Impulsive behaviors that distract from distress: Non-suicidal self-injury

There appear to be a set of behaviors that belong to a common response class, whichare characterized by rash, impulsive actions that provide immediate relief from intensenegative affect. First, we will review evidence identifying several behaviors as membersof this ?impulsive behavior for negative reinforcement? response class, including heavydrinking, smoking, and binge eating/purging. Second, we will review emerging evidencethat identifies non-suicidal self-injury (NSSI) as an additional member of this responseclass. NSSI refers to the direct, deliberate destruction of bodily tissue without suicidalintent (American Psychiatric Association, 2013). Third, we highlight the role of negativeurgency, the personality disposition to act rashly when distressed, as a personality traitprecursor to all behaviors in the response class, including NSSI. Fourth, we review amodel designed to help understand why an individual would choose to engage in onebehavior in the response class over another. This model emphasizes psychosociallearning, measured as expectancies for reinforcement from a given behavior.Expectancies are understood to reflect summaries of an individual's psychosociallearning history concerning anticipated reinforcement from behaviors. Individuals tend tochoose behaviors that are likely to provide reinforcement. Prediction from expectancies isdisorder-specific: for example, alcohol expectancies predict drinking problems and eatingand thinness expectancies predict bulimia nervosa.