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J Child Psychol Psychiatry. 2016 Jul;57(7):805-13. doi: 10.1111/jcpp.12500. Epub 2015 Dec 18.

Implicit cognition about self-injury predicts actual self-injurious behavior: results from a longitudinal study of adolescents.

Author information

1
Clinical and Social Sciences in Psychology, University of Rochester, Rochester, NY, USA.
2
Department of Psychology, Harvard University, Cambridge, MA, USA.
3
Teachers College, Columbia University, New York, NY, USA.
4
Department of Psychology, University of North Carolina, Chapel Hill, NC, USA.

Abstract

BACKGROUND:

The implicit association hypothesis of nonsuicidal self-injury (NSSI) proposes that individuals who engage in self-injury develop, over time, strong associations between themselves and NSSI, and their identification with this behavior guides their future selection of NSSI to cope. Prior research has established a relationship between implicit NSSI associations (using an Implicit Association Test for Self-Injury) and engagement in NSSI. However, previous studies have been small and cross-sectional, and thus underpowered to examine the nature of this association and the extent to which implicit associations predict the persistence of NSSI.

METHODS:

This study builds on previous research in a prospective, longitudinal examination of implicit self-identification with NSSI in a large sample of middle school students. NSSI behavior and implicit NSSI associations were assessed annually in school at three time points.

RESULTS:

Adolescents who engaged in NSSI exhibited stronger implicit self-identification with NSSI than adolescents who did not engage in NSSI. Moreover, implicit NSSI identification was stronger among adolescents who engaged in cutting, frequent NSSI, and recent NSSI. A reciprocal association was observed between NSSI frequency and implicit NSSI identification over 1 year. Notably, implicit NSSI identification uniquely and prospectively predicted engagement in NSSI over the subsequent year.

CONCLUSIONS:

Implicit self-identification with NSSI may track both trait- and state-related changes in the behavior and, importantly, may help predict continued engagement in NSSI.

KEYWORDS:

Self-injury; adolescence; assessment; longitudinal studies; self-harm

PMID:
26684880
PMCID:
PMC5985446
DOI:
10.1111/jcpp.12500
[Indexed for MEDLINE]
Free PMC Article

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