Skip to main content
Research Trends

Exploring Particular Facets of Cognitive Emotion Regulation and Their Relationships With Nonsuicidal Self-Injury Among Adolescents

Published Online:https://doi.org/10.1027/0227-5910/a000566

Abstract.Background: Nonsuicidal self-injury (NSSI) has been found to be associated with poor emotion regulation. Aims: The goal of this study was to examine the association of multidimensional cognitive emotion regulation strategies with NSSI among adolescents and compare the different patterns of NSSI. Method: A sample of 594 high-school students (54.4% boys; mean age = 14.96 years), from five regional schools across Israel, were assessed for five facets of cognitive emotion regulation strategies (acceptance, refocus on planning, positive refocusing, putting into perspective, and positive reappraisal) and NSSI behaviors using validated scales. Participants were allocated into three groups: repetitive NSSI (more than six occasions of NSSI; 7.1%), occasional NSSI (at least one incident but less than six; 8.3%), and no NSSI (84.6%). Results: Analysis of covariance, controlling for gender and depression symptoms, revealed that students with NSSI reported higher levels of acceptance, but lower levels of refocus on planning and putting into perspective. Limitations: The study used a cross-sectional design, which was a limitation. Conclusion: These findings demonstrate that particular cognitive emotion regulation strategies differ substantially in their relationship with NSSI. Adolescents who focus on planning and putting stressful situations into perspective may have increased resilience, whereas adolescents who are accepting of negative events that have happened may be more prone to maladaptive coping behaviors.

References

  • Ammerman, B. A., Jacobucci, R., Kleiman, E. M., Muehlenkamp, J. J., & McCloskey, M. S. (2017). Development and validation of empirically derived frequency criteria for NSSI disorder using exploratory data mining. Psychological Assessment, 29(2), 221–231. 10.1037/pas0000334 First citation in articleCrossref MedlineGoogle Scholar

  • Anderson, N. L., Smith, K. E., Mason, T. B., & Crowther, J. H. (2018). Testing an integrative model of affect regulation and avoidance in non-suicidal self-injury and disordered eating. Archives of Suicide Research, 22(2), 295–310. 10.1080/13811118.2017.1340854 First citation in articleCrossref MedlineGoogle Scholar

  • Baron, R. M., & Kenny, D. A. (1986). The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 1173–1182. 10.1037/0022-3514.51.6.1173 First citation in articleCrossref MedlineGoogle Scholar

  • Bresin, K., & Schoenleber, M. (2015). Gender differences in the prevalence of nonsuicidal self-injury: A meta-analysis. Clinical Psychology Review, 38, 55–64. 10.1016/j.cpr.2015.02.009 First citation in articleCrossref MedlineGoogle Scholar

  • Brunner, R., Kaess, M., Parzer, P., Fischer, G., Carli, V., Hoven, C. W., … Apter, A. (2014). Life-time prevalence and psychosocial correlates of adolescent direct self-injurious behavior: A comparative study of findings in 11 European countries. Journal of Child Psychology and Psychiatry, 55(4), 337–348. 10.1111/jcpp.12166 First citation in articleCrossref MedlineGoogle Scholar

  • Byrne, B. M. (2013). Structural equation modeling with AMOS: Basic concepts, applications, and programming. New York, NY: Routledge. First citation in articleGoogle Scholar

  • Chan, S., Denny, S., Fleming, T., Fortune, S., Peiris-John, R., & Dyson, B. (2018). Exposure to suicide behaviour and individual risk of self-harm: Findings from a nationally representative New Zealand high school survey. Australian & New Zealand Journal of Psychiatry, 52(4), 349–356. ​10.1177/0004867417710728 First citation in articleCrossref MedlineGoogle Scholar

  • Claes, L., Klonsky, E. D., Muehlenkamp, J., Kuppens, P., & Vandereycken, W. (2010). The affect-regulation function of nonsuicidal self-injury in eating-disordered patients: Which affect states are regulated? Comprehensive Psychiatry, 51(4), 386–392. 10.1016/j.comppsych.2009.09.001 First citation in articleCrossref MedlineGoogle Scholar

  • Claes, L., Luyckx, K., & Bijttebier, P. (2014). Non-suicidal self-injury in adolescents: Prevalence and associations with identity formation above and beyond depression. Personality and Individual Differences, 61, 101–104. 10.1016/j.paid.2013.12.019 First citation in articleCrossrefGoogle Scholar

  • Compas, B. E., Jaser, S. S., Bettis, A. H., Watson, K. H., Gruhn, M. A., Dunbar, J. P., … Thigpen, J. C. (2017). Coping, emotion regulation, and psychopathology in childhood and adolescence: A meta-analysis and narrative review. Psychological Bulletin, 143(9), 939–991. 10.1037/bul0000110 First citation in articleCrossref MedlineGoogle Scholar

