We have so much in common: Does shared variance between emotion-related constructs account for relationships with self-injury?

Background: Emotion regulation, distress tolerance, experiential avoidance, and both positive and negative affect have all been linked to NSSI. These constructs are proposed to be distinct; however, they share conceptual similarities. For example, some people may regulate emotions by avoiding stressful situations, conflating emotion regulation and avoidance. We tested if constructs linked with NSSI (when studied in isolation), remain significant correlates of NSSI when considered alongside related constructs (with which they may share variance). Method: University students (n = 487, M = 21.36, SD = 2.48, 74% female, 40% with lived experience of self-injury) completed well-validated self-report measures of NSSI, difficulties with emotion regulation, distress tolerance, experiential avoidance, emotional reactivity, positive and negative affect, and alexithymia. Results: As predicted, emotion-related constructs were generally highly correlated. Additionally, with the exception of lack of emotional awareness, all constructs were significantly associated with NSSI in bivariate analyses. In multivariate analyses, associations were substantially attenuated. Positive affect, distress tolerance, and experiential avoidance were negatively associated with NSSI, and limited emotion regulation strategies was positively associated with NSSI. No other constructs were uniquely associated with NSSI and exploratory factor analyses indicated that all constructs loaded onto a single factor Limitations: Cross-sectional design rules out temporal sequencing. Conclusion: Findings raise the possibility that associations between some emotion-related constructs (e.g., alexithymia) and NSSI may reflect variance shared with other emotion-related constructs. If true, this will have important theoretical, clinical, and measurement implications for NSSI research

Associations between non-suicidal self-injury and experiential avoidance: A systematic review and Robust Bayesian Meta-analysis

Objectives: Non-suicidal self-injury (NSSI) is the intentional and deliberate damage to an individual's own body tissue without the intent to suicide. Individuals who have higher self-reported levels of experiential avoidance are more likely to report a history of NSSI. The current study systematically reviewed the literature and meta-analysed studies assessing associations between experiential avoidance and self-injury. Method: An extensive review was conducted of several databases (including ProQuest, Joanna Briggs, Web of Science, PsychArticles, PubMed, Scopus, and Ovid). Nineteen articles (two dissertations) met the inclusion criteria for the systematic review and 14 were analysed in a Robust Bayesian Meta-analysis. This review was registered through PROSPERO (CRD42020198041). Results: There was a small to medium, pooled effect size (d = 0.48, 95 % Credibility Interval 0.00–0.85). There was strong evidence for this effect size (Bayes Factor = 12.16), although there was considerable heterogeneity between studies (τ =0.68, 95 % CI [0.44, 0.1.05]). The analysis testing whether these findings may be due to publication bias was inconclusive (Bayes Factor = 2.45). Limitations: The majority of studies included were cross-sectional, in English, and most studies were of university students. While some studies reported on recency/frequency of NSSI there was not enough data to conduct meta-analysis. Conclusion: These results suggest there is a robust association between history of NSSI and experiential avoidance. However, as most studies operationalise avoidance as a unidimensional construct, it is not clear which aspects of avoidance differentiate individuals with and without a history of NSSI

The potential individual- and population-level benefits of encouraging drinkers to count their drinks

Introduction: Cross-sectional studies have established a link between overall engagement in protective behavioral strategies (PBSs) and reduced alcohol consumption. However, there are mixed results on the effectiveness of individual PBSs, with some found to result in increased consumption. A recent study examining the effects of PBS use over time found the ‘Count your drinks’ strategy to be most reliably associated with reduced alcohol consumption among 16 strategies. Given the apparent superior efficacy of this PBS, this exploratory study aimed to extend these results by (i) determining the extent to which increasing the frequency of PBS enactment is associated with alcohol consumption over time and (ii) predicting potential changes in population-level consumption resulting from higher levels of PBS use. Method: 1250 drinkers aged 18–70 years provided data at two time points relating to their drinking practices. Multiple regression analyses were conducted to model the relationship between changes in frequency of enactment of the ‘Count your drinks’ PBS and alcohol consumption. Coefficients were used to predict average reductions in alcohol consumption over one year associated with increased frequency of use of this PBS. Results: Larger increases in the frequency of using the ‘Count your drinks’ PBS were associated with greater reductions in alcohol consumption. Exploratory extrapolation analyses demonstrated the potential for substantial reductions in overall alcohol consumption. Conclusion: The results suggest health promotion efforts designed to increase the frequency with which drinkers count their drinks could produce substantial annual decreases in alcohol consumption at both individual and population levels

Emotional reactivity and perseveration: Independent dimensions of trait positive and negative affectivity and differential associations with psychological distress

Background: Theoretically, two types of emotional responding could underlie individual differences in trait affect: 1) a disposition reflecting increased probability of experiencing positive or negative emotions (emotional reactivity), and 2) a disposition to experience prolonged emotional reactions once elicited (emotional perseveration). We developed a measure of these dimensions and investigated whether emotional reactivity and perseveration 1) account for unique variance in trait affect, and 2) are differentially associated with symptoms of psychological distress. Method: In Study 1, participants (T1: n = 90; T2: n = 51) completed the Positive and Negative Affect Schedule (PANAS) and the Emotional Reactivity and Perseveration Scale (ERPS, adapted from the PANAS). In study 2, participants (n = 228) completed the PANAS, ERPS, and Depression Anxiety Stress Scales. Results: Study 1 established the basic psychometric properties of the ERPS and demonstrated that emotional reactivity and perseveration accounted for unique variance in trait positive and negative effect. Study 2 confirmed these findings and established that emotional reactivity and perseveration are differentially associated with depression, anxiety, and stress scores. Conclusion: Emotional reactivity and perseveration represent independent dimensions of trait affect. Considering these dimension in future research could further the understanding of both normal emotional responding and emotional vulnerability

What is important to the decision to disclose nonsuicidal self-injury in formal and social contexts?

