(PS11-45) Exploring Facets of Mindfulness, Cognitive Flexibility, and Nonsuicidal Self-injury

Literature suggests mindfulness protects against nonsuicidal self-injury (NSSI; Caltabiano et al., 2016; Calvete et al., 2022); but prior operationalization of these variables has precluded exploring differential associations between facets of mindfulness and NSSI features—critical to identifying treatment targets pertinent to NSSI risk or NSSI treatment. Relatedly, scant research has examined individual differences in the mindfulness-NSSI relationship. Linked to trait (Moore & Malinowski, 2008) and state (Lee & Orsillo, 2013) mindfulness, and also NSSI risk (Callahan et al., 2020; Nilsson et al., 2021), cognitive flexibility (CF) may promote individual differences in this risk relationship. Thus, this study aimed to: 1) evaluate associations between mindfulness subscales and NSSI features, and 2) examine if CF moderated the significant associations from aim 1.

Participants were 377 undergraduates (Mage = 19.33, SD = 1.17; 68.7% white; 66.4% female; 40% NSSI history). We assessed CF (Dennis & VanderWal, 2010), NSSI history (Klonsky & Glenn, 2009), and five mindfulness subscales (observing, describing, acting with awareness, nonjudging, and nonreactivity; Baer et al., 2006). Linear regressions examined effects of each mindfulness subscale on three NSSI outcomes: 1) status (NSSI vs. no NSSI), 2) frequency, and 3) versatility (i.e., number of methods). For significant direct effects, PROCESS (Hayes, 2013) was used to examine CF as a moderator. Frequency was log transformed. Race and sexual minority identity were added as covariates in NSSI frequency models.

Results examining direct effects found observing had a significant, positive effect on status (b = .05, p = .004) and frequency (b = .03, p = .032), but not versatility. Describing had a significant, negative effect on status (b = - 0.04, p = .037) but not frequency or versatility. Acting with awareness had a significant, negative effect on status (b = -.05, p = .004) and versatility (b = -.12, p = .001), but not frequency. Nonjudging had significant, negative effect on status (b = -.05, p = .002), frequency (b = -.03, p = .001), and versatility (b = -.10, p = .001). Nonreactivity had no significant effects on NSSI outcomes.

CF moderated the relationship between acting with awareness and NSSI status (b = -.003, p = .018). At low levels of CF (£  (≤ -5.33 SDs below mean), acting with awareness did not predict NSSI status. At moderate to high levels of CF, higher levels of acting with awareness predicted decreased likelihood of status. The magnitude of this effect was larger at high versus moderate levels of CF. CF did not moderate other associations.

Most mindfulness subscales, except for nonreactivity, had significant associations with status. Models with frequency and versatility were differentially significant by subscale. Contrary to other models, higher levels of observing predicted increased odds of NSSI engagement and increased frequency. Results also suggest higher CF amplified the protective effect of acting with awareness on NSSI engagement. While highlighting a need for further research, our findings provide preliminary support for tailoring mindfulness interventions to individual differences in NSSI history and CF, possibly enhancing the effectiveness of these interventions.