Cognitive Factors Analysis of Persistent Non-suicidal Self-injury from Secondary School to University: a Short-Term Longitudinal Study

Abstract

Previous research has found correlations between outcome expectancies, self-efficacy to resist, and the occurrence of non-suicidal self-injury. However, it remains unclear whether these factors are associated with the persistence of self-injury. Based on social cognitive theory, this study aims to investigate the roles of outcome expectancies and self-efficacy to resist non-suicidal self-injury in the process of individuals engaging in persistent self-injury after transitioning into the college environment. A two-wave survey was conducted at a 6-month interval using self-report questionnaires to investigate 161 first-year college students with a history of self-injury in the past year. 21.7% of freshmen continued engaging in self-injury. There were significant differences in communication expectancies scores in outcome expectancies between those who continued and those who did not continue self-injury. Affect regulation expectancies in outcome expectancies positively predicted persistent self-injury, while communication expectancies in outcome expectancies negatively predicted persistent self-injury. Self-efficacy to resist self-injury moderated the relationship between pain expectancies and negative self-belief expectancies in predicting persistent self-injury. When self-efficacy to resist self-injury was low, pain expectancies significantly negatively predicted persistent self-injury. When self-efficacy to resist self-injury was high, negative self-belief expectancies significantly negatively predicted persistent self-injury. This study highlights the importance of considering relevant cognitive factors in the prevention and intervention of persistent self-injury.