Disordered Eating and Non-Suicidal Self-Injury: Emotion Dysregulation and Psychological Risk and Protective Factors

Emotion dysregulation contributes to the development of non-suicidal self-injury (NSSI) and disordered eating (DE) behaviours. Despite the high levels of comorbid NSSI and DE, it is unclear whether specific types of emotion regulation (ER) deficits are unique to NSSI and DE, and those that are associated with comorbidity. Through multinomial logistic regression, the present study investigated deficits in ER and maladaptive and adaptive cognitive ER strategies that are associated with engagement in NSSI, DE, comorbidity, or neither behaviours among young adults. Depressive symptoms, suicide attempt history, suicide risk, and investment in physical appearance were assessed as moderators between ER and the behavioural groups. Greater emotion dysregulation was associated with NSSI or DE compared to participants not engaging in these behaviours. Comorbid participants reported the greatest emotion dysregulation and the greatest difficulty accessing ER strategies compared to all other groups. Participants within the NSSI-only group had lower emotional awareness and less access to ER strategies compared to participants not engaging in either behaviours. Participants engaging in NSSI-only used more maladaptive cognitive ER strategies compared to Control participants, whereas Control participants were using greater overall adaptive cognitive ER strategies. Comorbid participants used the greatest overall maladaptive cognitive ER strategies compared to the other groups. Novel moderation effects were found for depressive symptoms, investment in physical appearance, and cognitive ER strategies and the behavioural groups. The findings of the current study have implications for interventions and assessment relating to engagement in NSSI and/or DE, as well as contribute to the growing literature on the impact of specific ER deficits on mental health difficulties.