Effects of distraction, cognitive reappraisal, and acceptance on the urge to self-harm and negative affect in nonsuicidal self-injury

The purpose of this study was to evaluate the effects of various emotion regulation (ER) strategies on emotional distress and the urge to self-harm in response to mood induction in individuals who engaged in nonsuicidal self-injury (NSSI). Sixty-one individuals who engaged in NSSI participated in this study were assigned to an experimental ER strategy group (Distraction = 20, Cognitive Reappraisal = 21, Acceptance = 20). Participants completed the Self-Injury Urge Scale (SIUS), State-Trait Anxiety Inventory-State (STAI X-1), and Positive and Negative Affect Scales (PANAS) at several time points: T1) baseline; T2) after watching a film to induce negative mood; and a final time T3) after watching the film again but while using the group-specific ER strategy in response to the induced negative mood. We found that distraction effectively reduced the urge for NSSI after a negative mood induction, as measured using the SIUS. Additionally, cognitive reappraisal and distraction significantly reduced the STAI X-1 and negative affect scale (NAS) scores of the PANAS in individuals with NSSI who underwent negative mood induction. However, acceptance was significantly less effective in relieving unpleasant and undesirable inner experiences in the short term. Our findings suggest that both distraction and cognitive reappraisal are helpful in alleviating negative emotional experiences, and distraction may be useful in dealing with the urge to engage in NSSI. More evidence-based research to test the current findings is required.