Hofstra University, Hempstead, New York.
Stony Brook University, New York.
J Am Acad Child Adolesc Psychiatry. 2020 Sep;59(9):1049-1057. doi: 10.1016/j.jaac.2019.08.006. Epub 2019 Aug 22.
Adolescent nonsuicidal self-injury (NSSI) is a significant risk factor for suicidal behavior and an important clinical marker of psychopathology. NSSI is especially common in adolescent girls. A number of psychosocial correlates of adolescent NSSI have been identified, including problems characterized by disinhibition and negative affectivity. However, it is unknown whether these characteristics prospectively predict first-onset NSSI, limiting our understanding of its etiology and prevention. The current study addresses this gap in the literature.
Participants in the Adolescent Development of Emotion and Personality Traits (ADEPT) project at Stony Brook University who had not experienced NSSI at baseline (462 girls, mean age = 14.39 years, SD = 0.62 years) completed baseline measures of hypothesized risk factors related to problems with disinhibition and negative affectivity, including adolescent psychopathology, personality and clinical traits, and parental psychopathology. First onset of NSSI was monitored at 9-month intervals by in-person and telephone interviews over the next 36 months.
There were 42 first onsets of NSSI (9.1%) in the 3 years since baseline. First-onset NSSI was independently predicted by adolescents' low conscientiousness, high avoidance, and parental substance abuse at baseline. The composite risk index predicting first-onset NSSI demonstrated good accuracy for identifying girls who will start self-injuring (area under the curve = 0.78, sensitivity = 0.85, specificity = 0.57).
These results highlight the role of disinhibition and avoidance in the development of NSSI. The risk index predicting NSSI onset may help to guide the design and application of novel interventions to prevent this condition in adolescent girls.
青少年非自杀性自伤（NSSI）是自杀行为的重要危险因素，也是精神病理学的重要临床标志。NSSI 在青少年女孩中尤为常见。已经确定了青少年 NSSI 的许多心理社会相关因素，包括以抑制障碍和负性情感为特征的问题。然而，尚不清楚这些特征是否可以前瞻性地预测首次 NSSI 的发生，这限制了我们对其病因和预防的理解。本研究填补了该文献中的这一空白。
在石溪大学青少年情绪和个性特质发展（ADEPT）项目中，基线时未发生 NSSI 的参与者（462 名女孩，平均年龄为 14.39 岁，标准差为 0.62 岁）完成了与抑制障碍和负性情感相关的假设风险因素的基线测量，包括青少年精神病理学、个性和临床特征以及父母的精神病理学。在接下来的 36 个月中，通过面对面和电话访谈，以 9 个月为间隔，监测 NSSI 的首次发生。
在基线后的 3 年内，有 42 例首次发生 NSSI（9.1%）。首次 NSSI 的发生独立预测了青少年在基线时的低尽责性、高回避和父母的物质滥用。预测首次 NSSI 发生的复合风险指数对识别开始自伤的女孩具有良好的准确性（曲线下面积为 0.78，敏感性为 0.85，特异性为 0.57）。
这些结果突出了抑制障碍和回避在 NSSI 发展中的作用。预测 NSSI 发作的风险指数可能有助于指导设计和应用新的干预措施，以预防青少年女性发生这种情况。
