Structural Validity of Negative Self-association Model in Attempting Nonsuicidal Self-injury

Background: Nonsuicidal self-injury (NSSI) is the direct and deliberate destruction of one’s own body tissue without suicidal intent. This prevalent behavior can have physical, psychological, and social consequences. Objectives: This study aimed to explain NSSI in adolescents based on Hooley’s negative self-association model. Patients and Methods: The sample consisted of 223 high school students in public schools in Tehran province, of whom 63 were self-injured and 160 were non-self-injured. The subjects were selected by purposive sampling. The data were gathered using the Deliberate Self-harm Inventory (DSHI), Forms of Self-criticism/Attacking and Self-reassuring Scale (FSCRS), Emotional Avoidance Strategy Inventory for Adolescents (EASI-A), Self-punishment Scale (SPS), Self-injury Implicit Association Test (SI-IAT), and General Health Questionnaire (GHQ). Data analysis was performed based on structural equation modeling (SEM) using the statistical software IBM SPSS AMOS v22.0. Results: The SEM indicated that among the goodness of fit indices, CFI, TLI, and RMSEA were in the desired range. Negative self-association played a central role in NSSI attempts. There was a significant relationship (P < 0.05) between self-punishment and self-injury. Negative associations made people more inclined to avoid negative emotions, but no significant relationship was found with NSSI. However, the path of negative self-association and its relationship with accessibility to and identification with self-injury and attempt to NSSI did not have enough significance and led to a decrease in the model’s fit. Conclusions: Consistent with the findings of research conducted in the field of self-injury, this study showed that negative self-associations play a central role in attempting NSSI. The results of this study provide a new guideline for designing prevention and treatment programs for self-injuring behavior.