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...aintenance of NSSI but has been limited by a general reliance on self-report, as individuals often are not able to adequately and accurately report on the forces influencing their own behavior (e.g., =-=Nisbett & Wilson, 1977-=-). Nevertheless, prior research points toward several processes believed to play a role in the maintenance of NSSI that could be more carefully tested in subsequent studies, such as physiological hype...

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...can inform treatment efforts and perhaps validating responses from family members. Moreover, these findings highlight the importance of focusing on distress tolerance skills in the treatment of NSSI (=-=Linehan, 1993-=-; Miller et al., 2007; Rudd et al., 2001). The findings from this study also extend prior work examining the relation between social problem–solving skills and NSSI. Prior studies have revealed social...

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...roups differences on the distress tolerance and problem-solving tests were not due to differences in IQ, we also assessed all participants using the Wechsler Abbreviated Scales of Intelligence (WASI; =-=Wechsler, 1999-=-). NSSI. All participants were administered the Self-Injurious Thoughts and Behaviors Interview (SITBI; Nock, Holmberg, et al., 2007), a structured interview used to assess the presence, frequency, se...

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...receiving psychological treatment (48.2%) and/or pharmacotherapy (46.3%), and most (76.6%) met criteria for at least one current psychiatric disorder according to semistructured diagnostic interview (=-=Kaufman, Birmaher, Brent, Rao, & Ryan, 1997-=-). The most common diagnoses were anxiety disorders (46.7%), mood disorders (32.6%), alcohol and substance use disorders (14.1%), impulse-control disorders (10.9%), and eating disorders (6.5%), with a...

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...tions can occur in the informationprocessing sequence that can influence engagement in maladaptive behaviors, such as problems with cue interpretation, response selection, and response enactment (see =-=Crick & Dodge, 1994-=-; Ingram, 1986; McFall, 1982). It would be instructive to know whether and how such processes may be different among those engaging in NSSI. For instance, early in the informationprocessing sequence, ...

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...siology of NSSI may similarly lead to improvements in the treatment of NSSI. There is a strong empirical basis for studying physiological arousal as indexed by changes in skin conductance level (SCL; =-=Dawson, Schell, & Filion, 2000-=-). The physiological basis of SC includes measuring changes in eccrine (sweat) glands, which are innervated by the sympathetic branch of the autonomic nervous system via acetylcholine. An advantage of...

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...cal difficulties during data collection. We focused on adolescence and young adulthood given the significantly increased risk of selfinjurious thoughts and behaviors during this developmental period (=-=Kessler, Borges, & Walters, 1999-=-; Nock & Kazdin, 2002). All participants were recruited via study advertisements placed in local psychiatric clinics, in newspapers, on community bulletin boards, and on the Internet. The announcement...

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...score to reduce their influence (Tabachnick & Fidell, 2001). In each case, the transformed variables more closely approximated a normal distribution, as measured by the Shapiro– Wilks normality test (=-=Shapiro & Wilks, 1965-=-). We conducted preliminary analyses (t tests and chi-square tests) to compare those with a history of NSSI to control participants on demographic factors and IQ to ensure equivalence between groups o...

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...es for normality and the presence of outliers, and in several cases variables were transformed and outliers assigned values one unit higher than the next most extreme score to reduce their influence (=-=Tabachnick & Fidell, 2001-=-). In each case, the transformed variables more closely approximated a normal distribution, as measured by the Shapiro– Wilks normality test (Shapiro & Wilks, 1965). We conducted preliminary analyses ...

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... NSSI described in prior studies (Nock & Prinstein, 2004, 2005). Suicidal and nonsuicidal self-injury have long been proposed to function as a means of escape from intolerable emotional states (e.g., =-=Baumeister, 1990-=-; Favazza, 1996), and treatments for selfinjurers have included components that teach patients how to better tolerate distress (Linehan et al., 1991; Miller, Rathus, & Linehan, 2007; Rudd, Joiner, & R...

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... one’s own body tissue in the absence of intent to die and outside the context of socially or medically sanctioned procedures (e.g., ear piercing), is reported to occur in approximately 4% of adults (=-=Briere & Gil, 1998-=-; Klonsky, Oltmanns, & Turkheimer, 2003) and 14%–21% of adolescents (Ross & Heath, 2002; Whitlock, Eckenrode, & Silverman, 2006; Zoroglu et al., 2003). Despite the seriousness and prevalence of NSSI, ...

