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Cognitive Therapy and Research

, Volume 43, Issue 2, pp 345–353 | Cite as

Does Nonsuicidal Self-injury Prospectively Predict Change in Depression and Self-criticism?

  • Taylor A. BurkeEmail author
  • Kathryn Fox
  • Rachel L. Zelkowitz
  • Diana M. Y. Smith
  • Lauren B. Alloy
  • Jill M. Hooley
  • David A. Cole
Original Article
  • 108 Downloads

Abstract

Few studies have investigated nonsuicidal self-injury (NSSI) as a predictor of outcomes other than suicidal self-injury, severely limiting our understanding of this behavior’s full range of consequences. Three independent studies were used to examine the prospective association between NSSI and two outcomes: depressive symptoms and self-criticism. Data were collected from samples of (1) adults with past-month NSSI, (2) adults with lifetime NSSI, and (3) adults with past-year NSSI. Studies included 1- and 6-month follow-up periods. Results were tested in an internal meta-analysis. Results suggested that NSSI did not prospectively predict changes in self-criticism. No changes in depressive symptoms were seen over shorter follow-up periods; however, NSSI predicted increases in depressive symptoms at 6-month follow-up in one sample. The internal meta-analysis indicated a null relationship between NSSI and prospective internalizing symptoms. Future research should replicate these findings and examine a broader range of outcomes of NSSI to better understand its complex relationship to psychopathology.

Keywords

Nonsuicidal self-injury Depression Self-criticism 

Notes

Acknowledgements

This research was supported by a Foundations of Human Behavior award to Jill M. Hooley. Taylor A. Burke was supported by a National Science Foundation Graduate Student Research Fellowship. Kathryn Fox was supported by The Sackler Scholars Programme in Psychobiology. Rachel L. Zelkowitz was supported by National Institute of Mental Health National Research Service Award F31MH108241-02. Lauren B. Alloy was supported by NIMH Grant MH101168. Jill Hooley was supported by a Foundations of Human Behavior grant from Harvard University. David Cole was supported by a gift from the Patricia and Rodes Hart Foundation.

Compliance with Ethical Standards

Conflict of Interest

Taylor A. Burke, Kathryn Fox, Rachel L. Zelkowitz, Diana M. Y. Smith, Lauren B. Alloy, Jill M. Hooley, and David A. Cole declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Animal Rights

No animal studies were carried out by the authors for this article.

