The functions of nonsuicidal self-injury: Support for cognitive–affective regulation and opponent processes from a novel psychophysiological paradigm.

Abstract

Although research on the reasons for engaging in nonsuicidal self-injury (NSSI) has increased dramatically in the last few years, there are still many aspects of this pernicious behavior that are not well understood. The purpose of this study was to address these gaps in the literature, with a particular focus on investigating whether NSSI (a) regulates affective valence in addition to affective arousal and (b) serves a cognitive regulation function in addition to an affect regulation function. To elucidate these issues, the present study utilized a sample of 112 participants (33 controls, 39 no pain controls, 16 NSSI individuals, and 24 controls matching the affect dysregulation levels of the NSSI group), employed psychophysiological measures of affective valence (startle-alone reactivity) and quality of information processing (prepulse inhibition), and used experimental methods involving an NSSI-proxy to model the NSSI process. Results largely were consistent with predictions, supporting the hypotheses that NSSI serves to regulate cognitive processing and affective valence. On this latter point, however, the control groups also showed a decrease in negative affective valence after the NSSI-proxy. This unexpected finding is consistent with the hypothesis that opponent processes may contribute to the development of self-injurious behaviors (Joiner, 2005). Overall, the present study represents an important extension of previous laboratory NSSI studies and provides a fertile foundation for future studies aimed at understanding why people engage in NSSI.

Pain and self-harm: A systematic review

“…The majority of participants within the community sample studies endorsed cutting and self-hitting as the most common types of NSSI (Franklin et al, 2010;Glenn et al, 2014;Hamza et al, 2014) and within the latter two studies, self-pinching, severe scratching as well as self-hitting were also reported. Little information was given by Bohus et al…”

“…Only two of the case control studies (Franklin et al, 2010;Glenn et al, 2014) reported any information regarding participants' ethnicity, with their sample being predominantly European American.…”

“…Little information is reported by Magerl et al (2012) regarding recruitment of BPD patients, however all but two were inpatients at the time of participation. Four recent case-control studies used community samples (Franklin et al, 2010;Glenn et al, 2014;Hamza et al, 2014;McCoy et al, 2010).…”

“…Bohus et al (2000) set an inclusion criterion of at least 3 episodes within the last two years and Franklin et al (2010) used more than 6 episodes in the last year as their inclusion criterion. Magerl et al (2012) used data from medical notes in addition to self-report and visual inspection of participants' injuries/scars to access lifetime history and recency of last episode.…”

“…Three case-control studies assessed NSSI by means of self-report (Bohus et al, 2000;Franklin et al, 2010;Magerl et al, 2012) and Franklin et al (2010) also used the FASM (Lloyd et al, 1997). Bohus et al (2000) set an inclusion criterion of at least 3 episodes within the last two years and Franklin et al (2010) used more than 6 episodes in the last year as their inclusion criterion.…”