Emotional responses to self-injury imagery among adults with borderline personality disorder.

Nonsuicidal self-injury (NSSI) and suicide attempts (SAs) are especially prevalent in borderline personality disorder. One proposed mechanism for the maintenance of NSSI and SAs is escape conditioning, whereby immediate reductions in aversive emotional states negatively reinforce the behaviors. Psychophysiological and subjective indicators of negative emotion associated with NSSI and SA imagery were examined in 42 individuals who met criteria for border personality disorder. Personally relevant imagery scripts that involved an NSSI and/or an SA incident were created, as were control scenes involving imagery of an accidental injury, an accidental death, or an emotionally neutral event. Results did not support the hypothesis that decreases in negative emotion would occur during NSSI imagery; however, decreases were found during imagery of the moments after NSSI, which suggests some support for escape conditioning. Support for the model was not found for SAs. Possible implications of patterns that demonstrate decreases in negative emotion during accidental death imagery are discussed.