(PS9-B42) Analyzing the Affect Regulation Hypothesis Among Self-injurers: What Happens When Urges to Self-injure Are Resisted?

Affect regulation is one of the most common reasons for engagement in non-suicidal self-injury (NSSI). The affect regulation hypothesis argues that negative affect (NA) increases, and positive affect (PA) decreases, before NSSI (antecedent hypothesis) and that after NSSI, NA decreases while PA increases (consequence hypothesis). Prior research has neglected to test this idea among individuals that resist their urges for NSSI, an important phenomenon given that NSSI urges occur much more frequently that NSSI behaviors. We sought to address this gap by 1) testing the antecedent hypothesis for NSSI urges and 2) testing the consequence hypothesis for NSSI urges that are not followed by NSSI. Participants (N=93) were young adults (ages 18-34) with lifetime NSSI and past-month NSSI urges or behaviors that were enrolled in a two-week ecological momentary assessment (EMA) protocol during which they were sent 6 surveys per day and asked to report on their experiences with NSSI urges, behaviors, PA, and NA. Dynamic structural equation modeling fixed-effects models were used to analyze both the antecedent and consequence hypotheses. First, we examined NSSI urges reported since the last survey as predicted by NA and PA from the prior survey. Higher NA (but not lower PA) predicted NSSI urges (within-person) at the next survey (B =.267). Between-person results showed that individuals with more NSSI urges (relative to the sample mean) also had higher NA (B = .452) and lower PA (B = -.290) over the EMA period. Next, we examined resisted NSSI urges (since last survey NSSI urges with no since last survey NSSI behaviors) predicting NA and PA at the same survey while controlling for NA and PA at the prior survey. Results showed that resisted urges did not predict changes in NA (B = .025) or PA (B= -.045) since the last survey. Between-person results mirrored findings for the antecedent hypothesis: more NSSI urges was associated with higher overall NA (B = .467) and lower overall PA (B= -.334). Interestingly, our antecedent hypothesis results only partially match well-established findings regarding NA and PA and NSSI behaviors; this is likely due to PA and NA being moderately and negatively correlated with each other (B = -.53) at the same survey, reducing unique variance which could explain NSSI urge occurrence. Overall, our results suggest that increased levels of NA may lead to NSSI urges, however, when those urges are resisted, this may not lead to a decrease in NA. Future studies should continue to focus on populations of people that resist their NSSI urges to better inform interventions for NSSI, with the goal of decreasing negative emotions and increasing positive ones. Specifically, determining what individuals are doing instead of acting on their NSSI urges, would help us to understand the underlying reinforcement process that may be maintaining NSSI urges and NA over time.