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. 2022 Jul;78(7):1463-1477.
doi: 10.1002/jclp.23315. Epub 2022 Jan 20.

Modeling pathways to non-suicidal self-injury: The roles of perfectionism, negative affect, rumination, and attention control

Kate E Tonta  1 , Mark Boyes  1   2 , Joel Howell  1 , Peter McEvoy  1   2   3 , Andrew Johnson  1 , Penelope Hasking  1   2
Affiliations

Modeling pathways to non-suicidal self-injury: The roles of perfectionism, negative affect, rumination, and attention control

Kate E Tonta et al. J Clin Psychol. 2022 Jul.

Abstract

Objective: Using the Emotional Cascade Model as a theoretical framework, this study tested whether the relationship between perfectionism and non-suicidal self-injury (NSSI) operates through rumination and negative affect. Additionally, we tested whether the associations between perfectionism and both rumination and negative affect are moderated by attention control.

Methods: Using a correlational cross-sectional design, adults aged 18-25 with (N = 197) and without (N = 271) a history of NSSI completed measures of perfectionism, rumination, negative affect, attention control, and NSSI.

Results: Perfectionism was directly associated with increased odds of NSSI, and indirectly associated with odds of NSSI through rumination and negative affect. The relationship between perfectionism and rumination was moderated by attention focusing, such that the relationship was stronger for individuals who were higher in attention focusing.

Conclusion: Integrating perfectionism and attention with existing models of NSSI may improve understanding of the factors contributing to NSSI and offers insights into future clinical directions.

Keywords: attention; emotional cascade; non-suicidal self-injury; perfectionism.

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Figures

Figure 1
Figure 1
Path analysis model predicting odds of NSSI. NSSI, non‐suicidal self‐injury
Figure 2
Figure 2
Tested path model with unstandardized b coefficients and associated 95% confidence intervals. Any coefficients with the NSSI as an outcome are in the logit scale. *p < 0.05, **p < 0.001. Dashed lines represent nonsignificant paths. NSSI, non‐suicidal self‐injury
Figure 3
Figure 3
Direct effect of perfectionism on rumination at the mean of attention shifting, moderated by attention focusing (with 95% confidence intervals). Confidence intervals indicated in shading, and vertical marker line indicating bounds of region of significance (from 2.31 standard deviations below the mean)
Figure 4
Figure 4
Indirect effect of perfectionism on odds of NSSI via rumination, moderated by attention focusing (with 95% confidence intervals). Confidence intervals indicated in shading, and vertical marker line indicating bounds of region of significance (from 2.38 standard deviations below the mean)
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