Mixture Modeling of Nonsuicidal Self-Injury and Binge Eating: Behaviors and Motives

Nonsuicidal self-injury (NSSI) and binge eating frequently co-occur. These behaviors are often used to alleviate distress. Previous studies examining this co-occurrence have used a variable-centered approach. The current study used a person-centered approach (mixture modeling) to examine how individuals cluster in groups based on their past-month NSSI, past-month objective and subjective binge episodes (OBEs and SBEs, respectively), and endorsement of coping motives for NSSI and eating in two large samples of emerging adults. Validators included self-report measures of emotion regulation, impulsivity, and negative affect. In Study 1, additional validators included lifetime history of mental health treatment and suicide attempts. In Study 2, additional validators included child abuse history. In both Study 1 and Study 2, a three-class solution provided the most interpretable fit with classes characterized as (a) low psychopathology; (b) the presence of OBEs and NSSI, and endorsement of NSSI coping motives; and (c) the presence of SBEs and NSSI, and endorsement of high levels of NSSI coping motives. In both studies, eating motives were equivalent in Classes 2 and 3, but NSSI motives were most strongly endorsed by Class 3. In Study 1, Class 2 endorsed higher rates of lifetime suicide attempts than Class 3. In Study 2, both Class 2 and Class 3 endorsed higher rates of child abuse than Class 1, although they did not differ from each other. The class structure and validator analysis were consistent across samples and measures. Results suggest that binge eating and NSSI tend to cluster together in otherwise healthy emerging adults.     

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.     

Composite Trauma and Mental Health Diagnosis as Predictors of Lifetime Nonsuicidal Self-Injury History in an Adult Online Sample

Some research indicates that trauma history might be related to nonsuicidal self-injury (NSSI), but the exact nature of this relationship is unknown. Therefore, we created and tested a structural equation model for the relationships between composite trauma, NSSI, mental health diagnosis, and gender in a community sample of 296 U.S. adults recruited through Amazon Mechanical Turk. Composite trauma and mental health diagnosis were significantly predictive of an NSSI history. The pathway between NSSI and gender was not significant. It is important to consider multiple domains of trauma, in the form of composite lifetime trauma, as risk factors for NSSI.     

Prospective prediction of nonsuicidal self-injury: a 1-year longitudinal study in young adults

Nonsuicidal self-injury (NSSI) has become a significant public health problem. Although numerous studies have examined cross-sectional psychological correlates of NSSI, there has been little research examining predictors of NSSI over time. The present study examined cross-sectional and longitudinal correlates of NSSI in 81 young adult self-injurers (M age = 19, 74.1% female, 51.9% Caucasian), 51 of whom were followed up 1 year later. At baseline, participants completed self-report measures of NSSI, Axis-I disorders, borderline personality disorder (BPD), and impulsivity, as well as an implicit measure of NSSI attitudes and identity. One year later, participants completed a Timeline Followback Method whereby they indicated their engagement in NSSI over the previous 12 months. Analyses replicated many known cross-sectional correlates of NSSI, including symptoms of several Axis-I disorders and BPD. However, many of these same variables failed to predict the course of NSSI over the 1-year follow-up. The only variables to prospectively predict NSSI were past NSSI (i.e., frequency, methods, and recency of NSSI), participants’ behavioral forecast of their engagement in future NSSI, and BPD features. Findings suggest that many cross-sectional correlates of NSSI may not be useful for predicting subsequent NSSI. Instead, NSSI severity and BPD features appear to best predict continued engagement in NSSI.     

From Zero to Sixty: Calibrating Real-Time Responses

Recent advances in data recording technology have given researchers new ways of collecting on-line and continuous data for analyzing input-output systems. For example, continuous response digital interfaces are increasingly used in psychophysics. The statistical problem related to these input-output systems reduces to linking time-varying covariates to a continuous response variate. Using real-time data obtained from an experiment in psychoacoustics, we showcase new statistical tools that incorporate dynamical elements of an input-output system. We employ functional data analysis (FDA) methods and a simple differential equation to analyze and model the continuous responses. Furthermore, we outline the issues involved in analyzing input-output systems when the exact form of the underlying mathematical model is not known. Finally, we develop a calibration method to facilitate inter-subject and intra-subject comparisons. This work was supported by grants from the National Sciences and Engineering Research Council (NSERC) to J. O. Ramsay and to D. J. Levitin, and by a grant from the Social Sciences and Humanities Research Council (SSHRC) to D. J. Levitin. We would like to thank Bennett Smith for designing and implementing the software used to conduct the pitch tracking experiment. Also, we wish to thank the research assistants in the Levitin Laboratory involved in the data collection: Catherine Chapados, Andrew Schaaf and Carla Himmelman. We would also like to acknowledge Giles Hooker’s work on implementing the generalized profiling software used within this paper.     

