Department of Psychology, University of British Columbia, Vancouver, Canada.
Psychiatry Res. 2012 May 15;197(1-2):73-7. doi: 10.1016/j.psychres.2011.12.011. Epub 2012 Mar 6.
There is debate among researchers regarding the most appropriate conceptual model of non-suicidal self-injury (NSSI). Some argue that NSSI is best viewed within an addictions framework. Because craving of substances is a key concept in the addictions literature, we sought to compare the nature of craving in NSSI and substance use. Measures of NSSI, substance use, and craving were administered to a sample of adolescents (n=58) receiving psychiatric treatment. It was found that total craving scores were significantly lower for NSSI than for substances. Item-level analyses suggested that substances are craved in a variety of contexts, whereas NSSI is typically craved in the context of negative emotions. The pattern of results remained the same when analyses were limited to patients who engaged in both NSSI and substance use. Thus, findings appear to be due to differences in the nature of the behaviors themselves rather than to individual differences between those who engage in NSSI or use substances. We conclude that, while both behaviors have powerful reinforcement contingencies, NSSI appears to be almost exclusively maintained by negative reinforcement (e.g., the reduction of aversive emotions). Findings are more consistent with emotion regulation than addiction models of NSSI.
关于非自杀性自我伤害（NSSI），研究者们存在争议，对于最合适的概念模型尚未达成一致。一些人认为，NSSI 最好在成瘾框架内进行观察。因为物质成瘾文献中的一个关键概念是渴望，我们试图比较 NSSI 和物质使用中的渴望本质。对接受精神科治疗的青少年样本（n=58）进行了 NSSI、物质使用和渴望的测量。结果发现，NSSI 的总渴望评分明显低于物质。项目水平分析表明，物质在各种情况下都被渴望，而 NSSI 通常是在负面情绪的情况下被渴望。当分析仅限于同时从事 NSSI 和物质使用的患者时，结果模式仍然相同。因此，这些发现似乎是由于行为本身的性质差异所致，而不是从事 NSSI 或使用物质的个体差异所致。我们的结论是，虽然这两种行为都具有强大的强化关联，但 NSSI 似乎几乎完全由负强化维持（例如，减少厌恶情绪）。这些发现与情绪调节模型更一致，而不是成瘾模型。
