Real-time monitoring of the associations between self-critical and self-punishment cognitions and nonsuicidal self-injury.

The Defective Self Model of nonsuicidal self-injury (NSSI) proposes that some people engage in NSSI to punish themselves and/or to respond to self-critical cognitions. Although there is a growing body of research to support this theory, there has been a lack of ecologically valid approaches employed to critically examine its tenets. The current study aimed to fill this gap in the literature. A sample of 64 undergraduates with a history of repetitive NSSI were recruited and completed an ecological momentary assessment (EMA) protocol. At baseline, participants completed trait measures of self-criticism and self-punishment cognitions. Over the EMA period, participants reported their experience of self-critical and self-punitive cognitions, and NSSI urge intensity three times daily. Our between-persons level findings suggest that trait and aggregated state self-punishment, but not self-critical cognitions, predict NSSI urges experienced over the EMA period. Our findings additionally provide evidence that both momentary self-critical and self-punishment cognitions are concomitantly and prospectively associated with NSSI urge intensity as measured in real-time and modeled at a within-persons level. However, after adjusting for concurrent NSSI urge intensity in prospective models, these within-persons level findings do not hold. Nevertheless, our findings provide greater support for the Defective Self Model of NSSI.