青少年自伤行为的机制及影响因素:基于情绪管理的视角

青少年是自伤的高危人群,这与自伤的情绪管理功能密切相关。基于情绪管理视角,生物社会模型、回避体验模型和情绪管理模型分别从不同侧面揭示了情绪管理在自伤发生中的核心地位。综合目前关于自伤的心理学及跨学科研究成果发现,青少年自伤的影响因素主要包括基因与脑等生物学因素、家庭与学校环境中的人际因素,以及个体的人格特征。其中,基因、脑与家庭环境对青少年自伤的影响尤为关键。今后应在纵向研究、基因与环境交互作用以及脑成像技术融合等方面对自伤进行进一步探讨。     

Predictors of improvement in an open-trial multisite evaluation of emotion regulation group therapy

Emotion regulation group therapy (ERGT) is a novel treatment specifically targeting deliberate non-suicidal self-harm (DSH) in individuals with borderline personality disorder (BPD). Identifying robust predictors of positive response to ERGT could aid clinicians in treatment selection; however, to date, only one such study has been conducted. Thus, we aimed to replicate previously identified predictors of treatment response to ERGT by investigating demographic, clinical, and diagnostic predictors in 95 women with BPD or subclinical BPD who had participated in an open-trial evaluation of ERGT. Outcomes evaluated were frequency of DSH and emotion dysregulation. Assessments were conducted at pretreatment, post-treatment, and 6-month follow-up. Multilevel mixed linear models and multilevel negative binomial generalized estimated equations were used to identify significant interactions between the predictors and outcomes.

We found that greater pretreatment DSH frequency was associated with greater improvements in DSH during treatment (b = 0.998, SE = 0.00, p = 0.03) and follow-up (b = 0.997, SE = 0.00, p < 0.01) and that greater BPD severity was associated with greater improvements in DSH during treatment (b = 0.84, SE = 0.06, p = 0.02) and in emotion dysregulation at follow-up (b = ?3.05, SE = 1.47, p = 0.04). Co-occurring disorders were associated with poorer treatment response during follow-up. Results were generally consistent with a previous study of the predictors of response to ERGT. The findings provide further support for the utility of this treatment across a range of BPD patients, including patients with severe DSH and BPD.     

Interoception,Pain Tolerance,and Self-Injurious Behaviors: A Multidimensional Assessment

Impairments in interoception have been linked to self-injurious behaviors, and capability for suicide may account for this relationship. However, past studies have relied primarily on self-report and unidimensional measures. The present study aimed to replicate and extend previous findings by examining the relationship between interoceptive dysfunction, pain tolerance, and self-injurious behaviors using a multidimensional and multi-method approach. A sample of 245 undergraduate students (M_age = 19.27 years, SD = 2.81; 73.7% female, 72.% White/European American), who reported lifetime suicidal ideation on a screening survey completed a battery of self-report measures, four counterbalanced pain tolerance tasks, and a clinical interview assessing their self-injurious behaviors. A tendency to stay attuned to bodily sensations was significantly related to decreased pain tolerance. Only trust in one’s body was significantly related to decreased presence of lifetime suicide attempts. No other facets of interoception or pain tolerance were significantly associated with self-injurious behaviors. Overall, these findings contrast with previous findings that capability for suicide may account for relations between interoceptive dysfunction and self-injurious behaviors. Nonetheless, the results of this study provide important information on the factor structure of interoceptive dysfunction and pain tolerance, and highlight the importance of careful selection of measures and operationalization of key constructs, particularly interoceptive dysfunction and pain tolerance.     

Exploring the motivations behind self-injury

This study explored self-described motivations for self-injuring behavior. One hundred and fifty four individuals were asked to express, in their own words, why they harmed themselves. The most frequently endorsed reason for self-injury was to obtain emotional release. The second most common intent was to resolve dissociation, and feel alive or real. Individuals also revealed that they self-injured in order to gain a sense of control, to punish themselves, to distract themselves, and to avoid suicidal or homicidal actions. Theoretical implications of these attributions for self-injury are discussed.     

Why Do People Hurt Themselves?: New Insights Into the Nature and Functions of Self-Injury

ABSTRACT— Nonsuicidal self-injury (NSSI) is a prevalent but perplexing behavior problem in which people deliberately harm themselves without lethal intent. Research reveals that NSSI typically has its onset during early adolescence; most often involves cutting or carving the skin; and appears equally prevalent across sexes, ethnicities, and socioeconomic statuses. Less is known about why people engage in NSSI. This article presents a theoretical model of the development and maintenance of NSSI. Rather than a symptom of mental disorder, NSSI is conceptualized as a harmful behavior that can serve several intrapersonal (e.g., affect regulation) and interpersonal (e.g., help-seeking) functions. Risk of NSSI is increased by general factors that contribute to problems with affect regulation or interpersonal communication (e.g., childhood abuse) and by specific factors that influence the decision to use NSSI rather than some other behavior to serve these functions (e.g., social modeling). This model synthesizes research from several different areas of the literature and points toward several lines of research needed to further advance the understanding of why people hurt themselves.     

