Kandsperger Stephanie, Madurkay Joseph, Schleicher Daniel, Otto Alexandra, Ecker Angelika, Brunner Romuald, Jarvers Irina
Clinic of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Regensburg, Regensburg, Germany.
Psychopathology. 2023;56(1-2):148-161. doi: 10.1159/000526611. Epub 2022 Oct 4.
The successful treatment of adolescents almost always requires parents' involvement in the treatment process. Thus, parental involvement will impact further treatment, especially concerning the acute management of self-harming behavior of their children. Parental burden or low parental motivation for treatment can significantly affect the success of the intervention. Therefore, this study aimed at investigating how especially motivational factors of the adolescents and parents, as well as stressors of the parents, affect the course of non-suicidal self-injury (NSSI) after an acute psychiatric emergency presentation.
Ninety-six adolescents aged 11-18 years who have been presented to an emergency service at a child and adolescent psychiatry clinic for suicidal and/or NSSI behavior were recruited together with their accompanying parents within the framework of a specified diagnostic procedure. This included detailed questionnaire and interview procedures for psychiatric assessment. The extent of parental stress and parents' motivation for treatment and its relations to adolescents' NSSI and own treatment motivation have been investigated in a follow-up examination in the aftermath of the acute presentation. We predicted adolescents' NSSI at follow-up based on their own motivation and parental motivation and stress.
Data analysis demonstrated that higher adolescents' treatment motivation was associated with higher parental stress. Also, higher parental treatment motivation was correlated with a higher degree of parental distress. Furthermore, parents showed lower treatment motivation when their children engaged in NSSI for a longer duration. Finally, lower adolescents' motivation and lower parental stress due to own parental concerns were predictive for higher adolescents' NSSI frequency at follow-up investigation.
DISCUSSION/CONCLUSION: Patients as well as their parents who present for an emergency service are especially likely to be exposed to increased stress and strain factors. During treatment, additional focus should be placed on parental stress and parental and adolescents' treatment motivation. Identifying and addressing deficits in motivation, increases in parental stress, as well as offering support could favorably impact future NSSI behavior.
青少年的成功治疗几乎总是需要父母参与治疗过程。因此，父母的参与会影响后续治疗，尤其是在对其子女自伤行为的急性处理方面。父母的负担或治疗积极性不高会显著影响干预的成功率。因此，本研究旨在调查青少年和父母的动机因素，以及父母的压力源如何影响急性精神科急诊后非自杀性自伤（NSSI）的病程。
在特定诊断程序框架内，招募了96名年龄在11至18岁之间、因自杀和/或NSSI行为前往儿童和青少年精神病诊所急诊服务的青少年及其陪同父母。这包括用于精神病评估的详细问卷和访谈程序。在急性就诊后的随访检查中，调查了父母压力的程度、父母的治疗动机及其与青少年NSSI和自身治疗动机的关系。我们根据青少年自身的动机、父母的动机和压力预测随访时的青少年NSSI。
数据分析表明，青少年较高的治疗动机与较高的父母压力相关。此外，父母较高的治疗动机与较高程度的父母困扰相关。此外，当孩子进行NSSI的时间较长时，父母的治疗动机较低。最后，青少年较低的动机和因自身父母担忧而导致的较低父母压力可预测随访调查中青少年较高的NSSI频率。
讨论/结论：前往急诊服务的患者及其父母尤其容易受到更多压力和紧张因素的影响。在治疗过程中，应额外关注父母压力以及父母和青少年的治疗动机。识别并解决动机缺陷、父母压力增加的问题，并提供支持，可能会对未来的NSSI行为产生积极影响。
