An Experimental Investigation of How Peer Criticism and Praise Affect Urges for Self-Injury

Nonsuicidal self-injury (NSSI) is prevalent among young adults, and is associated with increased suicide risk. The self-punishment hypothesis theorizes that individuals who are highly self-critical may engage in NSSI due to finding the experience of pain as ego-syntonic. Although evidence links self-critical views to NSSI, minimal research has examined how these views are influenced by more proximal social stressors, such as peer criticism, to trigger NSSI urges. The current study addresses the following questions: (1) Will the effects of recalled peer criticism (vs. praise and a neutral interaction) on pain endurance (a proxy measure for NSSI urges) and self-reported NSSI urges be moderated by group status (i.e., whether or not an individual has a history of NSSI)? We hypothesized that group status would moderate the effects of recalled peer criticism on pain endurance and NSSI urges, such that the relationships between these constructs would be stronger among the NSSI group vs. the no NSSI group; (2) If these interaction effects are present, will they be mediated by self-critical views? We hypothesized that the interaction between group status and peer criticism on pain endurance and NSSI urges would decrease in magnitude after accounting for self-critical views. Participants were 137 young adult women with either a recent or recurrent history of NSSI (n = 79) or no NSSI history (n = 58). Idiographic scripts of a recalled peer interaction involving critical, praising, or neutral feedback were used as the experimental manipulation, and measures of pain endurance (via a pressure algometer) and self-reported NSSI urges were administered at baseline and post-manipulation. The NSSI group demonstrated marginally higher pain endurance and stronger self-critical views than the control group. The overall effects of recalled peer criticism were not moderated by group status in predicting pain endurance or NSSI urges. Exploratory pairwise comparisons revealed that those in the NSSI group who received criticism (vs. the other conditions) demonstrated a significant increase in NSSI urges. Findings highlight peer criticism as one context in which risk for NSSI urges may be elevated among those with a history of NSSI, and underscore self-critical views as an important intervention target