Lack of exposure, sensitivity to blood, self-worth, and perceived stigma: Examining potential “barriers” to nonsuicidal self-injury among emerging adults in daily life

Sep 21, 2026

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Nonsuicidal self-injury (NSSI) is a prevalent mental health concern among adolescents and young adults, making it essential to understand not only risk factors but also day-to-day influences on urges and behaviors. This study tests theorized NSSI “barriers”—lack of exposure, sensitivity to blood, self-worth deficits, and perceived stigma—using 14-day daily diary sampling with 236 emerging adults. Those with recent NSSI showed greater exposure, blood insensitivity, stigma, and lower self-worth. Multilevel modeling linked unusually low blood aversion and lower self-worth to same-day urges and behaviors, and lower self-worth to next-day outcomes. Exposure predicted same-day urges and next-day behavior, supporting prevention targets to boost self-worth and reduce exposure.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages8

Reading Time20 min

AccessFree to download

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Journal of Aϱective Disorders 392 (2026) 120078 Contents lists available at ScienceDirect Journal of Affective Disorders journal [homepage:](homepage: www.elsevier.com/locate/jad)[ www.elsevier.com/locate/jad](homepage: www.elsevier.com/locate/jad) | Research paper
Lack of exposure, sensitivity to blood, self-worth, and perceived stigma: Examining potential “barriers” to nonsuicidal self-injury among emerging adults in daily life | | | | | --- | --- | --- | --- | | Chloe A. Hamza a,*, Sarah Kuburia, Tracy K. Wongb, Abby L. Goldstein a, Nancy L. Heath c
a Department of Applied Psychology and Human Development, Ontario Institute for Studies in Education, University of Toronto, Toronto, Ontario, Canada b Department of Educational Psychology, The Chinese University of Hong Kong, Hong Kong Shatin, NT, China
c Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada | | | | | A R T I C L E I N F O | | A B S T R A C T | | | Keywords:
Nonsuicidal self-injury Daily dairy Exposure to NSSI Blood insensitivity Self-worth
Emerging adults | | Nonsuicidal self-injury (NSSI) is a highly prevalent mental health concern among adolescents and young adults. Understanding not only who is most at risk, but when in daily life, is necessary to prevent NSSI. To explore the role of several theoretically relevant “barriers” to NSSI (i.e., lack of exposure to NSSI, sensitivity to blood, selfworth, and perceived stigma) in NSSI urges and behaviors, daily diary sampling was used in the present study. Participants included 236 young adults (130 with recent NSSI, 106 without recent NSSI) who completed daily assessments for 14 days. Across the daily diary period, participants who engaged in NSSI reported greater exposure to NSSI, insensitivity to blood, perceived stigma toward NSSI, and lower self-worth compared to individuals without a history of NSSI. Hierarchical linear modeling revealed that within individuals, greater than typical insensitivity to blood and lower self-worth predicted same day NSSI urges and behaviors, and lower selfworth also predicted next day NSSI urges and behaviors. Greater exposure to NSSI also predicted same day NSSI urges, and next day NSSI behavior. Findings underscore that increasing self-worth and aversion to NSSI, and decreasing exposure to NSSI, may serve as important targets for NSSI prevention and intervention. | | 1. Introduction Nonsuicidal self-injury (NSSI), refers to direct and deliberate damage or alteration of bodily tissue (e.g., self-cutting, burning) for purposes not socially sanctioned (International Society for the Study of Self-Injury, 2021). Rates of NSSI among adolescents and young adults range from 18 to 20 % internationally, with most reporting repetitive NSSI behaviors (Moloney et al., 2024; Xiao et al., 2022). NSSI may have increased in response to mounting distress during the COVID-19 pandemic (Denget al., 2023), and adolescents and young adults who engage in NSSI are at increased risk for later mental health challenges, as well as suicidal ideation and attempts (Daukantaite˙ et al., 2021; Kiekens et al., 2023). Understanding pathways to NSSI is an important first step in informing efforts to prevent this behavior. Research and theory underscore that NSSI often serves as a form of coping behavior, primarily used to regulate intrapersonal distress (Taylor et al., 2018; Wolffet al., 2019). NSSI engagement may be largely motivated by the desire to access these coping “benefits” of NSSI (Hooley and Franklin, 2017), but why some individuals choose NSSI, and others do not, remains poorly understood. Hooley and Franklin (2017) proposed the Benefits and Barriers Model of NSSI, suggesting that several NSSI specific “barriers” may prevent some individuals from accessing the benefits of NSSI. These barriers include: 1) having little awareness of NSSI, or lack of exposure, 2) high positive self-regard or worth, which makes self-directed harm to one’s bo

FAQs

What are the main NSSI “barriers” examined in this study?

The study evaluates lack of exposure to NSSI, sensitivity to blood (blood insensitivity/aversion), self-worth, and perceived stigma as potential barriers shaping NSSI urges and behaviors.

How was NSSI risk assessed over time in this research?

Participants completed daily assessments for 14 days, enabling within-person analysis of how barriers relate to same-day and next-day NSSI urges and behaviors.

Which barriers predicted NSSI urges and behaviors within individuals?

Greater than typical blood insensitivity and lower self-worth predicted same-day NSSI urges and behaviors, while lower self-worth also predicted next-day urges and behaviors.

Sep 21, 2026

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