Lack of exposure, sensitivity to blood, self-worth, and perceived stigma: Examining potential “barriers” to nonsuicidal self-injury among emerging adults in daily life

Nonsuicidal self-injury (NSSI) is a highly prevalent mental health concern among adolescents and young adults. Understanding not only who is most at risk, but when in daily life, is necessary to prevent NSSI. To explore the role of several theoretically relevant "barriers" to NSSI (i.e., lack of exposure to NSSI, sensitivity to blood, self-worth, and perceived stigma) in NSSI urges and behaviors, daily diary sampling was used in the present study. Participants included 236 young adults (130 with recent NSSI, 106 without recent NSSI) who completed daily assessments for 14 days. Across the daily diary period, participants who engaged in NSSI reported greater exposure to NSSI, insensitivity to blood, perceived stigma toward NSSI, and lower self-worth compared to individuals without a history of NSSI. Hierarchical linear modeling revealed that within individuals, greater than typical insensitivity to blood and lower self-worth predicted same day NSSI urges and behaviors, and lower self-worth also predicted next day NSSI urges and behaviors. Greater exposure to NSSI also predicted same day NSSI urges, and next day NSSI behavior. Findings underscore that increasing self-worth and aversion to NSSI, and decreasing exposure to NSSI, may serve as important targets for NSSI prevention and intervention.