述情障碍对非自杀性自伤青少年自伤成瘾的影响：内部情绪调节的中介作用

目的 探讨述情障碍对非自杀性自伤（NSSI）青少年自伤成瘾的影响及内部情绪调节在其中的中介作用，旨在为降低NSSI青少年自伤成瘾提供参考。方法 选取2021年12月至2022年8月在重庆医科大学附属第一医院精神科门诊和住院部就诊的有NSSI行为的123例青少年为研究对象。采用渥太华自伤行为问卷（OSI）中的功能分量表、成瘾分量表以及多伦多述情障碍量表（TAS-20）调查NSSI原因、自伤成瘾以及述情障碍情况，采用Pearson相关分析3者之间的相关性。采用Process插件和Bootstrap法对内部情绪调节在述情障碍与自伤成瘾之间的中介效应进行分析和检验。结果 123例NSSI青少年的TAS-20总分为（68.70±11.17）分，功能分量表中内部情绪调节维度得分为（19.32±6.02）分，社交影响维度得分为（15.29±6.24）分，外部情绪调节维度得分为（10.04±2.96）分，寻求刺激维度得分为（6.30±3.21）分，成瘾分量表得分为（20.26±8.16）分。不同性别、是否是独生子女NSSI青少年的TAS-20总分比较，差异有统计学意义（t=-2.64、-2.84;P&...     

青少年非自杀性自伤行为评估的系统性评价

非自杀性自伤(NSSI)已成为全球突出的公共卫生问题,是青少年未来发生自杀行为的重要危险因素,严重威胁青少年的身心健康.目前尚缺乏对NSSI统一评估的工具,导致NSSI的流行病学研究结论不一.如何对其进行可靠、精准、有效的评估至关重要.为此,本文对目前国内外关于NSSI评估方法的文献进行综述,以期为青少年非自杀性自伤行...     

中国青少年抑郁症患者非自杀性自伤行为发生率的Meta分析

目的 分析中国青少年抑郁症患者非自杀性自伤（NSSI）行为发生率,为对其NSSI行为进行干预提供参考。方法 计算机检索中国知网、维普、万方、中国生物医学文献数据库、PubMed、Web of Science、Cochrane Library、Embase数据库中关于青少年抑郁症患者NSSI行为发生率的横断面调查研究,检索时限均为建库至2022年2月。由2名研究员筛选文献、提取资料并对文献进行质量评价,采用RevMan 5.4进行Meta分析。结果 最终纳入10篇文献,共2 238例患者。Meta分析结果显示,中国青少年抑郁症患者NSSI行为发生率为51%(95%CI:43%～59%)。亚组分析结果显示,女性青少年抑郁症患者NSSI行为发生率为36%(95%CI:22%～50%),高于男性NSSI行为发生率18%(95%CI:12%～24%);有自杀意念的青少年抑郁症患者NSSI行为发生率为57%(95%CI:38%～77%),高于无自杀意念者NSSI行为发生率4%(95%CI:0～8%);以《精神障碍诊断与统计手册（第5版）》（DSM-5）为诊断标准进行诊断的患者NSSI行为发生率为5...     

伴与不伴非自杀性自伤行为青少年抑郁障碍的焦虑、应对方式对比及相关性分析

目的 探讨伴与不伴非自杀性自伤行为(NSSI)青少年抑郁障碍的焦虑情绪、应对方式的差异及其相关性,从而为制定有效的干预措施提供有利依据.方法 选取我院2017年11月～2019年12月期间就诊的符合ICD-10诊断标准的8～18岁抑郁障碍患者,根据有无NSSI分为两组,其中伴NSSI的71名为研究组,不伴NSSI的59...     

