Solving the puzzle of deliberate self-harm: the experiential avoidance model

Despite increasing attention to the phenomenon of deliberate self-harm (DSH), the literature currently lacks a unifying, evidence-based, theoretical framework within which to understand the factors that control this behavior. The purpose of the present paper is to outline such a framework-the Experiential Avoidance Model (EAM) of DSH. The EAM poses that DSH is primarily maintained by negative reinforcement in the form of escape from, or avoidance of, unwanted emotional experiences. Literature on factors that may lead to experiential avoidance is reviewed, along with the mounting empirical evidence that DSH functions to help the individual escape from unwanted emotional experiences. The EAM integrates a variety of research on emotions, experiential avoidance, and DSH within a clinically useful framework that sparks novel research directions.     

Peer influence and adolescent nonsuicidal self-injury: A theoretical review of mechanisms and moderators

Nonsuicidal self-injury (NSSI) is an increasingly prevalent health risk behavior among adolescents and represents a significant public health concern. Although researchers have identified numerous antecedents or risk factors that precede engagement in NSSI behaviors, few studies have examined the role of peer influence processes. Yet, recent research suggests that adolescents may be more likely to engage in NSSI when close friends or other peers engage in similar behaviors. The following paper reviews past research on peer influence effects, including potential mechanisms and moderating variables. Methodological considerations for future research on peer influence and NSSI are discussed.     

Predicting depression, anxiety and self-harm in adolescents: The role of perfectionism and acute life stress

Despite the growing evidence that perfectionism is associated with adolescent psychological distress, few studies have investigated this relationship prospectively with measures designed for use in adolescent populations. In the present study, within a diathesis-stress framework, we investigated the extent to which perfectionism and acute life stress predict depression, anxiety and self-harm among adolescent school children (n = 515) over a 6 month period (Time 1-Time 2). Socially prescribed perfectionism (SPP), self-oriented perfectionism-critical (SOP-critical) and the associated interactions with acute life stress differentially predicted anxiety, depression and self-harm. Acute life stress was an independent predictor of depression, anxiety and self-harm. SPP predicted depression and interacted with acute life stress to predict self-harm. SOP-critical and the SOP-critical by acute life stress interaction predicted anxiety. Self-oriented perfectionism-striving (SOP-striving) did not predict any of the Time 2 measures of distress. The dimensions of perfectionism are differentially associated with psychological distress. Tailored clinical interventions focused on adolescent perfectionism should offer promise in tackling psychological morbidity in adolescence.     

Conflicts and conflict management styles as precursors of workplace bullying: A two-wave longitudinal study

Abstract

The psychological contract is currently a popular concept. It has been used in several recent analyses of individuals' careers. However, there are a number of unresolved conceptual and empirical issues surrounding the psychological contract. These are described and discussed. The main issues concern the extent to which the psychological contract between employee and employer is mutual, the importance or otherwise of the promissory element, the distinction between transactional and relational contracts, and the detection of, and response to, contract violation. It is concluded that the psychological contract is probably a valuable concept, but that it needs more careful definition and more rigorous empirical testing.     

Child maltreatment, non-suicidal self-injury, and the mediating role of self-criticism

We examined the relation between child maltreatment and non-suicidal self-injury (NSSI). Participants were 86 adolescents who completed measures of child maltreatment, self-criticism, perceived criticism, depression, and NSSI. Analyses revealed significant, small-to-medium associations between specific forms of child maltreatment (physical neglect, emotional abuse, and sexual abuse) and the presence of a recent history of NSSI. Emotional and sexual abuse had the strongest relations with NSSI, and the data supported a theoretical model in which self-criticism mediates the relation between emotional abuse and engagement in NSSI. Specificity for the mediating role of self-criticism was demonstrated by ruling out alternative mediation models. Taken together, these results indicate that several different forms of childhood maltreatment are associated with NSSI and illuminate one mechanism through which maltreatment may be associated with NSSI. Future research is needed to test the temporal relation between maltreatment and NSSI and should aim to identify additional pathways to engagement in NSSI.     

Social anxiety and interpersonal stress generation: the moderating role of interpersonal distress

Background and Objectives: Existing models of social anxiety scarcely account for interpersonal stress generation. These models also seldom include interpersonal factors that compound the effects of social anxiety. Given recent findings that two forms of interpersonal distress, perceived burdensomeness and thwarted belongingness, intensify social anxiety and cause interpersonal stress generation, these two constructs may be especially relevant to examining social anxiety and interpersonal stress generation together.

