(PS2-C71) NSSI Scar Presence & Attachment Associated with Function & Method

Nonsuicidal self-injury (NSSI) often results in permanent and visible scars. Relatively little is known about NSSI scarring and psychological outcomes, including whether individuals’ attachment to their scars influences long-term differences in functioning. Research comparing scar meaning for individuals with scars from NSSI to people with other scars (e.g., accidents) found that people with NSSI scarring more often ascribed a particular meaning to their scars, ranging from reminders of failure, shame, or embarrassment to reminders of resilience, growth, and strength. However, no studies to date have examined differences in method or function among individuals who have a history of NSSI with or without scars. We hypothesized that people with attachment to their NSSI scars would have more severe methods, more functions, and more psychopathology than those with no NSSI scars and scar without attachment groups.

Psychology undergraduate students (n = 81; M_age = 19.91, 70.4% female, 84% White, 81.5% heterosexual) completed the Inventory of Statements about Self-Injury, questions about the presence of NSSI scars, and whether or not they have an emotional or psychological attachment to their scars, the Beck Depression Inventory-II, and the Self-Hate Scale. The Self Rating Survey was used to assess self-criticism. Groups consisted of No Scar (n = 31), Scar WithOut Attachment (n = 25), and Scar With Attachment (n = 24).

The primary method of NSSI differed across all three groups, with the No Scar group endorsing no primary method of self-injury, Scar WithOut attachment group endorsing wound interference, and the Scar With Attachment group endorsing cutting. The groups differed on NSSI functions, with the Scar With Attachment group reporting higher scores on affect regulation, interpersonal boundaries, self-care, anti-dissociation, anti-suicide, interpersonal influence, and marking distress functions than the no scar group (p < .001 for all). The No Scar group and Scar WithOut Attachment group did not differ on any NSSI functions. Notably, the Scar With Attachment group reported higher levels of anti-dissociation (p = .006), anti-suicide (p = .041), and marking distress (p < .001) functions of NSSI than the Scar WithOut Attachment group. Scar With and WithOut attachment groups did not significantly differ on depressive symptoms (p = .952), self-hate (p = .984), or self-criticism (p = .723), suggesting negative affect does not account for observed differences.  Results suggest NSSI scar attachment is associated with more severe methods of injury and a greater range of intrapersonal functions. CBT may be helpful in reducing scar attachment and increasing alternative means of preventing suicide and dissociation or ways of tolerating distress when treating individuals who self-injure.