青少年非自杀性自伤行为动机的研究进展

青少年是发生非自杀性自伤行为的高发群体。相关研究显示，青少年发生非自杀性自伤 行为的动机对自伤行为有很大影响。现从调节情绪、影响人际和自我强化三方面对青少年发生自伤行 为的动机进行综述，希望能对青少年自伤行为的干预和治疗提供参考。     

威廉姆斯生活技能训练在伴非自杀性自伤行为青少年抑郁症患者中的应用

目的探讨威廉姆斯生活技能训练(WLST)在伴非自杀性自伤(NSSI)行为青少年抑郁症患者中的应用效果。方法选取2019年1月-6月在苏州市广济医院住院的伴NSSI行为的青少年抑郁症患者88例。按入院顺序编号,偶数者为干预组(n=44),奇数者为对照组(n=44)。两组均接受为期4周的常规抑郁症疾病护理,干预组在此基础上接受WLST。两组患者分别于入院和出院时接受汉密尔顿抑郁量表17项版(HAMD-17)、一般自我效能感量表(GSES)、青少年学生生活满意度量表评定,并比较两组患者住院期间NSSI行为发生率、出院时HAMD-17评分减分率。结果两组患者住院期间NSSI行为发生率差异有统计学意义(χ~2=11.702,P=0.001)。出院时,两组HAMD-17、GSES、青少年学生生活满意度量表评分与入院时比较差异均有统计学意义(t_(对照组)=-5.256、10.690、-21.220,t_(干预组)=-12.540、11.300、-32.840,P0.01),两组组间HAMD-17、GSES、青少年学生生活满意度量表评分及HAMD-17评分减分率比较差异均有统计学意义(t=0.851、-12.809、-4.883,χ~2=75.990,P0.05或0.01)。结论 WLST可能有助于降低伴NSSI行为的青少年抑郁症患者NSSI行为发生率,减轻抑郁程度,增强自我效能感,提高生活满意度。     

辩证行为治疗在青少年非自杀性自伤行为中的应用

本文目的是分析辩证行为治疗(DBT)在青少年非自杀性自伤(NSSI)行为治疗中的有效性,以期为我国青少年NSSI行为的干预提供参考。NSSI行为是青少年常见的心理健康威胁,近年来已经成为全球范围内不容忽视的精神卫生问题,目前对于NSSI行为的干预主要采用心理治疗,其中越来越多的证据显示DBT在减少NSSI行为方面有效。本文从NSSI行为发生的危险因素、DBT的概述及DBT在NSSI应用中的疗效等方面进行阐述。     

青少年非自杀性自伤的神经生物学机制

本文目的是对近年来青少年非自杀性自伤(NSSI)的神经生物学机制的相关研究进行归纳汇总,并探讨青少年NSSI相关研究现状。NSSI在青少年中多发,是自杀的独立危险因素,严重影响青少年的身心健康,已成为普遍关注的公共卫生问题。本文总结青少年的NSSI研究现状及其神经生物学机制,以期为青少年NSSI的临床干预提供参考。     

伴非自杀性自伤行为的青少年心境障碍患者自杀未遂发生现状及影响因素分析

目的 探讨伴非自杀性自伤行为(NSSI)的青少年心境障碍患者合并自杀未遂(SA)及其与临床特征的关系.方法 选取于2020年12月至2021年8月在首都医科大学附属北京安定医院住院的有NSSI史的80例13～19岁青少年心境障碍患者进行横断面调查.采用自编一般资料问卷、青少年NSSI问卷、简易应对方式问卷、中文版正性与...     

心智化家庭治疗对青少年抑郁障碍患者抑郁症状及非自杀性自伤行为的影响

背景青少年抑郁障碍患病率高,且患者多伴有非自杀性自伤（NSSI）行为。改善青少年抑郁障碍患者病情已成为临床关注的重点。目的 探讨心智化家庭治疗（MBFT）对青少年抑郁障碍患者抑郁症状及NSSI行为的影响,为促进青少年抑郁障碍患者康复提供参考。方法 于2022年1月—12月选取武汉市精神卫生中心收治的符合《国际疾病分类（第10版）》（ICD-10）抑郁障碍诊断标准的90例青少年抑郁障碍患者为研究对象,采用随机数字表法分为研究组（n=44）和对照组（n=46）。两组均接受常规干预,研究组在此基础上接受为期8周、每周1次、每次60 min的MBFT干预。分别于干预前和干预第1、2、4、8周末,对两组患者进行汉密尔顿抑郁量表24项版（HAMD-24）、自我效能感量表（GSES）、匹兹堡睡眠质量指数量表（PSQI）以及渥太华自我伤害调查表（OSI）评定。结果 重复测量方差分析结果显示,干预前和干预第1、2、4、8周末,两组HAMD-24评分（F=69.621、15.428、29.623,P均?0.05）、OSI总评分（F=176.642、37.682、21.873,P均?0.05）、GSES评分...     

