Nonsuicidal Self-Injury: An Emotion Regulation Perspective

Abstract

Background: Nonsuicidal self-injury (NSSI) is widely thought to serve an emotion-regulatory function. Method: The focus of the present paper is to provide a conceptual framework for understanding how NSSI might modify a person's emotions. Results: Drawing upon the process model of emotion regulation, we argue that 5 families of emotion regulation strategies may be engaged by NSSI. Individuals may engage in NSSI as an alternative to more distressing situations. They also may use NSSI to modify their social environment. Individuals may shift their attention away from unpleasant emotions or thoughts via NSSI. NSSI may change cognitions about the self via self-punishment or transformation of the self from higher-order to lower-order awareness. NSSI may also bring about various physiological effects, such as changes in endogenous opioids or parasympathetic nervous system activation, as a way of modulating emotional responses. Conclusion: Simply labeling NSSI as ‘emotion regulatory' does not tell us precisely what is going on. This is because at any given moment, NSSI can serve to regulate emotions in many different ways. One key challenge is to clarify the precise functions NSSI may be serving for a given individual in a particular context.

Correlates of Non-suicidal Self-Injury and Suicide Attempts in Bulimic Spectrum Disorders

“…It further suggests that BSD + NSSI feel more connected to their social environment than BSD + SA, wherefore their self-injurious behavior may function as a cry for help, while BSD + SA may not believe that significant others are able to help them. Nevertheless, the present study was not able to determine whether these traits compel BSD patients to engage in NSSI or SA or if engaging in these behaviors isolates them from others, because of feelings of shame or guilt, as prior research has reported (Mckenzie and Gross, 2014). Unlike previous studies (Claes et al, 2012), the present study found no differences between groups in harm-avoidance and self-directedness.…”

Emotion Dysregulation and Military Suicidality Since 2001: A Review of the Literature

“…Research suggests emotion dysregulation is predictive of suicidal ideation (Arria et al, 2009;O'Connor & Nock, 2014). Some studies investigate disorders associated with emotion dysregulation and their relationship to suicidal ideation and/or attempts, including depression (Mościcki, 2001); substance use disorder (Fischer, Anderson, & Smith, 2004;Mościcki, 2001;Sher & Stanley, 2008); borderline personality disorder (Brown, Comtois, & Linehan, 2002;Selby & Joiner, 2009); anxiety disorders, and PTSD (Elbogen et al, 2017;Gradus et al, 2010); and nonsuicidal self-injury (NSSI; Anestis, Kleiman, Lavender, Tull, & Gratz, 2014;McKenzie & Gross, 2014). However, studies directly examining emotion dysregulation and suicide attempts are less conclusive: While several find the most common reasons given for attempts include escaping or obtaining relief from emotional distress (Brown et al, 2002;Bryan, Hernandez, et al, 2013;Bryan & Rudd, 2012;Bryan, Rudd, & Wertenberger, 2013), others find no correlation between emotion dysregulation and suicidal behavior (Garnefski, Kraaij, & Spinhoven, 2001;Tamás et al, 2007).…”

The Development of First‐Episode Direct Self‐Injurious Behavior and Association with Difficulties in Emotional Regulation in Adolescence

“…Although strong evidence exists for the association of self‐harm with regulation of emotions (Bentley et al., ; Klonsky, ; Mikolajczak, Petrides, & Hurry, ; Perez, Venta, Garnaat, & Sharp, ), there has been a lack of explicit assessment of emotional regulation in the development of self‐harm and a tendency to view emotional regulation in discrete terms (Cole, ; Mckenzie & Gross, ). Emotion‐generative theories suggest a linear process of emotion (Gross, ) in which emotional cues are subject to monitoring and evaluation early in the processing of emotions and have implications for later attempts at emotional modulation (Thompson & Calkins, ).…”