Department of Psychosomatic Medicine, Central Institute of Mental Health, Medical Faculty Mannheim at Heidelberg University, Mannheim, Germany.
Department of Psychosomatic Medicine, Central Institute of Mental Health, Medical Faculty Mannheim at Heidelberg University, Mannheim, Germany.
Behav Res Ther. 2023 Mar;162:104273. doi: 10.1016/j.brat.2023.104273. Epub 2023 Feb 2.
All theoretical models of non-suicidal self-injury (NSSI) posit that regulation of negative affect (NA) is a central motive for NSSI, and cross-sectional work supports this. However, previous ambulatory assessment (AA) studies that examined NSSI found mixed results. We investigated the affect regulation function of NSSI in 51 women with DSM-5 NSSI disorder in a 15-day AA study with five random daily prompts and self-initiated NSSI prompts. We extend previous work by i) comparing NSSI moments to moments of a high-urge for NSSI, ii) adding high-frequency sampling following NSSI and high-urge moments, and iii) including tension as a dependent variable. We hypothesized that NA and tension would show a steeper decrease following NSSI than following high-urge moments, if NSSI was effective in reducing NA and tension. Results showed that the significant linear NA decline following NSSI was not steeper than that following high-urge moments. For aversive tension, we found that NSSI was associated with a significant linear decrease in tension, whereas resisting an urge was not. High-urge moments were better described by an inverted U-shaped pattern, likewise leading to decreased NA and tension following the reported urge. In exploratory analyses, we provide visualized clustering of the NA and tension trajectories surrounding NSSI using k-means and relate these to participants' self-rated effectiveness of the NSSI events. Findings indicate that resisting an urge may also be effective in managing NA and tension and underline the utility of interventions such as urge-surfing.
所有非自杀性自我伤害（NSSI）的理论模型都假设，调节消极情绪（NA）是 NSSI 的核心动机，横断面研究支持这一点。然而，之前使用动态评估（AA）研究 NSSI 的研究结果喜忧参半。我们在一项为期 15 天的 AA 研究中，对 51 名符合 DSM-5 NSSI 障碍标准的女性进行了研究，在该研究中，每天有五个随机提示和自我触发的 NSSI 提示。我们通过以下方式扩展了之前的工作：i）将 NSSI 时刻与高 NSSI 冲动时刻进行比较；ii）在 NSSI 和高冲动时刻之后增加高频采样；iii）将紧张作为一个因变量。我们假设，如果 NSSI 能有效降低 NA 和紧张感，那么 NSSI 之后的 NA 和紧张感下降幅度会比高冲动时刻更大。结果表明，NSSI 后 NA 的显著线性下降并不比高冲动时刻更陡峭。对于令人厌恶的紧张感，我们发现 NSSI 与紧张感的显著线性下降有关，而抵制冲动则没有。高冲动时刻可以更好地用倒 U 型模式来描述，同样也可以在报告的冲动之后降低 NA 和紧张感。在探索性分析中，我们使用 k-均值对 NSSI 周围的 NA 和紧张轨迹进行可视化聚类，并将这些与参与者自我报告的 NSSI 事件的有效性相关联。研究结果表明，抵制冲动也可能有效地管理 NA 和紧张感，并强调了如冲动冲浪等干预措施的实用性。
