Mészáros Gergely, Győri Dora, Horváth Lili Olga, Szentiványi Dora, Balázs Judit
Department of Psychiatry and Psychotherapy, Faculty of Medicine, Semmelweis University, Budapest, Hungary.
Mental Health Sciences School of Ph.D., Semmelweis University, Budapest, Hungary.
Front Psychiatry. 2020 Aug 14;11:814. doi: 10.3389/fpsyt.2020.00814. eCollection 2020.
BACKGROUND/HYPOTHESES: As risk factors for nonsuicidal self-injury (NSSI), most studies highlight the importance of internalising disorders, while only a few researches show the connection between externalising disorders and NSSI. Although some papers have introduced the idea that increasing prevalence rates of NSSI are connected to the broader use of the internet, associations between NSSI and pathological internet use (PIU) are understudied. According to our hypothesis, there is a connection between PIU and NSSI, but this is mediated by psychopathological factors from both internalising and externalising dimensions.
In line with the dimensional approach of psychiatric disorders, participants (N = 363) were recruited from both clinical (N = 202 psychiatric inpatient) and nonclinical (N = 161 adolescents from secondary schools) settings. Measurements: Demographic Questionnaire; Strengths and Difficulties Questionnaire (SDQ); Deliberate Self-Harm Inventory (DSHI); Young Diagnostic Questionnaire for Internet Addiction (YDQ), Mini International Neuropsychiatric Interview Kid (M.I.N.I. Kid).
There was high NSSI frequency (39.9%-71% of them were girls) in our sample. NSSI was significantly more frequent among those who showed threshold symptoms on SDQ than in the subthreshold group [H(3) = 53.293, p <.001]. In the NSSI frequency, there was also a significant difference between 'normal' internet users and both 'maladaptive' and 'pathological' internet users [H(2) = 10.039, p <.05 p = .007]. According to the mediator models, the relationship between PIU and NSSI is not a direct association; it is mediated by all examined psychopathological factors (M.I.N.I. kid diagnoses) except for obsessive-compulsive disorder (OCD), alcohol abuse and dependence, and adjustment disorder.
We found a high frequency of NSSI. According to our results, PIU in itself is not a risk factor for NSSI but might become a risk factor in the presence of comorbid psychiatric disorders. All of these findings draw the attention of clinicians to the importance of careful screening of comorbid disorders with PIU.
背景/假设：作为非自杀性自伤（NSSI）的风险因素，大多数研究强调内化障碍的重要性，而只有少数研究表明外化障碍与NSSI之间的联系。尽管一些论文提出NSSI患病率上升与互联网的更广泛使用有关，但NSSI与病理性互联网使用（PIU）之间的关联研究不足。根据我们的假设，PIU与NSSI之间存在联系，但这是由内化和外化维度的精神病理因素介导的。
根据精神疾病的维度方法，从临床（N = 202名精神科住院患者）和非临床（N = 161名中学生）环境中招募参与者（N = 363）。测量工具：人口统计学问卷；优势与困难问卷（SDQ）；故意自伤量表（DSHI）；青少年互联网成瘾诊断问卷（YDQ），儿童版迷你国际神经精神访谈（M.I.N.I. Kid）。
我们样本中的NSSI频率较高（其中39.9%-71%为女孩）。在SDQ上表现出临界症状的人群中，NSSI的发生率明显高于亚临界组[H(3)=53.293，p<.001]。在NSSI频率方面，“正常”互联网用户与“适应不良”和“病理性”互联网用户之间也存在显著差异[H(2)=10.039，p<.05，p =.007]。根据中介模型，PIU与NSSI之间的关系不是直接关联；除强迫症（OCD）、酒精滥用和依赖以及适应障碍外，所有检查的精神病理因素（儿童版迷你国际神经精神访谈诊断）均介导了这种关系。
我们发现NSSI的频率很高。根据我们的结果，PIU本身不是NSSI的风险因素，但在存在共病精神障碍的情况下可能成为风险因素。所有这些发现都提醒临床医生注意仔细筛查PIU共病障碍的重要性。
