Prevalence of Nonsuicidal Self‐Injury in Nonclinical Samples: Systematic Review,Meta‐Analysis and Meta‐Regression

Published prevalence estimates of nonsuicidal self‐injury (NSSI) among nonclinical samples are highly heterogeneous, raising concerns about their reliability and hindering attempts to explore the alleged increase in NSSI over time. Accordingly, the objectives of this study were to investigate the influence of methodological factors on heterogeneity in NSSI prevalence estimates, explore changes over time, and estimate overall international NSSI prevalence. Results showed that methodological factors contributed over half (51.6%) of the heterogeneity in prevalence estimates, and, after adjusting for these factors, NSSI prevalence did not increase over time. Overall, pooled NSSI prevalence was 17.2% among adolescents, 13.4% among young adults, and 5.5% among adults. Clearly, development of standardized methodology in NSSI research is crucial if accurate estimates are desired.     

Self‐Criticism as a Transdiagnostic Process in Nonsuicidal Self‐Injury and Disordered Eating: Systematic Review and Meta‐Analysis

Nonsuicidal self‐injury (NSSI) and disordered eating (DE) are highly comorbid and may be regarded as belonging to a spectrum of self‐harm behaviors. We investigated self‐criticism as a transdiagnostic correlate of these behaviors, in keeping with etiological theories of both NSSI and DE. We reviewed the literature and meta‐analyzed the relation of self‐criticism to both NSSI (15 studies; 17 effect sizes) and DE (24 studies; 29 effect sizes). Results showed equivalent, moderate‐to‐large effects for the relation of self‐criticism to NSSI (r = .38; CI: .29–.46) and DE (r = .40; CI: .34–.45). The relation of NSSI to self‐criticism generalized across multiple potential moderators. DE behavior type moderated the relation of self‐criticism to DE, with a stronger relation emerging for purging than restriction. Findings support self‐criticism as a possible candidate for transdiagnostic pathways to self‐harm.     

Motivations for Self‐Injury,Affect, and Impulsivity: A Comparison of Individuals with Current Self‐Injury to Individuals with a History of Self‐Injury

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.     

Nonsuicidal Self‐Injury,Stress, and Self‐Differentiation

The authors surveyed 458 young adults and examined the relationships among stress, self‐differentiation, and nonsuicidal self‐injury (NSSI). They conducted multiple regression analyses to explore whether characteristics of self‐differentiation (i.e., emotional reactivity and “I position”) were related to NSSI after controlling for the effects of stress, as well as whether emotional reactivity and I position served as mediators in the stress–NSSI relationship. I position and emotional reactivity both contributed statistically significant variance to NSSI after accounting for stress. Moreover, both I position and emotional reactivity served as partial mediators in the stress–NSSI relationship. The authors discuss counseling and research implications.     

The Role of Self‐identity in the Theory of Planned Behavior: A Meta‐Analysis

The present study used meta‐analysis to evaluate the role of self‐identity in the theory of planned behavior (TPB). Altogether, 40 independent tests (N = 11607) could be included in the review. A large, sample‐weighted average correlation between self‐identity and behavioral intention was observed (r₊ = .47). Multiple regression analyses showed that self‐identity explained an increment of 6% of the variance in intention after controlling for the TPB components, and explained an increment of 9% of the variance when past behavior and the TPB components were controlled. The influence of self‐identity on behavior was largely mediated by the strength of behavioral intentions. Theoretical implications of the findings are discussed.     

The Association between Attachment Styles and Physical Intimate Partner Violence Perpetration and Victimization: A Meta‐Analysis

In this meta‐analysis, we examine attachment styles—something commonly incorporated into couples therapy—and their association with physical intimate partner violence (IPV) perpetration and victimization among men and women. This meta‐analysis incorporated 33 studies that looked at the association between four different attachment styles and IPV. This study examined the strength of the correlation among different attachment styles and IPV perpetration and victimization, examined gender differences in the strength of the association among attachment styles and IPV, and compared the strength of the association with IPV among different attachment styles. We found that anxious attachment, avoidant attachment, and disorganized attachment styles were all significantly associated with physical IPV perpetration and victimization. Secure attachment was significantly negatively related to IPV perpetration and victimization. There was a significantly stronger association between avoidant attachment and IPV victimization for women compared to men. Clinical implications related to the importance of fostering secure attachments when working with couples or individuals who have experienced IPV are addressed.     

Dating Violence Victimization,Dispositional Aggression,and Nonsuicidal Self‐Injury among Psychiatrically Hospitalized Male and Female Adolescents

The objective of the current study was to characterize the association between dating violence victimization and dispositional aggression in predicting nonsuicidal self‐injury (NSSI) among psychiatrically hospitalized male and female adolescents. One hundred fifty‐five adolescents (ages 13–17) and their parents completed the Schedule for Affective Disorders and Schizophrenia for School‐Age Children clinical interview to assess NSSI and child abuse; adolescents completed self‐report measures of aggression and dating violence victimization (verbal, physical, and sexual). Dating violence victimization and NSSI were found to be highly prevalent among both males and females in this psychiatric inpatient sample. Two moderational models were supported, wherein dating violence was associated with NSSI in the context of elevated trait anger in males and indirect aggression in females. Findings suggest that helping victims of dating violence acquire skills to address certain forms of dispositional aggression may attenuate NSSI.     

