Negative feelings such as anxiety, sadness, and stress are important predictors of self-harm thoughts and urges, but they may not be the whole story.
A recent daily life study looked at emptiness and identity functioning as risk factors for self-harm thoughts and urges. Over 28 days, researchers followed treatment-seeking adolescents and adults and examined how these experiences shifted in everyday life.
One part of identity functioning was identity synthesis, which means experiencing a relatively stable, coherent, and positive sense of self, including personally relevant goals, values, and beliefs. When synthesis was lower, self-harm thoughts and urges tended to become more intense about two hours later.
The other part was identity confusion, which means experiencing a more fragmented sense of self, with difficulty setting goals or making commitments. Here, the pattern moved in the other direction: higher identity confusion was linked to more intense self-harm thoughts and urges.
While negative feelings such as anxiety, sadness, and stress are already known to predict self-harm thoughts and urges, this study adds a more specific finding: emptiness and identity functioning still helped explain which moments were followed by stronger self-harm thoughts and urges, even after a broader measure of negative feelings was accounted for.
The cycle between emptiness and identity functioning added another layer of self-harm risk. Identity difficulties were followed by greater emptiness, and emptiness was followed by changes in identity functioning.
For example, when identity synthesis was lower, emptiness tended to increase, and that increase in emptiness was linked to more intense self-harm thoughts and urges.
Could strengthening identity integration potentially lower the risk of self-harm thoughts and urges, especially when these shifts are unfolding over hours rather than months?
Reference
Eggermont, K., Claes, L., Luyckx, K., Bogaerts, A., Myin-Germeys, I., & Kiekens, G. (2026). The real-time interplay between identity, emptiness, and nonsuicidal self-injury ideation: An ecological momentary assessment study in treatment-seeking individuals. Journal of Psychopathology and Clinical Science, 135(3), 391–402. https://doi.org/10.1037/abn0001098