The Role of Self-Control in Experiences, Attitudes, and Behaviors Related to Nonsuicidal Self-Injury: A Grounded Theory Analysis

Abstract

Nonsuicidal self-injury (NSSI) is a frequent presenting concern with a prevalence rate that appears to be increasing over time. NSSI has historically been associated with deficits in impulse control; however, evidence suggests that individuals high in self-control also self-injure. This constructivist grounded theory study aimed to generate a substantive theory regarding the nature of undercontrolled and overcontrolled self-injury to fill gaps in the literature and improve clinical understanding and treatment. The resulting Theory of Overcontrolled and Undercontrolled Self-Injury was derived inductively from the perspective of those who lived the experience and was constructed using the data they shared during intensive semi-structured interviews (n = 20). This theory provides a preliminary understanding of the mechanisms that guide overcontrolled and undercontrolled NSSI, the processes that can facilitate individuals switching profiles, and the processes that lead to cessation of self-injurious behavior. The findings of this study provide a deeper understanding of the role of self-control in NSSI, thereby contributing to the development of more comprehensive theories of self-injury. Additionally, clinical implications for the development of assessments and interventions aimed at preventing and treating NSSI are discussed. The findings of this study may be used to inform future research focused on the assessment, conceptualization, and treatment of NSSI.