Poster #23 - Risk and Protective Effects of Need for Approval on Self-Injurious Thoughts and Behaviors in Girls

• In Event: Poster Session 02

Abstract

Self-injurious thoughts and behaviors (SITBs) are a major public health concern among teenage girls. Because peer group belonging is of utmost importance during adolescence, self-worth that is contingent on peer approval (need for approval; NFA) may contribute to adolescent mental health, yet little research investigates its impact on risk for SITBs. NFA includes two dimensions: NFAavoid (decreases in self-worth following peer disapproval) and NFAapproach (increases in self-worth following peer approval). Whereas NFAavoid encourages a focus on negative peer feedback and consequent feelings of shame or rejection, potentially increasing risk for SITBs, NFAapproach encourages a focus on positive peer feedback and bolsters self-worth, potentially protecting against SITBs. Moreover, these risk-augmenting and protective effects may be especially potent in the context of high rumination. Feelings of distress tied to NFAavoid may be exacerbated when girls perseverate on such feelings through rumination (Hypothesis 1), whereas feelings of belonging tied to NFAapproach may be particularly beneficial to girls who ruminate (Hypothesis 2). This study examined these novel hypotheses in early and mid-adolescent girls, who tend to have more social-evaluative concerns and highly value peer connectedness.

Participants were 229 girls (49.8% White, 27.5% African American; ages 9-15) at risk for internalizing psychopathology. At baseline, participants reported on NFAavoid, NFAapproach, and rumination. At baseline and 8-month follow-up, participants rated the severity of recent suicide ideation and completed an interview assessing suicide behaviors and non-suicidal self-injury (NSSI).

Hierarchical linear and logistic regressions revealed that NFAavoid was associated with more baseline suicide ideation, suicide behaviors, and NSSI as well as follow-up NSSI; there were also significant NFAavoid X Rumination interactions associated with baseline suicide ideation and follow-up suicide behaviors (Table 1). As hypothesized, higher levels of NFAavoid were associated with more baseline suicide ideation (Figure 1a) and more follow-up suicide behaviors (Figure 1b) at high (+ 1 SD), but not low (- 1 SD), levels of rumination. In addition, higher levels of NFAapproach were associated with less baseline suicide ideation, suicide behaviors, and NSSI. The NFAapproach X Rumination interaction was marginally associated with less baseline suicide ideation and NSSI (Table 1). NFAapproach was significantly associated with less baseline suicide ideation at high but not low levels of rumination (Figure 1c), and less baseline NSSI at low but not high levels of rumination (Figure 1d).

These results suggest that NFAavoid may exacerbate risk for SITBs, particularly when girls have a tendency to engage in negative perseverative thinking when they are upset. In contrast, NFAapproach may protect girls against SITBs. Consistent with Hypothesis 2, NFAapproach was protective against suicide ideation among girls who ruminate. However, NFAapproach was associated with less baseline NSSI at low levels of rumination, suggesting that girls whose self-worth is bolstered by peer approval and who ruminate less may be protected against NSSI, whereas girls who were high in rumination were at greater risk for NSSI regardless of their NFAapproach. Together, these results suggest that encouraging girls to develop diverse foundations for their sense of self-worth beyond peer judgements may help boost self-esteem and protect against SITBs.

Authors

• Rebekah Clapham, University of Illinois at Urbana-Champaign
  Presenting Author

• Zihua Ye, University of Illinois at Urbana-Champaign

• Leah H. Somerville, Harvard University

• Adam Bryant Miller, RTI International

• Matteo Giletta, Ghent University

• Paul David Hastings, University of California - Davis

• George M Slavich, University of California, Los Angeles

• Matthew K. Nock, Harvard University

• Mitchell J Prinstein, University of North Carolina at Chapel Hill

• Karen Rudolph, University of Illinois at Urbana-Champaign