Mental Health & Well-being, University of Warwick Medical School, Coventry, UK.
Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
Suicide Life Threat Behav. 2019 Oct;49(5):1266-1280. doi: 10.1111/sltb.12512. Epub 2018 Sep 3.
Self-harm remains a serious public health concern; however, identifying adolescents at risk is challenging. While self-harm has been linked with difficulties in emotional regulation postinjury, comparatively little is known about how such difficulties may impact on the future development of self-harm behavior.
A total of 318 pupils aged 14-15 years completed measures on history of direct self-injurious behavior (D-SIB), emotional regulation, depression, and anxiety at two time points across a six-month period.
Of 13% (42) of participants reported their first episode of D-SIB over the six-month period and reported increased difficulties with emotional regulation prior to initial D-SIB. Regression analyses found significant associations for emotional regulation and specifically lack of emotional clarity prior to first episode of D-SIB. Lack of emotional awareness and difficulties with impulse control was significantly associated in those with ongoing D-SIB.
Prior to first episode of D-SIB, young people may experience difficulty regulating emotions, a difficulty which appears less pronounced following their engagement with D-SIB. Our findings implicate difficulties in the early evaluation and understanding of emotions which may later impair attempts at emotion modulation and increase risk of D-SIB. Such findings might help inform early identification of adolescents at risk of initial D-SIB.
自残仍然是一个严重的公共卫生问题；然而，识别有风险的青少年具有挑战性。虽然自残与受伤后情绪调节困难有关，但对于这些困难如何影响自残行为的未来发展，人们知之甚少。
共有 318 名 14-15 岁的学生在六个月的时间内分两个时间点完成了直接自伤行为（D-SIB）、情绪调节、抑郁和焦虑的历史记录的测量。
在 13%（42 人）的参与者中，有 42 人报告在六个月内首次出现 D-SIB，并在首次出现 D-SIB 前报告情绪调节困难增加。回归分析发现，在首次出现 D-SIB 前，情绪调节与情绪清晰度缺乏显著相关。在持续 D-SIB 患者中，情绪意识缺乏和冲动控制困难显著相关。
在首次出现 D-SIB 之前，年轻人可能会经历情绪调节困难，而在他们参与 D-SIB 后，这种困难似乎不那么明显。我们的研究结果表明，在早期评估和理解情绪方面存在困难，这可能会损害后来的情绪调节尝试，并增加 D-SIB 的风险。这些发现可能有助于为最初的 D-SIB 风险青少年提供早期识别。
