Stroehmer Rachel, Edel Marc A, Pott Steffi, Juckel Georg, Haussleiter Ida S
LWL-Institute of Mental Health, LWL-University Hospital Bochum, Alexandrinenstr. 1, 44791 Bochum, Germany.
Dept. of Psychiatry, LWL-University Hospital Bochum, Alexandrinenstr. 1, 44791 Bochum, Germany.
Ann Gen Psychiatry. 2015 Dec 21;14:47. doi: 10.1186/s12991-015-0088-5. eCollection 2015.
It still remains unclear whether non-suicidal self-injury (NSSI) in young adult populations represents an actual symptom leading to psychiatric illness, constitutes a disorder itself or is rather a cultural peer influence. The purpose of this web-based qualitative cross-sectional study was to characterize NSSI (type of injury, frequency, tools, body parts, circumstances) in 50 patients with borderline personality disorder (NSSI + BPD) in direct comparison with 50 age and gender matched non-clinical young adults (NSSI - BPD), all of them currently or previously engaged in NSSI.
Self-harming participants completed an open-access, anonymous 75-items questionnaire including the temperament questionnaire briefTEMPS-M.
The mean age of NSSI onset was 20.56 ± 6.36 (NSSI + BPD) and 17.5 ± 9.28 years (NSSI - BPD), respectively (p = 0.261). NSSI - BPD participants (1) rarely sought out medical treatment (p < 0.001) and differed significantly from BPD patients; They (2) reported more often fear and disappointment as feelings preceding their self-harm (p < 0.001 each); (3) cut themselves in more locations (p = 0.005) and (4) in rather hidden areas (lower limb, proximal) (p = 0.002); (5) had lower depressive temperament scores (p = 0.007); and (6) scored generally fewer character traits "at risk" (p = 0.043) with a lower total score (p = 0.018). NSSI tended to onset slightly earlier in life and in different shape when BPD was absent.
Our findings support current approaches of early NSSI recognition and identification of risk profiles. Further prospective studies, which have to be sufficiently large and longitudinal, are needed and of great importance.
在年轻成年人群体中，非自杀性自伤行为（NSSI）究竟是导致精神疾病的一种实际症状、本身构成一种疾病，还是仅仅是一种文化层面的同伴影响，目前仍不清楚。这项基于网络的定性横断面研究的目的是，对50名边缘型人格障碍患者（NSSI + BPD）的NSSI（伤害类型、频率、工具、身体部位、情境）进行特征描述，并与50名年龄和性别匹配的非临床年轻成年人（NSSI - BPD）进行直接比较，所有这些人目前或曾经有过NSSI行为。
有自伤行为的参与者完成了一份开放式、匿名的75项问卷，包括气质问卷briefTEMPS - M。
NSSI开始的平均年龄分别为20.56±6.36岁（NSSI + BPD）和17.5±9.28岁（NSSI - BPD）（p = 0.261）。NSSI - BPD参与者（1）很少寻求医疗治疗（p < 0.001），且与BPD患者有显著差异；他们（2）更常报告在自伤之前有恐惧和失望的情绪（每项p < 0.001）；（3）在更多部位进行自我切割（p = 0.005），且（4）多在较为隐蔽的部位（下肢、近端）（p = 0.002）；（5）抑郁气质得分较低（p = 0.007）；以及（6）一般“有风险”的性格特征得分较少（p = 0.043），总分较低（p = 0.018）。当不存在BPD时，NSSI往往在生命中稍早开始且表现形式不同。
我们的研究结果支持当前早期识别NSSI和确定风险概况的方法。需要进一步开展足够大规模的纵向前瞻性研究，这非常重要。
