Alpert Medical School of Brown University; Butler Hospital.
Harvard University.
Behav Ther. 2019 Sep;50(5):924-937. doi: 10.1016/j.beth.2019.02.001. Epub 2019 Feb 14.
Negative urgency, the self-reported tendency to act impulsively when distressed, increases risk for nonsuicidal self-injury (NSSI). NSSI is also associated with impaired negative emotional response inhibition (NERI), specifically negative emotional action termination (NEAT), a cognitive process theoretically related to negative urgency. We previously found that adults with NSSI history had difficulty inhibiting behavioral responses to affective images depicting negative content (but not positive or neutral images) in an Emotional Stop-Signal Task. We sought to replicate this finding, determine whether this deficit extends to negative emotional action suppression (NEAS; an earlier stage of NERI), and explore whether impairment in these two stages of emotional response inhibition helps explain the relationship between negative urgency and NSSI. Eighty-eight adults with NSSI history (n = 45) and healthy control participants (n = 43) without NSSI history or psychopathology completed a clinical interview, symptom inventories, an impulsivity questionnaire, and behavioral assays of early and late NERI (NEAS and NEAT, respectively). The NSSI group had worse NEAT than the control group in the Emotional Stop-Signal Task, but no group differences in NEAS were observed in an Emotional Go/No-go task. However, both early and late stages of NERI accounted for independent variance in negative urgency. We additionally found that NEAT explained variance in the association between negative urgency and NSSI. These results suggest that impulsive behavior in NSSI may involve specifically impaired inhibitory control over initiated negative emotional impulses. This deficit in late response inhibition to negative emotional stimuli might reflect a cognitive mechanism or pathway to elevated negative urgency among people who self-injure.
消极紧迫感，即当感到痛苦时自我报告的冲动行为倾向，会增加非自杀性自我伤害（NSSI）的风险。NSSI 还与负面情绪反应抑制（NERI）受损有关，特别是负面情绪行为终止（NEAT），这是一个与消极紧迫感理论上相关的认知过程。我们之前发现，有 NSSI 病史的成年人在情感停止信号任务中难以抑制对描述负面内容的情感图像（但不是正面或中性图像）的行为反应。我们试图复制这一发现，确定这种缺陷是否扩展到负面情绪行为抑制（NEAS；NERI 的早期阶段），并探讨这两个情感反应抑制阶段的损伤是否有助于解释消极紧迫感与 NSSI 之间的关系。88 名有 NSSI 病史的成年人（n = 45）和没有 NSSI 病史或精神病理学的健康对照组参与者（n = 43）完成了临床访谈、症状量表、冲动性问卷以及早期和晚期 NERI 的行为测试（分别为 NEAS 和 NEAT）。在情感停止信号任务中，NSSI 组的 NEAT 比对照组差，但在情感 Go/No-go 任务中没有观察到 NEAS 的组间差异。然而，NERI 的早期和晚期阶段都独立解释了消极紧迫感的变异性。我们还发现，NEAT 解释了消极紧迫感与 NSSI 之间关联的变异性。这些结果表明，NSSI 中的冲动行为可能涉及对启动的负面情绪冲动的特定受损的抑制控制。对负面情绪刺激的晚期反应抑制的这种缺陷可能反映了自我伤害者中消极紧迫感升高的认知机制或途径。
