Nonsuicidal self-injury, sleep quality, and shame response to a laboratory stress task

Abstract

Objective: Nonsuicidal self-injury (NSSI) frequently functions to regulate shame-based emotions and cognitions in the context of interpersonal stress. The present study sought to examine how sleep quality (SQ) may influence this process in a laboratory setting.

Methods: Participants included 72 adults (M_age = 24.28; 36 with a lifetime history of NSSI) who completed a self-report measure of prior month SQ and engaged in a modified Trier social stress task (TSST). State shame ratings were collected immediately before and following the TSST, as well as 5 min post-TSST, to allow for the measurement of shame reactivity and recovery.

Results: No significant results emerged for NSSI history and SQ as statistical predictors of shame reactivity. However, NSSI history was significantly associated with heightened shame intensity during the recovery period of the task, and this was moderated by SQ. Simple slopes analyses revealed a conditional effect whereby poorer SQ (1SD above the mean) was associated with greater intensity of shame during recovery, but only for those with a history of NSSI.

Conclusion: Poor SQ may contribute to worrisome emotional responses to daytime stressors in those at risk for NSSI.

Keywords: emotion regulation; insomnia; nonsuicidal self-injury; self-harm; shame; sleep.

Figure 1.

Visualization of the moderating role of SQ in the association between NSSI history and shame recovery (i.e., shame intensity during the recovery phase of the stress task). The moderating effect is graphed for two levels of SQ: (1) good SQ (1 SD below the mean of PSQI total score) and (2) poor SQ (1 SD above the mean of PSQI total score). Higher total score of PSQI indicates poorer SQ.