Preferred Name
Katie Callahan
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
ORCID
https://orcid.org/0009-0005-5945-6242
Date of Graduation
8-14-2026
Semester of Graduation
Summer
Degree Name
Doctor of Psychology (PsyD)
Department
Department of Graduate Psychology
First Advisor
Anne Stewart
Abstract
Nonsuicidal self-injury (NSSI) is a clinically significant behavior associated with substantial psychological distress and elevated suicide risk. Despite considerable research on the emotional triggers and functional implications of NSSI, the internal relational states activated during self-harm remain poorly understood. This study examined shifts in self-directed relational patterns during NSSI episodes using the Structural Analysis of Social Behavior (SASB) model and Interpersonal Reconstructive Therapy (IRT) theory. A cross-sectional secondary data analysis was conducted with 125 participants who reported current or past NSSI. Residualized change scores were computed to index shifts in self-state between general and NSSI conditions. Measures included the SASB-based Intrex Questionnaire (behavioral self-treatment), the Relational Cognitions and Affects Questionnaire, Introject (RCA-Q; self-directed cognitions and affects), the Inventory of Statements About Self-Injury—Extended (ISAS), and the Childhood Trauma Questionnaire (CTQ). Across both instruments measuring self-states, NSSI was associated with large shifts toward self-directed hostility (Intrex Affiliation d = 1.11; RCA-Q Affiliation d = 1.02) and marked reductions in friendliness to the self compared to self-treatment in general. Slight differences were observed for measures of self-directed behavior versus cognitions and affects directed toward the self. Childhood physical neglect was the most consistent trauma predictor of self-state shifts. Self-punishment emerged as the dominant function, or reason, for NSSI associated with self-state shifts across both instruments (rs = .18–.48). Findings are discussed in relation to IRT’s copy process theory, with implications for SASB-informed clinical assessment and differential treatment of self-punishment versus autonomy-organized NSSI.