Design: The current study extended prior research by examining the role of social anxiety in the occurrence of negative and positive interpersonal events and evaluated whether interpersonal distress moderated these associations.

Methods: Undergraduate students (N?=?243; M?=?20.46 years; 83% female) completed self-report measures of social anxiety, perceived burdensomeness, and thwarted belongingness, as well as a self-report measure and clinician-rated interview assessing negative and positive interpersonal events that occurred over the past six weeks.

Results: Higher levels of social anxiety were associated only with a higher occurrence of negative interpersonal dependent events, after controlling for depressive symptoms. This relationship was stronger among individuals who also reported higher levels of perceived burdensomeness, but not thwarted belongingness.

Conclusions: It may be important to more strongly consider interpersonal stress generation in models of social anxiety.     

The effect of rumination on recall of emotional words: comparison of dysphoric individuals with and without a history of nonsuicidal self-injury

ABSTRACT

Prior research and theory has suggested that rumination plays a role in nonsuicidal self-injury (NSSI), and rumination increases recall of negative autobiographical information in dysphoric individuals. Across two studies, we investigated whether rumination (versus distraction) differentially influences the recall of emotional words among dysphoric persons with and without a history of NSSI. Participants encoded unpleasant, neutral, and pleasant words and then were randomly assigned to either focus on the meaning and consequences of their emotions (i.e. rumination) or unrelated thoughts (i.e. distraction) before they were asked to recall encoded words. Across the two studies, we did not find a significant effect of rumination on memory for emotional words among dysphoric people with (Studies 1 and 2) or without a history of NSSI (Study 1). We did find that people were more likely to remember neutral words as opposed to unpleasant or pleasant words across studies, regardless of rumination condition. Together, results from these two well-powered studies provide fairly compelling evidence that rumination after encoding has little to no effect on recall for emotional words in people elevated on symptoms of depression or with NSSI history. These findings can be used to refine theories of rumination and NSSI.     

A longitudinal analysis of self-regulation and well-being: avoidance personal goals, avoidance coping, stress generation, and subjective well-being

We conducted 2 longitudinal meditational studies to test an integrative model of goals, stress and coping, and well-being. Study 1 documented avoidance personal goals as an antecedent of life stressors and life stressors as a partial mediator of the relation between avoidance goals and longitudinal change in subjective well-being (SWB). Study 2 fully replicated Study 1 and likewise validated avoidance goals as an antecedent of avoidance coping and avoidance coping as a partial mediator of the relation between avoidance goals and longitudinal change in SWB. It also showed that avoidance coping partially mediates the link between avoidance goals and life stressors and validated a sequential meditational model involving both avoidance coping and life stressors. The aforementioned results held when controlling for social desirability, basic traits, and general motivational dispositions. The findings are discussed with regard to the integration of various strands of research on self-regulation.     

Actions speak louder than words: An elaborated theoretical model of the social functions of self-injury and other harmful behaviors

The question of why some people do things that are intentionally harmful to themselves continues to puzzle scientists, clinicians, and the public. Prior studies have demonstrated that one fairly extreme, direct form of self-harm, non-suicidal self-injury (NSSI), is maintained by both automatic (i.e., intrapersonal) as well as social (i.e., interpersonal) reinforcement. However, the majority of theoretical and empirical papers on this topic focus almost exclusively on the automatic functions. The purpose of this paper is to provide a more comprehensive analysis of the social functions of NSSI. Evidence is presented supporting the notion that NSSI is maintained by social reinforcement in at least a substantial minority of instances. Moreover, an elaborated theoretical model of the social functions of NSSI is outlined that proposes that this behavior represents a high intensity social signal used when less intense communication strategies fail (e.g., speaking, yelling, crying). The model further proposes that NSSI can serve not only as a signal of distress that is reinforced primarily by the caregiving behavior it elicits from others, but that it can also serve as a signal of strength and fitness that is reinforced by warding off potential threats (e.g., peer victimization), and in some cases can strengthen affiliation with others. Support for this theoretical model is drawn from diverse literatures including psychology, evolutionary biology, and cultural anthropology. The paper concludes with specific recommendations for empirical tests of the proposed model of the social functions of NSSI, as well as other harmful behaviors such as alcohol and drug use.     

