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青少年非自杀性自伤障碍:使用非自杀性自伤障碍指数临床评估进行诊断的临床效用

Nonsuicidal Self-Injury Disorder in Adolescents: Clinical Utility of the Diagnosis Using the Clinical Assessment of Nonsuicidal Self-Injury Disorder Index.

作者信息

Zetterqvist Maria, Perini Irene, Mayo Leah M, Gustafsson Per A

机构信息

Center for Social and Affective Neuroscience, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden.

Department of Child and Adolescent Psychiatry, Region Östergötland, Linköping, Sweden.

出版信息

Front Psychiatry. 2020 Feb 14;11:8. doi: 10.3389/fpsyt.2020.00008. eCollection 2020.

Abstract

Nonsuicidal self-injury disorder (NSSID) is a condition in need of further study, especially in adolescent and clinical populations where it is particularly prevalent and studies are limited. Twenty-nine clinical self-injuring adolescents were included in the study. The Clinical Assessment of Nonsuicidal Self-Injury Disorder Index (CANDI) was used to assess prevalence of NSSID. The NSSID diagnosis criteria were met by 62.1% of adolescents. The impairment or distress criterion was least often met. Criteria B and C (assessing reasons for NSSI and cognitions/emotions prior to NSSI) were confirmed by 96-100% of all participants. Adolescents with NSSI in this clinical sample had several comorbidities and high levels of psychopathology. NSSID occurred both in combination with and independently of borderline personality disorder traits as well as suicide plans and attempts. Those with NSSID had a significantly higher cutting frequency than those not meeting full NSSID criteria. Other NSSI characteristics, comorbidity, psychopathology, and trauma experiences did not differ between groups. CANDI was a feasible tool to assess NSSID in adolescents. It is important to use structured measures to assess the validity of the NSSID diagnosis across development in both community and clinical samples. The clinical utility of the NSSID diagnosis is discussed.

摘要

非自杀性自伤障碍(NSSID)是一种需要进一步研究的病症,尤其是在青少年和临床人群中,该病症在这些人群中尤为普遍,但相关研究有限。本研究纳入了29名有自伤行为的临床青少年。使用非自杀性自伤障碍指数临床评估量表(CANDI)来评估NSSID的患病率。62.1%的青少年符合NSSID诊断标准。损害或痛苦标准最常未被满足。所有参与者中有96 - 100%的人符合标准B和C(评估非自杀性自伤的原因以及非自杀性自伤之前的认知/情绪)。该临床样本中有非自杀性自伤行为的青少年存在多种共病情况且精神病理学水平较高。NSSID既与边缘型人格障碍特征同时出现,也独立出现,同时还伴有自杀计划和企图。患有NSSID的青少年的切割频率显著高于未达到完整NSSID标准的青少年。其他非自杀性自伤特征、共病情况、精神病理学以及创伤经历在两组之间没有差异。CANDI是评估青少年NSSID的一种可行工具。使用结构化测量方法来评估社区和临床样本中NSSID诊断在不同发育阶段的有效性非常重要。文中还讨论了NSSID诊断的临床实用性。

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