Cognitive and Emotion‐Regulatory Mediators of the Relationship Between Behavioral Approach System Sensitivity and Nonsuicidal Self‐Injury Frequency

Nonsuicidal self‐injury (NSSI) is highly prevalent among late adolescents and predicts the onset of suicidal ideation and behavior. Although research has established an association between the behavioral approach system (BAS) and NSSI, less research has explored mechanisms underlying this relationship. The authors examined negative and positive emotion regulation patterns, as well as the BAS‐relevant cognitive style of self‐criticism, as potential mechanisms through which a hypersensitive BAS might be related to NSSI frequency. Late adolescents (N = 177) with high and moderate BAS levels completed measures of self‐criticism, positive emotion regulation, brooding, and both lifetime and last‐year frequency of NSSI. Results indicated that self‐criticism and positive emotion dampening independently mediated the relationship between BAS and last‐year frequency of NSSI. Self‐criticism also mediated the relationship between BAS and lifetime frequency of NSSI. Results suggest that cognitive and emotion‐regulatory styles may help to explain why high BAS individuals are likely to engage in NSSI.     

An Ecological Investigation of the Emotional Context Surrounding Nonsuicidal Self‐Injurious Thoughts and Behaviors in Adolescents and Young Adults

Ecological momentary assessment (EMA ) methodology was used to examine the emotional context of nonsuicidal self‐injury (NSSI). Forty‐seven adolescents and young adults used a novel smartphone app to monitor their emotional experiences, NSSI thoughts, and NSSI behaviors for 2 weeks. Momentary changes in both negative and positive emotions predicted greater intensity of NSSI thoughts at the subsequent assessment, while only increases in negative emotion predicted NSSI behaviors. Immediately following NSSI behaviors participants reported reduced high‐arousal negative emotions and increased low‐arousal positive emotions, suggesting that NSSI may be an efficient and effective method of regulating emotion. Findings highlight the importance of addressing emotion regulation in NSSI interventions.     

The Incremental Utility of Emotion Regulation But Not Emotion Reactivity in Nonsuicidal Self‐Injury

This study assessed the incremental utility of emotion reactivity and emotion regulation in relation to nonsuicidal self‐injury (NSSI). Participants included 379 college students aged 18–22 who completed self‐report measures of emotion regulation, emotion reactivity, and NSSI. Emotion regulation was significantly related to NSSI both ignoring and controlling for reactivity, but the reverse was not true. Participants' use of NSSI for affect regulation appeared to moderate this relation. Findings support emotion regulation deficits as a target for intervention over and above heightened emotion reactivity, especially in those who use NSSI to regulate negative affect.     

Body Regard as a Moderator of the Relation between Emotion Dysregulation and Nonsuicidal Self‐Injury

Despite research documenting a strong association between emotion dysregulation and nonsuicidal self‐injury (NSSI), the moderators of this association have received little attention. Thus, it remains unclear why some individuals with heightened emotion dysregulation engage in NSSI and others do not. Body regard (i.e., how one perceives, experiences, and cares for the body) may be one such moderator, explaining the risk for NSSI among some individuals with emotion dysregulation. The current study used structural equation modeling within a sample of 398 undergraduates (26% reporting NSSI, mean frequency = 25.16, SD = 40.5) to test the interactive effect of emotion dysregulation and body regard on NSSI frequency when controlling for negative affect and borderline personality disorder symptoms. The interaction model provided a strong fit to the data and showed that emotion regulation was associated with NSSI only when low levels of body regard were present. Results suggest that body regard may be important to understanding who engages in NSSI within the context of emotion dysregulation. Possible mechanisms underlying the interaction between body regard and emotion dysregulation are discussed along with treatment and prevention implications.     

Emotional states preceding and following acts of non-suicidal self-injury in bulimia nervosa patients

Bulimia nervosa and non-suicidal self-injury (NSSI) co-occur at high rates, and both have been conceptualized as maladaptive emotion regulation strategies. Treatments focusing on emotion regulation have been designed for both problem behaviors, yet, there exists very little research examining the temporal emotional states surrounding acts of NSSI. Using ecological momentary assessment (EMA) methodology, the current study examined the temporal association between positive and negative emotional states prior to and consequent to acts of NSSI within a subset of bulimia nervosa patients. Results indicate significant increases in negative affect, and decreases in positive affect, prior to an NSSI act. Post-NSSI, positive affect significantly increased while negative affect remained unchanged. The findings offer partial support for an emotion regulation paradigm to understanding NSSI within bulimic populations and implications for treatment are discussed.     