Social anxiety and the experience of positive emotion and anger in everyday life: an ecological momentary assessment approach

Abstract

A few recent studies have found evidence showing that social anxiety is associated with diminished positive affect and elevated anger. However, prior work has relied on trait self-report measures of global positive mood or anger. In this preliminary study, we examined how trait social anxiety relates to moment-to-moment positive and angry emotional states as people navigate through their natural environment in a given day. Of additional interest was whether any associations were limited to social situations or were evident more broadly in non-social situations as well. For 14 days, 38 non-clinical community adults carried electronic diaries to assess their experience of positive emotions, anger, and their current social context and activity. Participants were randomly prompted up to four times per day, leading to 1702 observations. Results showed that social anxiety was associated with less time spent feeling happy and relaxed and more time spent feeling angry throughout the day. In general, people felt happier when they were with other people compared to being alone. Interestingly, people with relatively higher levels of social anxiety reported fewer and less intense positive emotions and greater anger episodes across social and non-social situations.     

Examining the effects of perceived social support on momentary mood and symptom reports in asthma and arthritis patients

Objective: Social support has been linked to beneficial effects on health directly (main effect) and as a buffer to stress. Most research, however, has examined these relationships using global and retrospective assessments of health and stress, which may be subject to recall biases. This study used ambulatory ecological momentary assessment (EMA) methods to test the main and stress-buffering effects of social support on the daily health and well-being of asthma and rheumatoid arthritis (RA) patients.

Design: Community volunteers with asthma (n?=?97) or RA (n?=?31) responded to EMA prompts five times daily for one week.

Main outcomes: Baseline perceived social support was obtained, and then, participants reported mood, stress and symptoms using EMA. Multilevel mixed-modelling examined whether social support predicted mood and symptoms directly or via stress-reducing effects.

Results: Supporting a main effect, more perceived social support predicted decreased negative mood and stress severity. Supporting a stress-buffering effect, more perceived social support resulted in fewer reported symptoms when stress was present.

Conclusion: Results suggest perceived social support directly relates to better ambulatory status and dynamically buffers individuals against the negative effects of stressors, and highlight the importance of studying social support across different temporal and contextual levels.     

社会排斥对青少年自伤的影响:羞耻感的中介和认知重评的调节

通过3个行为实验考察了社会排斥对青少年自伤的影响。实验1发现,社会排斥和自伤经历能明显增加青少年的自伤时长(假设1);实验2进一步验证假设1,并验证了羞耻感的中介作用(假设2);实验3验证了认知重评对羞耻感中介效应的调节作用(假设3)。结果表明,社会排斥通过诱发羞耻感影响青少年自伤,但采用认知重评的情绪管理策略能够有效阻断羞耻感的中介作用。本研究为青少年自伤的认知干预提供了有力的实证支持。     

Understanding the utility of emotional approach coping: evidence from a laboratory stressor and daily life

Background: Dispositional emotional approach coping (EAC) marks an adaptive tendency to process and express emotions. EAC's association with cognitions, affect, and intra- and interindividual characteristics that may account for its utility was examined in response to an acute stressor and in daily life. Design: This study included a laboratory stress task and ecological momentary assessment. Methods: Healthy undergraduate students (n = 124; mean age: 20; women: 56%) completed a laboratory component (baseline survey, speech stress task, pre- and posttask measures) and five subsequent days of surveys via palm pilot (six surveys/day). Results: Controlling for sex, neuroticism, and social support, greater EAC was associated with more positive cognitive appraisals, personal resources, and positive affect and less-negative affect during the lab stressor, and with more perceived control and positive affect in daily life. Significant EAC × sex interactions were found for poststressor affect: men with high EAC reported more positive affect and women with high EAC reported less negative affect. Conclusions: Findings provide support that EAC's utility may be independent of intra- and interindividual characteristics, and that men and women may benefit from EAC in different ways in regards to affect. The proclivity to use EAC may come with a resiliency that protects against stress and promotes general well-being.     