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...lly or medically sanctioned procedures (e.g., ear piercing), is reported to occur in approximately 4% of adults (Briere & Gil, 1998; Klonsky, Oltmanns, & Turkheimer, 2003) and 14%–21% of adolescents (=-=Ross & Heath, 2002-=-; Whitlock, Eckenrode, & Silverman, 2006; Zoroglu et al., 2003). Despite the seriousness and prevalence of NSSI, it continues to be a perplexing clinical problem, as it remains unclear why some indivi...

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...lerance among self-injurers has been conducted. There are significant clinical implications for such a test, as improving distress tolerance is a key focus in commonly used treatments for NSSI (e.g., =-=Linehan, Armstrong, Suarez, Allmon, & Heard, 1991-=-; Linehan et al., 2006). The demonstration that self-injurers actually have a problem tolerating distress would support this treatment focus, and the development of a behavioral measure of distress to...

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...es may be different among those engaging in NSSI. For instance, early in the informationprocessing sequence, self-injurers might make more self-critical attributions about the behavior of others (cf. =-=Dodge & Frame, 1982-=-), which could lead to engagement in NSSI as a means of 29SPECIAL SECTION: AROUSAL, DISTRESS TOLERANCE, AND PROBLEM SOLVING self-punishment. It is also possible that those engaging in NSSI generate fe...

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...ect or aversive arousal—and (b) for social communication—such as to get attention from others or to influence their behavior in some way. These functions have been demonstrated among both adolescent (=-=Nock & Prinstein, 2004-=-, 2005) and adult (Brown, Comtois, & Linehan, 2002) samples of those engaging in NSSI as well as in a rich literature on NSSI among those with developmental disabilities (Durand & Crimmins, 1988; Iwat...

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...e solutions and select the one most likely to be most effective, not merely the first one generated. This same clinical approach has proven effective in the treatment of child conduct problems (e.g., =-=Kazdin, Siegel, & Bass, 1992-=-; Nock, 2003) and may be similarly beneficial in the case of NSSI. Moreover, the SPST (and perhaps the DTT) can be used in clinical and clinical research settings more generally, such as to test socia...

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...rticipant), and all remaining cards were “incorrect,” with a brief pause for mood rating after the 20th card. Prior studies have used similar card sorting tasks to induce experimental distress (e.g., =-=Hirito & Seligman, 1975-=-; Ruggero & Johnson, 2006). The DTT builds on this earlier work by providing more consistently negative feedback over a smaller number of trials (thus serving as a more “compact” distress induction) a...

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...2004, 2005) and adult (Brown, Comtois, & Linehan, 2002) samples of those engaging in NSSI as well as in a rich literature on NSSI among those with developmental disabilities (Durand & Crimmins, 1988; =-=Iwata et al., 1994-=-). This earlier work has provided useful initial information about the processes that may be involved in the etiology and maintenance of NSSI but has been limited by a general reliance on self-report,...

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... distress would support this treatment focus, and the development of a behavioral measure of distress tolerance could be useful for measuring and studying potential mechanisms of change in treatment (=-=Kazdin & Nock, 2003-=-; Lynch, Chapman, Rosenthal, Kuo, & Linehan, 2006). In addition, information about how increased distress and an inability to tolerate such distress interact with other cognitive processes could be us...

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...re are significant clinical implications for such a test, as improving distress tolerance is a key focus in commonly used treatments for NSSI (e.g., Linehan, Armstrong, Suarez, Allmon, & Heard, 1991; =-=Linehan et al., 2006-=-). The demonstration that self-injurers actually have a problem tolerating distress would support this treatment focus, and the development of a behavioral measure of distress tolerance could be usefu...

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...l communication—such as to get attention from others or to influence their behavior in some way. These functions have been demonstrated among both adolescent (Nock & Prinstein, 2004, 2005) and adult (=-=Brown, Comtois, & Linehan, 2002-=-) samples of those engaging in NSSI as well as in a rich literature on NSSI among those with developmental disabilities (Durand & Crimmins, 1988; Iwata et al., 1994). This earlier work has provided us...

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...rocessing sequence that can influence engagement in maladaptive behaviors, such as problems with cue interpretation, response selection, and response enactment (see Crick & Dodge, 1994; Ingram, 1986; =-=McFall, 1982-=-). It would be instructive to know whether and how such processes may be different among those engaging in NSSI. For instance, early in the informationprocessing sequence, self-injurers might make mor...