United Kingdom legislation on pack sizes of analgesics: background,rationale, and effects on suicide and deliberate self-harm

Following increasing concern in the UK about the mortality and morbidity associated with self-poisoning with analgesics, especially paracetamol (Tylenol, acetaminophen), legislation was introduced in 1998 to modify packs sold over-the-counter. The most important change was a reduction in the maximum size of packs. In this paper the background to the legislation, the rationale behind it, and its early impact are reviewed. The changes have had significant positive initial benefits on the mortality and morbidity associated with self-poisoning with analgesics.     

Selling behaviours and sales performance: the moderating and mediating effects of interpersonal mentalizing

A random sample of independent insurance agents was surveyed to explore the relationships among learned behaviours, such as, adaptive selling and customer orientation and personal dispositions, such as, interpersonal mentalizing in predicting sales performance. The primary focus of this research was to reexamine salespeople's theory of mind in a broader theoretical base of human abilities. The results confirmed that the dimensions of interpersonal mentalizing, such as, taking a bird's-eye view, shaping the interaction by creating a positive ambience, detecting nonverbal cues and rapport building have different roles for the effectiveness of selling behaviours. While taking a bird's-eye view was a moderator, creating a positive ambience was a mediator of the relationship between selling behaviours and performance. Furthermore, salespeople's ability to build rapport improved sales performance only when they were able to detect nonverbal cues from customers. Taken together, these findings shed light on the complementary role of autonomous abilities of salespeople in improving the productivity of their learned selling behaviours. Several managerial implications were derived from the findings.     

Reciprocal relations between workplace bullying,anxiety, and vigor: a two-wave longitudinal study

Background and Objectives: Workplace bullying has been classified as an extreme social stressor in work contexts and has been repeatedly linked to several negative consequences. However, little research has examined reversed or reciprocal relations of bullying and outcomes. Design: We conducted a two-wave longitudinal study with a time lag of six months. Methods: The study sample consisted of 348 employees of the Spanish workforce. The present study examined longitudinal relationships between workplace bullying, psychological health, and well-being. On the basis of conservation of resources theory, we hypothesized that we would find reciprocal relations among study variables over time. Results: Results of cross-lagged structural equation modeling analyses supported our hypotheses. Specifically, it was found that Time 1 (T1) workplace bullying was negatively related to Time 2 (T2) vigor and positively related to T2 anxiety. Additionally, T1 anxiety and vigor had an effect on T2 workplace bullying. Conclusions: Overall, these findings support the validity of the theoretical models postulating a reciprocal bullying–outcome relationship, rather than simple one-way causal pathways approaches.     

Hopelessness,stress, and perfectionism: The moderating effects of future thinking

It has been argued that a negative view of the future characterised by impaired positive future thinking is associated with increased hopelessness and suicide risk (e.g., MacLeod & Moore, 2000). Hence, the central focus of the two studies reported in this paper was to extend our knowledge of positive future thinking by investigating its relationship with established suicide risk factors: stress, perfectionism, and hopelessness. Study 1 demonstrates, for the first time, that positive future thinking moderates the relationship between stress and hopelessness. The findings of Study 2 replicated those found in Study 1 and they also supported the notion that perfectionism is best understood as a multidimensional construct and that its relationship with future thinking and hopelessness is not straightforward. The results are also discussed in terms of the relationship between the structure of affect and motivational systems.     

Adolescents' individuation,romantic involvement,and mothers' wellbeing: A comparison of three family structures

This study compared concurrent as well as longitudinal associations between adolescent development and maternal wellbeing, in nuclear families with both biological parents and in single-mother and stepfather families. It relied on data from the first two waves of a longitudinal study in Germany (N = 436). Maternal wellbeing was assessed from mothers' reports of their sense of family mastery and self-esteem. Adolescent development was assessed from adolescents' reports of three aspects of individuation and of their romantic involvement. For single mothers and mothers in nuclear families, the associations between maternal wellbeing and adolescents' development were inconsistent. Mothers in stepfather families with daughters profited from their daughters' growing detachment. The results suggested that the associations between adolescent development and maternal wellbeing are family structure specific, and observable concurrently and across a one-year time period. The discussion considers the different demands and living situations of the three family structures.     