Social interactions and physical symptoms in daily life: quality matters for older adults,quantity matters for younger adults

Objective: The present study examined how the different attributes of daily social interactions (quality and quantity) were associated with physical health, and how these associations vary with age.

Method: Using an ecological momentary assessment approach, participants from an adulthood lifespan sample (n = 172; aged 20–79 years) reported their social interactions five times daily, and physical symptoms and symptom severity at the end of each day, for one week.

Main outcome measures: Number of physical symptoms and physical symptom severity.

Results: There was a within-person main effect of the quality (positivity), but not the quantity (frequency), of social interactions on the number of reported physical symptoms and their severity. Moderation analyses further revealed that the quality of daily social interactions predicted fewer physical symptoms for older adults, but not for younger adults; in contrast, the frequency of social interactions predicted less severe physical symptoms for younger adults, but not for older adults. Finally, the reported severity of physical symptoms predicted less frequent but more positive social interactions the next day.

Conclusions: Our findings point to the bidirectional associations between social interactions and health and highlight the importance of considering individuals' developmental context in future research and interventions.     

Idiographic network analysis of discrete mood states prior to treatment

Idiographic network models based on time‐series data have received recent attention for their ability to model relationships among symptoms and behaviours as they unfold in time within a single individual (cf. Epskamp, Borsboom, & Fried, 2018; Fisher, Medaglia, & Jeronimus, 2018). Rather than examine the correlational relationships between variables in a sample of individuals, an idiographic network examines correlations within a single person, averaged over many time points. Because the approach averages over time, the data must be stationary (i.e. relatively consistent over time). If individuals experience varying states over time—different mixtures of symptoms and behaviours in one moment or another—then averaging over categorically different moments may undermine model accuracy. Fisher and Bosley (2019) address these concerns via the application of Gaussian finite mixture modelling to identify latent classes of time points in intraindividual time‐series data from a sample of adults with major depressive disorder and/or generalised anxiety disorder (n = 45). The present paper outlines an extension of this work, wherein network analysis is used to model within‐class covariation of symptoms. To illustrate this approach, network models were constructed for each intraindividual class identified by Fisher and Bosley (137 networks across the 45 participants, mean classes/person = ~3, range = 2–4 classes/person). We examine the relative consistency in symptom organisation between each individual's multiple mood state networks and assess emergent group‐level patterns. We highlight opportunities for enhanced treatment personalisation and review nomothetic patterns relevant to transdiagnostic conceptualisations of psychopathology. We address opportunities for integrating this approach into clinical practice and outline potential shortcomings.     

Prospective and Concurrent Affective Dynamics in Self-Injurious Thoughts and Behaviors: An Examination in Young Adult Women

Affective dynamics, assessed using ecological momentary assessment (EMA), provide a nuanced understanding of within-person fluctuations of negative affect (NA) and positive affect (PA) in daily life. NA and PA dynamics have been associated with psychopathology and response to psychological treatments. NA and PA dynamics have been rarely studied concurrently in association with self-injurious thoughts and behaviors (SITB), transdiagnostic difficulties encountered regularly in clinical and community settings. Here we present EMA data from a large, diverse sample of young adult women with high rates of SITB to examine NA and PA dynamics (mean intensity, variability, and inertia). Specifically, we considered the prospective associations between past-year suicidal thoughts and past-year nonsuicidal self-injury and affective dynamics, as well as the concurrent associations between affective dynamics, EMA-reported suicidal thoughts, and EMA-reported urges for nonsuicidal self-injury. Results demonstrate that elevated mean NA and NA variability are robustly associated with all types of SITB assessed prospectively or concurrently. Interestingly, these associations were weakest for past-year nonsuicidal self-injurious behaviors, relative to past-year and concurrent suicidal or nonsuicidal self-injurious thoughts. Past-year suicidal thoughts further predicted increased NA inertia. Decreased PA inertia was associated with past-year nonsuicidal self-injury behavior, as well as concurrent EMA suicidal thoughts. We found no associations (prospective or concurrent) between SITB and mean PA intensity or PA variability. These results highlight the importance of understanding affective processes to develop real-world interventions to prevent nonsuicidal self-injury and suicidal behavior in daily life.     