Emotion Differentiation as a Protective Factor Against Nonsuicidal Self-Injury in Borderline Personality Disorder

Evidence that nonsuicidal self-injury (NSSI) serves a maladaptive emotion regulation function in borderline personality disorder (BPD) has drawn attention to processes that may increase risk for NSSI by exacerbating negative emotion, such as rumination. However, more adaptive forms of emotion processing, including differentiating broad emotional experiences into nuanced emotion categories, might serve as a protective factor against NSSI. Using an experience-sampling diary, the present study tested whether differentiation of negative emotion was associated with lower frequency of NSSI acts and urges in 38 individuals with BPD who reported histories of NSSI. Participants completed a dispositional measure of rumination and a 21-day experience-sampling diary, which yielded an index of negative emotion differentiation and frequency of NSSI acts and urges. A significant rumination by negative emotion differentiation interaction revealed that rumination predicted higher rates of NSSI acts and urges in participants with difficulty differentiating their negative emotions. The results extend research on emotion differentiation into the clinical literature and provide empirical support for clinical theories that suggest emotion identification and labeling underlie strategies for adaptive self-regulation and decreased NSSI risk in BPD.     

Predicting Persistence of Nonsuicidal Self‐Injury in Suicidal Adolescents

Prospective predictors of persistent nonsuicidal self‐injury (NSSI) were examined in adolescents admitted to an inpatient psychiatric unit for suicidal behaviors and followed naturalistically for 6 months. Seventy‐one (77%) participants reported NSSI at baseline, and 40 (56%) persisted at the 6 month follow‐up. Those who endorsed automatic positive reinforcement (APR) as the predominant reason for NSSI were more likely to persist in NSSI. Depression over follow‐up, but not at baseline, also predicted persistence. These results suggest that helping high‐risk adolescents to identify alternative ways of generating emotion(s) to counter the effects of APR that may accompany NSSI should be a high priority treatment target.     

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.     

Emotion regulation in depression: Examining the role of cognitive processes

Sustained negative affect is a hallmark feature of depressive episodes. The ability to regulate emotional responses to negative events may therefore play a critical role in our understanding of this debilitating disorder. Individual differences in cognitive processes such as attention, memory, and interpretation may underlie difficulties in emotion regulation and numerous studies have identified cognitive biases and deficits that characterise depressed people. Few studies, however, have explicitly linked these biases to the difficulties in emotion regulation that are associated with depression. In this paper we discuss relations among cognitive processes and emotion regulation and review the depression literature to identify cognitive biases and deficits that may underlie maladaptive responses to negative events and mood states. Our review suggests that difficulties in the disengagement from negative material, memory biases, and deficits in cognitive control are frequently observed in depressive disorders and may be associated with the use of maladaptive emotion regulation strategies, such as rumination. These biases may also be related to difficulties implementing strategies that are effective for non-depressed people, such as recall of mood-incongruent material and reappraisal. Our review also suggests, however, that empirical studies linking cognitive biases and emotion regulation in depression are still largely missing and would present an important goal for future research in this area.     

Interpersonal Features and Functions of Nonsuicidal Self‐injury

Etiological models of nonsuicidal self‐injury (NSSI) suggest interpersonal features may be important to understand this behavior, but social functions and correlates have not been extensively studied. This study addresses existing limitations by examining interpersonal correlates and functions of NSSI within a stratified random sample of 1,243 predominantly Caucasian college students (mean age = 21.52, SD = 4.15 years). Participants completed an anonymous online survey assessing NSSI features, perceived social support, and disclosure experiences. Approximately 15% of the students endorsed NSSI. Interpersonal reasons were endorsed proportionally more often for initiating rather than repeating the behavior. Individuals with repetitive NSSI reported significantly lower perceived social support from family members and fewer individuals to seek advice from than single‐act and control participants. Fifty‐nine percent had disclosed their NSSI, but rarely to mental health professionals. Conversations with others about NSSI were rated as being mostly unhelpful. These results emphasize the importance of interpersonal features and functions of NSSI, suggesting treatments should focus on strengthening interpersonal bonds alongside emotion regulation. Improving responses to disclosures of NSSI is needed to promote communication about this behavior and perceived helpfulness of such conversations.     