非自杀性自伤与接纳承诺疗法的多维解析

接纳承诺疗法干预非自杀性自伤已经被一些临床案例证实疗效显著,与其他传统的心理治疗相比,接纳承诺疗法的干预效果更加持久。首先分析了非自杀性自伤基本含义以及各类特征,从心理动机的角度简要说明了非自杀性自伤发生的原因,再结合接纳承诺疗法的心理病理模型及治疗模型,阐述了接纳承诺疗法是通过提高个体心理灵活性减少非自杀性自伤发生的的理论依据与治疗过程,最后梳理了近年来国外学者通过接纳承诺疗法干预非自杀性自伤的实证研究及效果,为其他研究者实践该疗法治疗非自杀性自伤提供借鉴思路。     

自伤青少年的冲动性

以自我报告、行为学和脑电为指标, 检验自伤青少年的冲动性。研究1, 对820名普通中学生和72名工读生进行问卷调查, 探讨自伤行为与情绪调节困难、冲动性的关系。结果表明, 冲动性能够预测自伤行为, 且预测效应量大于情绪调节困难。研究2, 采用Go/Nogo范式的ERPs实验, 检验自伤组与对照组冲动控制的行为学与脑电差异。结果表明, 自伤组Nogo正确反应的N2波幅显著高于对照组, N2潜伏期在部分电极点处高于对照组。脑电地形图显示两者的脑电差异主要体现在前额叶区。结论：自伤青少年的冲动性高于同龄普通青少年。     

累积环境风险与大学生自伤的关系:情绪调节策略的作用

通过两个子研究分别考察累积环境风险与大学生自伤行为间的关系模式,并探讨注意分散与认知重评两种情绪调节策略对高风险大学生自伤意图的缓解作用。研究1在1066名大学生中采用问卷调查,探索累积环境风险对大学生自伤行为的作用及模式。基于研究1的结果,研究2选取符合高风险背景的62名大学生为被试,采用实验室实验对两种情绪调节策略的作用予以考察。本研究结果表明：累积环境风险对男女大学生自伤行为均有显著的正向作用,且均符合非线性“正加速模式”,但男生群体随累积风险数量增加而引发的自伤行为增长速度明显快于女生。对于高环境风险背景下的大学生,注意分散和认知重评两种策略均能降低其自伤倾向性与自伤认同,但不能降低其自伤意念。这提示应重视对经历了高环境风险的大学生进行情绪调节策略等方面的干预,以减少其采取自伤行为的倾向性。     

父母冲突与青少年自伤的关系:一个有调节的中介模型

以情绪安全感理论为依据考察父母冲突与青少年自伤的关系,并在此基础上提出一个有调节的中介模型,探讨情绪不安全感的中介作用以及情绪调节自我效能感的调节作用。采用整群抽样法对2800名中学生进行问卷调查,结果表明:(1)在所有青少年被试中有自伤行为的比例占41.49%,青少年的自伤水平在年级、学校类型和是否为独生子女这些人口学变量上有显著差异;(2)父母冲突能显著地正向预测青少年的自伤水平,情绪不安全感在两者之间起部分中介作用;(3)控制消极情绪自我效能感对情绪不安全感的中介作用有显著的负向调节作用,只有当控制消极情绪自我效能感很低时,情绪不安全感在父母冲突和青少年自伤水平的中介作用才是显著的。     

Changes in ecological momentary assessment reported affect associated with episodes of nonsuicidal self-injury

Although emotion regulation deficits have been frequently implicated in the incidence of nonsuicidal self-injurious behavior (NSSI), no research to date has examined in vivo change of affect associated with real-world NSSI behavior. The present study employed Ecological Momentary Assessment (EMA) to assess change in affect associated with episodes of experienced NSSI in a sample of 36 college students with a self-reported history of NSSI. Results indicated that individuals who reported NSSI behavior over the course of the study experienced increases in negative affect prior to an episode of NSSI that peaked during the episode and faded gradually in the hours following the episode, with affect change roughly approximating a quadratic curve. These changes in affect were detected only at times in which individuals engaged in NSSI and were absent for individuals who did not report NSSI over the course of the study. Moreover, changes in negative affect associated with NSSI were, on average, detectable hours prior to the NSSI event. These findings suggest that episodes of NSSI may be predicted through a careful examination of affect change long before actual NSSI behavior occurs.