(PS11-21) Cognitive Flexibility in the Relationship Between PTSD Symptoms and NSSI

Background

Individuals with PTSD use a variety of strategies to manage their symptoms, such as nonsuicidal self-injury (NSSI; Smith et al., 2014). Given the relationship between posttraumatic symptoms and NSSI, it is critical to explore the elements that might explain why PTSD symptoms relate to increased NSSI. Cognitive flexibility is one possible factor as it has been associated with less severe posttraumatic symptoms over time (Ben-Zion et al., 2018). Multiple studies report that cognitive inflexibility is a significant predictor of future NSSI behaviors (Antezana, 2022; Fallah et al., 2023), but some other studies disagree (Chung et al. 2023) which may be due to how cognitive flexibility is assessed. The Wisconsin Card Sorting Task (WCST) is a commonly used tool for assessing cognitive flexibility (Heaton, 1981), and may tap into a different aspect of cognitive flexibility than self-report. To clarify how cognitive flexibility relates to NSSI, using both self-report and the WCST is important. We aimed to evaluate the role of cognitive flexibility in the relationship between PTSD symptoms and NSSI using both self-report and the WCST.

Methods

Data collection is ongoing. To date, 34 undergraduate students (M_age = 20.2, SD = 1.21, 79% white, 67% women, 53% heterosexual) who endorsed having ever experienced a traumatic event (Mean events = 5.59, SD=3.98) or ever engaged in self-injury (Mean frequency = 12.97, SD=24.29) took an online survey on Inquisit. Participants completed measures of trauma history, PTSD symptoms, NSSI, and both self-reported cognitive flexibility and the WCST. The WCST was scored by tallying the number of perseverative errors, with a higher score meaning lower cognitive flexibility. Preliminary data was analyzed in SPSS using the PROCESS macro.

Results

Preliminary analyses show that cognitive flexibility did not significantly mediate PTSD symptoms and NSSI. PTSD symptoms correlated with higher self-reported cognitive flexibility (r = -.42, p = .013), and the total number of traumatic events correlated with PTSD symptoms (r = .46, p = .006). However, there was no relationship between PTSD symptoms and NSSI (r = -.19, p = .287) or between NSSI and cognitive flexibility (WCST: r = .045, p = .803; self-report: r = .310, p = .075).

Discussion

These preliminary findings do not align with previous research suggesting that PTSD symptoms are related to NSSI, or that cognitive flexibility is a mediator. The null results may be due to the small sample, and we will continue to collect data, presenting results from the full sample upon study completion (e.g., May). Implications of the final results and limitations of the study will be presented.