Abstract
Previous research has found correlations between outcome expectancies, self-efficacy to resist, and the occurrence of non-suicidal self-injury. However, it remains unclear whether these factors are associated with the persistence of self-injury. Based on social cognitive theory, this study aims to investigate the roles of outcome expectancies and self-efficacy to resist non-suicidal self-injury in the process of individuals engaging in persistent self-injury after transitioning into the college environment. A two-wave survey was conducted at a 6-month interval using self-report questionnaires to investigate 161 first-year college students with a history of self-injury in the past year. 21.7% of freshmen continued engaging in self-injury. There were significant differences in communication expectancies scores in outcome expectancies between those who continued and those who did not continue self-injury. Affect regulation expectancies in outcome expectancies positively predicted persistent self-injury, while communication expectancies in outcome expectancies negatively predicted persistent self-injury. Self-efficacy to resist self-injury moderated the relationship between pain expectancies and negative self-belief expectancies in predicting persistent self-injury. When self-efficacy to resist self-injury was low, pain expectancies significantly negatively predicted persistent self-injury. When self-efficacy to resist self-injury was high, negative self-belief expectancies significantly negatively predicted persistent self-injury. This study highlights the importance of considering relevant cognitive factors in the prevention and intervention of persistent self-injury.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
Data Availability
The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.
References
Andrews, T., Martin, G., Hasking, P., & Page, A. (2013). Predictors of continuation and cessation of nonsuicidal self-injury. Journal of Adolescent Health, 53(1), 40–46. https://doi.org/10.1016/j.jadohealth.2013.01.009
Arnett, J. J. (2014). Emerging adulthood: The winding road from the late teens through the twenties. Oxford University Press.
Bandura, A. (1989). Human agency in social cognitive theory. American Psychologist, 44(9), 1175–1184. https://doi.org/10.1037/0003-066x.44.9.1175
Bandura, A., Freeman, W. H., & Lightsey, R. (1999). Self-efficacy: The exercise of control. Springer.
Brown, R. C., & Plener, P. L. (2017). Non-suicidal self-injury in adolescence. Current Psychiatry Reports, 19(3). https://doi.org/10.1007/s11920-017-0767-9
Chapman, A. L., Gratz, K. L., & Brown, M. Z. (2006). Solving the puzzle of deliberate self-harm: The experiential avoidance model. Behaviour Research and Therapy, 44(3), 371–394. https://doi.org/10.1016/j.brat.2005.03.005
Chen, Z., Li, J., Liu, J., & Liu, X. (2022). Adverse childhood experiences, recent negative life events, and non-suicidal self-injury among Chinese college students: The protective role of self-efficacy. Child and Adolescent Psychiatry and Mental Health, 16(1). https://doi.org/10.1186/s13034-022-00535-1
Czyz, E. K., Bohnert, A. S. B., King, C. A., Price, A. M., Kleinberg, F., & Ilgen, M. A. (2014). Self-efficacy to avoid suicidal action: Factor structure and convergent validity among adults in substance use disorder treatment. Suicide and Life-Threatening Behavior, 44(6), 698–709. https://doi.org/10.1111/sltb.12101
Dawkins, J. C., Hasking, P. A., Boyes, M. E., Greene, D., & Passchier, C. (2019). Applying a cognitive-emotional model to nonsuicidal self-injury. Stress and Health, 35(1), 39–48. https://doi.org/10.1002/smi.2837
Dawkins, J. C., Hasking, P. A., & Boyes, M. E. (2021). Thoughts and beliefs about nonsuicidal self-injury: An application of social cognitive theory. Journal of American College Health, 69(4), 428–434. https://doi.org/10.1080/07448481.2019.1679817
Garett, R., Liu, S., & Young, S. D. (2017). A longitudinal analysis of stress among incoming college freshmen. Journal of American College Health, 65(5), 331–338.
Gelinas, B. L., & Wright, K. D. (2013). The cessation of deliberate self-harm in a university sample: The reasons, barriers, and strategies involved. Archives of Suicide Research, 17(4), 373–386.
Gray, N., Hasking, P., & Boyes, M. (2022). Cognitive and emotional factors associated with the desire to cease non-suicidal self‐injury. Journal of Clinical Psychology, 78(9), 1896–1911.
Gwaltney, C. J., Metrik, J., Kahler, C. W., & Shiffman, S. (2009). Self-efficacy and smoking cessation: A meta-analysis. Psychology of Addictive Behaviors, 23(1), 56.
