Oxford Institute of Clinical Psychology Training, The Isis Education Centre, Oxford, UK.
Horizon, Oxford Health NHS Foundation Trust, Witney, UK.
Clin Psychol Psychother. 2019 May;26(3):328-338. doi: 10.1002/cpp.2354. Epub 2019 Mar 5.
Deliberate self-harm in adolescents is an increasing clinical problem, but there is a limited understanding of the mechanisms causing or maintaining this behaviour. One proposed mechanism is that of dissociation. However, the role this mechanism may play is unclear: although some suggest that adolescents engage in self-harm to end the aversive experience of dissociation, others propose that self-harm is used to purposefully trigger a dissociative state to avoid emotional pain. This systematic review is the first to evaluate the available evidence regarding the relationship between dissociation and deliberate self-harm in adolescents (aged 18 or younger). Nineteen relevant studies were identified. These studies were limited by cross-sectional design and poor methods of measurement, but some important conclusions could be drawn. The majority of studies found a positive correlation between the severity of dissociation and the severity and frequency of deliberate self-harm in adolescents, and a small number of results suggest that dissociation mediates the relationship between childhood trauma and adolescent self-harm.
青少年蓄意自伤是一个日益严重的临床问题，但人们对导致或维持这种行为的机制知之甚少。一种被提出的机制是解离。然而，这种机制可能扮演的角色尚不清楚：尽管有些人认为青少年进行自伤是为了结束令人痛苦的解离体验，而另一些人则提出自伤是为了有目的地引发解离状态以避免情绪痛苦。这是首次评估有关青少年（18 岁或以下）中解离与蓄意自伤之间关系的现有证据的系统评价。确定了 19 项相关研究。这些研究受到横断面设计和测量方法不佳的限制，但可以得出一些重要结论。大多数研究发现，青少年的解离严重程度与蓄意自伤的严重程度和频率之间存在正相关，少数结果表明，解离在童年创伤与青少年自伤之间的关系中起中介作用。
