Chair of Applied Psychology, Institute of Sport and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany.
Section for Translational Psychobiology in Child and Adolescent Psychiatry, Department of Child and Adolescent Psychiatry, Centre of Psychosocial Medicine, University of Heidelberg, Blumenstrasse 8, 69115, Heidelberg, Germany.
J Abnorm Child Psychol. 2017 Oct;45(7):1429-1438. doi: 10.1007/s10802-016-0249-2.
Affective and interpersonal instability, both core features of Borderline Personality Disorder (BPD), have been suggested to underlie non-suicidal self-injury (NSSI). Ecological momentary assessment (EMA) is the method of choice when investigating dynamic processes. Previously no study addressed affective and interpersonal instability in daily life of adolescents engaging in NSSI. Female adolescents with NSSI (n = 26) and age- and sex-matched healthy controls (n = 20) carried e-diaries on 2 consecutive weekends and were prompted in hourly intervals to rate their momentary affective state and feelings of attachment towards their mother and best friend. The majority of participants in the NSSI group also fulfilled diagnostic criteria for BPD (73%). Squared successive differences were calculated to quantify instability. Adolescents with NSSI reported less positive affect, t = 6.94, p < 0.01, lower levels of attachment to the mother, t = 5.53, p < 0.01, and best friend, t = 4.36, p < 0.01. Both affective, t = -5.55, p < 0.01, and interpersonal instability, mother: t = -4.10, p < 0.01; best friend: t = -4.57, p < 0.01, were significantly greater in adolescents engaging in NSSI. In the NSSI group, the number of BPD criteria met was positively correlated with affective instability, r = 0.40, p < 0.05, and instability of attachment to the best friend, r = 0.42, p < 0.05, but not instability of attachment towards the mother, r = 0.06, p = 0.79. In line with previous work in adults, NSSI is associated with affective and interpersonal instability assessed by EMA in adolescents. Preliminary findings highlight the association of affective and interpersonal instability with diagnostic criteria for BPD. Clinical implications and avenues for further research are discussed.
情感和人际关系不稳定，这两个都是边缘型人格障碍（BPD）的核心特征，据推测这是导致非自杀性自我伤害（NSSI）的原因。生态瞬时评估（EMA）是研究动态过程的首选方法。此前，尚无研究探讨参与 NSSI 的青少年日常生活中的情感和人际关系不稳定。26 名患有 NSSI 的女性青少年和 20 名年龄和性别匹配的健康对照组在连续两个周末携带电子日记，并按小时间隔提示他们即时的情绪状态和对母亲和最好朋友的依恋感。NSSI 组中的大多数参与者也符合 BPD 的诊断标准（73%）。计算平方连续差异以量化不稳定性。患有 NSSI 的青少年报告的积极情绪较少，t=6.94，p<0.01，与母亲的依恋程度较低，t=5.53，p<0.01，与最好朋友的依恋程度较低，t=4.36，p<0.01。情感不稳定，t=-5.55，p<0.01，人际关系不稳定，母亲：t=-4.10，p<0.01；最好的朋友：t=-4.57，p<0.01，在参与 NSSI 的青少年中显著更大。在 NSSI 组中，符合 BPD 标准的数量与情感不稳定呈正相关，r=0.40，p<0.05，与对最好朋友的依恋不稳定呈正相关，r=0.42，p<0.05，但与对母亲的依恋不稳定无关，r=0.06，p=0.79。与以前在成年人中的工作一致，NSSI 与青少年通过 EMA 评估的情感和人际关系不稳定有关。初步研究结果强调了情感和人际关系不稳定与 BPD 诊断标准的关联。讨论了临床意义和进一步研究的途径。
