Impulsivity and nonsuicidal self-injury: A review and meta-analysis

Nonsuicidal self-injury (NSSI; direct self-injury without lethal intent) often is thought to be associated with impulse control problems. Recent research, however, offers conflicting results about whether impulsivity is a risk factor for NSSI engagement. To disentangle findings on the link between impulsivity and NSSI, an extensive review of the literature was conducted using several electronic databases (i.e., PsychInfo, PsychArticles, ERIC, CINAHL, and MEDLINE). In total, 27 studies that met the specific inclusion criteria were identified. Results of a meta-analysis revealed that individuals who engaged in NSSI self-reported greater impulsivity than individuals who did not engage in NSSI, and that this effect was most consistent for measures of negative urgency. In contrast, there was little evidence of an association between lab-based measures of impulsivity (e.g., Go/No-Go, Stop/Signal Task) and NSSI. Moreover, the link between impulsivity and NSSI found for self-report measures was sometimes eliminated when other risk factors for NSSI were controlled (e.g., abuse, depression, post-traumatic stress disorder). In addition to integrating findings, the present review provides several explanations for the discrepancies in findings between studies employing self-report versus lab-based measures of impulsivity. To conclude, several specific recommendations for future research directions to extend the literature on impulsivity and NSSI are offered.