Social stressors, emotional responses, and NSSI urges and behaviors in daily life

Exploring the mediating role of self-hate in the relationship between adverse childhood experiences and non-suicidal self-injury among adolescents

BACKGROUND

Non-suicidal self-injury (NSSI) has become a serious global problem among adolescents. This study aimed to explore the relationships between adverse childhood experiences, self-hate, and non-suicidal self-injury in adolescents.

METHODS

A total of 7009 adolescents participated in a survey from August 1 to December 31, 2023. The survey comprised the revised Adverse Childhood Experience (ACE) Questionnaire, Self-Hate Scale, and Adolescent Non-Suicidal Self-Injury Assessment Questionnaire. SPSS 22.0 was utilized for data entry and analysis. Spearman's correlation analysis was employed to examine the relationships between the variables. The bias-corrected nonparametric percentile bootstrap method was used to test the significance of the mediating effect.

RESULTS

Adverse childhood experiences, self-hate, and non-suicidal self-injury were positively correlated. Adverse childhood experiences directly affected self-injury without obvious tissue damage. Self-hate mediated the relationship between adverse childhood experiences and self-injury without obvious tissue damage. Adverse childhood experiences directly affected self-injury with obvious tissue damage. Self-hate mediated between adverse childhood experiences and self-injury with obvious tissue damage.

LIMITATIONS

The data were cross-sectional, and the effects of adverse childhood experiences were not immediate. Further, because this was a subjective study, reporting bias was inevitable. Finally, future research should expand the discussion and improve the global relevance of the study.

CONCLUSION

Self-hate mediates the relationship between adverse childhood experiences and NSSI in adolescents. This study explores the underlying mechanisms and influencing factors of NSSI in adolescents and provides important evidence-based support for the prevention and intervention of NSSI in adolescents with different characteristics to maintain adolescents' physical and mental health.

IMPLICATIONS AND CONTRIBUTION

Given the close relationships found between adverse childhood experiences, self-hate, and non-suicidal self-injury (NSSI) in adolescents, it is crucial to address adverse childhood experiences to prevent and treat NSSI. Providing necessary psychological support and interventions can help foster positive self-awareness, enhance self-esteem and self-efficacy, reduce self-disgust, and mitigate the negative effects of adverse childhood experiences.

The emotional surge: in-depth qualitative exploration of rumination and emotional turbulence in non-suicidal self-injurers

Non-suicidal self-injury (NSSI) is an emerging pathological condition among emerging adults, causing significant distress and hindering daily life functioning. The increasing prevalence of NSSI highlights its importance as a crucial area requiring clinical attention. To devise effective interventions for managing NSSI, it is important to identify the factors contributing to its onset and maintenance. Therefore, the current study aims to explore emotional and cognitive factors to provide a holistic understanding of NSSI in emerging adults in the Pakistani context. For this purpose, a qualitative study was conducted using in-depth, semi-structured interviews with N = 10 self-injurers (mean age: 22.2 years) recruited through purposive sampling. Participants had engaged in self-injury at least five times in the past year without suicidal intent. The arm was identified as the most common site for self-injury, with cutting being the most frequently used method. Data from the transcribed interviews were analyzed using Braun and Clarke's reflexive thematic analysis. Three main themes-'emotional turbulence,' 'low distress tolerance,' and 'rumination'-and nine subthemes emerged, highlighting the emotional and cognitive factors contributing to the initiation and maintenance of NSSI. The findings of this study provide valuable insights into the emotional and cognitive dimensions of NSSI in emerging Pakistani adults. These insights will aid in treatment planning and in selecting appropriate strategies for reducing and ultimately eradicating NSSI.

A systematic review of interpersonal processes and their measurement within experience sampling studies of self-injurious thoughts and behaviours

Self-injurious thoughts and behaviours (SITBs) are a leading cause of death, and interpersonal processes (IPs) appear to play a role in SITBs. This systematic review synthesises the literature on IPs and SITBs in daily life and addresses four critical questions: (1) Which IPs have been assessed and how, (2) How are differences in IPs between individuals associated with SITBs?, (3) How are differences in IPs within individuals associated with SITBs? and (4) Do IPs relate differently to self-injurious thoughts than behaviours? Our review followed PRISMA guidelines and eligible literature was screened until 25 April 2024. We identified 58 Experience Sampling studies (32.76% daily-diary studies) of which most focused on IPs from major SITBs theories (e.g., thwarted belongingness) but largely used inconsistent operationalizations. Results from 39 studies investigating within-person associations were mixed. Based on 26 studies, whether differences in IPs between individuals relate to SITBs remains unclear. Three studies have investigated whether IPs relate to the transition from thoughts to behaviours, but temporal models are needed to draw firm conclusions. Studies investigating IPs and SITBs in daily life are largely inconclusive. Psychometrically validated measures are warranted, and future daily-life studies would benefit from drawing on ideation-to-action frameworks.

