Implicit and explicit attitudes toward self harm: support for a functional model

Background and objectives: Self harm is a serious public health problem worldwide. Implicit attitude measures offer a novel method of exploring associations with self harm (SH). Here we used implicit measures in order to (i) examine implicit evaluative and arousal associations with SH (ii) compare the discriminatory power of implicit and explicit attitude measures in a non-clinical sample at high risk of SH.

Methods: Two experiments using Go No-Go Association (GNAT) tasks designed to tap implicit attitudes toward SH in an undergraduate sample.

Results: In Study One logistic regression analysis demonstrated that explicit, rather than implicit measures successfully discriminated between SH cases and controls which contrasts with previous research. Faster reaction times were observed for negative implicit associations (SH and 'I dislike') compared to positive implicit associations (SH and 'I like') for both SH cases and controls. The SH group were faster to respond to arousal implicit associations compared to implicit sedation associations. Study Two extended this finding to demonstrate associations between evaluative/arousal GNATs and self-reported functions of SH. Internal motivations for self harmful behaviour were significantly related to an implicit sedation association with SH, whereas interpersonal motivations were associated with an implicit arousal association with SH. These findings are consonant with existing functional accounts of SH.

Limitations: Longitudinal data is necessary to identify whether the attitudes assessed could predict future SH.

Conclusions: The findings provide novel experimental support for the hypothesised role of automatic/affect regulation and social/interpersonal functions of SH. Implications for intervention are discussed.