Impulsivity as a Predictor of Non-Suicidal Self-Injurious Thoughts and Behaviors in Adolescent Inpatients
Lutz, Nina M.
- The high prevalence of non-suicidal self-injury (NSSI) within community and psychiatric populations is a pressing public health concern. Impulsivity is a heterogeneous construct, and although prior research has found that emotion-relevant impulsivity is associated with the occurrence of NSSI in adolescents, it remains unclear whether different components of impulsivity are differentially related ... read moreto distinct NSSI outcomes. Presently, predictors of future NSSI above and beyond NSSI history remain unclear, however, emotion-relevant impulsivity may be a promising factor that confers increased vulnerability. The current study included 526 adolescent psychiatric inpatients (72.8% with lifetime NSSI). Participants completed assessments regarding mental illness, lifetime NSSI, impulsivity, and psychiatric symptoms within 48 hours of hospitalization, and a subset of the initial participants (36.3%) completed a 1-month follow-up assessment after hospital discharge. An exploratory factor analysis identified three distinct domains within the multidimensional self-report impulsivity instrument. Two emotion-relevant factors emerged: (a) Pervasive Influence of Feelings (PIF; i.e., tendency to generalize negative experiences) and (b) Feelings Trigger Action (FTA; i.e., tendency to reflexively respond to strong emotions). PIF was uniquely associated with more frequency NSSI thoughts, while FTA was uniquely related to more intense thoughts, shorter duration of thoughts before action, and younger age of onset. We found that emotion-relevant impulsivity was not significantly associated with the occurrence of lifetime NSSI, or predictive of NSSI outcomes after hospital discharge. These results point to the importance of emotion-relevant impulsivity in understanding NSSI, and indicated that specific factors of emotion-relevant of impulsivity are differentially related to NSSI thought and behavior outcomes.read less