Interactive effects of motivational functions and perceived outcomes on nonsuicidal self-injury

Nonsuicidal self-injury (NSSI) is an increasingly pressing mental health concern. Although prior research has primarily focused on intra- and interpersonal motivations as triggers for NSSI, relatively few studies have examined the perceived outcomes of self-injurious behaviors, and more importantly, how these perceptions interact with an individual's underlying motivations. This study examined the interaction between NSSI motivations and perceived outcomes on the frequency of self-injurious behavior. A total of 128 individuals who met DSM-5-TR criteria for NSSI (≥5 self-injury episodes) participated in the study. Data were collected using a self-report survey and a semi-structured interview assessing NSSI motivations, perceived outcomes, and the frequency of self-injurious behavior. Motivations and perceived outcomes were each classified into four factors based on the Four-Function Model: automatic-negative, automatic-positive, social-negative, and social-positive. Interaction effects between NSSI motivations and perceived outcomes were analyzed to assess their association with the frequency of self-injurious behavior. Results revealed significant interaction effects between social-positive motivations and both perceived social-negative and social-positive outcomes in predicting the frequency of self-injurious behavior. In addition, the interaction between automatic-positive motivations and automatic-positive outcomes was also significant. Specifically, high levels of these perceived outcomes strengthened the positive associations between the corresponding motivations and the frequency of self-injurious behavior. These findings highlight the importance of understanding the nuanced interplay between motivational intent and perceived outcomes, which may help explain patterns of NSSI and inform more targeted interventions. Clinical implications and recommendations for future research are discussed.