Negative feelings such as anxiety, sadness, and stress are important predictors of nonsuicidal self-injury thoughts and urges, but they may not be the whole story.
A recent daily-life study examined emptiness and identity functioning as short-term predictors of nonsuicidal self-injury (NSSI) ideation. Over 28 days, researchers surveyed 123 treatment-seeking people ages 15–39 in Belgium six times a day. All had experienced NSSI urges within the previous month. NSSI ideation was measured as a combined score of thoughts about injuring oneself without wanting to die since the previous survey and current urges to do so.
One dimension 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 identity synthesis was lower than usual for a person, NSSI ideation tended to become more intense at the next survey, about two hours later.
The other dimension 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: when identity confusion was higher than usual for a person, NSSI ideation tended to become more intense at the next survey, about two hours later.
In the study’s three-wave models, specific pathways linking identity functioning and emptiness predicted later NSSI ideation even after momentary negative affect was accounted for.
The results were also consistent with a short-term cycle between emptiness and identity functioning. Lower-than-usual identity synthesis and higher-than-usual identity confusion were followed by greater emptiness. Greater emptiness, in turn, was followed by lower identity synthesis and higher identity confusion.
Greater emptiness was also followed by more intense NSSI ideation at the next survey, about two hours later.
Because this was an observational study, these temporal associations do not show that identity difficulties or emptiness caused the later changes in NSSI ideation.
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