Evaluating the Role of Social Interactions and Shame in Self-Injurious Behaviors using Ecological Momentary Assessment

Abstract

Self-injurious thoughts and behaviors (SITBs) are increasingly prevalent in the United States, particularly among adolescents and young adults. The transactional model of emotion dysregulation provides a framework for understanding the development and maintenance of many of these behaviors. In particular, the experience of shame and self-invalidation following social invalidation appear to play significant roles in SITBs. However, a more comprehensive evaluation of this model would include real-time, in-vivo assessment. Ecological momentary assessment (EMA) methods provide one way to fill this gap by assessing the moment to moment a person’s natural social environments and subsequent private experiences that may contribute to SITBs. This study evaluated a portion of the transactional model using EMA methods. The present study tested the relationship between antecedent social invalidation, heightened emotional arousal and SITBs. Specifically: (1) whether greater invalidation from others during social interactions increases subsequent self-invalidation and shame; (2) whether invalidation from others, self-invalidation and shame during or immediately following social interactions together increase urges for SITBs; and (3) whether self-invalidation and/or shame act as mediating variables between social invalidation and SITBs. Results partially supported the hypotheses for a subsample of participants: for that subsample social invalidation was significantly associated with subsequent self-invalidation and shame. Social invalidation, self-invalidation and shame were also significantly associated with non-suicidal self-injury urges, but less consistently associated with suicide urges. The hypothesis that the relationship between social invalidation and SITBs was mediated by self-invalidation and shame was not supported. Despite its limitations, this study represents a first step at examining the inter- and intra-personal variation in invalidation from others, self-invalidation, shame and SITBs in real time.