Citation

Kiekens G, Hasking PA, Nock MK, Boyes M, Kirtley O, Bruffaerts R, Myin-Germeys I, Claes L. Front. Psychiatry 2020; 11: e214.

Affiliation

Faculty of Medicine and Health Sciences (CAPRI), University of Antwerp, Antwerp, Belgium.

Copyright

(Copyright © 2020, Frontiers Media)

DOI

10.3389/fpsyt.2020.00214

PMID

32265760

PMCID

PMC7099647

Abstract

INTRODUCTION: Although research over the past decade has resulted in significantly increased knowledge about distal risk factors for non-suicidal self-injury (NSSI), little is known about short-term (proximal) factors that predict NSSI thoughts and behaviors. Drawing on contemporaneous theories of NSSI, as well as the concept of ideation-to-action, the present study clarifies (a) real-time factors that predict NSSI thoughts and (b) the extent to which theoretically important momentary factors (i.e., negative affect, positive affect, and self-efficacy to resist NSSI) predict NSSI behavior in daily life, beyond NSSI thoughts.

METHODS: Using experience sampling methodology, intensive longitudinal data was obtained from 30 young adults with frequent NSSI episodes in the last year. Participants completed assessments up to eight times per day for 12 consecutive days (signal-contingent sampling). This resulted in the collection of 2,222 assessments (median compliance = 79.2%) during which 591 NSSI thoughts and 270 NSSI behaviors were recorded. Using the dynamic structural equation modeling framework, multilevel vector autoregressive models were constructed.

RESULTS: Within the same assessment, negative affect was positively associated with NSSI thoughts, whereas positive affect and self-efficacy to resist NSSI were each negatively associated with NSSI thoughts. Across assessments, higher-than-usual negative affect and self-efficacy to resist NSSI were predictive of short-term change in NSSI thoughts. While fluctuations in both negative affect and positive affect prospectively predicted NSSI behavior, these factors became non-significant in models that controlled for the predictive effect of NSSI thoughts. In contrast, self-efficacy to resist NSSI incrementally predicted a lower probability of engaging in NSSI, above and beyond NSSI thoughts.

DISCUSSION: This study provides preliminary evidence that affective fluctuations may uniquely predict NSSI thoughts but not NSSI behaviors, and point to the role of personal belief in the ability to resist NSSI in preventing NSSI behavior. These findings illustrate the need to differentiate between the development of NSSI thoughts and the progression from NSSI thoughts to behavior, as these are likely distinct processes, with different predictors.

Copyright © 2020 Kiekens, Hasking, Nock, Boyes, Kirtley, Bruffaerts, Myin-Germeys and Claes.

Language: en

Keywords

ecological momentary assessment; ideation-to-action; intensive longitudinal assessment; non-suicidal self-injury; real-time prediction