情绪调节对消极元刻板印象激活的认知效应的影响

以101名中职生为被试,采用不同难度的工作记忆任务,探讨认知重评与表达抑制两种情绪调节策略对消极元刻板印象激活的认知效应的影响。结果发现:(1)情绪调节策略对元刻板印象激活的认知效应具有影响,且与认知任务的难度有关;(2)在低难度工作记忆任务中,情绪调节策略对元刻板印象激活的认知效应没有影响,在中等难度任务中,认知重评减弱了激活的认知效应,但表达抑制没有影响,在高难度任务中,认知重评没有影响,表达抑制反而增强了激活的认知效应。总之,不同情绪调节策略会对消极元刻板印象激活的认知效应产生不同的作用。     

Nonsuicidal Self‐Injury in College Students: The Role of Perfectionism and Rumination

A paucity of research exists examining personality and cognitive characteristics that may contribute to nonsuicidal self‐injury (NSSI). The purpose of the current study was to clarify the contribution of perfectionism and rumination, along with depression and anxiety, to NSSI within a sample of 170 college students. Group comparisons revealed that participants with a history of NSSI endorsed significantly more rumination and depressive and anxious symptoms then non‐NSSI controls. Results regarding perfectionism were mixed, with NSSI participants differing from controls on select aspects of perfectionism. Results suggest higher levels of depression and anxiety and a ruminative cognitive style may increase vulnerability for NSSI; however, further research is needed to clarify the contribution of perfectionism.     

Similarities and Differences in the Functions of Nonsuicidal Self‐Injury (NSSI) and Sex as Self‐Injury (SASI)

Differences and similarities were studied in the functions of two different self‐injurious behaviors (SIB): nonsuicidal self‐injury (NSSI) and sex as self‐injury (SASI). Based on type of SIB reported, adolescents were classified in one of three groups: NSSI only (n = 910), SASI only (n = 41), and both NSSI and SASI (n = 76). There was support for functional equivalence in the two forms of SIB, with automatic functions being most commonly endorsed in all three groups. There were also functional differences, with adolescents in the SASI only group reporting more social influence functions than those with NSSI only. Adolescents reporting both NSSI and SASI endorsed the highest number of functions for both behaviors. Clinical implications are discussed, emphasizing the need for emotion regulation skills.     

Physical Activity,Exercise Motivations,Depression, and Nonsuicidal Self‐Injury in Youth

This study explored the relationship between physical activity, depression, and nonsuicidal self‐injury (NSSI) in 167 high school and undergraduate students (mean age = 17.37, range 14–25). Results indicated that NSSI frequency had a significant negative relationship with physical activity, and physical activity moderated the relationship between depressive symptoms and self‐harm. Specifically, high levels of depressive symptoms and low levels of physical activity had the greatest frequency of NSSI. Lastly, appearance‐based exercise motivations were significantly related to increased frequencies of NSSI. Overall, physical activity may possess a protective nature against NSSI, especially in individuals with depressive symptoms.     

A cognitive-emotional model of NSSI: using emotion regulation and cognitive processes to explain why people self-injure

Non-suicidal self-injury (NSSI) is a complex behaviour, routinely engaged for emotion regulatory purposes. As such, a number of theoretical accounts regarding the aetiology and maintenance of NSSI are grounded in models of emotion regulation; the role that cognition plays in the behaviour is less well known. In this paper, we summarise four models of emotion regulation that have repeatedly been related to NSSI and identify the core components across them. We then draw on social cognitive theory to unite models of cognition and models of emotion in developing a new cognitive-emotional model of NSSI. Our model articulates how emotion regulation and cognition can work in concert to govern NSSI, and offers several new research questions that can be addressed within this framework.     

The Relationship Between Nonsuicidal Self‐Injury Age of Onset and Severity of Self‐Harm

This study examined how age of nonsuicidal self‐injury (NSSI ) onset relates to NSSI severity and suicidality using decision tree analyses (nonparametric regression models that recursively partition predictor variables to create groupings). Those with an earlier age of NSSI onset reported greater NSSI frequency, NSSI methods, and NSSI ‐related hospital visits. No significant splits were found for suicide ideation or attempts, although those with an earlier onset were more likely to have a suicide plan. Overall, findings suggest that onset of NSSI before age 12 is associated with more severe NSSI and may be a crucial age for prevention efforts.     

