Motivational Dynamics Among Eating-disordered Patients With and Without Nonsuicidal Self-injury: A Self-Determination Theory Approach

Objective The presence of nonsuicidal self-injury (NSSI) in eating-disordered (ED) patients is considered a complicating factor in treatment with a possibly adverse influence on patients' motivation to change. Using Self-Determination Theory as a guiding framework, we compared ED patients with and without NSSI in terms of their well-being and their motives to undertake psychotherapeutic change. Method Data were collected in a sample of 95 ED patients, including 37 patients displaying at least some type of NSSI. Results Patients with NSSI, relative to those without, felt more externally pressured to undertake change and reported lower overall well-being. Mean level differences in well-being between both patient groups were fully accounted for by patients' externally pressuring motives for pursuing change. Discussion In ED patients with NSSI, there is an important link between their more externally driven motivation to change and their lowered psychological well-being. It is discussed how clinicians can approach these patients to pursue change. Copyright (c) 2012 John Wiley & Sons, Ltd and Eating Disorders Association.