  • Deiter, P. J., Nicholls, S. S., & Pearlman, L. A. (2000). Self-injury and self capacities: Assisting an individual in crisis. Journal of Clinical Psychology, 56(9), 1173–1191. 10.1002/1097-4679(200009)56:9<1173::AID-JCLP5>3.0.CO;2-P First citation in articleCrossref MedlineGoogle Scholar

  • Garnefski, N., Kraaij, V., & Spinhoven, P. (2001). Negative life events, cognitive emotion regulation and emotional problems. Personality and Individual Differences, 30(8), 1311–1327. 10.1016/S0191-8869(00)00113-6 First citation in articleCrossrefGoogle Scholar

  • Gratz, K. L., & Roemer, L. (2004). Multidimensional assessment of emotion regulation and dysregulation: Development, factor structure, and initial validation of the difficulties in emotion regulation scale. Journal of Psychopathology and Behavioral Assessment, 26(1), 41–54. 10.1023/​B:JOBA.0000007455.08539.94 First citation in articleCrossrefGoogle Scholar

  • Gross, J. J., & John, O. P. (2003). Individual differences in two emotion regulation processes: Implications for affect, relationships, and well-being. Journal of Personality and Social Psychology, 85(2), 348–362. 10.1037/0022-3514.85.2.348 First citation in articleCrossref MedlineGoogle Scholar

  • Hamza, C. A., Stewart, S. L., & Willoughby, T. (2012). Examining the link between nonsuicidal self-injury and suicidal behavior: A review of the literature and an integrated model. Clinical Psychology Review, 32(6), 482–495. 10.1016/j.cpr.​2012.05.003 First citation in articleCrossref MedlineGoogle Scholar

  • Hasking, P., Whitlock, J., Voon, D., & Rose, A. (2017). A cognitive-emotional model of NSSI: Using emotion regulation and cognitive processes to explain why people self-injure. Cognition and Emotion, 31, 1543–1556. 10.1080/02699931.​2016.1241219 First citation in articleCrossref MedlineGoogle Scholar

  • Hasking, P. A., Coric, S. J., Swannell, S., Martin, G., Thompson, H. K., & Frost, A. D. (2010). Brief report: Emotion regulation and coping as moderators in the relationship between personality and self-injury. Journal of Adolescence, 33(5), 767–773. 10.1016/j.adolescence.2009.12.006 First citation in articleCrossref MedlineGoogle Scholar

  • Heath, N. L., Carsley, D., De Riggi, M. E., Mills, D., & Mettler, J. (2016). The relationship between mindfulness, depressive symptoms, and non-suicidal self-injury amongst adolescents. Archives of Suicide Research, 20(4), 635–649. 10.1080/13811118.2016.1162243 First citation in articleCrossref MedlineGoogle Scholar

  • Kelada, L., Hasking, P., & Melvin, G. (2018). Adolescent NSSI and recovery: The role of family functioning and emotion regulation. Youth & Society, 50(8), 1056–1077. ​10.1177/0044118X16653153 First citation in articleCrossrefGoogle Scholar

  • Kiekens, G., Hasking, P., & Boyes, M. (2018). An investigation of measurement invariance of three brief emotion regulation instruments in young adults with and without a history of non-suicidal self-injury. European Journal of Psychological Assessment. Advance online publication. 10.1027/1015-5759/a000464 First citation in articleLinkGoogle Scholar

  • Koole, S. L. (2009). The psychology of emotion regulation: An integrative review. Cognition and Emotion, 23, 4–41. 10.1080/02699930802619031 First citation in articleCrossrefGoogle Scholar

  • Kovacs, M. (1984). The Children's Depression, Inventory (CDI). Psychopharmacology Bulletin, 21(4), 995–998. First citation in articleGoogle Scholar

  • Kraemer, H. C. (2015). A source of false findings in published research studies: adjusting for covariates. Jama Psychiatry, 72(10), 961–962. 10.1001/jamapsychiatry.2015.1178 First citation in articleCrossref MedlineGoogle Scholar

  • Laukkanen, E., Rissanen, M.-L., Tolmunen, T., Kylmä, J., & Hintikka, J. (2013). Adolescent self-cutting elsewhere than on the arms reveals more serious psychiatric symptoms. European Child and Adolescent Psychiatry, 22(8), 501–510. 10.1007/s00787-013-0390-1 First citation in articleCrossref MedlineGoogle Scholar

  • Lee, D. J., Witte, T. K., Bardeen, J. R., Davis, M. T., & Weathers, F. W. (2016). A factor analytic evaluation of the difficulties in emotion regulation scale. Journal of Clinical Psychology, 72(9), 933–946. 10.1002/jclp.22297 First citation in articleCrossref MedlineGoogle Scholar

  • Medrano, L., & Trógolo, M. (2016). Construct Validity of the Difficulties in Emotion Regulation Scale: Further evidence using confirmatory factor analytic approach. Abnormal and Behavioral Psychology, 2(2), 1–7. 10.4172/2472-0496.​1000117 First citation in articleCrossrefGoogle Scholar

