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.     

Determinants of social integration in the community: an exploratory analysis of personal,interpersonal and situational variables

This article aims to explore the effects of personal, interpersonal, and situational variables on social integration in the community. Structural equation analyses from two‐wave panel data (N = 536) of adult participants living in an urban area showed that personal determinants (perceived stress and depressive mood), and situational determinants (undesirable life events) were statistically related to a decrease in social integration in the community. Interpersonal determinants (emotional, guidance, and instrumental support) were positively associated with an increase in social integration in the community. Implications of these and other findings are discussed. Copyright © 2003 John Wiley & Sons, Ltd.     

Impact of Transplant-Related Stressors and Feelings of Indebtedness on Psychosocial Adjustment Following Kidney Transplantation

Forty-seven patients answered a questionnaire about stress, feelings of indebtedness toward the donor, and psychosocial adjustment following kidney transplantation. The combination of age, general life stress, and transplant-related stress explained 47% of the variance in psychosocial adjustment. Areas of adjustment most influenced by this combination of predictors included attitudes toward health care, domestic, vocational, social adjustment, and psychological distress. Younger patients endorsed higher levels of transplant-related stress and higher levels of psychological distress. Moderate to intense feelings of indebtedness toward the donor were common but were unrelated to psychosocial adjustment posttransplant.     

Worried About us: Evaluating an Intervention for Relationship‐Based Anxiety

Although romantic relationships are commonly a source of pleasure and comfort, for some individuals they can be a source of persistent anxiety. The aim of the current investigation was to explore the construct of relationship‐based anxiety and to evaluate the effectiveness of a brief couple‐based psychoeducational session for this issue. Common behavioral patterns and cognitive tendencies seen among individuals with relationship‐based anxiety were examined, including excessive reassurance‐seeking, self‐silencing, and partner accommodation. In the current investigation, a single psychoeducational session was developed to address these maladaptive interactive patterns of behavior specifically. The session was administered to a sample of 21 couples and was found to decrease levels of reassurance‐seeking and self‐silencing significantly among individuals with relationship anxiety, and to decrease levels of maladaptive accommodation behaviors significantly in their partners.     

Faces of Shame: Implications for Self-Esteem,Emotion Regulation,Aggression, and Well-Being

There is an increasing interest in psychological research on shame experiences and their associations with other aspects of psychological functioning and well-being, as well as with possible maladaptive outcomes. In an attempt to confirm and extend previous knowledge on this topic, we investigated the nomological network of shame experiences in a large community sample (N = 380; 66.1% females), adopting a multidimensional conceptualization of shame. Females reported higher levels of shame (in particular, bodily and behavioral shame), guilt, psychological distress, emotional reappraisal, and hostility. Males had higher levels of self-esteem, emotional suppression, and physical aggression. Shame feelings were associated with low self-esteem, hostility, and psychological distress in a consistent way across gender. Associations between characterological shame and emotional suppression, as well as between bodily shame and anger occurred only among females. Moreover, characterological and bodily shame added to the prediction of low self-esteem, hostility, and psychological distress above and beyond the influence of trait shame. Finally, among females, emotional suppression mediated the influence of characterological shame on hostility and psychological distress. These findings extend current knowledge on the nomological net surrounding shame experiences in everyday life, supporting the added value of a multidimensional conceptualization of shame feelings.     

Critical Time Intervention for Homeless People Making the Transition to Community Living: A Randomized Controlled Trial

To help create an evidence base in Europe for effective interventions that improve the well‐being of homeless people, we tested whether critical time intervention (CTI), a time‐limited intervention developed to support vulnerable people during times of transition, is effective outside the United States. For this multicenter, parallel‐group randomized controlled trial, 183 adults who were moving from shelters in the Netherlands to supported or independent housing were allocated to CTI or care‐as‐usual. The primary outcome was number of days rehoused, which was assessed by interviewing participants four times during a 9‐month follow‐up. Outcomes were analyzed with three‐level mixed‐effects models. The primary outcome did not differ between groups. CTI had a significant effect on family support and, for people experiencing less social support, psychological distress. Groups did not differ significantly on social support, fulfillment of care needs, quality of life, self‐esteem, excessive alcohol use, or cannabis use. Because few participants were homeless at 9 months, more research is needed to establish whether CTI can prevent long‐term recurrent homelessness. Given recent emphasis on informal support in public services and positive effects of CTI on family support and psychological distress, CTI is a fitting intervention for Dutch shelter services.     