Adding insult to injury: effects of interpersonal rejection types, rejection sensitivity, and self-regulation on obsessive relational intrusion

This study tested the I(3) model [Finkel, 2007; 2008] of intimate partner violence as applied to obsessive relational intrusion (ORI) to assess the relation among self-regulation, rejection, rejection sensitivity (RS), and stalking-related aggression. In Study 1, participants (N=221) read one of three vignettes: no relationship termination, an "internal" rejection (involves an internal attribution to the rejected as cause of relationship ending), or an "external" rejection (external attributions for relationship demise). Next, participants experienced one of two conditions manipulating self-regulation (no depletion vs. depletion). Finally, participants rated their likelihood of engaging in ORI (e.g. unwanted pursuit and/or aggression). Consistent with predictions, participants receiving an internal rejection reported higher aggression than participants experiencing an external rejection, especially when depleted of self-regulation. Study 2 extended the design of Study 1 by adding in a screening survey of RS. Internal rejections still yielded more aggression than other conditions, but this was especially so when rejection-sensitive persons were depleted of self-regulation. In addition to providing support for the I(3) model of aggression, this research shows that not all types of rejection are created equal.     

Bullying bystander behaviors: The role of coping effectiveness and the moderating effect of gender

Researchers have suggested that bystander behaviors and victim coping play an important role in counteracting the negative effects of bullying. The current study investigated the relationship between students’ ratings of coping effectiveness when addressing bullying and their behaviors as bystanders when witnessing bullying. Surveys were administered in a Midwestern, suburban school district. Some associations between perceptions of coping effectiveness and bystander behavior supported our hypotheses (e.g., constructive coping associated with defending bystander behaviors, externalizing associated with pro-bullying behaviors). However, some findings did not support hypothesized relationships. For example, higher ratings of effectiveness for cognitive distancing as a coping strategy were associated with increased defending behaviors as a bystander. Gender moderated some of these relationships. Pro-bullying bystander behavior was associated with increased ratings of cognitive distancing and decreased reports of constructive coping effectiveness for girls. Implications for future research and practice are discussed.     

The effect of the September 11 terrorist attacks on suicide and deliberate self-harm: a time trend study

Suicide rates may be affected by world news. Our objective was to investigate the possible impact of the terrorist attacks of September 11, 2001, on suicidal behavior in the Netherlands. There was evidence of an increase in rates of suicide and deliberate self-harm in the weeks immediately following the attacks. These findings contrast with Durkheim's (1897) original suggestion that suicide rates decline in times of war and outside threat but are in line with findings of increases in suicidal behavior after media coverage of lethal violence.     

Differential effects of manual assisted cognitive behavior therapy in the treatment of recurrent deliberate self-harm and personality disturbance: the POPMACT study

A total of 480 patients were treated in a large, multicenter randomized trial of a brief form of cognitive therapy, manual-assisted cognitive behavior therapy (MACT) versus treatment as usual (TAU) for recurrent deliberate self-harm. Each patient was randomized after a self-harm episode assessed at an accident and emergency center and followed up over 1 year. The main hypothesis tested was that those allocated to MACT would have a lower proportion of self-harm episodes in the succeeding year. A total of 60% of those allocated to MACT had face-to-face treatment and 430 (90%) of all patients had self-harm data recorded after 1 year. Although the results showed no significant difference between those repeating self-harm in the MACT group (39%) compared with the TAU group (46%) (P = 0.20), the treatment was cost effective (10% cheaper than TAU) and the frequency of self-harm episodes was fewer (50%) in the MACT group. A total of nine of 10 patients had some personality disturbance (42% of these with disorder), and for those where information on parasuicide events was collected, the proportion having a repeat episode ranged from 33% to 63% for different personality disorders. Those with BPD were most likely to repeat episodes quickly (mean 89 days for 25% to repeat) with dissocial personality disorder (equivalent mean 384 days) the slowest to repeat. Total costs were significantly greater in those with personality disorder and were reduced in those allocated to MACT; this saving was reversed in those with borderline disorder. On average, MACT appeared to increase the cost of those patients with BPD (BPD) and reduce the cost of those with other personality disorders. It is concluded that MACT has value in preventing self-harm cost effectively but this appears to be confined mainly to those who do not have BPD.     

Personality, coping, and family resources in stress resistance: a longitudinal analysis

Earlier cross-sectional analyses have made causal inferences about stress-resistance variables problematic. This study used a longitudinal analysis where stress-resistance factors in the areas of personality, coping, and family support assessed at an initial testing were used to predict psychological and physical adjustment one year later, controlling for initial adjustment. The study involved a survey of 245 men and 248 women in randomly selected families in the San Francisco Bay area. Findings demonstrated that feelings of self-confidence, an easy-going disposition, a disinclination to use avoidance coping, and the availability of family support operate jointly to protect individuals from negative psychological consequences of life stress. For women the stress-resistance index also predicted psychosomatic complaints experienced one year after initial testing.