References

  1. Bachtelle, S. E., & Pepper, C. M. (2015). The physical results of nonsuicidal self-injury: The meaning behind the scars. Journal of Nervous and Mental Disease, 203(12), 927–933.  https://doi.org/10.1097/NMD.0000000000000398.Google Scholar
  2. Bagby, R. M., Parker, J. D. A., Joffe, R. T., & Buis, T. (1994). Reconstruction and validation of the Depressive Experiences Questionnaire. Assessment, 1(1), 59–68.  https://doi.org/10.1177/1073191194001001009.Google Scholar
  3. Batejan, K. L., Jarvi, S. M., & Swenson, L. P. (2015). Sexual orientation and non-suicidal self-injury: A meta-analytic review. Archives of Suicide Research, 19(2), 131–150.  https://doi.org/10.1080/13811118.2014.957450.Google Scholar
  4. Beck, A. T., Steer, R. A., Ball, R., & Ranieri, W. F. (1996). Comparison of Beck depression inventories-IA and -II in psychiatric outpatients. Journal of Personality Assessment, 67(3), 588–597.  https://doi.org/10.1207/s15327752jpa6703_13.Google Scholar
  5. Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck depression inventory-II (pp. 1–82). San Antonio, TX: Psychological Corporation.Google Scholar
  6. Blatt, S. J., D’Afflitti, J. P., & Quinlan, D. M. (1976). Experiences of depression in normal young adults. Journal of Abnormal Psychology, 85(4), 383–389.  https://doi.org/10.1037//0021-843X.85.4.383.Google Scholar
  7. Borenstein, M., Hedges, L. V., Higgins, J. P. T., Rothstein, H. R. (2010). A basic introduction to fixed-effect and random-effects models for meta-analysis. Research Synthesis Methods, 1(2), 97–111.Google Scholar
  8. Borenstein, M., Hedges, L. V., Higgins, J. P. T., & Rothstein, H. R. (2014). Comprehensive Meta-Analysis (CMA) software (Version 3.0). Englewood, NJ: Biostat. Retrieved from http://www.meta-analysis.com.
  9. Bresin, K., & Schoenleber, M. (2015). Gender differences in the prevalence of nonsuicidal self-injury: A meta-analysis. Clinical Psychology Review, 38, 55–64.  https://doi.org/10.1016/j.cpr.2015.02.009.Google Scholar
  10. Burke, T. A., Hamilton, J. L., Abramson, L. Y., & Alloy, L. B. (2015). Non-suicidal self-injury prospectively predicts interpersonal stressful life events and depressive symptoms among adolescent girls. Psychiatry Research, 228(3), 416–424.  https://doi.org/10.1016/j.psychres.2015.06.021.Google Scholar
  11. Burke, T. A., Jacobucci, R., Ammerman, B. A., Piccirillo, M., McCloskey, M. S., Heimberg, R. G., & Alloy, L. B. (2018). Identifying the relative importance of non-suicidal self-injury features in classifying suicidal ideation, plans, and behavior using exploratory data mining. Psychiatry Research.  https://doi.org/10.1016/j.psychres.2018.01.045.Google Scholar
  12. Burke, T. A., Piccirillo, M. P., Moore-Berg, S. L., Heimberg, R. & Alloy, L. B. (in press). The stigmatization of non-suicidal self-injury. Journal of Clinical Psychology.Google Scholar
  13. DiClemente, R. J., Ponton, L. E., & Hartley, D. (1991). Prevalence and correlates of cutting behavior: Risk for HIV transmission. Journal of the American Academy of Child & Adolescent Psychiatry, 30(5), 735–739.Google Scholar
  14. Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175–191.  https://doi.org/10.3758/BF03193146.Google Scholar
  15. Forrester, R. L., Slater, H., Jomar, K., Mitzman, S., & Taylor, P. J. (2017). Self-esteem and non-suicidal self-injury in adulthood: A systematic review. Journal of Affective Disorders, 221, 172–183.  https://doi.org/10.1016/j.jad.2017.06.027.Google Scholar
  16. Fox, K. R., Ribeiro, J. D., Kleiman, E. M., Hooley, J. M., Nock, M. K., & Franklin, J. C. (2018). Affect toward the self and self-injury stimuli as potential risk factors for nonsuicidal self-injury. Psychiatry Research, 260, 279–285.Google Scholar
  17. Fox, K. R., Toole, K. E., Franklin, J. C., & Hooley, J. M. (2017). Why does nonsuicidal self-injury improve mood? A preliminary test of three hypotheses. Clinical Psychological Science, 5(1), 111–121.  https://doi.org/10.1177/2167702616662270.Google Scholar
  18. Franklin, J. C., Lee, K. M., Hanna, E. K., & Prinstein, M. J. (2013). Feeling worse to feel better: Pain-offset relief simultaneously stimulates positive affect and reduces negative affect. Psychological Science, 24(4), 521–529.  https://doi.org/10.1177/0956797612458805.Google Scholar
  19. Franklin, J. C., Puzia, M. E., Lee, K. M., & Prinstein, M. J. (2014). Low implicit and explicit aversion toward self-cutting stimuli longitudinally predict nonsuicidal self-injury. Journal of Abnormal Psychology, 123(2), 463–469.  https://doi.org/10.1037/a0036436.Google Scholar
  20. Garisch, J. A., & Wilson, M. S. (2015). Prevalence, correlates, and prospective predictors of non-suicidal self-injury among New Zealand adolescents: Cross-sectional and longitudinal survey data. Child and Adolescent Psychiatry and Mental Health.  https://doi.org/10.1186/s13034-015-0055-6.Google Scholar
