Micro‐sequences of anger and shame and non‐suicidal self‐injury in youth: an ecological momentary assessment study

Abstract

ObjectiveNon‐suicidal self‐injury (NSSI) is a significant mental health concern with the highest prevalence among adolescents. NSSI has been conceptualized as one of the maladaptive strategies to cope with challenging affect or a form of self‐punishment. Although characterizing moment‐to‐moment associations between shame and NSSI in individuals' real‐world environment and partitioning between‐ and within‐person effects is critical for mobile and timely interventions, most studies examined habitual experiences of negative affective states and focused on adults.MethodIn this study, we focused on in vivo anger at self and others and shame and NSSI among 158 adolescents 3 weeks following their psychiatric hospitalizations using ecological momentary assessment (EMA) technology.ResultsWe found that greater between‐person levels of anger at self and others were linked to a higher number of subsequent NSSI occurrences within a day. These findings remained primarily unchanged when we statistically adjusted for participants' age, sex assigned at birth, the number of current psychiatric diagnoses, EMA response rates, and youth lifetime history of SI. Within‐person increases in NSSI were linked to increased anger at self over and beyond between‐person average levels of NSSI.ConclusionsThese findings highlight the potential regulatory role of NSSI to decrease negative affective states and point to the clinical utility of assessing and early mobile interventions targeting challenging affect in youth.

Negative self‐perceptions and severity of NSSI: Testing the benefits and barriers model

“…Self-criticism, like a generally negative self-view, is a well-known risk factor for engagement in NSSI (Zelkowitz & Cole, 2019), but it is possible that self-directed anger is a key component in determining who will engage in more severe NSSI. Anger is generally considered to be an "activating" emotion that increases the tendency to approach or engage in behaviors (Carver & Harmon-Jones, 2009), and previous research has demonstrated the importance of anger generally in NSSI (Cassiello-Robbins et al, 2021), as well as the importance of self-directed anger in NSSI (Dillon et al, 2021;Kudinova et al, 2024;Muehlenkamp et al, 2013). However, to our knowledge, no one has yet examined the relationships between self-directed anger, self-punishment motives, and NSSI.…”

The Effect of Bullying Victimization on Adolescent Non-Suicidal Self-Injury: The Mediating Roles of Alexithymia and Self-Esteem

“…Therefore, when subjected to verbal, physical, and social-relational aggression, adolescents may develop a negative self-appraisal of themselves as rejected and isolated, which lowers their self-esteem levels. Besides, concepts associated with low self-esteem, such as self-critical, 88 feelings of shame, 89 and self-punishment, 90 have been indicated as motivations for NSSI. These findings also demonstrated individuals with low self-esteem were more inclined to develop NSSI behavior, consistent with previous findings that the level of self-esteem was negatively correlated with the frequency and severity of NSSI.…”

Risky decision-making and nonsuicidal self-injury among university students: Examining the role of criticism feedback

“…Indeed, interpersonal life stress (e.g., arguments) often precedes or co-occurs with NSSI (35)(36)(37)(38). Interpersonal emotional processes, such as rejection sensitivity (39) and anger towards others (e.g., 40), are linked to NSSI behaviour over brief periods. NSSI may reduce negative affect, including interpersonally relevant emotions (e.g., guilt), shortly after engagement (e.g., 41-43; c.f.…”