Measurement of Deliberate Self-Harm: Preliminary Data on the Deliberate Self-Harm Inventory

Deliberate self-harm has recently begun to receive more systematic attention from clinical researchers. However, there remains a general lack of consensus as to how to define and measure this important clinical construct. There is still no standardized, empirically validated measure of deliberate self-harm, making it more difficult for research in this area to advance. The present paper provides an integrative, conceptual definition of deliberate self-harm as well as preliminary psychometric data on a newly developed measure of self-harm, the Deliberate Self-Harm Inventory (DSHI). One hundred and fifty participants from undergraduate psychology courses completed research packets consisting of the DSHI and other measures, and 93 of these participants completed the DSHI again after an interval of 2–4 weeks (M = 3.3 weeks). Preliminary findings indicate that the DSHI has high internal consistency; adequate construct, convergent, and discriminant validity; and adequate test-retest reliability.     

Affect and between-meal snacking in daily life: the moderating role of gender and age

Objective: Affect-related energy intake from snacks remains relatively unexplored in daily life. This study examines the associations between momentary positive affect (PA) and momentary negative affect (NA) and subsequent energy intake from snacks. In addition, the moderating role of BMI, gender, age and level of education is investigated.

Design: Adults (N = 269), aged 20–50, participated in this study. Demographics were assessed in an online composite questionnaire. An experience sampling smartphone application was used to map momentary NA/PA and energy intake (kilocalories) from snacks in the context of daily life.

Main outcome measures: Energy intake from moment-to-moment self-reported snacks in real-life settings.

Results: A significant negative main effect of momentary NA on moment-to-moment energy intake was found. The higher the momentary NA, the lower the subsequent amount of kilocalories consumed. There was no main effect with regard to PA. Interaction analyses showed that men decreased their energy intake after experiencing NA, and increased their intake after experiencing PA. No associations were found in women. Additionally, young adults (20–30) increased their energy intake after experiencing PA. No associations were found in the other age groups.

Conclusion: Interventions aiming at reducing energy intake might also address PA-related snacking in young adults and men.     

Effects of photoaging information and UV photo on sun protection intentions and behaviours: A cross-regional comparison

The physical environment is thought to influence walking; however, daily variations in perceived environment have received little attention. The current study sought to examine if key within-person factors (i.e., implementation intentions, social support, affect and self-efficacy) would be associated with walking and if perceived access to supportive environments (e.g., access to nice walking paths) and perceived environmental barriers (e.g., bad weather and safety issues) were uniquely associated with walking after controlling for other constructs. Participants (N?=?14, 50.0% men, 78.6% White, M age?=?59.4?±?6.4) were in the intervention arm of an 8-week controlled trial promoting walking via personal digital assistants. Participants completed electronic surveys twice a day (total entries?=?804) in which they reported brisk walking levels and psychosocial and environmental factors. Multilevel modelling was used to examine within-person variations in constructs as determinants of walking. Results suggested that daily variations in implementation intentions, social support and positive affect were positively associated with walking. Further, perceived access to supportive environments, though not perceived environmental barriers, was positively associated with walking after controlling for other constructs (p?<?0.05). Future research should explore intervention components that target context-specific information about perceived access to supportive environments as part of a broader perspective on intervention development.     

基因-脑-行为视角下的自伤行为产生机制

自伤是遗传与环境共同作用的结果。目前对于自伤行为的探讨已深入到基因及神经系统层面，基因-脑-行为的综合视角为客观揭示自伤产生机制提供了一条有效途径。本文将在已有研究的基础上，结合分子遗传学和神经生物学的最新成果，对自伤候选基因多态性及其可能的脑机制进行系统阐述，并提出今后应在基因多态性的交互作用及其脑机制、积极环境下自伤行为研究、自伤青少年的追踪研究以及自伤行为的系统性探讨等方面进一步深化。