首次住院的青少年抑郁障碍患者非自杀性自伤行为与冲动性的关系

目的 探讨伴有非自杀性自伤（NSSI）行为的青少年抑郁障碍患者在冲动性方面的特征,分析NSSI行为与冲动性的关系,以便早期识别有NSSI行为风险的患者并及时干预。方法 采取顺序入组的方式,选取在深圳市康宁医院首次住院的青少年抑郁障碍患者共53例,根据《精神障碍诊断与统计手册（第5版）》（DSM-5）诊断标准评估患者有无NSSI行为,将患者分为伴NSSI行为组（n=30）和不伴NSSI行为组（n=23）。采用汉密尔顿抑郁量表17项版（HAMD-17）、青少年自我伤害问卷和Barratt冲动性量表（BIS-11）评定患者抑郁情绪、自伤严重程度和冲动性。结果 伴NSSI行为组HAMD-17评分[（25.50±4.10）分vs.(21.43±4.64)分,t=3.379,P<0.01]、BIS-11运动冲动性[（51.67±15.95）分vs.(38.70±14.90)分,t=3.018,P<0.01]、认知冲动性[（52.75±13.22）分vs.(43.37±18.40)分,t=2.161,P<0.05]、无计划冲动性[（68.00±15.32）分vs.(50.76±21...     

Longitudinal development of pain sensitivity in adolescent non-suicidal self-injury

Nonsuicidal self-injury (NSSI) is associated with reduced pain sensitivity (PS). Existing theories posit that altered PS is a risk factor for NSSI. Cross-sectional data suggest that PS normalizes in those terminating self-injury. However, previously no study addressed the longitudinal course of PS in patients engaging in NSSI. We addressed changes in PS and clinical symptomatology in adolescents with NSSI (n = 18) and matched controls (n = 19) over one year. Despite significant clinical improvements, PS did not change in the NSSI group but decreased in controls. Greater NSSI reduction was associated with increased pain tolerance. Findings are discussed in the light of current theories on PS in NSSI.     

The role of parental psychopathology and personality in adolescent non-suicidal self-injury

Adolescent non-suicidal self-injury (NSSI), a significant risk factor for suicidal behavior, is strongly associated with adolescent psychopathology and personality traits, particularly those characterized by poor self-regulation. Some parental psychopathology and personality traits have also been identified as risk factors for adolescent NSSI, but specific parental characteristics and mechanisms involved in this association have not been systematically examined. The current study comprehensively investigated the contribution of parental psychopathology and personality to adolescent NSSI using data from the baseline wave of the Adolescent Development of Emotion and Personality Traits (ADEPT) study of 550 adolescent girls (mean age = 14.39 years, SD = 0.63) and their biological parents. We first investigated whether parental lifetime psychiatric diagnoses, and personality and clinical (rumination, self-criticism, emotional reliance) traits were associated with adolescent NSSI. We also tested whether adolescent history of psychiatric illness, personality, and clinical traits mediated the associations between parental characteristics and adolescent NSSI. Parental substance use disorder, adult-ADHD symptoms, self-criticism, and lower agreeableness and conscientiousness were associated with offspring's NSSI. These associations were mediated through adolescent characteristics. In contrast, parental mood and anxiety disorders and neuroticism were unrelated to adolescent NSSI. The results suggest that parental traits and disorders characterized by self-regulatory difficulties and lack of support constitute risk factors for self-injury in adolescent girls, acting via adolescent traits. This demonstrates that parental influences play a significant role in the etiology of adolescent NSSI.     