  21. Gholamrezaei, M., De Stefano, J., & Heath, N. L. (2015). Nonsuicidal self-injury across cultures and ethnic and racial minorities: A review. International Journal of Psychology.  https://doi.org/10.1002/ijop.12230.Google Scholar
  22. Gilbert, P., Clarke, M., Hempel, S., Miles, J. N. V., & Irons, C. (2004). Criticizing and reassuring oneself: An exploration of forms, styles and reasons in female students. British Journal of Clinical Psychology, 43(1), 31–50.  https://doi.org/10.1348/014466504772812959.Google Scholar
  23. Goh, J. X., Hall, J. A., & Rosenthal, R. (2016). Mini meta-analysis of your own studies: Some arguments on why and a primer on how. Social and Personality Psychology Compass, 10(10), 535–549.Google Scholar
  24. Hankin, B. L., & Abela, J. R. Z. (2011). Nonsuicidal self-injury in adolescence: Prospective rates and risk factors in a 2½ year longitudinal study. Psychiatry Research, 186(1), 65–70.Google Scholar
  25. Heatherton, T. F., Kleck, R. E., Hebl, M., & Hull, J. (2000). Stigma: Social psychological perspectives. New York: Guilford Press.Google Scholar
  26. Higgins, J. P. T. (2003). Measuring inconsistency in meta-analyses. British Medical Journal, 327(7414), 557–560.Google Scholar
  27. Hinshaw, S. P., & Stier, A. (2008). Stigma as related to mental disorders. Annual Review of Clinical Psychology, 4(1), 367–393.  https://doi.org/10.1146/annurev.clinpsy.4.022007.141245.Google Scholar
  28. Hofmann, W., Gawronski, B., Gschwendner, T., Le, H., & Schmitt, M. (2005). A meta-analysis on the correlation between the Implicit Association Test and explicit self-report measures. Personality and Social Psychology Bulletin.  https://doi.org/10.1177/0146167205275613.Google Scholar
  29. Hooley, J. M., Fox, K. R., Wang, S. B., & Kwashie, A. (in press). Self-criticism and self-injury: Testing a novel treatment approach. BMC Psychiatry.Google Scholar
  30. Hooley, J. M., & Franklin, J. C. (2017). Why do people hurt themselves? A new conceptual model of nonsuicidal Self-injury. Clinical Psychological Science, 6(3), 428–451.Google Scholar
  31. Hooley, J. M., Ho, D. T., Slater, J., & Lockshin, A. (2010). Pain perception and nonsuicidal self-injury: A laboratory investigation. Personality Disorders: Theory, Research, and Treatment, 1(3), 170–179.  https://doi.org/10.1037/a0020106.Google Scholar
  32. Houben, M., Claes, L., Vansteelandt, K., Berens, A., Sleuwaegen, E., & Kuppens, P. (2017). The emotion regulation function of nonsuicidal self-injury: A momentary assessment study in inpatients with borderline personality disorder features. Journal of Abnormal Psychology, 126(1), 89–95.  https://doi.org/10.1037/abn0000229.Google Scholar
  33. Jacobson, C. M., & Gould, M. (2007). The epidemiology and phenomenology of non-suicidal self-injurious behavior among adolescents: A critical review of the literature. Archives of Suicide Research, 11(2), 129–147.  https://doi.org/10.1080/13811110701247602.Google Scholar
  34. Kiekens, G., Hasking, P., Boyes, M., Claes, L., Mortier, P., Auerbach, R. P., et al. (2018). The associations between non-suicidal self-injury and first onset suicidal thoughts and behaviors. Journal of Affective Disorders, 239, 171–179.Google Scholar
  35. Klonsky, E. D. (2009). The functions of self-injury in young adults who cut themselves: Clarifying the evidence for affect-regulation. Psychiatry Research, 166(2–3), 260–268.  https://doi.org/10.1016/j.psychres.2008.02.008.Google Scholar
  36. Link, B. G., Struening, E. L., Rahav, M., Phelan, J. C., & Nuttbrock, L. (1997). On stigma and its consequences: Evidence from a longitudinal study of men with dual diagnoses of mental illness and substance abuse. Journal of Health and Social Behavior, 38, 177–190.  https://doi.org/10.2307/2955424.Google Scholar
  37. Lipsey, M. W., & Wilson, D. B. (2001). Practical meta-analysis. Sage Publications, Inc.Google Scholar
  38. Lundh, L. G., Wångby-Lundh, M., & Bjärehed, J. (2011a). Deliberate self-harm and psychological problems in young adolescents: Evidence of a bidirectional relationship in girls. Scandinavian Journal of Psychology, 52(5), 476–483.  https://doi.org/10.1111/j.1467-9450.2011.00894.x.Google Scholar
  39. Lundh, L.-G., Wångby-Lundh, M., Paaske, M., Ingesson, S., & Bjärehed, J. (2011b). Depressive symptoms and deliberate self-harm in a community sample of adolescents: A prospective study. Depression Research and Treatment.  https://doi.org/10.1155/2011/935871.Google Scholar
  40. Mars, B., Heron, J., Crane, C., Hawton, K., Lewis, G., Macleod, J., et al. (2014). Clinical and social outcomes of adolescent self harm: Population based birth cohort study. BMJ.  https://doi.org/10.1136/bmj.g5954.Google Scholar
