Klonsky E David, Oltmanns Thomas F, Turkheimer Eric
Department of Psychology, University of Virginia, Charlottesville, VA 22904-4400, USA.
Am J Psychiatry. 2003 Aug;160(8):1501-8. doi: 10.1176/appi.ajp.160.8.1501.
Research on deliberate self-harm (intentionally injuring oneself without suicidal intent) has focused on clinical and forensic populations. Studying only these populations, which typically have serious psychopathology, may lead to inflated estimates of the association between self-harm and psychiatric disorder, as well as of the prevalence of deliberate self-harm. The present study investigated the prevalence and correlates of deliberate self-harm in a large group of nonclinical subjects.
Participants were 1,986 military recruits, 62% of whom were men, who were participating in a study of peer assessment of personality traits and pathology. Individuals who did and did not report a history of self-harm were compared on measures of personality and psychopathology.
Approximately 4% of the participants reported a history of deliberate self-harm. Compared with participants without a history of deliberate self-harm, self-harmers scored higher on self- and peer-report measures of borderline, schizotypal, dependent, and avoidant personality disorder symptoms and reported more symptoms of anxiety and depression. Item-level analyses indicated that peers viewed self-harmers as having strange and intense emotions and a heightened sensitivity to interpersonal rejection.
About one of every 25 members of a large group of relatively high-functioning nonclinical subjects reported a history of self-harm. Self-harmers had more symptoms of several personality disorders than non-self-harmers, and their performance across measures suggested that anxiety plays a prominent role in their psychopathology. Future research should investigate whether psychotherapies or psychiatric medications known to reduce symptoms of anxiety can be effective in treating deliberate self-harm.
对蓄意自我伤害（故意伤害自己但无自杀意图）的研究主要集中在临床和法医群体。仅研究这些通常患有严重精神病理学问题的群体，可能会导致对自我伤害与精神障碍之间关联以及蓄意自我伤害患病率的高估。本研究调查了一大群非临床受试者中蓄意自我伤害的患病率及其相关因素。
参与者为1986名新兵，其中62%为男性，他们参与了一项关于人格特质和病理学同伴评估的研究。对报告有和没有自我伤害史的个体在人格和精神病理学测量方面进行了比较。
约4%的参与者报告有蓄意自我伤害史。与没有蓄意自我伤害史的参与者相比，自我伤害者在边缘型、分裂型、依赖型和回避型人格障碍症状的自我报告和同伴报告测量中得分更高，且报告的焦虑和抑郁症状更多。项目层面的分析表明，同伴认为自我伤害者有奇怪而强烈的情绪，且对人际排斥更为敏感。
在一大群功能相对较高的非临床受试者中，约每25人中有1人报告有自我伤害史。自我伤害者比非自我伤害者有更多几种人格障碍的症状，而且他们在各项测量中的表现表明焦虑在其精神病理学中起着突出作用。未来的研究应调查已知能减轻焦虑症状的心理治疗或精神药物是否能有效治疗蓄意自我伤害。
