Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University.
Center for Alcohol and Addiction Studies, Brown University.
Personal Disord. 2021 Jan;12(1):29-38. doi: 10.1037/per0000456. Epub 2020 Sep 3.
Urges for nonsuicidal self-injury (NSSI) are important precursors to NSSI acts and may serve as a point of intervention. A close understanding of the phenomenology of NSSI urges and the contexts in which they occur is therefore warranted. We used ambulatory assessment to examine the environmental, interpersonal, and affective contexts of NSSI urges. We recruited 56 participants with borderline personality disorder who reported on urges and contexts for 21 days with six random daily prompts, resulting in 5,750 completed assessments. Twenty-two participants reported 160 NSSI urges. We provide extensive descriptive results characterizing the interaction partners, activities, and events participants reported in association with NSSI urges. Results from a logistic multilevel model using the full sample (testing associations between all contexts and urges simultaneously) revealed that urges were more likely to occur at higher levels of negative affect, when rejection was experienced, and later in the day. Urges were not associated with disagreements or feeling let down, being at home versus away, being alone versus in company, socializing versus doing another activity, and it being a weekday versus weekend. Additional growth curve analysis for negative affect using the subsample of 22 participants who reported urges showed that, over the course of urge days compared with nonurge days, negative affect increased before urges, peaked during the urge, and then decreased, approximating a quadratic curve. We conclude that urges occurred primarily in the context of negative affect and rejection, which is consistent with theories on intra- and interpersonal functions of NSSI. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
非自杀性自伤（NSSI）的冲动是 NSSI 行为的重要前兆，可能成为干预的切入点。因此，有必要深入了解 NSSI 冲动的现象学及其发生的背景。我们使用动态评估来检查 NSSI 冲动的环境、人际和情感背景。我们招募了 56 名患有边缘型人格障碍的参与者，他们在 21 天内通过 6 个随机日常提示报告冲动和背景，共完成了 5750 次评估。22 名参与者报告了 160 次 NSSI 冲动。我们提供了广泛的描述性结果，描述了参与者报告的与 NSSI 冲动相关的互动伙伴、活动和事件。使用全样本进行的逻辑多层模型的结果（同时测试所有背景与冲动之间的关联）表明，冲动更可能发生在负面情绪较高、经历拒绝和一天较晚的时候。冲动与分歧或失望感、在家或外出、独处或与他人在一起、社交或从事其他活动以及工作日或周末无关。对报告冲动的 22 名参与者的负性情绪进行的附加增长曲线分析表明，与非冲动日相比，在冲动日期间，负性情绪在冲动之前增加，在冲动期间达到峰值，然后下降，接近二次曲线。我们的结论是，冲动主要发生在负面情绪和拒绝的背景下，这与 NSSI 的内在和人际功能理论一致。（PsycInfo 数据库记录（c）2021 APA，保留所有权利）。
