Spohrs Jennifer, Michelsen Anna, Abler Birgit, Chioccheti Andreas G, Ebner Priemer Ulrich W, Fegert Jörg M, Höper Saskia, In-Albon Tina, Kaess Michael, Koelch Michael, Koenig Elisa, Koenig Julian, Kraus Laura, Nickel Sandra, Santangelo Philip, Schmahl Christian, Sicorello Maurizio, van der Venne Patrice, Plener Paul L
Department for Child and Adolescent Psychiatry and Psychotherapy, Ulm University Medical Centre, Ulm, Germany.
Department of Psychiatry, Psychotherapy and Psychotraumatology Military Medical Centre, Ulm, Germany.
Child Adolesc Psychiatry Ment Health. 2024 Oct 30;18(1):138. doi: 10.1186/s13034-024-00820-1.
Nonsuicidal self-injury (NSSI) is highly prevalent in adolescents and young adults worldwide. It is linked to a broad variety of mental disorders and an increased suicide risk. Despite its high prevalence, research on the underlying mechanisms and on potential risk and resilience factors for maintaining or quitting NSSI remains scarce. This manuscript presents an overview of the "Self-injury: Treatment-Assessment-Recovery" (STAR) collaboration, which aimed to address these gaps.
We investigated the natural course of NSSI as well as its social, psychological, and neurobiological predictors (observational study; OS). OS data collection occurred at four timepoints (baseline [T0], 4 [post, T1], 12 [follow-up (FU), T2], and 18 [FU, T3] months after baseline) for the NSSI group, which was compared to a healthy control (HC) group at T0 only. Online self-report was used at all timepoints, while semi-structured interviews (face-to-face (f2f)) were conducted at T0 and T3. At T0 only, we conducted ecological momentary assessment and neurobiological investigations. Here, we present the general methodology and sample characteristics of the completed OS including the f2f subprojects, while other subprojects are not within the scope of this paper.
The OS sample consists of 343 participants at T0 (180 NSSI, 163 HC). Mean age in the NSSI group (T0) was 18.1 years (SD = 2.09, range: 15-25), gender-related data is available for 166: 156 = female, 7 = male, 3 = transgender, 10 = not disclosed). In the HC group, mean age (T0) was 19.1 years (SD = 2.35, range: 15-25) (142 = female, 21 = male). At T1, 128 (71.11%) of the NSSI participants completed the questionnaires, at T2 125 (69.44%) and at T3 104 (57.78%). In the fMRI subproject, 126 adolescents participated (NSSI = 66, HC = 60, 100% female; mean age (T0): NSSI = 18.10 years, SD = 2.21; HC = 19.08, SD = 2.36).
Understanding predictors is of utmost importance for adequate diagnosis and intervention for NSSI. Our OS applied a multimodal investigation of social, psychological, and neurobiological parameters and is the largest sample of adolescents with NSSI to date including follow-up assessments. As health care providers require specific knowledge to develop new treatments, we believe that our in-depth assessments can potentially enhance care for youths engaging in NSSI.
非自杀性自伤行为（NSSI）在全球青少年和青年中极为普遍。它与多种精神障碍相关，并增加了自杀风险。尽管其患病率很高，但关于其潜在机制以及维持或戒除NSSI的潜在风险和复原力因素的研究仍然很少。本手稿概述了“自伤：治疗-评估-康复”（STAR）合作项目，该项目旨在填补这些空白。
我们调查了NSSI的自然病程及其社会、心理和神经生物学预测因素（观察性研究；OS）。OS数据收集在NSSI组的四个时间点进行（基线[T0]、4个月[后期，T1]、12个月[随访（FU），T2]和18个月[FU，T3]，基线后），仅在T0时与健康对照组（HC）进行比较。所有时间点均采用在线自我报告，而在T0和T3进行半结构化访谈（面对面[f2f]）。仅在T0时，我们进行了生态瞬时评估和神经生物学研究。在此，我们介绍了已完成的OS（包括f2f子项目）的一般方法和样本特征，而其他子项目不在本文范围内。
OS样本在T0时有343名参与者（180名NSSI，163名HC）。NSSI组（T0）的平均年龄为18.1岁（标准差=2.09，范围：15-25岁），可获得166人的性别相关数据：156名女性，7名男性，3名跨性别者，10名未披露）。在HC组中，平均年龄（T0）为19.1岁（标准差=2.35，范围：15-25岁）（142名女性，21名男性）。在T1时，128名（71.11%）NSSI参与者完成了问卷，T2时为125名（69.44%），T3时为104名（57.78%）。在功能磁共振成像子项目中，有126名青少年参与（NSSI=66，HC=60，100%为女性；平均年龄（T0）：NSSI=18.10岁，标准差=2.21；HC=19.08，标准差=2.36）。
了解预测因素对于NSSI的充分诊断和干预至关重要。我们的OS对社会、心理和神经生物学参数进行了多模式调查，是迄今为止包括随访评估在内的最大规模的NSSI青少年样本。由于医疗保健提供者需要特定知识来开发新的治疗方法，我们相信我们的深入评估可能会加强对参与NSSI的青少年的护理。