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...nce of intense distress. This lack of distress tolerance is widely held to be an important explanatory factor in the development and maintenance of NSSI (Chapman, Gratz, & Brown, 2006; Favazza, 1996; =-=Klonsky, 2007-=-). It is surprising, however, that no objective behavioral test of distress tolerance among self-injurers has been conducted. There are significant clinical implications for such a test, as improving ...

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...o more impaired by the DTT than those of the noninjurers. This was surprising given prior research suggesting that cognitive abilities can be impaired through the experience of intense emotion (e.g., =-=MacKay et al., 2004-=-; Ruggero & Johnson, 2006) and because self-injurers showed great physiological arousal on the DTT. It is possible that the distress induced by the DTT was different in quantity or quality from the ty...

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... be a perplexing clinical problem, as it remains unclear why some individuals intentionally and repeatedly inflict harm on themselves. Authors have theorized about the causes of NSSI for years (e.g., =-=Menninger, 1938-=-); however, systematic research has addressed this topic only more recently. Studies examining the proposed functions of self-injury suggest that individuals engage in such behaviors primarily (a) for...

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...ctioned procedures (e.g., ear piercing), is reported to occur in approximately 4% of adults (Briere & Gil, 1998; Klonsky, Oltmanns, & Turkheimer, 2003) and 14%–21% of adolescents (Ross & Heath, 2002; =-=Whitlock, Eckenrode, & Silverman, 2006-=-; Zoroglu et al., 2003). Despite the seriousness and prevalence of NSSI, it continues to be a perplexing clinical problem, as it remains unclear why some individuals intentionally and repeatedly infli...

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...rom the experience of intense distress. This lack of distress tolerance is widely held to be an important explanatory factor in the development and maintenance of NSSI (Chapman, Gratz, & Brown, 2006; =-=Favazza, 1996-=-; Klonsky, 2007). It is surprising, however, that no objective behavioral test of distress tolerance among self-injurers has been conducted. There are significant clinical implications for such a test...

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...scent (Nock & Prinstein, 2004, 2005) and adult (Brown, Comtois, & Linehan, 2002) samples of those engaging in NSSI as well as in a rich literature on NSSI among those with developmental disabilities (=-=Durand & Crimmins, 1988-=-; Iwata et al., 1994). This earlier work has provided useful initial information about the processes that may be involved in the etiology and maintenance of NSSI but has been limited by a general reli...

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...e NSSI as a means of escaping from the experience of intense distress. This lack of distress tolerance is widely held to be an important explanatory factor in the development and maintenance of NSSI (=-=Chapman, Gratz, & Brown, 2006-=-; Favazza, 1996; Klonsky, 2007). It is surprising, however, that no objective behavioral test of distress tolerance among self-injurers has been conducted. There are significant clinical implications ...

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...eas, such as the study of suicidal self-injury and borderline personality disorder, which both overlap with but are distinct from NSSI (e.g., Nock, Joiner, Gordon, LloydRichardson, & Prinstein, 2006; =-=Nock & Kessler, 2006-=-; O’Carroll, Berman, Maris, & Moscicki, 1996), has failed to find consistent differences between these clinical groups and control participants on objective, peripheral physiological measures (e.g., s...

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...ange of problem-solving skills on the basis of behavioral performance. Drawing on prior work from other areas that has used multicomponent, performance-based measures of problem-solving skills (e.g., =-=Dodge & Somberg, 1987-=-; Goddard & McFall, 1992), the SPST asked participants to listen to a series of audio recordings describing eight social scenarios in four different domains (i.e., two scenarios in each domain) involv...

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...ue in the absence of intent to die and outside the context of socially or medically sanctioned procedures (e.g., ear piercing), is reported to occur in approximately 4% of adults (Briere & Gil, 1998; =-=Klonsky, Oltmanns, & Turkheimer, 2003-=-) and 14%–21% of adolescents (Ross & Heath, 2002; Whitlock, Eckenrode, & Silverman, 2006; Zoroglu et al., 2003). Despite the seriousness and prevalence of NSSI, it continues to be a perplexing clinica...