The Social Goals of Excuses: Self‐Serving Attributions or Politeness Strategies1

Participants provided examples of explanations given as excuses, or withheld in favor of a false excuse, both for failing to keep a social contract and for rejecting a social invitation. Results show that the likelihood of an explanation being given in social‐contract situations was best predicted by intentionality and controllability; while in social‐rejection situations, the most important factor was to avoid personal reasons (related to the recipient). Excuse‐givers were even willing to blame themselves to do this. These results are discussed in terms of the need to extend attributional categories beyond traditional self‐serving functions to include social goals. such as the recipient saving face, to provide an adequate account of how excuse‐making varies across different types of social predicaments.     

Accuracy of Clinician Predictions of Future Self‐Harm: A Systematic Review and Meta‐Analysis of Predictive Studies

Assessment of a patient after hospital‐treated self‐harm or psychiatric hospitalization often includes a risk assessment, resulting in a classification of high risk versus low risk for a future episode of self‐harm. Through systematic review and a series of meta‐analyses looking at unassisted clinician risk classification (eight studies; N = 22,499), we found pooled estimates for sensitivity 0.31 (95% CI: 0.18–0.50), specificity 0.85 (0.75–0.92), positive predictive value 0.22 (0.21–0.23), and negative predictive value 0.89 (0.86–0.92). Clinician classification was too inaccurate to be clinically useful. After‐care should therefore be allocated on the basis of a needs rather than risk assessment.     

Sexual Victimization History and Perceived Similarity to a Sexual Assault Victim: A Path Model of Perceiver Variables Predicting Victim Culpability Attributions

Extant research consistently has shown that culpability attributions toward sexual assault victims are predicted by perceiver gender, perceived similarity to victims, empathy for victims, and rape myth acceptance. The purpose of the present study was to conceptually organize these predictors, which often have been treated disparately in literature. The present sample was composed of 69 female undergraduate students, recruited from a psychology research pool at a university in the southwestern United States. Results of a path analysis demonstrated strong empirical support for a hypothesized causal model linking perceivers?? sexual victimization histories and, in turn, perceptions of similarity to a sexual assault victim based upon these histories, to established predictors of perceivers?? culpability attributions toward sexual assault victims. Basic and applied research implications are discussed.     

Victimization and Exposure to Pro‐Self‐Harm and Pro‐Suicide Websites: A Cross‐National Study

The study of websites displaying methods of both physical self‐harm and suicide has become an important aspect of deliberate self‐injury and suicide research. However, little is known about contextual factors related to entering such sites. Using data from 3,567 respondents aged 15–30 in the US, UK, Germany, and Finland, we found that experiences of victimization are associated with entering pro‐self‐harm sites and pro‐suicide sites. Also, the victimization context had relevance, as online victimization was particularly related to pro‐self‐harm behavior. The findings suggest a need to organize more specific online support for the victims of violence and online aggression.     

The Longevity Effects of Religious and Nonreligious Participation: A Meta‐Analysis and Meta‐Regression

Scholars have long argued that the reduced mortality risk associated with frequent participation in religious services derives from two sources: social participation and religious belief efficacy. In contrast, the reduced mortality risk associated with participation in nonreligious groups is thought to derive solely from the social participation component. This study tests the religious efficacy hypothesis by comparing the effects of religious participation with nonreligious participation using meta‐analyses of 312 mortality risk estimates from 74 publications (providing data on more than 300,000 persons). We found no significant difference between the mean hazard ratio (HR) for low religious participation (HR, 1.32; 95% CI, 1.24–1.41) and the mean HR for low nonreligious participation (HR, 1.25; 95% CI, 1.17–1.33). These findings suggest that the positive health effects of religious participation may largely be attributed to the social participation component, rather than to the religious component of the act.     

Pornography Consumption and Satisfaction: A Meta‐Analysis

A classic question in the communication literature is whether pornography consumption affects consumers' satisfaction. The present paper represents the first attempt to address this question via meta‐analysis. Fifty studies collectively including more than 50,000 participants from 10 countries were located across the interpersonal domains of sexual and relational satisfaction and the intrapersonal domains of body and self satisfaction. Pornography consumption was not related to the intrapersonal satisfaction outcomes that were studied. However, pornography consumption was associated with lower interpersonal satisfaction outcomes in cross‐sectional surveys, longitudinal surveys, and experiments. Associations between pornography consumption and reduced interpersonal satisfaction outcomes were not moderated by their year of release or their publication status. But analyses by sex indicted significant results for men only.     

