Body Appreciation Protects Against Proximal Self-Harm Urges in a Clinical Sample of Adults

Scholars have suggested negative self-perceptions are central to understanding risk for non-suicidal (NSSI) and suicidal self-injury. Body attitudes are a core aspect of the self, and research has found that negative body attitudes relate to both NSSI and suicide, but it remains unclear if the risk is more distal or proximal. The current study utilized a 21-day EMA protocol to examine how momentary changes in body appreciation (valuing the body, a facet of positive body image) corresponded to concurrent and next-day NSSI and suicide urges. Participants included 25 adult outpatients (Mage = 35.6, SD = 14.3) who received notifications three times daily, randomized within 4-hour time blocks, across the 21 days (1,301 total responses). At each notification, participants indicated their current level of body appreciation, and both NSSI and suicide urges. Both state (within-subject) and trait (between-subject) body appreciation were negatively associated with concurrent NSSI and suicide urges. Only trait body appreciation was prospectively associated with NSSI urges; no other significant prospective relationships were observed. These findings provide evidence that body appreciation has a momentary protective effect on NSSI and suicide urges, as well as may reduce prospective risk for NSSI. The results are consistent with theoretical arguments emphasizing the importance of body attitudes in conceptualizing risk and could open innovative avenues for intervention and prevention. Cross-sectional studies suggest body attitudes may impact risk for self-injurious and suicidal behaviors. Using EMA, we examined momentary associations of body appreciation, NSSI urges, and suicide urges. Both state and trait body appreciation were negatively related to concurrent NSSI and suicide urges. Trait body appreciation was prospectively associated with NSSI urges but not suicide urges. Body appreciation may help to reduce risk for NSSI and suicide.