Untangling the Impact of Social Context on Non-suicidal Self-injury

Although accumulating research is clarifying the role of negative affect in non-suicidal self-injury (NSSI), few studies have considered the social context of NSSI. Participants with recent and repeated NSSI (N = 60) completed daily diaries for 14 days assessing perceived support, interpersonal conflict, stress, negative affect, and NSSI thoughts, urges, and acts. Descriptive analyses revealed that, in most cases, others in the participant’s social network (friends, therapists/doctors, family members, romantic partners) were aware of the participant’s history of NSSI. Interpersonal functions of NSSI were less frequently and strongly endorsed than intrapersonal functions. Hierarchical linear models (HLM) examined the temporal associations between NSSI and social context in the daily reports, including a) a contemporaneous model, examining whether support or conflict were concurrently associated with NSSI, b) a prospective model, examining whether support or conflict predicted later NSSI, and c) a subsequent model, examining whether NSSI predicted later changes in support or conflict. Perceived support, particularly from romantic partners, was negatively related to concurrent (same-day) NSSI urges, thoughts, and acts. Perceived support was positively associated with NSSI urges on the following day. Interpersonal conflict was positively associated with concurrent (same-day) NSSI urges but unrelated to next-day NSSI. NSSI that was disclosed to or discovered by others was associated with greater perceived support on the following day, but this was not the case for NSSI that was unknown to others. Negative affect partially mediated the concurrent association between support and NSSI. Further, perceived support moderated the concurrent association of negative affect and NSSI urges, such that greater support buffered the effect of negative affect, whereas lower support exacerbated the effect of negative affect. Together, this research provides important insight into the ways that social context can impact NSSI urges and behaviour.