Cognitive Therapy and Research

, Volume 34, Issue 5, pp 421–428 | Cite as

The Pernicious Blend of Rumination and Fearlessness in Non-Suicidal Self-Injury

  • Edward A. Selby
  • Lavonna D. Connell
  • Thomas E. JoinerJr.
Original Article


Recent theory suggests that people may engage in dysregulated behaviors, such as non-suicidal self-injury (NSSI), as a way to distract from rumination and emotional cascades (Selby et al. 2008); similarly, another theory suggests that people may not engage in self-injurious behavior without habituation to fear through repeated exposure to painful events (Joiner 2005). We hypothesized that both high rumination and habituation to the fear of pain may strongly influence NSSI because those who lack a fear of pain and ruminate intensely will not be afraid to inflict physical pain as a way to distract from negative affect. Participants were undergraduate students (N = 94), a large portion of whom reported engaging in NSSI. These participants were given measures of past painful experiences, rumination, and frequency of recent self-injury. Using hierarchical linear regression, evidence was found to support the interaction effect of rumination and painful/provocative experiences on the frequency of NSSI, even after controlling for important variables such as age, gender, and sensation seeking. Although the interaction significantly predicted NSSI, it did not predict dysregulated eating behaviors or drinking to cope.


Rumination Self-injury Self-harm Emotional cascades Acquired capability 



This study was funded, in part, by National Institute of Mental Health grant F31MH081396 to E. A. Selby, under the sponsorship of T. E. Joiner. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute of Mental Health or the National Institutes of Health.