Halpin, S. A., & Duffy, N. M. (2020). Predictors of non-suicidal self-injury cessation in adults who self-injured during adolescence. Journal of Affective Disorders Reports, 1, 100017. https://doi.org/10.1016/j.jadr.2020.100017
Hambleton, A. L., Hanstock, T. L., Halpin, S., & Dempsey, C. (2020). Initiation, meaning and cessation of self-harm: Australian adults’ retrospective reflections and advice to adolescents who currently self-harm. Counselling Psychology Quarterly, 35(2), 260–283. https://doi.org/10.1080/09515070.2020.1737509
Hasking, P. (2017). Differentiating non-suicidal self-injury and risky drinking: A role for outcome expectancies and self-efficacy beliefs. Prevention Science, 18(6), 694–703. https://doi.org/10.1007/s11121-017-0755-7
Hasking, P., & Boyes, M. (2018). The non-suicidal self‐injury expectancy questionnaire: Factor structure and initial validation. Clinical Psychologist (Australian Psychological Society), 22(2), 251–261. https://doi.org/10.1111/cp.12127
Hasking, P. A., & Oei, T. P. S. (2002). The differential role of alcohol expectancies, drinking refusal self-efficacy and coping resources in predicting alcohol consumption in community and clinical samples. Addiction Research & Theory, 10(5), 465–494. https://doi.org/10.1080/1606635021000034049
Hasking, P., Whitlock, J., Voon, D., & Rose, A. (2017). A cognitive-emotional model of NSSI: Using emotion regulation and cognitive processes to explain why people self-injure. Cognition and Emotion, 31(8), 1543–1556. https://doi.org/10.1080/02699931.2016.1241219
He, S., & Xu, S. (2022). Study on the influence of introduction course on freshmen’s college life adaptation and emotional regulation. International Journal of Neuropsychopharmacology, 25(Supplement_1), A56–A57.
Kadden, R. M., & Litt, M. D. (2011). The role of self-efficacy in the treatment of substance use disorders. Addictive Behaviors, 36(12), 1120–1126.
Kiekens, G., Claes, L., Demyttenaere, K., Auerbach, R. P., Green, J. G., Kessler, R. C., Mortier, P., Nock, M. K., & Bruffaerts, R. (2016). Lifetime and 12-month nonsuicidal self-injury and academic performance in college freshmen. Suicide and Life-Threatening Behavior, 46(5), 563–576. https://doi.org/10.1111/sltb.12237
Kiekens, G., Hasking, P., Bruffaerts, R., Claes, L., Baetens, I., Boyes, M., Mortier, P., Demyttenaere, K., & Whitlock, J. (2017). What predicts ongoing nonsuicidal self-injury? Journal of Nervous & Mental Disease, 205(10), 762–770. https://doi.org/10.1097/NMD.0000000000000726
Kiekens, G., Hasking, P., Boyes, M., Claes, L., Mortier, P., Auerbach, R. P., Cuijpers, P., Demyttenaere, K., Green, J. G., & Kessler, R. C. (2018). The associations between non-suicidal self-injury and first onset suicidal thoughts and behaviors. Journal of Affective Disorders, 239, 171–179. https://doi.org/10.1016/j.jad.2018.06.033
Kiekens, G., Hasking, P., Claes, L., Boyes, M., Mortier, P., Auerbach, R. P., Cuijpers, P., Demyttenaere, K., Green, J. G., Kessler, R. C., Myin-Germeys, I., Nock, M. K., & Bruffaerts, R. (2019). Predicting the incidence of non-suicidal self-injury in college students. European Psychiatry, 59, 44–51. https://doi.org/10.1016/j.eurpsy.2019.04.002
Klonsky, E. D. (2011). Non-suicidal self-injury in United States adults: Prevalence, sociodemographics, topography and functions. Psychological Medicine, 41(9), 1981–1986. https://doi.org/10.1017/S0033291710002497
Koenig, J., Klier, J., Parzer, P., Santangelo, P., Resch, F., Ebner-Priemer, U., & Kaess, M. (2021). High-frequency ecological momentary assessment of emotional and interpersonal states preceding and following self-injury in female adolescents. European Child & Adolescent Psychiatry, 30(8), 1299–1308. https://doi.org/10.1007/s00787-020-01626-0
McEvoy, P. M., Hayes, S., Hasking, P. A., & Rees, C. S. (2017). Thoughts, images, and appraisals associated with acting and not acting on the urge to self-injure. Journal of Behavior Therapy and Experimental Psychiatry, 57, 163–171. https://doi.org/10.1016/j.jbtep.2017.05.010
Nock, M. K. (2009). Why do people hurt themselves? New insights into the nature and functions of self-injury. Current Directions in Psychological Science, 18(2), 78–83. https://doi.org/10.1111/j.1467-8721.2009.01613.x