In Sync and in Control: A Meta‐Analysis of Parent–Child Positive Behavioral Synchrony and Youth Self‐Regulation

A growing body of research has highlighted the connection between parent–child positive behavioral synchrony and youth self‐regulation; however, this association has yet to be the focus of a meta‐analytic review. Therefore, the present meta‐analysis aimed to estimate the magnitude of the relation between parent–child positive behavioral synchrony and youth self‐regulation and to identify moderator variables that can explain the variability in the degree of this association across the extant literature. A thorough literature search of two major databases, in addition to scanning the reference sections of relevant articles, yielded a total of 10 peer‐reviewed articles (24 effect sizes, 658 children) that were eligible for inclusion in the current meta‐analysis. Results from the overall mean effect size calculation using a random‐effects model indicated that parent–child positive behavioral synchrony was significantly, positively correlated with youth self‐regulation and the effect size was medium. Children's ages at the time of synchrony and self‐regulation measurements, as well as parent gender, served as significant moderator variables. Findings from the present meta‐analysis can help to refine existing theoretical models on the role of the parent–child relationship in youth adjustment. Prevention and intervention efforts may benefit from an increased emphasis on building parent–child positive behavioral synchrony to promote youth self‐regulation and thus children's overall well‐being.     

Counseling and Guided Self‐Help Outcomes for Clients With Bulimia Nervosa: A Meta‐Analysis of Clinical Trials From 1980 to 2010

This meta‐analysis included 111 clinical trials exploring the effectiveness of counseling/psychotherapy and guided self‐help approaches in the treatment of bulimia nervosa. In general, single‐group studies supported higher efficacy of counseling/psychotherapy, whereas wait‐list, treatment‐as‐usual, and placebo studies indicated both approaches were equally effective at termination (posttest) and follow‐up in altering binging, purging, laxative use, and self‐reported bulimia or body dissatisfaction perceptions in nearly all comparisons.     

Reflective Self‐Control in Self‐Control Scholarship: A Peircean Analysis

Vosgerau, Scopelliti, and Huh (this issue) present an important critique of much self‐control research, highlighting some of the ways that our customary operationalizations and methods may have created more confusion than clarity. Their insights, rooted in past literature and new data, offer recommendations that will undoubtedly help us improve our research in consumption self‐control. In this commentary, I frame their work using the thought of Charles Sanders Peirce, a philosopher, mathematician, and logician whose frustration with the management of the self‐control construct and subsequent revision parallels Vosgerau et al's in many ways. Further, his thought proposes that their thought traces the boundary of another type of self‐control problem, which I'll refer to as “reflective self‐control.” Taking together consumption self‐control and reflective self‐control, we're able to address a wide range of human experiences and connect self‐control to ethics, consistent with a long tradition bridging the two. Perhaps most importantly, though, a Peircean analysis suggests that Vosgerau et al's paper—whether we agree or disagree with its conclusions—exemplifies the kind of scholarly self‐control we need to display to make scientific progress, regardless of our specific domain of study.     

Masculine Ideology,Sexual Communication,and Sexual Self‐Efficacy Among Parenting Adolescent Couples

This study examined the relationship between traditional masculine role norms (status, toughness, anti‐femininity) and psychosocial mechanisms of sexual risk (sexual communication, sexual self‐efficacy) among young, low‐income, and minority parenting couples. Between 2007 and 2011, 296 pregnant adolescent females and their male partners were recruited from urban obstetrics clinics in Connecticut. Data regarding participants' beliefs in masculine role norms, frequency of general sex communication and sexual risk communication, and sexual self‐efficacy were collected via computer‐assisted self‐interviews. Generalized estimating equation (GEE) models were used to test for actor effects (whether a person's masculine role norms at baseline influence the person's own psychosocial variables at 6‐month follow‐up) and partner effects (whether a partner's masculine role norms at baseline influence an actor's psychosocial variables at 6‐month follow‐up). Results revealed that higher actor status norms were significantly associated with more sexual self‐efficacy, higher actor toughness norms were associated with less sexual self‐efficacy, and higher actor anti‐femininity norms were significantly associated with less general sex communication, sexual risk communication, and sexual self‐efficacy. No partner effects were found. These results indicate a need for redefining masculine role norms through family centered approaches in pregnant or parenting adolescent couples to increase sexual communication and sexual self‐efficacy. Further research is needed to understand partner effects in the context of a relationship and on subsequent sexual risk behavior.     

Intervention Studies on Forgiveness: A Meta‐Analysis

In this meta‐analysis, 9 published studies (N = 330) that investigated the efficacy of forgiveness interventions within counseling were examined. After a review of theories of forgiveness, it was discovered that the studies could logically be grouped into 3 categories: decision‐based, process‐based group, and process‐based individual interventions. When compared with control groups, for measures of forgiveness and other emotional health measures, the decision‐based interventions showed no effect, the process‐based group interventions showed significant effects, and the process‐based individual interventions showed large effects. Consequently, effectiveness has been shown for use of forgiveness in clinical and other settings.