Emotion dysregulation in nonsuicidal self-injury: Dissociations between global self-reports and real-time responses to emotional challenge

Prominent theories of nonsuicidal self-injury (NSSI) propose that the behaviour is characterised by amplified emotional responses, primarily because people who self-injure report elevated global emotion dysregulation. However, little is known about how people who self-injure respond during emotional challenge. In a preregistered study, we measured subjective and physiological responding (heart rate, heart rate variability, and electrodermal responding) among young adults with past-year NSSI (n = 51) and those with no lifetime NSSI (n = 50) during a resting baseline, a stress induction, and a post-test resting phase. Although the NSSI group reported considerably greater emotion dysregulation than Controls, both groups showed similar subjective and psychological reactivity to, and recovery from, emotional challenge. These dissociations between global self-reports and real-time emotional responding demonstrate that the role of emotion dysregulation in NSSI is more complex than prominent theories can account for, raising substantial questions regarding the nature of emotion dysregulation in NSSI.