sass, & Favazza, 1997;Janis & Nock, 2009;You & Leung, 2012). There has however also been some inconsistency in results, depending among other things on how impulsivity is conceptualized (Glenn & Klonsky, 2010a;Janis & Nock, 2009). Glenn and Klonsky (2010a) found that it was mainly urgency, defined as "a tendency to engage in rash behaviors in the face of negative affect" (p. 72), that differed between groups.…”