An Examination of Disclosure of Nonsuicidal Self‐injury among University Students

Despite the widespread prevalence of nonsuicidal self‐injury (NSSI) among community‐based samples, little is known about which self‐injurers disclose their NSSI or the factors that promote disclosure among self‐injurers. To address this gap in the literature, we examined whether disclosers could be differentiated from nondisclosers on the basis of NSSI characteristics (e.g. frequency of NSSI and severity of NSSI), NSSI motivations (e.g. interpersonal and intrapersonal motivations) and psychosocial factors (e.g. suicidal ideation and self‐esteem). Participants consisted of a large sample of 268 self‐injuring undergraduate students (M_age = 19.07 years, 70.3% women) at a Canadian university. Results indicated that 57% of self‐injurers had never disclosed their NSSI to anyone. Self‐injurers were most likely to disclose to peers and romantic partners. Logistic regression analyses revealed that pain during NSSI, severity of NSSI, interpersonal motivations for engaging in NSSI, higher suicidal ideation and higher friendship quality were all associated with a greater likelihood of NSSI disclosure. Our findings suggest that individuals with severe NSSI and suicidal ideation may be more likely to disclose. Moreover, our findings underscore the importance of equipping friends and romantic partners with effective responses to NSSI disclosures to promote more formal help‐seeking behaviours among self‐injurers. Copyright © 2014 John Wiley & Sons, Ltd.     

心理虐待对儿童认知情绪调节策略的影响：人格特质的中介作用

采用儿童认知情绪调节问卷、儿童版艾森克人格问卷、儿童心理虐待量表对405名8～12岁儿童进行研究,考察人格特质在心理虐待对认知情绪调节策略关系中的中介作用。结果发现：(1)儿童心理虐待与不适应性认知情绪调节策略呈显著正相关;儿童神经质与不适应性认知情绪调节策略呈显著正相关儿童内外倾与适应性认知情绪调节策略呈显著正相关(2)儿童神经质在心理虐待与儿童不适应性认知情绪调节策略关系间起到完全中介作用（3）该中介模型具有性别和年龄的测量等值性。研究结果显示,儿童心理虐待可以通过神经质的中介作用影响不适应性认知情绪调节策略。     

累积环境风险与大学生自伤的关系:情绪调节策略的作用

通过两个子研究分别考察累积环境风险与大学生自伤行为间的关系模式,并探讨注意分散与认知重评两种情绪调节策略对高风险大学生自伤意图的缓解作用。研究1在1066名大学生中采用问卷调查,探索累积环境风险对大学生自伤行为的作用及模式。基于研究1的结果,研究2选取符合高风险背景的62名大学生为被试,采用实验室实验对两种情绪调节策略的作用予以考察。本研究结果表明：累积环境风险对男女大学生自伤行为均有显著的正向作用,且均符合非线性“正加速模式”,但男生群体随累积风险数量增加而引发的自伤行为增长速度明显快于女生。对于高环境风险背景下的大学生,注意分散和认知重评两种策略均能降低其自伤倾向性与自伤认同,但不能降低其自伤意念。这提示应重视对经历了高环境风险的大学生进行情绪调节策略等方面的干预,以减少其采取自伤行为的倾向性。     

Social anxiety and emotion regulation in daily life: spillover effects on positive and negative social events

To minimize the possibility of scrutiny, people with social anxiety difficulties exert great effort to manage their emotions, particularly during social interactions. We examined how the use of two emotion regulation strategies, emotion suppression and cognitive reappraisal, predict the generation of emotions and social events in daily life. Over 14 consecutive days, 89 participants completed daily diary entries on emotions, positive and negative social events, and their regulation of emotions. Using multilevel modeling, we found that when people high in social anxiety relied more on positive emotion suppression, they reported fewer positive social events and less positive emotion on the subsequent day. In contrast, people low in social anxiety reported fewer negative social events on days subsequent to using cognitive reappraisal to reduce distress; the use of cognitive reappraisal did not influence the daily lives of people high in social anxiety. Our findings support theories of emotion regulation difficulties associated with social anxiety. In particular, for people high in social anxiety, maladaptive strategy use contributed to diminished reward responsiveness.