Nonsuicidal Self-Injury Is Associated With Attenuated Interoceptive Responses to Self-Critical Rumination

Nonsuicidal self-injury (NSSI) is a prevalent and dangerous behavior. Those with a history of NSSI often report high levels of self-critical rumination (SCR), a form of nega-tively valenced introspective self-referential processing. It is plausible that this overly analytical style of relating to the self might hinder the ability to process interoceptive sig-nals, thereby increasing the capacity to engage in behaviors that cause bodily harm. Two studies investigated whether trait or state SCR influenced aspects of interoception in those with and without a history of NSSI. In Study 1 (N = 180), irrespective of NSSI history, trait SCR was asso-ciated with finding attending to the heartbeat unpleasant. However, no associations were observed for interoceptive confidence, or metacognitive insight into their interocep-tive abilities (confidence-accuracy correspondence). Trait SCR was associated with having higher interoceptive accu-racy, but only in those without a history of NSSI. In Study 2 (N = 98), irrespective of NSSI history, state self-criticism led to a more negative interoceptive valence, and reduced participants' metacognitive insight. In those without a his-tory of NSSI, state self-criticism also increased interocep-tive accuracy-an effect attenuated in those with NSSI. These findings suggest that those with NSSI are character-ized by a blunted interoceptive response to negatively valenced self-focused attention.