Alexithymia and peer victimisation: interconnected pathways to adolescent non-suicidal self-injury

BACKGROUND

The prevalence of non-suicidal self-injury (NSSI) among adolescents underscores the importance of understanding the complex factors that drive this behaviour. Framed within broader constructs of emotional regulation theories, alexithymia and peer victimisation are thought to interact to influence NSSI behaviours.

AIM

This research addresses whether alexithymia and peer victimisation serve as risk factors for NSSI and, if so, how these factors interact with each other.

METHOD

This quantitative study analysed data from 605 adolescents, using a range of validated self-report measures including the Toronto Alexithymia Scale. Statistical analyses including one-way analysis of variance, multiple regression and structural equation modelling were employed to scrutinise the relationships among the variables.

RESULTS

Alexithymia and peer victimisation significantly predicted NSSI behaviours. Specifically, the 'difficulty in identifying feelings' subscale of alexithymia emerged as a noteworthy predictor of NSSI (P < 0.001). Peer victimisation mediated the relationship between alexithymia and NSSI, explaining approximately 24.50% of alexithymia's total effect on NSSI. In addition, age was a significant predictor of NSSI, but gender and education years were not (P > 0.05). These relationships were found to be invariant across genders.

CONCLUSIONS

This study enriches our understanding of the interplay between alexithymia, peer victimisation and NSSI, particularly within the Chinese context. Its findings have significant implications for a rethinking of alexithymia's theoretical construct and interventions targeting emotional literacy and peer dynamics among adolescents. Future research could benefit from a longitudinal design to establish causality.

How does emotional abuse affect adolescents' non-suicidal self-injury urges? A moderated chain mediation model

BACKGROUND

Studying non-suicidal self-injury (NSSI) among adolescents has high clinical significance. Its urges have been identified as a potential predictor of NSSI behavior and may serve as a crucial intervention target.

OBJECTIVE

This study uses a moderated chain mediation model to explore the relationship between emotional abuse and adolescent NSSI urges. Additionally, we examine the mediating roles of ego depletion and self-esteem and the moderating effect of resilience.

PARTICIPANTS AND SETTING

We recruited 1129 Chinese adolescents (age M = 16.68; SD = 0.78; 49.4 % men) from secondary vocational schools in China.

METHODS

We assessed emotional abuse, ego depletion, self-esteem, and NSSI urges in a longitudinal investigation across two time points (T1: March 2023, T2: June 2023).

RESULTS

After controlling for age, sex, NSSI urges and self-esteem at T1, our study validates a moderated chain mediation model and finds that the mediating effect via self-esteem is 0.026 (95%CI = [0.011,0.046]), and the chain mediating effect via ego depletion and self-esteem is 0.031 (95%CI = [0.022,0.045]), whereas the direct effect of emotional abuse T1 on NSSI urges T2 is not significant (DE = 0.082, 95%CI = [-0.002, 0.167]) and the mediating effect via ego depletion is also not significant (IE = -0.003, 95%CI = [-0.022, 0.015]). Resilience moderates the impact of emotional abuse on ego depletion (β = 0.09, p < 0.01).

CONCLUSIONS

These findings suggest that ego depletion and self-esteem are potential mechanisms related to emotional abuse and adolescents' NSSI urges, whereas resilience can play a moderating role in reducing ego depletion.

Examining the dynamic relationship between nonsuicidal self-injury and alcohol use experiences

INTRODUCTION

Nonsuicidal self-injury (NSSI) is a prevalent and concerning behavior and its risk pathways require a greater understanding, particularly in predicting short-term risk. Although the literature has supported a between-person link among NSSI and alcohol use, limited research has directly examined the nuances of this relationship at the within-person level using intensive longitudinal data.

METHOD

Utilizing two independent samples (total n = 85), the current study examined bidirectional, concurrent and prospective risk relationships between NSSI and alcohol, considering both urges and behavior engagement, via ecological momentary assessment.

RESULTS

Findings demonstrate concurrent, within-person relationships between NSSI urges and alcohol urges, as well as alcohol use. Alternatively, prospective between-person findings demonstrated negative relationships between NSSI urges and alcohol use, as well as alcohol urges and NSSI acts; however, this may represent suppression effects as associations were positive with the removal of autoregressive effects.

CONCLUSIONS

Together, findings support proximal risk relationships between NSSI and alcohol experiences that, for urges in particular, is bidirectional.