Testing an Integrative Model of Affect Regulation and Avoidance in Non-Suicidal Self-Injury and Disordered Eating

Abstract

This research tested a model that integrates risk factors among non-suicidal self-injury (NSSI) and eating disorder (ED) behaviors with the aim of elucidating possible shared and unique mechanisms underlying both behaviors. Emotional distress, limited access to emotion regulation (ER) strategies, experiential avoidance, and NSSI/ED frequency were examined in a sample of 230 female undergraduates. Structural equation modeling indicated that limited access to ER strategies and avoidance mediated relationship between emotional distress and avoidance, which in turn was associated with NSSI and ED behaviors. Results suggest NSSI and ED behaviors may serve similar emotion regulation functions, and specifically highlight the role of experiential avoidance in these behaviors.

Keywords: eating disorders; emotion regulation; experiential avoidance; non-suicidal self-injury (NSSI).

FIGURE 1

Hypothesized relationships between emotional distress, avoidance, Non-Suicidal Self-Injury (NSSI), and disordered eating. MASQQ-D=Mood and Anxiety Symptom Questionnaire-Short Form (MASQ) General Distress Depressive Symptoms subscale; MASQ-A = MASQ General Distress Anxious Symptoms subscale; Strategies = Difficulties in Emotion Regulation Scale (DERS) Limited Access to Emotion Regulation Strategies subscale; WBSI = White Bear Suppression Inventory; AAQ = Acceptance and Action Questionnaire; NSSI Behavior = NSSI as measured by the Deliberate Self-Harm Inventory; Binge = Frequency of binge episodes as measured by the Eating Disorder Diagnostic Scale; Purge = Frequency of purging episodes as measured by the Eating Disorder Diagnostic Scale.

FIGURE 2

Revised model with standardized parameter estimates and significance levels (*p<.05).