(PS2-B45) Emotion Regulation in Self-injurious Thoughts and Behaviors: Specific vs. Global Deficits

Title: Emotion regulation in self-injurious thoughts and behaviors: specific vs. global deficits

Authors: Brianna Pastro, Caroline Holman, Gracie Jenkins, Margaret Andover

Intro: Previous research has implicated deficits in emotion regulation (ER) in the development and maintenance of self-injurious behaviors (SIB), including suicide attempts (SA) and non-suicidal self-injury (NSSI). Research, however, has often relied on retrospective, rather than in-the-moment reports, and has not investigated specific deficits in ER that may account for this global deficit. Gross’s model of ER breaks down active processes to five strategies, three of which were tested in the present study: distraction, suppression, and reappraisal. Specific deficits in these strategies among individuals who engage in self-injurious behaviors are not yet understood and may inform targeted interventions. The current study aimed to understand real-time implementation of three specific ER strategies by women with and without a history of SIB while viewing negative images.

Methods: Participants were 78 women ages 19-54 recruited from the community; 21.6% had a history of SA, and 45.2% had a history of NSSI. Participants completed a computer task that involved viewing and negatively-valenced images and rating their emotional experience throughout. In the first block, they were instructed to respond naturally to the images. In the second, they were asked to regulate their emotions as they usually do. For the remaining three blocks, participants were given instructions to regulate their emotions via distraction, suppression, and reappraisal. 

Results: We first investigated ER instruction type and SA history. There was a significant fixed effect of ER instruction type, F(4, 239.19)=44.81, p< 0.001, but the interaction between instruction type and SA history was not significant, F(4, 239.19)=0.64, p=0.63. Pairwise comparisons were investigated; individuals without a history of SA reported significantly less emotional distress than those without an SA history when utilizing distraction (p < .001) and reappraisal (p = .014). There was no significant difference in ratings of distress when utilizing suppression (p = .102). Participants with a history of SA reported significantly less emotional distress when utilizing distraction as compared to their non-instructed ER strategy (p = .002); this pattern was not found among those without a SA history. There were no significant differences in ratings of distress when utilizing reappraisal and suppression techniques (all ps > .08). A similar pattern emerged for participants with NSSI history.  

Discussion: These results suggest that women with a history of SIB, as compared to those without, are less effective at reducing the intensity of negative emotions when using distraction and reappraisal techniques, suggesting specific deficits in the attention and appraisal processes of ER.  Acquiring skills utilizing distraction specifically as an ER strategy may be particularly beneficial in decreasing the intensity of negative emotions among those with a SIB history.

References:
Chapman, A. L., Gratz, K. L., & Brown, M. Z. (2006). Solving the puzzle of deliberate self-harm: The experiential avoidance model. Behaviour Research & Therapy, 44(3), 371–394. Academic Search Complete.
Gross, J. J. (n.d.). Antecedent- and Response-Focused Emotion Regulation: Divergent Consequences for Experience, Expression, and Physiology. 14.