  1. Anestis, M. D., Selby, E. A., & Joiner, T. E. (2007). The role of urgency in maladaptive behaviors. Behaviour Research and Therapy, 45, 3018–3029.CrossRefPubMedGoogle Scholar
  2. Armey, M. F., & Crowther, J. H. (2008). A comparison of linear versus non-linear models of aversive self-awareness, dissociation, and non-suicidal self-injury among young adults. Journal of Consulting and Clinical Psychology, 76(1), 9–14.CrossRefPubMedGoogle Scholar
  3. Brown, M. Z., Comtois, K. A., & Linehan, M. M. (2002). Reasons for suicide attempts and non-suicidal self-injury in women with borderline personality disorder. Journal of Abnormal Psychology, 111(1), 198–202.CrossRefPubMedGoogle Scholar
  4. Bushman, B. J., Bonacci, A. M., Pederson, W. C., Vasquez, E. A., & Miller, N. (2005). Chewing on it can chew you up: Effects of rumination on triggered displaced aggression. Journal of Personality and Social Psychology, 88(6), 969–983.CrossRefPubMedGoogle Scholar
  5. Chapman, A. L., Gratz, K. L., & Brown, M. Z. (2006). Solving the puzzle of deliberate self-harm: The experiential avoidance model. Behavior Research Therapy, 44, 371–394.CrossRefGoogle Scholar
  6. Cooper, M. L., Russell, M., Skinner, J. B., & Windle, M. (1992). Development and validation of a three-dimensional measure of drinking motives. Psychological Assessment: Journal of Consulting and Clinical Psychology, 4, 123–132.Google Scholar
  7. Faul, F., Erdfelder, E., Lang, A. G., & Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behaviour Research Methods, 39, 175–191.Google Scholar
  8. Garner, D. M., Olmstead, M. P., & Polivy, J. (1983). Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia. International Journal of Eating Disorders, 2, 15–19.CrossRefGoogle Scholar
  9. Gratz, K. L. (2006). Risk factors for deliberate self-harm among female college students: The role and interaction of childhood maltreatment, emotional inexpressivity, and affect intensity/reactivity. American Journal of Orthopsychiatry, 76(2), 238–250.CrossRefPubMedGoogle Scholar
  10. Gratz, K. L., Conrad, S. D., & Roemer, L. (2002). Risk factors for deliberate self-harm among college students. American Journal of Orthopsychiatry, 72(1), 128–140.CrossRefPubMedGoogle Scholar
  11. Guertin, T., Lloyd-Richardsonm, E., Spirito, A., Donaldson, D., & Boergers, J. (2001). Self-mutilative behavior in adolescents who attempt suicide by overdose. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 1062–1069.CrossRefPubMedGoogle Scholar
  12. Hilt, L. M., Cha, C. B., & Nolen-Hoeksema, S. (2008). Nonsuicidal self-injury in young adolescent girls: Moderators of distress—function relationship. Journal of Counseling and Clinical Psychology, 76(1), 63–71.CrossRefGoogle Scholar
  13. Joiner, T. E., Jr. (2005). Why people die by suicide. Cambridge, MA: Harvard University Press.Google Scholar
  14. Kemperman, I., Russ, M. J., Clark, W. C., Kakuma, T., Zanine, E., & Harrison, K. (1997). Pain assessment in self-injurious patients with borderline personality disorder using signal detection theory. Psychiatry Research, 70, 175–183.CrossRefPubMedGoogle Scholar
  15. Kline, R. B. (2005). Principles and practice of structural equation modeling (2nd ed.). New York: Guildford Press.Google Scholar
  16. Klonsky, E. D. (2007). The functions of deliberate self-injury: A review of the evidence. Clinical Psychology Review, 27, 226–239.CrossRefPubMedGoogle Scholar
  17. Lloyd, E. E., Kelly, M. L., & Hope, T. (1997). Self-mutilation in a community sample of adolescents: Descriptive characteristics and provisional prevalence rates. Poster session presented at the annual meeting of the society for Behavioral Medicine. New Orleans, LA.Google Scholar
  18. Moberly, N. J., & Watkins, E. R. (2008). Ruminative self-focus and negative affect: An experience sampling study. Journal of Abnormal Psychology, 117(2), 314–323.CrossRefPubMedGoogle Scholar
  19. Nock, M. K., Joiner, T. E., Jr., Gordon, K. H., Lloyd-Richardson, E., & Prinstein, M. J. (2006). Non-suicidal self-injury among adolescents: Diagnostic correlates and relation to suicide attempts. Psychiatry Research, 144, 65–72.CrossRefPubMedGoogle Scholar
  20. Nock, M. K., & Prinstein, M. J. (2004). A functional approach to the assessment of self-mutilative behavior. Journal of Consulting and Counseling Psychology, 72(5), 885–890.Google Scholar
  21. Nolen-Hoeksema, S., & Morrow, J. (1991). A prospective study of depression and posttraumatic stress symptoms after a natural disaster: The 1989 Loma Prieta earthquake. Journal of Personality and Social Psychology, 61(1), 115–121.CrossRefPubMedGoogle Scholar
  22. Nolen-Hoeksema, S., Stice, E., Wade, E., & Bohon, C. (2007). Reciprocal relations between rumination and bulimic, substance abuse, and depressive symptoms in female adolescents. Journal of Abnormal Psychology, 116(1), 198–207.CrossRefPubMedGoogle Scholar
  23. Romans, S. E., Martin, J. L., Anderson, J. C., Herbinson, P. G., & Mullen, P. E. (1995). Sexual abuse in childhood and deliberate self-harm. American Journal of Psychiatry, 152, 1336–1342.PubMedGoogle Scholar
  24. Russ, M. J., Roth, S. D., Lerman, A., Kakuma, T., Harrison, K., Shindledecker, R. D., et al. (1992). Pain perception in self-injurious patients with borderline personality disorder. Biological Psychiatry, 32, 501–511.CrossRefPubMedGoogle Scholar
  25. Selby, E. A., Anestis, M. D., Bender, T. E., & Joiner, T. E., Jr. (2009). An exploration of the emotional cascade model in borderline personality disorder. Journal of Abnormal Psychology, 118(2), 375–387.CrossRefPubMedGoogle Scholar
  26. Selby, E. A., Anestis, M. D., & Joiner, T. E. (2008). Understanding the relationship between emotional and behavioral dysregulation: Emotional cascades. Behaviour Research and Therapy, 46, 593–611.CrossRefPubMedGoogle Scholar
  27. Selby, E. A., & Joiner, T. E., Jr. (2009). Cascades of emotion: The emergence of borderline personality disorder from emotional and behavioral dysregulation. Review of General Psychology. doi: 10.1037/a0015687.
  28. Smyth, J. M., Wonderlich, S. A., Heron, K. E., Sliwinski, M. J., Crosby, R. D., Mitchell, J. E., et al. (2007). Daily and momentary mood and stress are associated with binge eating and vomiting in bulimia nervosa patients in the natural environment. Journal of Consulting and Clinical Psychology, 75(4), 629–638.CrossRefPubMedGoogle Scholar
  29. Thomsen, D. K. (2006). The association between rumination and negative affect: A review. Cognition and Emotion, 20(8), 1216–1235.CrossRefGoogle Scholar
  30. Treynor, W., Gonzalez, R., & Nolen-Hoeksema, S. (2003). Rumination reconsidered: A psychometric analysis. Cognitive Therapy and Research, 27(3), 247–259.CrossRefGoogle Scholar
  31. Van Orden, K. A., Witte, T. K., Gordon, K. H., Bender, T. W., & Joiner, T. E., Jr. (2008). Suicidal desire and the capability for suicide: Tests of the interpersonal-psychological theory of suicidal behavior among adults. Journal of Consulting and Clinical Psychology, 70(1), 72–83.CrossRefGoogle Scholar
  32. Wallenstein, M. B., & Nock, M. K. (2007). Physical exercise for the treatment of non-suicidal self-injury: Evidence from a single-case study. American Journal of Psychiatry, 164, 350–351.CrossRefPubMedGoogle Scholar
  33. Weierich, M. R., & Nock, M. K. (2008). Posttraumatic stress symptoms mediate the relation between childhood sexual abuse and non-suicidal self-injury. Journal of Consulting and Counseling Psychology, 76(1), 39–44.Google Scholar
  34. Whiteside, S. P., & Lynam, D. R. (2001). The five-factor model and impulsivity: Using a structural model of personality to understand impulsivity. Personality and Individual Differences, 30, 669–689.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Edward A. Selby
    • 1
  • Lavonna D. Connell
    • 2
  • Thomas E. JoinerJr.
    • 1
  1. 1.Department of PsychologyFlorida State UniversityTallahasseeUSA
  2. 2.Oakwood UniversityHuntsvilleUSA

Personalised recommendations