Self-other representations, emotion regulation and psychological distress as pathways to non-suicidal self-injury in emerging adults

Theoretical models of non-suicidal self-injury (NSSI) have highlighted the complex interaction between underlying psychosocial vulnerabilities, but, there is limited empirical support for these conceptualizations. The aim of the study was to examine affective, cognitive and interpersonal factors predicting NSSI among emerging adults. A sample of 1,574 emerging adults aged 18-25 years, drawn from 19 colleges via multi-stage sampling completed measures of NSSI, emotion regulation, experiential avoidance, psychological distress, self-criticism, brooding-rumination, attachment style and perceived social support. The results indicated that 22.40% had engaged in one or more self-injuring behaviours in the past 12 months, with cutting skin, hitting self and severely scratching self as the most commonly endorsed methods. Exploratory structural equation modelling identified differential pathways to NSSI, with difficulties in regulating emotions emerging as the only direct predictor of NSSI. Two latent constructs reflecting relationally based affective and cognitive structures: a negative self-other representation, and attachment style of considering relationships as secondary to achievement were identified. These differentially, and indirectly impacted NSSI engagement through psychological distress and difficulties in emotion regulation. The implications for interventions to expand beyond addressing emotion regulation deficits, and include other affective, cognitive and relational vulnerabilities are discussed.