Investigating Motivational Abnormalities Driving Self-Harm and other dysregulated behaviours in young people

Self-harm behaviour affects around 20% of young people  aged 16-25 in their lifetime. It is often a response to struggling with difficult feelings, thoughts and situations. Current treatments primarily focus on improving emotion regulation strategies and interpersonal skills, which helps to minimise the negative emotions often triggering self-harm. However, the efficacy of these interventions in reducing self-harm remains mixed.

Given that self-harm is both positively and negatively reinforcing dysfunctional reward-related processes may contribute to its persistence. Emerging evidence indicates a high prevalence of self-harm-related mental imagery in young people who self-harm. This imagery is vivid, preoccupying, and emotionally arousing which can intensify the urge to self-harm.

The IMAGINE study investigates the role of biases in reward and motivational processes in self-harm using cognitive tasks and questionnaires. Additionally, we explore whether manipulating self-harm-related mental imagery can modify cognitive biases, emotional responses, and beliefs associated with these images.

Our results have shown that young people with repetitive self-harm present a complex pattern of avoidance toward self-harm-related cues and no generalised incentive response to such cues, even after a stress induction. We have also explored similar biases in young people with other dysregulated behaviours, such as binge/purging. Furthermore, our research indicates that manipulating self-harm-related mental imaginary reduces maladaptive cognitions associated with the mental imagery and generating positive imagery increases adaptive emotions and beliefs.

Current study:

We are conducting a new study exploring differences self-harm-related mental imagery and cognitive processes associated with self-harm, between autistic and non-autistic young people. Participants undergo an online and telephone screening followed by an in-person visit, where they complete questionnaires on their self-harm experiences and mental health, followed by computer-based tasks. They also complete a simplified mental imagery manipulation focus on change perceptual elements of self-harm-related imagery. 

Inclusion criteria:

All participants: 

  • Aged 16 to 25 years  
  • Experience of self-harm in the past year 
  • Experience of self-harm-related mental imagery  
  • Willing to talk about mental health and self-harm behaviour 
  • Willing to engage in tasks featuring self-harm images 
  • Good command of the English language

Autistic participants: 

  • Proof of confirmed diagnosis of Autism Spectrum Disorder (ASD)

Non-autistic participants: 

  • Absence of indications of Autism Spectrum Disorder (i.e. no confirmed diagnosis of ASD, not awaiting an assessment for ASD, no first or second-degree relative with a diagnosis of ASD)

You can find the protocol and data from the IMAGINE study here.

Getting involved: 

If you have questions, need more information, or would like to express your interest, we encourage you to contact the study team at: imagine@imperial.ac.uk 

Instagram page: @mir_imperial 

Your participation could make a difference!