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Models aimed at understanding the mechanism whereby childhood abuse may exert negative effects frequently highlight alterations or dysregulations in experienced affect, particularly during times of stress. The period immediately following discharge from psychiatric hospitalization represents a time of risk for individuals experiencing NSSI. We aimed to investigate the extent to which childhood abuse predicts affective variability and examine whether affective variability predicts who will experience NSSI thoughts or behaviors in the 6 months following hospital discharge. Participants were adults (<jats:italic>N<\/jats:italic> = 133) engaged in a 3\u2010week ecological momentary assessment study immediately following psychiatric hospitalization who returned for a 6\u2010month follow\u2010up. Location scale modeling (LSM) was used to model the impact of childhood abuse on affect variability; estimates of affect variability were then resampled and examined as risk factors for NSSI at follow\u2010up. Overall, individuals who experienced childhood abuse reported lower positive affect intensity. Participants exposed to emotional and sexual abuse reported less between\u2010person variability in positive affect, and those who experienced sexual abuse evidenced higher between\u2010person variability in negative affect. Models indicated that higher overall negative affect was associated with a higher NSSI risk, <jats:italic>ORs<\/jats:italic> \u223c 1.82\u20132.10 even after accounting for childhood abuse and lifetime NSSI. These findings indicate the importance of in vivo affect as a critical influence on behavior during high\u2010risk periods, reinforcing the need to move beyond traditional cross\u2010sectional approaches of assessment, analysis, and treatment.<\/jats:p>","DOI":"10.1002\/jts.22739","type":"journal-article","created":{"date-parts":[[2021,10,20]],"date-time":"2021-10-20T19:20:39Z","timestamp":1634757639000},"page":"1118-1131","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Affective variability and childhood abuse increase the risk for nonsuicidal self\u2010injury following psychiatric hospitalization"],"prefix":"10.1002","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1877-2493","authenticated-orcid":false,"given":"Leslie","family":"Brick","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Human Behavior Alpert Medical School of Brown University  Providence Rhode Island 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