Bentley Kate H, Nock Matthew K, Sauer-Zavala Shannon, Gorman Bernard S, Barlow David H
Department of Psychology, Boston University.
Department of Psychology, Harvard University.
J Consult Clin Psychol. 2017 Jun;85(6):632-646. doi: 10.1037/ccp0000205. Epub 2017 Apr 10.
Nonsuicidal self-injury (NSSI) is prevalent and associated with clinically significant consequences. Developing time-efficient and cost-effective interventions for NSSI has proven difficult given that the critical components for NSSI treatment remain largely unknown. The aim of this study was to examine the specific effects of mindful emotion awareness training and cognitive reappraisal, 2 transdiagnostic treatment strategies that purportedly address the functional processes thought to maintain self-injurious behavior, on NSSI urges and acts.
Using a counterbalanced, combined series (multiple baseline and data-driven phase change) aggregated single-case experimental design, the unique and combined impact of these 2 4-week interventions was evaluated among 10 diagnostically heterogeneous self-injuring adults. Ecological momentary assessment was used to provide daily ratings of NSSI urges and acts during all study phases.
Eight of 10 participants demonstrated clinically meaningful reductions in NSSI; 6 participants responded to 1 intervention alone, whereas 2 participants responded after the addition of the alternative intervention. Group analyses indicated statistically significant overall effects of study phase on NSSI, with fewer NSSI urges and acts occurring after the interventions were introduced. The interventions were also associated with moderate to large reductions in self-reported levels of anxiety and depression, and large improvements in mindful emotion awareness and cognitive reappraisal skills.
Findings suggest that brief mindful emotion awareness and cognitive reappraisal interventions can lead to reductions in NSSI urges and acts. Transdiagnostic, emotion-focused therapeutic strategies delivered in time-limited formats may serve as practical yet powerful treatment approaches, especially for lower-risk self-injuring individuals. (PsycINFO Database Record
非自杀性自伤行为（NSSI）很常见，且会产生具有临床意义的后果。鉴于NSSI治疗的关键组成部分在很大程度上仍不明确，因此开发高效且经济的NSSI干预措施颇具难度。本研究旨在检验正念情绪觉察训练和认知重评这两种跨诊断治疗策略对NSSI冲动及行为的特定影响，这两种策略据称可针对被认为维持自伤行为的功能过程。
采用平衡组合系列（多基线和数据驱动的阶段变化）聚合单病例实验设计，在10名诊断各异的自伤成年人中评估这两种为期4周的干预措施的独特及综合影响。在所有研究阶段，采用生态瞬时评估法对NSSI冲动及行为进行每日评分。
10名参与者中有8名在NSSI方面出现了具有临床意义的减少；6名参与者仅对一种干预有反应，而2名参与者在加入另一种干预后才有反应。组间分析表明，研究阶段对NSSI有统计学上的显著总体影响，在引入干预措施后，NSSI冲动及行为减少。这些干预措施还与自我报告的焦虑和抑郁水平的中度至大幅降低，以及正念情绪觉察和认知重评技能的大幅提高有关。
研究结果表明，简短的正念情绪觉察和认知重评干预可减少NSSI冲动及行为。以限时形式提供的跨诊断、以情绪为中心的治疗策略可能是实用且有效的治疗方法，尤其适用于低风险的自伤个体。（《心理学文摘数据库记录》