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...ts (Najmi, Wegner, & Nock, 2007; Nock, Wedig, Holmberg, & Hooley, in press) and also have demonstrated that imagining that one is engaging in NSSI decreases physiological arousal among self-injurers (=-=Haines, Williams, Brain, & Wilson, 1995-=-). However, no studies have provided objective evidence of increased reactivity to stressful events among nonsuicidal self-injurers. This is not merely an academic point but represents an important ga...

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...01). However, beyond obtaining self-reports of the reasons for engaging in these behaviors (Brown et al., 2002; Durand & Crimmins, 1988; Hawton, Cole, O’Grady, & Osborn, 1982; Nock & Prinstein, 2004; =-=Rodham, Hawton, & Evans, 2004-=-), there has been no test of whether self-injurers are actually more likely to have trouble tolerating or persisting in the face of distress and whether they attempt to escape from distressing situati...

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...earch demonstrating these are the most commonly reported functions of NSSI (Durand & Crimmins, 1988; Nock & Prinstein, 2004, 2005), and each correlates strongly with longer measures of each function (=-=Lloyd, Kelley, & Hope, 1997-=-; Nock & Prinstein, 2004; rs .64 to .73), supporting the validity of using these individual items. Physiological arousal. Skin conductance data were collected during the distress tolerance and probl...

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...tolerable emotional states (e.g., Baumeister, 1990; Favazza, 1996), and treatments for selfinjurers have included components that teach patients how to better tolerate distress (Linehan et al., 1991; =-=Miller, Rathus, & Linehan, 2007-=-; Rudd, Joiner, & Rajab, 2001). However, beyond obtaining self-reports of the reasons for engaging in these behaviors (Brown et al., 2002; Durand & Crimmins, 1988; Hawton, Cole, O’Grady, & Osborn, 198...

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...rt this treatment focus, and the development of a behavioral measure of distress tolerance could be useful for measuring and studying potential mechanisms of change in treatment (Kazdin & Nock, 2003; =-=Lynch, Chapman, Rosenthal, Kuo, & Linehan, 2006-=-). In addition, information about how increased distress and an inability to tolerate such distress interact with other cognitive processes could be used to further inform and enhance such treatments....

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...unishment. It is also possible that those engaging in NSSI generate fewer or less effective solutions than noninjurers, as has been shown to be the case in some studies of suicidal individuals (e.g., =-=Schotte & Clum, 1987-=-), although not others (e.g., Sadowski & Kelley, 1993). Different still, regardless of the solutions generated, it may be that self-injurers select less effective responses from among those generated....

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...ostile attributions toward others (Dodge & Frame, 1982; Dodge & Somberg, 1987), and prior work suggests that adolescents engaging in NSSI report being more self-critical than noninjuring adolescents (=-=Glassman, Weierich, Hooley, Deliberto, & Nock, 2007-=-), the current study did not reveal a self-directed hostile attribution bias among self-injurious adolescents. It is possible that self-criticism among self-injurers is more general and does not neces...

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...ction. We focused on adolescence and young adulthood given the significantly increased risk of selfinjurious thoughts and behaviors during this developmental period (Kessler, Borges, & Walters, 1999; =-=Nock & Kazdin, 2002-=-). All participants were recruited via study advertisements placed in local psychiatric clinics, in newspapers, on community bulletin boards, and on the Internet. The announcements for both control an...

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...ory sinus arrhythmia activity (Crowell et al., 2005). In addition, several recent studies have reported amygdala hyperreactivity among women with borderline personality disorder relative to controls (=-=Donegan et al., 2003-=-; Herpertz, Dietrich, et al., 2001). Taken together, these findings suggest that although individuals with NSSI have a more aversive subjective emotional experience, there is mixed evidence of hyperar...

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... used to further inform and enhance such treatments. Problem Solving and NSSI Clinicians and researchers have focused primarily on the affectregulating properties of NSSI (e.g., Chapman et al., 2006; =-=Favazza, 1989-=-; Klonsky, 2007), with much less attention given to the social functions of this behavior. This is likely due to the fact that prior work on the functions of NSSI suggests that people most often engag...

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... thus causing NSSI to be negatively reinforced. Prior studies have demonstrated that self-injurers report higher levels of subjectively experienced emotional distress in response to stressful events (=-=Najmi, Wegner, & Nock, 2007-=-; Nock, Wedig, Holmberg, & Hooley, in press) and also have demonstrated that imagining that one is engaging in NSSI decreases physiological arousal among self-injurers (Haines, Williams, Brain, & Wils...

