Relationships between Outcome Expectancies and Non-Suicidal Self-Injury: Moderating Roles of Emotion Regulation Difficulties and Self-Efficacy to Resist Self-Injury

Abstract

Background

Non-suicidal self-injury (NSSI) is the deliberate damage of one’s own body tissue in the absence of suicidal intent. Research suggests that individuals engage in NSSI as a means of regulating their emotions and that NSSI is associated with emotion regulation difficulties. There is also evidence supporting the role of outcome expectancies and self-efficacy to resist NSSI. However, it is unclear how these factors work together to explain NSSI.

Objective

To explore whether the relationships between five NSSI-specific outcome expectancies and NSSI history are moderated by emotion regulation difficulties and self-efficacy to resist NSSI.

Method

1002 participants (Mage = 20.51, 72.5% female, 39.7% lifetime history of NSSI) completed an online survey including measures of NSSI history, outcome expectancies, self-efficacy to resist NSSI, and emotion regulation difficulties.

Results

Emotion regulation difficulties were associated with NSSI, as was expecting NSSI to regulate affect. Conversely, expectations of communication and/or pain, as well as self-efficacy to resist NSSI were negatively associated with NSSI. Expectancies also interacted with both difficulties in emotion regulation and self-efficacy to resist NSSI in predicting self-injury. For example, the association between expectations of affect regulation and self-injury was weaker when associated with greater self-efficacy to resist NSSI.

Conclusion

These findings provide support for considering NSSI-specific cognitions in concert with emotion regulation when understanding NSSI.

Highlights

• Outcome expectancies can differentiate people based on NSSI history.

• Emotion regulation difficulties and self-efficacy to resist NSSI moderate the relationships between outcome expectancies and NSSI history.

• Emotion regulation difficulties and low self-efficacy to resist NSSI work together to predict NSSI history.

Keywords:

• NSSI
• self-injury
• emotion regulation difficulties
• self-efficacy
• outcome expectancies

AUTHOR NOTES

Kirsty Hird, School of Population Health, Curtin University, Perth, Australia.

Penelope Hasking, School of Population Health, Curtin University, Perth, Australia.

Mark Boyes, School of Population Health, Curtin University, Perth, Australia.

Additional information

Funding

Kirsty Hird was supported by a 2020/2021 Health Sciences Summer Scholarship from Curtin University. Mark Boyes is supported by the National Health and Medical Research Council, Australia (Investigator Grant 1173043).