School of Mental Health, Bengbu Medical University, Bengbu, Anhui, 233030, China.
Anhui Province Veterans Hospital, Bengbu, Anhui, 233499, China.
BMC Psychiatry. 2024 Oct 18;24(1):708. doi: 10.1186/s12888-024-06121-3.
Non-suicidal self-injury (NSSI) behaviors pose a significant threat to the physical and psychological well-being of adolescents. Recent research suggests that persistent, uncontrollable and repetitive NSSI can be conceptualized as a behavioral addiction. The addictive feature of NSSI behavior can be assessed using Ottawa self-injury inventory (OSI), the higher addiction score indicates the more serious NSSI behavior. This study aims to explore the relationship of impulsivity and decision-making on the addictive features of NSSI in adolescents with depressive disorder, to explore the influencing factors of behavioral addictive features of NSSI and to predict the addictive features of NSSI.
Using a cross-sectional design, a total of 126 adolescent outpatients and inpatients with a mean age of 15.49 years old (M = 15.49, SD = 1.56), male students (n = 28, 22.2%) and female students (n = 98, 77.8%) diagnosed with depressive disorders were recruited according to the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), and clinical interviews were completed by two psychiatrists. NSSI addictive features according to the OSI's addictive features items. The final group was categorized into three groups: depression without NSSI (n = 42), depression with NSSI without addictive features (n = 44), and depression with NSSI and addictive features (n = 40). The present study employed the Hamilton Depression Scale (HAMD-24), Chinese Revised Barratt Impulsiveness Scale Version 11 (BIS-11), OSI, and the Adolescent Non-Suicidal Self-Injury Questionnaire (ANSSIQ). Cognitive decision-making abilities were assessed using the Iowa Gambling Task (IGT).
The depression with NSSI addictive features group had significantly lower total net scores and net scores of block3, block4, and block5 in the IGT than the depression without NSSI group, whereas there was no statistically significant difference between the two in net scores of block1 and block2. Lower scores mean more unfavorable decisions and strategy adjustments. The addictive features of NSSI behaviors were significantly and positively correlated with the severity of NSSI behaviors, depression, and cognitive impulsiveness, and significantly and negatively correlated with the total net score of the IGT. The severity of NSSI behaviors, severity of depression, cognitive impulsiveness positively predicts the addictive features of NSSI behaviors, the total net score of the IGT negatively predicted the addictive features of NSSI behaviors.
Adolescents with depressive disorders with NSSI behavioral addictive features had higher severity of depression, exhibited higher cognitive impulsivity, and made more unfavorable decisions when making choices.
非自杀性自伤（NSSI）行为对青少年的身心健康构成重大威胁。最近的研究表明，持续、无法控制和重复的 NSSI 可以被概念化为一种行为成瘾。可以使用渥太华自伤量表（OSI）评估 NSSI 行为的成瘾特征，较高的成瘾得分表明 NSSI 行为越严重。本研究旨在探讨冲动性和决策对青少年抑郁症患者 NSSI 成瘾特征的关系，探讨 NSSI 行为成瘾特征的影响因素，并预测 NSSI 的成瘾特征。
采用横断面设计，共纳入 126 名年龄在 15.49 岁（M=15.49，SD=1.56）的青少年门诊和住院患者，其中男生（n=28，22.2%）和女生（n=98，77.8%），根据《精神障碍诊断与统计手册》第 5 版（DSM-5）的标准诊断为抑郁症，并由两名精神科医生进行临床访谈。NSSI 根据 OSI 的成瘾特征项目的成瘾特征。最终组分为三组：无 NSSI 的抑郁症（n=42）、无成瘾特征的 NSSI 伴抑郁症（n=44）和有 NSSI 及成瘾特征的抑郁症（n=40）。本研究采用汉密尔顿抑郁量表（HAMD-24）、中文版修订巴瑞特冲动量表 11 版（BIS-11）、OSI 和青少年非自杀性自伤问卷（ANSSIQ）。采用 Iowa 赌博任务（IGT）评估认知决策能力。
与无 NSSI 的抑郁症组相比，NSSI 成瘾特征组的 IGT 总分和第 3、4、5 块的净分明显较低，而第 1、2 块的净分无统计学差异。分数越低意味着更不利的决策和策略调整。NSSI 行为成瘾特征与 NSSI 行为严重程度、抑郁程度和认知冲动性呈显著正相关，与 IGT 总净分呈显著负相关。NSSI 行为严重程度、抑郁严重程度、认知冲动性均正向预测 NSSI 行为成瘾特征，IGT 总净分负向预测 NSSI 行为成瘾特征。
伴有 NSSI 行为成瘾特征的青少年抑郁症患者抑郁程度较高，表现出较高的认知冲动性，在做出选择时做出更不利的决策。