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... Baumeister, 1990; Favazza, 1996), and treatments for selfinjurers have included components that teach patients how to better tolerate distress (Linehan et al., 1991; Miller, Rathus, & Linehan, 2007; =-=Rudd, Joiner, & Rajab, 2001-=-). However, beyond obtaining self-reports of the reasons for engaging in these behaviors (Brown et al., 2002; Durand & Crimmins, 1988; Hawton, Cole, O’Grady, & Osborn, 1982; Nock & Prinstein, 2004; Ro...

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...ong developmentally disabled samples suggests that social reinforcement is the primary motivator of this behavior in this group (Iwata et al., 1994). In addition, a significant portion of adolescent (=-=Nock, Holmberg, Photos, & Michel, 2007-=-; Nock & Prinstein, 2004, 2005) and adult (Brown et al., 2002) self-injurers without developmental disabilities report engaging in NSSI to influence their environment in some way. A related and fairly...

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...aris, & Moscicki, 1996), has failed to find consistent differences between these clinical groups and control participants on objective, peripheral physiological measures (e.g., skin conductance [SC]; =-=Crowell et al., 2005-=-; Ebner-Priemer et al., 2005; Matthew K. Nock and Wendy Berry Mendes, Department of Psychology, Harvard University. This research was supported by National Institute of Mental Health Grant MH076047 as...

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... would support this treatment focus, and the development of a behavioral measure of distress tolerance could be useful for measuring and studying potential mechanisms of change in treatment (Kazdin & =-=Nock, 2003-=-; Lynch, Chapman, Rosenthal, Kuo, & Linehan, 2006). In addition, information about how increased distress and an inability to tolerate such distress interact with other cognitive processes could be us...

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...d attempts among adults (Schotte, Cools, & Payvar, 1990; Williams, Barnhofer, Crane, & Beck, 2005) and among children and adolescents (Orbach, Rosenheim, & Hary, 1987; Pollock & Williams, 1998, 2001; =-=Sadowski & Kelley, 1993-=-). This work has shown that suicidal individuals generate fewer and less effective solutions to social problems than those who are nonsuicidal and that these differences are not explained by IQ or the...

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... is reported to occur in approximately 4% of adults (Briere & Gil, 1998; Klonsky, Oltmanns, & Turkheimer, 2003) and 14%–21% of adolescents (Ross & Heath, 2002; Whitlock, Eckenrode, & Silverman, 2006; =-=Zoroglu et al., 2003-=-). Despite the seriousness and prevalence of NSSI, it continues to be a perplexing clinical problem, as it remains unclear why some individuals intentionally and repeatedly inflict harm on themselves....

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...utions to social problems than those who are nonsuicidal and that these differences are not explained by IQ or the presence of other psychological disorders, such as depression (Biggam & Power, 1999; =-=Pollock & Williams, 2001-=-; Williams et al., 2005). Although valuable, this earlier research is limited by the fact that it did not examine NSSI, and the range of problem-solving deficits explored has been relatively narrow. W...

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...y. A related and fairly extensive literature has demonstrated that deficits in social problem–solving skills are related to suicide ideation and attempts among adults (Schotte, Cools, & Payvar, 1990; =-=Williams, Barnhofer, Crane, & Beck, 2005-=-) and among children and adolescents (Orbach, Rosenheim, & Hary, 1987; Pollock & Williams, 1998, 2001; Sadowski & Kelley, 1993). This work has shown that suicidal individuals generate fewer and less e...

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...nce their environment in some way. A related and fairly extensive literature has demonstrated that deficits in social problem–solving skills are related to suicide ideation and attempts among adults (=-=Schotte, Cools, & Payvar, 1990-=-; Williams, Barnhofer, Crane, & Beck, 2005) and among children and adolescents (Orbach, Rosenheim, & Hary, 1987; Pollock & Williams, 1998, 2001; Sadowski & Kelley, 1993). This work has shown that suic...

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... most efficacious treatments now incorporate psychoeducational materials early in the course of treatment to facilitate greater client understanding of and response to physiological reactivity (e.g., =-=Barlow & Craske, 2000-=-). The achievement of a greater understanding of the psychophysiology of NSSI may similarly lead to improvements in the treatment of NSSI. There is a strong empirical basis for studying physiological ...

