Analyzing Affective Dynamics and the Affect Regulation Hypothesis in NSSI Urges: A New Perspective using Ecological Momentary Assessment

Engagement in non-suicidal self-injury (NSSI) has been found to be associated with changes in affect levels and can be predicted by affective dynamics (e.g., variability, inertia, and intensity). Prior to NSSI engagement levels of negative affect (NA) will often increase and positive affect (PA) will often decrease. After NSSI engagement NA will often and decrease while PA will often increase, suggesting that NSSI helps to regulate one’s affect. However, less is known about affect levels and affective dynamics in relation to NSSI urges that are not acted upon, which is a phenomenon worth further study given its high rate of occurrence. Such a phenomenon should be studied in real-time through ecological momentary assessment (EMA) given the varying durations and frequency of NSSI urges. The current study examined affective dynamics in relation to EMA-reported NSSI urges (compared to EMA-reported NSSI behaviors), as well as the affect regulation hypothesis of NSSI, in a sample of 93 young adults (ages 18-34) with past-month NSSI urges or behaviors. Dynamic structural equation modeling (DSEM) was used to analyze affective dynamics, compare affective dynamics of participants who reported NSSI urges only with participants who reported NSSI behaviors during EMA, and the affect regulation hypothesis in relation to NSSI urges. Results show that greater NSSI urges were associated with greater NA variability and intensity and with lower PA intensity. Further, NA intensity increased prior to the experience of a NSSI urge and continued to increase if those urges were resisted. Lastly, individuals that engaged in any NSSI behavior had significantly higher NA variability and intensity than those who only reported NSSI urges. This study has important implications for risk identification and later treatment of NSSI urges.