Kruzan Kaylee Payne, Whitlock Janis, Bazarova Natalya N, Bhandari Aparajita, Chapman Julia
Center for Behavioral Intervention Technologies, Northwestern University, Chicago, IL, United States.
Bronfenbrenner Center for Translational Research, Cornell University, Ithaca, NY, United States.
JMIR Form Res. 2022 Jan 10;6(1):e26526. doi: 10.2196/26526.
Nonsuicidal self-injury (NSSI) is a widespread behavior among adolescents and young adults. Although many individuals who self-injure do not seek treatment, there is evidence for web-based help-seeking through web-based communities and mobile peer support networks. However, few studies have rigorously tested the efficacy of such platforms on outcomes relevant for NSSI recovery.
The aim of this small-scale preregistered randomized controlled trial is to provide preliminary insight into the shorter- and longer-term efficacy of the use of a peer support app, TalkLife, in reducing NSSI frequency and urges and increasing readiness to change. In addition, we explore contact with informal support, interest in therapy, and attitudes toward professional help-seeking.
Individuals aged 16-25 years with current (within 3 months) and chronic (>6 episodes in the past year) NSSI history were eligible to participate in this study. After baseline assessments, the intervention group was instructed to use the app actively (eg, post or comment at least three times per week) and the control group received weekly psychoeducational materials through email, for 8 weeks. Follow-up was assessed at 1 month and 2 months. Linear mixed modeling was used to evaluate condition and time point effects for the primary outcomes of NSSI frequency and urges, readiness to change, contact with informal support, interest in therapy, and attitudes toward professional help-seeking.
A total of 131 participants were included in the analysis. We evidenced a significant effect of condition on NSSI frequency such that the participants using the peer support app self-injured less over the course of the study (mean 1.30, SE 0.18) than those in the control condition (mean 1.62, SE 0.18; P=.02; η=0.02). We also evidenced a significant condition effect of readiness to change such that the treatment participants reported greater confidence in their ability to change their NSSI behavior (mean 6.28, SE 0.41) than the control participants (mean 5.67, SE 0.41; P=.04; η=0.02). No significant differences were observed for contact with informal support, interest in therapy, or attitudes toward professional help-seeking.
Use of the peer support app was related to reduced NSSI frequency and greater confidence in one's ability to change NSSI behavior over the course of the study period, but no effects on NSSI urges, contact with informal support, interest in therapy, or attitudes toward professional help-seeking were observed. The findings provide preliminary support for considering the use of mobile peer support apps as a supplement to NSSI intervention and point to the need for larger-scale trials.
Open Science Foundation; https://osf.io/3uay9.
非自杀性自伤行为（NSSI）在青少年和青年中广泛存在。尽管许多自伤个体未寻求治疗，但有证据表明他们会通过网络社区和移动同伴支持网络寻求帮助。然而，很少有研究严格检验此类平台对与NSSI康复相关结果的疗效。
这项小规模的预注册随机对照试验旨在初步了解同伴支持应用程序TalkLife在减少NSSI频率和冲动以及增强改变意愿方面的短期和长期疗效。此外，我们还探讨了与非正式支持的接触、对治疗的兴趣以及对寻求专业帮助的态度。
年龄在16 - 25岁、有当前（3个月内）和慢性（过去一年中发作超过6次）NSSI史的个体有资格参与本研究。在基线评估后，干预组被指示积极使用该应用程序（例如，每周至少发布或评论三次），对照组通过电子邮件每周接收心理教育材料，为期8周。在1个月和2个月时进行随访评估。使用线性混合模型评估NSSI频率和冲动这两个主要结果的干预条件和时间点效应，以及改变意愿、与非正式支持的接触、对治疗的兴趣和对寻求专业帮助的态度。
共有131名参与者纳入分析。我们证明了干预条件对NSSI频率有显著影响，即使用同伴支持应用程序的参与者在研究过程中的自伤次数（均值1.30，标准误0.18）少于对照组（均值1.62，标准误0.18；P = 0.02；η = 0.02）。我们还证明了干预条件对改变意愿有显著影响，即接受治疗的参与者报告其改变NSSI行为的能力信心更强（均值6.28，标准误0.41），高于对照组参与者（均值5.67，标准误0.41；P = 0.04；η = 0.02）。在与非正式支持的接触、对治疗的兴趣或对寻求专业帮助的态度方面未观察到显著差异。
在研究期间，使用同伴支持应用程序与NSSI频率降低以及改变NSSI行为能力的信心增强有关，但未观察到对NSSI冲动、与非正式支持的接触、对治疗的兴趣或对寻求专业帮助的态度有影响。这些发现为考虑将移动同伴支持应用程序作为NSSI干预的补充提供了初步支持，并指出需要进行更大规模的试验。
开放科学基金会；https://osf.io/3uay9 。
