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Abstract

The question of why some people do things that are intentionally harmful to themselves continues to puzzle scientists, clinicians, and the public. Prior studies have demonstrated that one fairly extreme, direct form of self-harm, non-suicidal self-injury (NSSI), is maintained by both automatic (i.e., intrapersonal) as well as social (i.e., interpersonal) reinforcement. However, the majority of theoretical and empirical papers on this topic focus almost exclusively on the automatic functions. The purpose of this paper is to provide a more comprehensive analysis of the social functions of NSSI. Evidence is presented supporting the notion that NSSI is maintained by social reinforcement in at least a substantial minority of instances. Moreover, an elaborated theoretical model of the social functions of NSSI is outlined that proposes that this behavior represents a high intensity social signal used when less intense communication strategies fail (e.g., speaking, yelling, crying). The model further proposes that NSSI can serve not only as a signal of distress that is reinforced primarily by the caregiving behavior it elicits from others, but that it can also serve as a signal of strength and fitness that is reinforced by warding off potential threats (e.g., peer victimization), and in some cases can strengthen affiliation with others. Support for this theoretical model is drawn from diverse literatures including psychology, evolutionary biology, and cultural anthropology. The paper concludes with specific recommendations for empirical tests of the proposed model of the social functions of NSSI, as well as other harmful behaviors such as alcohol and drug use.

8. Conclusions and needed research directions

An increasing amount of research has focused on the automatically reinforcing nature of NSSI, whilemuch less work has examined the socially reinforcing nature of this behavior. At first blush, such an imbalance in research focus may seem warranted given that many people who engage in NSSI report doing so for automatic reinforcement (e.g., affect regulation). However, it is important to bear in mind that many self-injurers report using this behavior as a means of social influence, and it is likely that studies using self-report data to identify the functions of NSSI provide an underestimate of the importance of the social functions due to obvious issues related to social desirability. Drawing on prior research on animal signaling and idioms of distress, it was proposed that NSSI may be used as a display of either strength or stress when language and less intense forms of behavior fail to elicit a desired outcome. Toward this end, an elaborated model of our earlier four function model of NSSI was presented that described how the two social functions of NSSI could explain the reinforcement of both signals of strength and distress. Prior research on NSSI provides some support for the social positive reinforcement of signals of distress as well as social negative reinforcement of signals of strength and fitness. The two alternative cells in this four-part elaborated model may occur less frequently (i.e., signals of distress for social negative reinforcement and signals of strength for social positive reinforcement); however, to my knowledge they have not been examined in prior work and so await empirical investigation.