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...lerate distress was assessed with a behavioral task developed for the current study. The Distress Tolerance Test (DTT) was administered via the stimulus cards from the Wisconsin Card Sort Test (WCST; =-=Grant & Berg, 1948-=-; Heaton, Chelune, Talley, Kay, & Curtis, 1993), and, as in the WCST, four key cards were dealt face up on the table and the standard WCST instructions were read, indicating that the participant was t...

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...deficits among suicidal individuals (Sadowski & Kelley, 1993; Schotte & Clum, 1987; Schotte et al., 1990; Williams et al., 2005) and women with borderline personality disorder displaying parasuicide (=-=Kehrer & Linehan, 1996-=-), and the current findings suggest such deficits also are present among those engaging in NSSI. It is interesting, however, that deficits in social problem–solving skills were not observed to be glob...

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... using a person’s self-report (e.g., D’Zurilla & Nezu, 1990) or that assess a specific problem-solving skill (e.g., generation of potential responses to a problem) using behavioral performance (e.g., =-=Platt, Spivack, & Bloom, 1975-=-). The SPST was designed to build on these earlier tasks by measuring a broad range of problem-solving skills on the basis of behavioral performance. Drawing on prior work from other areas that has us...

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...ning cards were “incorrect,” with a brief pause for mood rating after the 20th card. Prior studies have used similar card sorting tasks to induce experimental distress (e.g., Hirito & Seligman, 1975; =-=Ruggero & Johnson, 2006-=-). The DTT builds on this earlier work by providing more consistently negative feedback over a smaller number of trials (thus serving as a more “compact” distress induction) and by including the oppor...

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...and less effective solutions to social problems than those who are nonsuicidal and that these differences are not explained by IQ or the presence of other psychological disorders, such as depression (=-=Biggam & Power, 1999-=-; Pollock & Williams, 2001; Williams et al., 2005). Although valuable, this earlier research is limited by the fact that it did not examine NSSI, and the range of problem-solving deficits explored has...

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...jh.harvard.edu Journal of Consulting and Clinical Psychology Copyright 2008 by the American Psychological Association 2008, Vol. 76, No. 1, 28–38 0022-006X/08/$12.00 DOI: 10.1037/0022-006X.76.1.28 28 =-=Edman, Asberg, Levander, & Schalling, 1986-=-; Herpertz, Kunert, Schwenger, & Sass, 1999; Herpertz, Werth, et al., 2001). Notably, one recent study reported that although “parasuicidal” adolescent girls (a group combining suicidal and nonsuicida...

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... skills on the basis of behavioral performance. Drawing on prior work from other areas that has used multicomponent, performance-based measures of problem-solving skills (e.g., Dodge & Somberg, 1987; =-=Goddard & McFall, 1992-=-), the SPST asked participants to listen to a series of audio recordings describing eight social scenarios in four different domains (i.e., two scenarios in each domain) involving potential problems w...

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...e informationprocessing sequence that can influence engagement in maladaptive behaviors, such as problems with cue interpretation, response selection, and response enactment (see Crick & Dodge, 1994; =-=Ingram, 1986-=-; McFall, 1982). It would be instructive to know whether and how such processes may be different among those engaging in NSSI. For instance, early in the informationprocessing sequence, self-injurers ...

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... social problem–solving skills are related to suicide ideation and attempts among adults (Schotte, Cools, & Payvar, 1990; Williams, Barnhofer, Crane, & Beck, 2005) and among children and adolescents (=-=Orbach, Rosenheim, & Hary, 1987-=-; Pollock & Williams, 1998, 2001; Sadowski & Kelley, 1993). This work has shown that suicidal individuals generate fewer and less effective solutions to social problems than those who are nonsuicidal ...

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...e related to suicide ideation and attempts among adults (Schotte, Cools, & Payvar, 1990; Williams, Barnhofer, Crane, & Beck, 2005) and among children and adolescents (Orbach, Rosenheim, & Hary, 1987; =-=Pollock & Williams, 1998-=-, 2001; Sadowski & Kelley, 1993). This work has shown that suicidal individuals generate fewer and less effective solutions to social problems than those who are nonsuicidal and that these differences...

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...ure had greater distress tolerance. Social problem–solving skills. Social problem–solving skills were assessed with a novel performance-based task called the Social Problem–Solving Skills Test (SPST; =-=Nock, 2006-=-). Measures exist that assess a broad range of problem-solving skills using a person’s self-report (e.g., D’Zurilla & Nezu, 1990) or that assess a specific problem-solving skill (e.g., generation of p...