Objective: Disclosure of nonsuicidal self-injury (NSSI) is associated with a range of both positive (e.g., help-seeking) and negative (e.g., discrimination) outcomes. The aim of this study was to assess the importance of a range of factors concerned with: NSSI experiences, self-efficacy to disclose self-injury, interpersonal factors, and reasons for or expectations of disclosure, to the decision to disclose self-injury to friends, family members, significant others, and health professionals. Methods: Three hundred seventy-one participants with lived experience of NSSI completed a survey in which they rated the importance of the aforementioned factors to the decision of whether to disclose NSSI to different people. A mixed-model analysis of variance was conducted to investigate whether the factors differed in importance and if this importance differed across relationship types. Results: All factors held importance, though to differing degrees, with those related to relationship quality being most important overall. Generally, factors relating to tangible aid were considered more important when considering disclosure to health professionals than to other people. Conversely, interpersonal factors, particularly trust, were more important when disclosing to individuals in social or personal relationships. Conclusion: The findings provide preliminary insight into how different considerations may be prioritized when navigating NSSI disclosure, in a way that may be tailored to different contexts. For clinicians, the findings highlight that clients may expect tangible forms of support and nonjudgment in the event that they disclose their self-injury in this formal setting

Cognitive-emotional networks in students with and without a history of non-suicidal self-injury

Background: Contemporary models of non-suicidal self-injury (NSSI) suggest that emotional vulnerabilities, negative self-schemas, and beliefs about NSSI work together to differentiate students who self-injure from those who do not. However, it is unclear how these mechanisms are differentially related among students with and without a history of NSSI. Considering this, we used a network analysis approach to explore how students with and without a history of NSSI vary in processing their emotional experiences in relation to their self-concepts and beliefs about NSSI. Method: A sample of 480 university students (Mage = 21.18, SD = 2.43; 73.5 % female) completed self-report measures about their perceived emotional experiences (e.g., emotional reactivity, emotion regulation difficulties), self-concepts (e.g., self-esteem, self-efficacy), and NSSI. Results: A network comparison test revealed that students with a history of NSSI perceived themselves to have difficulties regulating particularly intense, unwanted negative emotions. In light of this, students with a history of NSSI expected some benefits of NSSI (e.g., emotion regulation) regardless of potential barriers (e.g., pain). Conversely, for students without a history of NSSI, expecting NSSI to have aversive outcomes was tied to expecting NSSI to have few benefits. Limitations: The cross-sectional design limits inferences to be made about the network structures. Conclusions: Students with and without a history of NSSI appear to differ in their cognitive processing of negative emotions and strategies used to deal with these emotions

The relationship between clinical perfectionism and nonsuicidal self-injury: The roles of experiential avoidance, self-esteem, and locus of control

Objectives: Perfectionism is linked to nonsuicidal self-injury (NSSI). Individuals with elevated perfectionism tend to avoid undesirable emotions and experience lower self-esteem, which are associated with NSSI. However, it is unclear if these mechanisms explain the link between clinical perfectionism and NSSI, and if locus of control is involved. We aimed to explore whether experiential avoidance and self-esteem would mediate the relationship between clinical perfectionism and NSSI, and if locus of control would moderate links between clinical perfectionism and both experiential avoidance and self-esteem. Method: As part of a larger study, 514 Australian university students (Mage = 21.15 years, SD = 2.40; 73.5% female) completed an online survey of NSSI, clinical perfectionism, experiential avoidance, self-esteem, and locus of control. Results: Clinical perfectionism was associated with NSSI history, but not with recent NSSI or past year NSSI frequency. Lower self-esteem, but not experiential avoidance, mediated links between clinical perfectionism and NSSI history, recent NSSI, and NSSI frequency. More external locus of control was associated with NSSI, experiential avoidance, and lower self-esteem, but locus of control did not moderate pathways between clinical perfectionism and experiential avoidance or self-esteem. Conclusion: University students reporting elevated clinical perfectionism may have a tendency to experience lower self-esteem which is associated with NSSI history, recency, and severity

Cognitive and emotional factors associated with the desire to cease non-suicidal self-injury

Background: Due to cognitive and emotional differences between individuals who have and have not stopped self-injuring, we explored these in the context of desire to stop. Method: Australian university students (n = 374) completed cognitive and emotional measures. Comparisons were made between those who had self-injured in the past 12 months and those who had not, and between individuals who reported wanting to stop self-injuring and those who did not. Results: Approximately 20% of participants did not want to stop self-injuring. Cognitive emotional factors (psychological distress, self-efficacy to resist, difficulties regulating emotion, interpersonal functions, and outcome expectancies) differentiated individuals who had and had not stopped, but could not explain differences in desire to stop. Conclusion: Factors associated with desire to stop are not the same as factors underlying behavioural cessation. Motivational approaches to changes in self-injurious behaviour would be beneficial for clinicians and their clients