(PS11-57) From Compassion to Crisis: Cognitive and Affective Empathy as Correlates of Non-suicidal Self-injury and Suicidal Behavior

Empathy is central to the human ability to connect with others, and is a precursor to prosocial behavior and self-compassion (Stevens & Taber, 2021). Thus, it is unsurprising that deficits in empathy have been associated with negative psychosocial outcomes, including aggression and other psychopathology (e.g., Blair, 2018), but research examining the relationship between empathy and self-injurious behavior is limited and less clear. Empathy is commonly defined using a dual component model, consisting of a cognitive component, involving the ability to recognize and understand another person’s mental state, and an affective component, reflecting a sensitivity for and tendency to share in others’ emotions. Previous research has observed diminished perspective-taking abilities among people with histories of non-suicidal self-injury (NSSI; Laghi et al., 2016) and suicide attempts (Nestor & Sutherland, 2021), indicating that disrupted cognitive empathy may be implicated in these behaviors. On the other hand, increased self-reported emotional sensitivity has been associated with engagement in both forms of self-injury (Kirtley & O’Connor, 2015; Scocco et al., 2020), suggesting that affective empathy may in fact confer risk for self-harm. However, no study has jointly examined both components of empathy in relation to NSSI and suicidal behavior. The present study sought to parse the relationship between empathy and self-injury using both categorical (e.g., any reported history) and continuous (e.g., frequency and severity) measures of NSSI and suicidal behavior. Participants were college students (N = 5,484), 40% of whom reported a history of NSSI (n = 2191) and 7.6% a history of suicide attempt (n = 388). They completed the following self-report measures: (1) the Basic Empathy Scale (BES; Joliffe & Farrington, 2006), which contains subscales for cognitive and affective empathy; (2) the Suicidal Behaviors Questionnaire – Revised (SBQ-R; Osman et al., 2001), which assesses four dimensions of suicidality to arrive at a continuous risk score; and (3) a measure of lifetime frequency of NSSI acts. Analyses consisted of logistic (NSSI and suicide attempt history), linear (SBQ-R score), and negative binomial (lifetime NSSI frequency) regressions that controlled for gender, race, and ethnicity. Continuous explanatory variables (i.e., BES subscales) were Z-scored. In contrast to previous findings, both cognitive and affective empathy were associated with a history of NSSI (ORs = 1.031 & 1.047, respectively, ps < .001) but not lifetime frequency of NSSI (ps = .419 & .922, respectively). Similarly, both empathy constructs were associated with SBQ-R score (cognitive: β = .114, p = .007; affective: β = .335, p < .001), but not lifetime history of suicide attempt (ps = .350 & .139, respectively). Taken together, these results provide evidence for both cognitive and affective empathy as risk factors for NSSI and suicidal behavior. Empathy, while generally considered an adaptive trait, may increase sensitivity to the negative thoughts and feelings of others, in turn facilitating engagement in self-injury. The adverse psychological consequences of empathy are an important target for future research.