Recent and Frequent Nonsuicidal Self-Injury Is Associated With Diminished Implicit and Explicit

In the present study, we tested the hypothesis that an instinctive barrier to nonsuicidal self-injury (NSSI)—the aversion to self-cutting stimuli—is diminished in people who engage in NSSI. In a sample of 86 noninjurers and 58 people with a history of self-cutting, we found that NSSI was associated with substantially reduced aversion to self-cutting stimuli across measures of both implicit (d = 0.61) and explicit (d = 0.93) affect even after controlling for emotion reactivity and dysregulation. This diminished aversion primarily applied to individuals who had engaged in NSSI within the past year or who had 10 or more lifetime episodes of self-cutting (ds = 0.87–1.23). Implicit identification with NSSI also significantly distinguished between groups (d = 0.67) but was not correlated with affective measures or NSSI recency/ frequency. Although previous work has shown that the affective benefits of NSSI are natural and universal, these findings suggest that diminished instinctive barriers to NSSI may be specific NSSI risk factors that can be targeted in novel interventions.