An Explanation of Impulsivity, Cognitive Flexibility, and Metacognitive Thinking in Non-Suicidal Self-Injury Behaviors

The role of three specific aspects in the prediction of adolescent NSSI

Impulsivity behavior Cognition Flexibility Metacognition Thinking Non-suicidal self-injury Adolescence


  • Sepideh Asadolahi Department of Clinical Psychology, Zahedan Branch, Islamic Azad University, Zahedan, Iran, Iran, Islamic Republic of
  • Nilofar Gholamipour
    Department of Clinical Psychology, Shahid Bahonar University of Kerman, Kerman, Iran, Iran, Islamic Republic of
August 19, 2023
November 6, 2023


Background: Non-suicidal self-injury (NSSI) is a common symptom of psychiatric disorders. The main aim of the current study was to explain the role of three specific aspects of executive functioning (EF) (impulsivity, cognitive flexibility, and metacognitive thinking) in the prediction of adolescent NSSI.

Methods: This was a descriptive and correlational study. The statistical population consisted of all online responders in Iran under the age of 18, in the year 2022-2023. An online sample of 250 individuals was selected using voluntary sampling. The subjects completed the Barratt Impulsiveness Scale-11 (BIS-11(, Cognitive Flexibility Inventory-Iranian Version (CFI-I), the Metacognitions Questionnaire-30 (MCQ-30), and Deliberate Self-Harm Inventory (DSHI). To analyze data, descriptive statistics, correlation matrix, Pearson correlation coefficient, and multiple regression method with SPSS software were used.

Results: The patients with deliberate self-harm (DSH) showed a positive and significant relationship between impulsivity and self-harm (r = 0.526, P < 0.001). Besides, there was a negative and significant relationship between the variable of cognitive flexibility and self-harm (r = -0.519, P < 0.001). Research has suggested an association between NSSI behaviors in adolescence and deficits in EF.

Conclusion: According to the study, metacognitive thinking and impulsivity were significantly associated with self-harm. More research is needed to understand the implications of such deficits, and if the results could be used for adapting treatment services and strategies.