Non-suicidal self-injury in adolescence: A longitudinal study of the relationship between NSSI,psychological distress and perceived parenting

ObjectiveThe present study investigates whether either adolescents' psychological distress and/or perceived parenting predicted the occurrence of NSSI. Furthermore, the consequences of NSSI are examined in a three-wave longitudinal study.DesignThe sample at time 1 (age 12) consisted of 1396 adolescent reports and 1438 parent reports. At time 2 (age 13), 827 adolescent reports and 936 parent reports were obtained. Time 3 (age 14) included 754 adolescent reports and 790 parent reports. Psychological distress of adolescents was measured using the Strengths and Difficulties Questionnaire. Perceived parenting behaviors were examined by the Parental Behavior Scale and the Psychological Control Scale.ResultsA total of 10% of the adolescents engaged in NSSI at least once before age 15. Higher psychological distress of adolescents at time 1 was associated with the presence of NSSI at time 2 or 3. The association between psychological distress at time 1 and perception of decreased parental rule setting at time 3 was mediated by the presence of NSSI at time 2.ConclusionsThe present study showed that psychological distress at age 12 predicts NSSI over time and that parental awareness of NSSI changes the perception of parenting behaviors.     

Parental bonding and alexithymia: A meta-analysis

Aim

The primary purpose of this meta-analysis was to explore, clarify and report the strength of the relationship between alexithymia, as measured by the Toronto Alexithymia Scale (TAS-20), and parenting style as measured by the Parental Bonding Instrument (PBI).

Methods

Web of Science, PsycInfo, PubMed and ProQuest: Dissertations and Theses searches were undertaken, yielding nine samples with sufficient data to be included in the meta-analysis.

Results

Evidence indicated moderate to strong relationships between maternal care and alexithymia, and between maternal care and two of the three TAS-20 alexithymia facets (Difficulties Describing Feelings and Difficulties Identifying Feelings, but not Externally Oriented Thinking). Moderate relationships were observed for both maternal- and paternal-overprotection and alexithymia respectively, and for overprotection (both maternal and paternal) and Difficulties Describing Feelings.

Conclusion

This study is the first meta-analysis of the relationship between parenting styles and alexithymia, and findings confirm an especially strong association between maternal care and key elements of alexithymia. This review highlights the issues that still remain to be addressed in exploring the link between parenting style and alexithymia.     

Impulsivity and clinical symptoms among adolescents with non-suicidal self-injury with or without attempted suicide

This study examined clinical characteristics and laboratory-measured impulsive behavior of adolescents engaging in either non-suicidal self-injury with (NSSI + SA; n = 25) or without (NSSI-Only; n = 31) suicide attempts. We hypothesized that adolescent with NSSI + SI would exhibit more severe clinical symptoms and higher levels of behavioral impulsivity compared to adolescents with NSSI-Only. Adolescents were recruited from an inpatient psychiatric hospital unit and the two groups were compared on demographic characteristics, psychopathology, self-reported clinical ratings, methods of non-suicidal self-injury, and two laboratory impulsivity measures. Primary evaluations were conducted during psychiatric hospitalization, and a subset of those tested during hospitalization was retested 4–6 weeks after discharge. During hospitalization, NSSI + SA patients reported worse depression, hopelessness, and impulsivity on standard clinical measures, and demonstrated elevated impulsivity on a reward-directed laboratory measure compared to NSSI-Only patients. In the follow-up analyses, depression, hopelessness, suicidal ideation, and laboratory impulsivity were improved for both groups, but the NSSI + SA group still exhibited significantly more depressive symptoms, hopelessness, and impulsivity than the NSSI-Only group. Risk assessments for adolescents with NSSI + SA should include consideration not only of the severity of clinical symptoms but of the current level impulsivity as well.     

辩证行为疗法在非自杀性自伤干预中的应用

本文目的是系统分析辩证行为疗法(DBT)在非自杀性自伤(NSSI)治疗中的疗效、优势及应用前景,为后续治疗提供参考。近年来,世界范围内NSSI发生率逐年上升,已成为影响人类健康发展、降低人类生活质量的主要因素之一,目前NSSI已正式纳入《精神障碍诊断与统计手册(第5版)》(DSM-5)精神疾病的诊断之中,但其治疗方式尚未确定,亟待研究。已有研究显示,DBT对NSSI的干预效果较好,可改善NSSI患者负性情绪、减少自伤次数,但此方法的效果仍存在争议。