Nonsuicidal Self‐Injury and Affect Regulation: Recent Findings From Experimental and Ecological Momentary Assessment Studies and Future Directions

Hamza, Chloe A.; Willoughby, Teena

doi:10.1002/jclp.22174

Cited by 50 publications

(33 citation statements)

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“…Prior research suggests that both NSSI and ED behaviors serve to regulate emotion. Negative affect typically precedes NSSI, and the most common outcomes of NSSI include reducing distress and achieving relief [21][22][23]25,[30][31][32]. Negative mood is similarly hypothesized to trigger dysregulated eating and compensatory behaviors, and people generally report reduced negative affect following episodes of ED behaviors, e.g., [26][27][28][29].…”

Section: Discussionmentioning

confidence: 99%

“…2020, 10, 104 2 of 17 of diverse self-injurious behaviors [12][13][14][15][16] and a putative non-specific marker of general vulnerability for psychopathology [17,18]. Consistent with this notion, the most commonly reported function of NSSI and ED behaviors is to reduce negative affect [19][20][21][22][23][24][25]. Ecological momentary assessment corroborates the idea that direct and indirect self-injury are both motivated by a desire to alleviate unpleasant emotional states, as increased negative affect proximally predicts episodes of NSSI, dysregulated eating, and compensatory behaviors [26][27][28][29][30][31][32].Much like emotion dysregulation, impulsivity is implicated in various psychiatric disorders and self-injurious behaviors.…”

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confidence: 93%

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Emotional Response Inhibition: A Shared Neurocognitive Deficit in Eating Disorder Symptoms and Nonsuicidal Self-Injury

et al. 2020

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Eating disorder (ED) symptoms often co-occur with non-suicidal self-injury (NSSI). This comorbidity is consistent with evidence that trait negative urgency increases risk for both of these phenomena. We previously found that impaired late-stage negative emotional response inhibition (i.e., negative emotional action termination or NEAT) might represent a neurocognitive mechanism for heightened negative urgency among people with NSSI history. The current study evaluated whether relations between negative urgency and ED symptoms similarly reflect deficits in this neurocognitive process. A total of 105 community adults completed an assessment of ED symptoms, negative urgency, and an emotional response inhibition task. Results indicated that, contrary to predictions, negative urgency and NEAT contributed independent variance to the prediction of ED symptoms, while controlling for demographic covariates and NSSI history. Worse NEAT was also uniquely associated with restrictive eating, after accounting for negative urgency. Our findings suggest that difficulty inhibiting ongoing motor responses triggered by negative emotional reactions (i.e., NEAT) may be a shared neurocognitive characteristic of ED symptoms and NSSI. However, negative urgency and NEAT dysfunction capture separate variance in the prediction of ED-related cognitions and behaviors, distinct from the pattern of results we previously observed in NSSI.Brain Sci. 2020, 10, 104 2 of 17 of diverse self-injurious behaviors [12][13][14][15][16] and a putative non-specific marker of general vulnerability for psychopathology [17,18]. Consistent with this notion, the most commonly reported function of NSSI and ED behaviors is to reduce negative affect [19][20][21][22][23][24][25]. Ecological momentary assessment corroborates the idea that direct and indirect self-injury are both motivated by a desire to alleviate unpleasant emotional states, as increased negative affect proximally predicts episodes of NSSI, dysregulated eating, and compensatory behaviors [26][27][28][29][30][31][32].Much like emotion dysregulation, impulsivity is implicated in various psychiatric disorders and self-injurious behaviors. This multifaceted construct encompasses several subfactors, including impulsive personality traits and impulsive behavior, or motor impulsivity. Impulsive behavior can be further divided into impulsive action and impulsive choice, which reflect inhibitory control and decision-making deficits, respectively. Impaired inhibitory control and consequently, impulsive action, are aspects of altered neurocognition broadly involved in suicidal thoughts and behaviors [12]. Impulsive personality traits, especially negative urgency, are also associated with NSSI [11,[33][34][35][36] and dysregulated eating [36][37][38][39][40]. Negative urgency is a transdiagnostic personality characteristic that refers to individual differences in the tendency to act impulsively in response to negative affect [41]. Heightened negative urgency among people who engage in self-injurious behaviors s...

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 93%

Emotional Response Inhibition: A Shared Neurocognitive Deficit in Eating Disorder Symptoms and Nonsuicidal Self-Injury

et al. 2020

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“…Studies using economical momentary assessment (EMA) have shown increased feelings of loneliness, sadness, and feeling overwhelmed before engaging in NSSI [59]. In a systematic review, Hamza and Willoughby [60] found the administration of physical pain to be associated with a decrease in negative affect in all studies.…”

Section: Functions Of Nssimentioning

confidence: 99%

Non-suicidal Self-Injury in Adolescence

Brown

Plener

2017

Curr Psychiatry Rep

327

187

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Purpose of ReviewNon-suicidal self-injury (NSSI) is a common mental health threat among adolescents. This review aims to present the current literature on epidemiology, etiology, and therapeutic approaches with a focus on the period of adolescence.Recent FindingsNSSI is widespread among adolescents both in community as well as in clinical settings with lifetime prevalence rates between 17 and 60% in recent studies. It is influenced by multiple factors including social contagion, interpersonal stressors, neurobiological background, as well as emotional dysregulation and adverse experiences in childhood.SummaryThere is still a lack of studies regarding the psychotherapeutic as well as the psychopharmacological treatment of NSSI in adolescence. Furthermore, sufficient evidence for prevention programs is missing.

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“…Emotion dysregulation has received considerable attention as a risk factor and correlate of NSSI (Hamza & Willoughby, ; Klonsky, ; Klonsky, Glenn, Styler, Olino, & Washburn, ). Several theories posit that emotion dysregulation and emotion deficits lie at the core of NSSI.…”

Section: Emotion Skill Deficits and Nssimentioning

confidence: 99%

Profiles of Emotion Deficits and Adolescent Nonsuicidal Self‐Injury in an Inpatient Sample

Thomassin

Quint

Sezlik

et al. 2017

J of Research on Adolesc

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This study examined profiles of specific emotion deficits, including poor emotion awareness, reluctance to express emotion, sadness inhibition and dysregulation, and anger inhibition and dysregulation. Self-report questionnaires assessed adolescents' emotion skills and nonsuicidal self-injury (NSSI) engagement, frequency, severity, methods, and age of onset. Latent profile analysis yielded a three-profile solution: Low Deficit (LD; n = 49), Unaware/Anger Dysregulated (UAD; n = 24), and Anger Inhibited (AI; n = 20) profiles. Adolescents in the UAD profile were more likely to engage in NSSI, displayed a higher NSSI frequency, and reported a higher number of NSSI methods when compared to adolescents in the LD profile. No links emerged for NSSI severity or age of onset.

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Nonsuicidal Self‐Injury and Affect Regulation: Recent Findings From Experimental and Ecological Momentary Assessment Studies and Future Directions

Abstract: We discuss findings within the context of two central theories (i.e., opponent-process theory and distraction theory) and offer several recommendations for future research in this area.

Cited by 50 publications

References 48 publications

Emotional Response Inhibition: A Shared Neurocognitive Deficit in Eating Disorder Symptoms and Nonsuicidal Self-Injury

Emotional Response Inhibition: A Shared Neurocognitive Deficit in Eating Disorder Symptoms and Nonsuicidal Self-Injury

Non-suicidal Self-Injury in Adolescence

Profiles of Emotion Deficits and Adolescent Nonsuicidal Self‐Injury in an Inpatient Sample

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