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. 2021 Mar;135:47-51.
doi: 10.1016/j.jpsychires.2021.01.011. Epub 2021 Jan 7.

Anger precedes and predicts nonsuicidal self-injury in veterans: Findings from an ecological momentary assessment study

Kirsten H Dillon  1 , Jeffrey J Glenn  2 , Paul A Dennis  3 , Stefanie T LoSavio  4 , Clair Cassiello-Robbins  5 , Molly A Gromatsky  6 , Jean C Beckham  3 , Patrick S Calhoun  7 , Nathan A Kimbrel  3
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Free PMC article

Anger precedes and predicts nonsuicidal self-injury in veterans: Findings from an ecological momentary assessment study

Kirsten H Dillon et al. J Psychiatr Res. 2021 Mar.
Free PMC article

Abstract

Veterans have high rates of suicide, and nonsuicidal self-injury (NSSI) is one of the strongest predictors of suicide risk; however, there is presently little known about antecedents of NSSI that might inform intervention efforts. Accumulating research suggests that anger and hostility play an important role in NSSI, but whether these emotions precede and predict NSSI is currently unknown. The aim of the current study was to examine the temporal relationships between anger/hostility and NSSI urges and behavior among veterans diagnosed with NSSI disorder. Our hypothesis was that angry/hostile affect would predict subsequent NSSI urge and engagement, but not vice versa. Forty veterans with NSSI disorder completed a 28-day ecological momentary assessment study with three daily prompts to report on their affect and NSSI urges and engagement. Multilevel cross-lagged path modeling was used to determine the direction of effects between angry/hostile affect and NSSI urges and engagement over time. Consistent with our hypothesis, results indicated that the lagged effects of angry/hostile affect on subsequent NSSI urge and engagement were significant, whereas the lagged effects of NSSI urge and engagement on angry/hostile affect were not significant. Findings highlight the importance of assessing and treating anger among veterans who engage in NSSI.

Keywords: Anger; Ecological momentary assessment; Hostility; Nonsuicidal self-injury; Risk factors; Veterans.

Figures

Figure 1
Figure 1
Cross-Lagged Path Models Note. Cross-lagged path models of angry/hostile affect, NSSI urge, and NSSI engagement. Level 1 represents within-person relationships, Level 2 between-person relationships. NSSI urge and engagement are dichotomous variables; thus, corresponding path coefficients may be exponentiated to produce odds ratios.
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