Picturing self‐harm: Investigating flash‐forward mental imagery as a proximal and modifiable driver of non‐suicidal self‐injury

Julie L. Ji*, Michael Kyron, Lisa Saulsman, Rodrigo Becerra, Ashleigh Lin, Penelope Hasking, Emily A. Holmes

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

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Abstract

Objectives: Non-suicidal self-injury (NSSI) is theorized to be reinforced by its emotional consequences. Mental images of NSSI are commonly reported as occurring prior to NSSI. Based on the known functional properties of anticipatory mental imagery as an emotional and motivational amplifier, this study investigated whether NSSI mental imagery constitutes a proximal and dynamic mechanism underpinning NSSI risk. Method: An intensive ecological momentary assessment (EMA) study was conducted to track the occurrence and characteristics of NSSI mental imagery alongside NSSI urge and behavior in naturalistic settings. A sample of N = 43 individuals aged 17 to 24 with a history of repetitive NSSI completed EMA surveys seven times a day for 14 days. Results: Mental preoccupation in the form of NSSI mental imagery-based flash-forwards to the actions, bodily sensations, and emotional benefits of NSSI was found to occur when NSSI urge was high but not when urge was low. Critically, objective cross-panel analyses showed that higher frequencies of NSSI imagery occurrence predicted greater future NSSI urge and increased likelihood of acting on urge, over and above current urge. Conclusions: Mental imagery of NSSI is not simply an epiphenomenal by-product of NSSI urge and may constitute a dynamic and proximal novel intervention target.

Original languageEnglish
Pages (from-to)713-727
Number of pages15
JournalSuicide and Life-Threatening Behavior
Volume54
Issue number4
Publication statusPublished - 10 Apr 2024

ASJC Scopus subject areas

  • Clinical Psychology
  • Public Health, Environmental and Occupational Health
  • Psychiatry and Mental Health

Keywords

  • flash-forward mental imagery
  • motivation
  • non-suicidal self-injury
  • self-harm

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