  • Miller, G. A., & Chapman, J. P. (2001). Misunderstanding analysis of covariance. Journal of Abnormal Psychology, 110(1), 40–48. 10.1037/0021-843X.110.1.40 First citation in articleCrossref MedlineGoogle Scholar

  • Muehlenkamp, J. J., Engel, S. G., Wadeson, A., Crosby, R. D., Wonderlich, S. A., Simonich, H., & Mitchell, J. E. (2009). Emotional states preceding and following acts of non-suicidal self-injury in bulimia nervosa patients. Behaviour Research and Therapy, 47(1), 83–87. 10.1016/j.brat.2008.10.011 First citation in articleCrossref MedlineGoogle Scholar

  • Nock, M. K. (2009). Why do people hurt themselves?: New insights into the nature and functions of self-injury. Current Directions in Psychological Science, 18(2), 78–83. 10.1111/j.1467-8721.2009.01613.x First citation in articleCrossref MedlineGoogle Scholar

  • Rowland, J. E., Hamilton, M. K., Vella, N. C., Lino, B. J., Mitchell, P. B., & Green, M. J. (2013). Adaptive associations between social cognition and emotion regulation are absent in schizophrenia and bipolar disorder. Frontiers in Psychology, 3(607), 1–11. 10.3389/fpsyg.2012.00607 First citation in articleCrossrefGoogle Scholar

  • Schreiber, J. B., Nora, A., Stage, F. K., Barlow, E. A., & King, J. (2006). Reporting structural equation modeling and confirmatory factor analysis results: A review. The Journal of Educational Research, 99(6), 323–338. 10.3200/JOER.99.6.323-338 First citation in articleCrossrefGoogle Scholar

  • Skinner, E. A., Edge, K., Altman, J., & Sherwood, H. (2003). Searching for the structure of coping: A review and critique of category systems for classifying ways of coping. Psychological Bulletin, 129(2), 216–269. 10.1037/0033-2909.129.2.216 First citation in articleCrossref MedlineGoogle Scholar

  • Skinner, E. A., & Zimmer-Gembeck, M. J. (2007). The development of coping. Annual Review of Psychology, 58, 119–144. 10.1146/annurev.psych.58.110405.085705 First citation in articleCrossref MedlineGoogle Scholar

  • 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, 44(3), 273–303. 10.1111/sltb.12070 First citation in articleCrossref MedlineGoogle Scholar

  • Taliaferro, L. A., Muehlenkamp, J. J., Borowsky, I. W., McMorris, B. J., & Kugler, K. C. (2012). Factors distinguishing youth who report self-injurious behavior: A population-based sample. Academic Pediatrics, 12(3), 205–213. 10.1016/j.acap.​2012.01.008 First citation in articleCrossref MedlineGoogle Scholar

  • Thyssen, L. S., & van Camp, I. (2014). Non-SUICIDAL SELF-INJURY IN Latin America. Salud Mental, 37(2), 153–157. 10.17711/SM.0185-3325.2014.019 First citation in articleCrossrefGoogle Scholar

  • Tuisku, V., Kiviruusu, O., Pelkonen, M., Karlsson, L., Strandholm, T., & Marttunen, M. (2014). Depressed adolescents as young adults – predictors of suicide attempt and non-suicidal self-injury during an 8-year follow-up. Journal of Affective Disorders, 152, 313–319. 10.1016/j.jad.2013.09.031 First citation in articleCrossref MedlineGoogle Scholar

  • Vansteelandt, K., Claes, L., Muehlenkamp, J., De Cuyper, K., Lemmens, J., Probst, M., … Pieters, G. (2013). Variability in affective activation predicts non-suicidal self-injury in eating disorders. European Eating Disorders Review, 21(2), 143–147. 10.1002/erv.2220 First citation in articleCrossref MedlineGoogle Scholar

  • Whitlock, J., Exner-Cortens, D., & Purington, A. (2014). Assessment of nonsuicidal self-injury: Development and initial validation of the Non-Suicidal Self-Injury–Assessment Tool (NSSI-AT). Psychological Assessment, 26(3), 935–946. 10.1037/a0036611 First citation in articleCrossref MedlineGoogle Scholar

  • Zalsman, G., Misgav, S., Sommerfeld, E., Kohn, Y., Brunstein-Klomek, A., Diller, R., … Ben-Dor, D. H. (2005). Children's Depression Inventory (CDI) and the Children's Depression Rating Scale-Revised (CDRS-R): Reliability of the Hebrew version. International Journal of Adolescent Medicine and Health, 17(3), 255–258. 10.1515/IJAMH.2005.17.3.255 First citation in articleCrossref MedlineGoogle Scholar

  • Zielinski, M. J., Veilleux, J. C., Winer, E. S., & Nadorff, M. R. (2017). A short-term longitudinal examination of the relations between depression, anhedonia, and self-injurious thoughts and behaviors in adults with a history of self-injury. Comprehensive Psychiatry, 73, 187–195. 10.1016/j.comp​psych.2016.11.013 First citation in articleCrossref MedlineGoogle Scholar