Nock, M. K. (2010). Self-injury. Annual Review of Clinical Psychology, (6), 339–363. https://doi.org/10.1146/annurev.clinpsy.121208.131258
Nock, M. K., & Prinstein, M. J. (2004). A functional approach to the assessment of self-mutilative behavior. Journal of Consulting and Clinical Psychology, 72(5), 885–890. https://doi.org/10.1037/0022-006X.72.5.885
Oei, T. P. S., Hasking, P., & Phillips, L. (2009). A comparison of general self-efficacy and drinking refusal self-efficacy in predicting drinking behavior. The American Journal of Drug and Alcohol Abuse, 33(6), 833–841. https://doi.org/10.1080/00952990701653818
Plener, P. L., Schumacher, T. S., Munz, L. M., & Groschwitz, R. C. (2015). The longitudinal course of non-suicidal self-injury and deliberate self-harm: A systematic review of the literature. Borderline Personality Disorder and Emotion Dysregulation, 2(1), 2. https://doi.org/10.1186/s40479-014-0024-3
Rotolone, C., & Martin, G. (2012). Giving up self-injury: A comparison of everyday social and personal resources in past versus current self-injurers. Archives of Suicide Research, 16(2), 147–158. https://doi.org/10.1080/13811118.2012.667333
Selby, E. A., & Joiner, T. E. (2009). Cascades of emotion: The emergence of borderline personality disorder from emotional and behavioral dysregulation. Review of General Psychology, 13(3), 219–229. https://doi.org/10.1037/a0015687
Van Zundert, R. M. P., Nijhof, L. M., & Engels, R. C. M. E. (2009). Testing social cognitive theory as a theoretical framework to predict smoking relapse among daily smoking adolescents. Addictive Behaviors, 34(3), 281–286. https://doi.org/10.1016/j.addbeh.2008.11.004
Whitlock, J., Prussien, K., & Pietrusza, C. (2015). Predictors of self-injury cessation and subsequent psychological growth: Results of a probability sample survey of students in eight universities and colleges. Child and Adolescent Psychiatry and Mental Health, 9(1). https://doi.org/10.1186/s13034-015-0048-5
Wong, S. L., & Chung, M. C. (2021). Child abuse and non-suicidal self-injury among Chinese university students: The role of emotion dysregulation and attachment style. Current Psychology. https://doi.org/10.1007/s12144-021-01832-2
Wu, J., & Liu, H. (2019). Features of nonsuicidal self-injury and relationships with coping methods among college students [Journal Article]. Iranian Journal of Public Health, 48(2), 270–277.
You, J., & Lin, M. (2015). Predicting suicide attempts by time-varying frequency of nonsuicidal self-injury among Chinese community adolescents. Journal of Consulting and Clinical Psychology, 83(3), 524–533. https://doi.org/10.1037/a0039055
You, J., Lin, M. P., Fu, K., & Leung, F. (2013). The best friend and friendship group influence on adolescent nonsuicidal self-injury. Journal of Abnormal Child Psychology, 41(6), 993–1004. https://doi.org/10.1007/s10802-013-9734-z
Zhou, J., Zhang, J., Huang, Y., Zhao, J., Xiao, Y., Zhang, S., Li, Y., Zhao, T., Ma, J., Ou, N., Wang, S., Ou, Q., & Luo, J. (2022). Associations between coping styles, gender, their interaction and non-suicidal self-injury among middle school students in rural west China: A multicentre cross-sectional study. Frontiers in Psychiatry, 13. https://doi.org/10.3389/fpsyt.2022.861917
Funding
This research is supported by the North Sichuan Medical College (grant number: CBY22-QNB05), and the Nanchong Federation of Social Science Associations (grant number: NC23C183), and the Bureau of Science & Technology Nanchong City (grant number: 20YFZJ0101).
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Ethics Approval
This study was approved by the Ethics Committee of North Sichuan Medical College.
Consent to Participate
Written informed consent was obtained from participants before the assessment.
Conflict of Interest
All authors declare that they have no conflict of interest.
Additional information
Publisher’s Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Zhou, J., Luo, J. Cognitive Factors Analysis of Persistent Non-suicidal Self-injury from Secondary School to University: a Short-Term Longitudinal Study. Int J Ment Health Addiction (2024). https://doi.org/10.1007/s11469-024-01260-w
Accepted:
Published:
DOI: https://doi.org/10.1007/s11469-024-01260-w