  41. Marshall, S. K., Tilton-Weaver, L. C., & Stattin, H. (2013). Non-suicidal self-injury and depressive symptoms during middle adolescence: A longitudinal analysis. Journal of Youth and Adolescence, 42(8), 1234–1242.  https://doi.org/10.1007/s10964-013-9919-3.Google Scholar
  42. Mitten, N., Preyde, M., Lewis, S., Vanderkooy, J., & Heintzman, J. (2016). The perceptions of adolescents who self-harm on stigma and care following inpatient psychiatric treatment. Social Work in Mental Health, 14(1), 1–21.  https://doi.org/10.1080/15332985.2015.1080783.Google Scholar
  43. Nitkowski, D., & Petermann, F. (2011). Non-suicidal self-injury and comorbid mental disorders: A review. Fortschritte Der Neurologie Psychiatrie, 79(1), 9–20.  https://doi.org/10.1055/s-0029-1245772.Google Scholar
  44. Nock, M. K. (2010). Self-injury. Annual Review of Clinical Psychology, 6(1), 339–363.  https://doi.org/10.1146/annurev.clinpsy.121208.131258.Google Scholar
  45. Nock, M. K., Holmberg, E. B., Photos, V. I., & Michel, B. D. (2007). Self-injurious thoughts and behaviors interview: Development, reliability, and validity in an adolescent sample. Psychological Assessment, 19(3), 309–317.  https://doi.org/10.1037/1040-3590.19.3.309.Google Scholar
  46. Ribeiro, J. D., Franklin, J. C., Fox, K. R., Bentley, K. H., Kleiman, E. M., Chang, B. P., & Nock, M. K. (2016). Self-injurious thoughts and behaviors as risk factors for future suicide ideation, attempts, and death: A meta-analysis of longitudinal studies. Psychological Medicine, 46, 225–236.  https://doi.org/10.1017/S0033291715001804.Google Scholar
  47. St. Germain, S. A., & Hooley, J. M. (2012). Direct and indirect forms of non-suicidal self-injury: Evidence for a distinction. Psychiatry Research, 197(1–2), 78–84.  https://doi.org/10.1016/j.psychres.2011.12.050.Google Scholar
  48. Steer, R. A., Ball, R., Ranieri, W. F., & Beck, A. T. (1999). Dimensions of the Beck Depression Inventory-II in clinically depressed outpatients. Journal of Clinical Psychology, 55(1), 117–128.  https://doi.org/10.1002/(SICI)1097-4679(199901)55:1%3C117::AID-JCLP12%3E3.0.CO;2-A Google Scholar
  49. Swannell, S. V., Martin, G. E., Page, A., Hasking, P., & St John, N. J. (2014). Prevalence of nonsuicidal self-injury in nonclinical samples: Systematic review, meta-analysis and meta-regression. Suicide and Life-Threatening Behavior.  https://doi.org/10.1111/sltb.12070.Google Scholar
  50. Tatnell, R., Kelada, L., Hasking, P., & Martin, G. (2014). Longitudinal analysis of adolescent NSSI: The role of intrapersonal and interpersonal factors. Journal of Abnormal Child Psychology, 42(6), 885–896.  https://doi.org/10.1007/s10802-013-9837-6.Google Scholar
  51. Taylor, T. L., Hawton, K., Fortune, S., & Kapur, N. (2009). Attitudes towards clinical services among people who self-harm: Systematic review. The British Journal of Psychiatry, 194(2), 104–110.  https://doi.org/10.1192/bjp.bp.107.046425.Google Scholar
  52. Taylor, P. J., Jomar, K., Dhingra, K., Forrester, R., Shahmalak, U., & Dickson, J. M. (2018). A meta-analysis of the prevalence of different functions of non-suicidal self-injury. Journal of Affective Disorders, 227, 759–769.Google Scholar
  53. Turner, B. J., Yiu, A., Claes, L., Muehlenkamp, J. J., & Chapman, A. L. (2016). Occurrence and co-occurrence of nonsuicidal self-injury and disordered eating in a daily diary study: Which behavior, when? Psychiatry Research, 246, 39–47.  https://doi.org/10.1016/j.psychres.2016.09.012.Google Scholar
  54. Victor, S. E., & Klonsky, E. D. (2014). Correlates of suicide attempts among self-injurers: A meta-analysis. Clinical Psychology Review.  https://doi.org/10.1016/j.cpr.2014.03.005.Google Scholar
  55. Zelkowitz, R. L., & Cole, D. A. (2018). Self-criticism as a transdiagnostic process in nonsuicidal self-injury and disordered eating: Systematic review and meta-analysis. Suicide and Life-Threatening Behavior.  https://doi.org/10.1111/sltb.12436.Google Scholar
  56. Zuroff, D. C., Sadikaj, G., Kelly, A. C., & Leybman, M. J. (2016). Conceptualizing and measuring self-criticism as both a personality trait and a personality state. Journal of Personality Assessment, 98(1), 14–21.  https://doi.org/10.1080/00223891.2015.1044604.Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Taylor A. Burke
    • 1
    Email author
  • Kathryn Fox
    • 2
  • Rachel L. Zelkowitz
    • 3
  • Diana M. Y. Smith
    • 2
  • Lauren B. Alloy
    • 1
  • Jill M. Hooley
    • 2
  • David A. Cole
    • 3
  1. 1.Department of Psychology, Weiss HallTemple UniversityPhiladelphiaUSA
  2. 2.Department of PsychologyHarvard UniversityCambridgeUSA
  3. 3.Department of Psychology and Human DevelopmentVanderbilt UniversityNashvilleUSA

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