University of Texas Southwestern Medical Center, USA.
J Clin Psychol. 2012 Jul;68(7):809-29. doi: 10.1002/jclp.21868. Epub 2012 May 15.
This study examined the relationship between experiential avoidance, functionally equivalent behaviors, and repetitive nonsuicidal self-injury (NSSI/RNSSI) among adolescents.
Self-report questionnaires from adolescents (N = 211) from 3 school-based samples were employed to assess three forms of experiential avoidance (thought suppression, alexithymia, and avoidance/cognitive fusion), various aspects of self-mutilating behaviors, and the existence of functionally equivalent behaviors (disordered eating, substance abuse, suicidal ideation/behaviors).
Results indicated one third of participants reported a history of NSSI and 16% reported engaging in RNSSI in the past 6 months. Female adolescents were twice as likely as males to report a history of RNSSI. Unwanted inner experiences, thought suppression, and alexithymia differentiated adolescents with a history of NSSI from their counterparts. Functionally equivalent behaviors occurred more frequently among those with a history of NSSI and increased in severity as NSSI increased, particularly suicidal ideation and behaviors. However, results for patterns of avoidance were not as consistent for males as females, which questions the broad application of this model.
NSSI continues to be surprisingly common among adolescents in the community. NSSI, particularly repetitive forms, appears to be strongly related to common forms of experiential avoidance, moreso for female adolescents. Results also illustrate the importance of conceptualizing and treating self-injury as a form of experiential avoidance.
本研究考察了经验回避、功能等效行为与青少年重复非自杀性自我伤害（RNSSI）之间的关系。
采用来自 3 个基于学校样本的青少年自我报告问卷，评估经验回避的三种形式（思维抑制、述情障碍和回避/认知融合）、自我伤害行为的各个方面以及功能等效行为（饮食紊乱、物质滥用、自杀意念/行为）的存在。
结果表明，三分之一的参与者报告有 NSSI 史，16%的参与者报告在过去 6 个月内有过 RNSSI。女性青少年报告 RNSSI 史的可能性是男性的两倍。不良的内在体验、思维抑制和述情障碍将有 NSSI 史的青少年与无 NSSI 史的青少年区分开来。有 NSSI 史的青少年更频繁地出现功能等效行为，且随着 NSSI 的增加，这些行为的严重程度也会增加，特别是自杀意念和行为。然而，对于男性来说，回避模式的结果并不像女性那样一致，这对该模型的广泛应用提出了质疑。
NSSI 在社区青少年中仍然惊人地普遍。NSSI，特别是重复形式，似乎与常见的经验回避形式密切相关，对女性青少年的影响更为明显。研究结果还说明了将自我伤害概念化为一种经验回避形式的重要性。
