Franklin Joseph C, Fox Kathryn R, Franklin Christopher R, Kleiman Evan M, Ribeiro Jessica D, Jaroszewski Adam C, Hooley Jill M, Nock Matthew K
Department of Psychology, Harvard University.
J Consult Clin Psychol. 2016 Jun;84(6):544-57. doi: 10.1037/ccp0000093. Epub 2016 Mar 28.
Self-injurious thoughts and behaviors (SITBs) are a major public health problem that traditional interventions have been unable to address on a large scale. The goal of this series of studies was to take initial steps toward developing an effective SITB treatment that can be easily delivered on a very large scale.
We created a brief (1-2 min), game-like app called Therapeutic Evaluative Conditioning (TEC), designed to increase aversion to SITBs and decrease aversion to the self. In 3 separate studies, we recruited participants with recent and severe histories of SITBs from web forums focused on self-injury and psychopathology (Ns = 114, 131, and 163) and randomly assigned them to receive access to the mobile treatment TEC app or a control app for 1 month. We tested the effect of TEC on the frequency of self-cutting, nonsuicidal self-injury more generally, suicide ideation, suicide plans, and suicidal behaviors.
Analyses showed that, compared with the control app, TEC produced moderate reductions for all SITBs except suicide ideation. Across studies, the largest and most consistent reductions were for self-cutting episodes (32%-40%), suicide plans (21%-59%), and suicidal behaviors (33%-77%). Two of the 3 studies showed that TEC impacted its intended treatment targets and that greater change in these targets was associated with greater SITB reductions. TEC effects were not maintained at the 1-month posttreatment follow-up.
Future versions of brief, mobile interventions like that tested here may have the potential to reduce SITBs and related behaviors on a large scale. (PsycINFO Database Record
自我伤害性想法和行为（SITBs）是一个重大的公共卫生问题，传统干预措施无法大规模解决这一问题。本系列研究的目标是朝着开发一种可轻松大规模实施的有效SITB治疗方法迈出初步步伐。
我们创建了一个简短（1 - 2分钟）、类似游戏的应用程序，称为治疗性评估性条件反射（TEC），旨在增加对SITBs的厌恶并减少对自我的厌恶。在3项独立研究中，我们从专注于自我伤害和精神病理学的网络论坛招募了近期有严重SITB病史的参与者（N分别为114、131和163），并随机分配他们在1个月内使用移动治疗TEC应用程序或对照应用程序。我们测试了TEC对自我切割频率、更普遍的非自杀性自我伤害、自杀意念、自杀计划和自杀行为的影响。
分析表明，与对照应用程序相比，除自杀意念外，TEC对所有SITBs都产生了适度的减少。在各项研究中，减少幅度最大且最一致的是自我切割事件（32% - 40%）、自杀计划（21% - 59%）和自杀行为（33% - 77%）。3项研究中的2项表明，TEC影响了其预期的治疗目标，并且这些目标的更大变化与SITBs的更大减少相关。TEC的效果在治疗后1个月的随访中未得到维持。
未来类似于此处测试的简短移动干预措施可能有潜力大规模减少SITBs及相关行为。（PsycINFO数据库记录