The role of social support on the disclosure of everyday unpleasant emotional events

Talking about unpleasant events has important implications for coping with distress, but the literature has not thoroughly addressed the role of social support on the decision to disclose these events. The authors hypothesized that perceptions of the availability of social support and satisfaction with support received regarding an event would be positively related to the disclosure of the event, and participants’ sex, emotional disclosure tendencies, depression symptoms, and global perceptions of support would moderate these relations. College students (N = 365) reported on 2,001 unpleasant emotional events that they personally experienced in the past week. Multilevel modeling analyses revealed that the perceived availability of support for an event predicted the degree of disclosure of that event, even while controlling for its intensity. Event disclosure predicted satisfaction with the support received for the event, controlling for event intensity and available support. This latter relation was moderated by the participants’ global perceptions of social support, such that the disclosure–satisfaction relation was stronger for individuals who perceived relatively less global social support. These findings suggest that characteristics of the social-support network ought to be considered as an important factor relevant to the decision to disclose everyday unpleasant events.     

情绪调节困难对大学生手机成瘾的影响:相貌负面身体自我和社交回避与苦恼的链式中介作用

为考察相貌负面身体自我、社交回避与苦恼在情绪调节困难和手机成瘾关系中的链式中介效应,使用情绪调节困难量表、相貌负面身体自我量表、社交回避与苦恼量表和大学生手机成瘾倾向量表对734名大学生进行问卷调查。研究显示：（1）情绪调节困难会正向预测大学生手机成瘾;（2）相貌负面身体自我是情绪调节困难与大学生手机成瘾之间关系的中介变量;（3）社交回避与苦恼是相貌负面身体自我与大学生手机成瘾之间关系的中介变量;（4）社交回避与苦恼是情绪调节困难与大学生手机成瘾之间关系的中介变量。因此,相貌负面身体自我和社交回避与苦恼在情绪调节困难与大学生手机成瘾之间起链式中介作用,这些结果对于大学生手机成瘾的预防与干预具有重要的价值。     

Relations between symptom severity,illness perceptions,visceral sensitivity,coping strategies and well-being in irritable bowel syndrome guided by the common sense model of illness

Irritable Bowel Syndrome (IBS) is a common condition affecting around 10–20% of the population and associated with poorer psychological well-being and quality of life. The aim of the current study was to explore the efficacy of the Common Sense Model (CSM) using Structural Equation Modelling (SEM) in an IBS cohort. One hundred and thirty-one IBS patients (29 males, 102 females, mean age 38 years) participating in the IBSclinic.org.au pre-intervention assessment were included. Measures included IBS severity (Irritable Bowel Syndrome Severity Scoring System), coping patterns (Carver Brief COPE), visceral sensitivity (Visceral Sensitivity Index), illness perceptions (Brief Illness Perceptions Questionnaire), psychological distress (Depression, Anxiety and Stress Scale), and quality of life (IBS Quality of Life scale; IBS-QoL). Using SEM, a final model with an excellent fit was identified (χ² (8) = 11.91, p = .16, χ²/N = 1.49, CFI > .98, TLI > .96, SRMR < .05). Consistent with the CSM, Illness perceptions were significantly and directly influenced by IBS severity (β = .90, p < .001). Illness perceptions in turn directly influenced maladaptive coping (β = .40, p < .001) and visceral sensitivity (β = .70, p < .001). Maladaptive coping and visceral sensitivity were significantly associated with psychological distress (β = .55, p < .001; β = .22, p < .01) and IBS-QoL (β = –.28, p < .001; β = –.62, p < .001). Based on these findings, we argue that to augment the adverse impact of IBS severity on IBS-QoL and psychological distress, psychological interventions will be best to target the mediating psychological processes including illness beliefs, visceral sensitivity and maladaptive coping.