Motivational dynamics among eating-disordered patients with and without nonsuicidal self-injury: a self-determination theory approach

Eur Eat Disord Rev. 2013 May;21(3):209-14. doi: 10.1002/erv.2215. Epub 2012 Dec 3.

Abstract

Objective: The presence of nonsuicidal self-injury (NSSI) in eating-disordered (ED) patients is considered a complicating factor in treatment with a possibly adverse influence on patients' motivation to change. Using Self-Determination Theory as a guiding framework, we compared ED patients with and without NSSI in terms of their well-being and their motives to undertake psychotherapeutic change.

Method: Data were collected in a sample of 95 ED patients, including 37 patients displaying at least some type of NSSI.

Results: Patients with NSSI, relative to those without, felt more externally pressured to undertake change and reported lower overall well-being. Mean level differences in well-being between both patient groups were fully accounted for by patients' externally pressuring motives for pursuing change.

Discussion: In ED patients with NSSI, there is an important link between their more externally driven motivation to change and their lowered psychological well-being. It is discussed how clinicians can approach these patients to pursue change.

MeSH terms

  • Adult
  • Feeding and Eating Disorders / complications
  • Feeding and Eating Disorders / psychology*
  • Female
  • Health Behavior
  • Humans
  • Motivation*
  • Personal Autonomy*
  • Self-Injurious Behavior / complications
  • Self-Injurious Behavior / psychology*
  • Severity of Illness Index
  • Suicide / psychology*
  • Surveys and Questionnaires