Jørgensen Mie Sedoc, Sharp Carla, Bo Sune, Møhl Bo, Kongerslev Mickey T, Møller Lise, Vestergaard Martin, Storebø Ole Jakob, Poulsen Stig, Beck Emma, Simonsen Erik
Psychiatric Research Unit, Mental Health Services of Region Zealand, Slagelse, Denmark.
Department of Psychology, University of Houston, Houston, USA.
Borderline Personal Disord Emot Dysregul. 2024 Nov 18;11(1):28. doi: 10.1186/s40479-024-00272-1.
Engagement in Non-Suicidal Self-Injury (NSSI) is high among adolescents with borderline personality disorder (BPD), but the trajectory of NSSI in the transition period from adolescence to adulthood is unclear, and studies that look at predictors of persistence are highly needed.
This study followed 111 adolescents aged 14-17 with BPD over a five-year period to observe the prevalence and predictors of NSSI. Information on NSSI was based on both self-report and clinician-administered interviews.
At the outset, 92.8% reported a history of NSSI, with an average of nearly five different types of NSSI. Despite this high initial prevalence, the rates of NSSI within the past two weeks decreased over time from 48% at baseline to 26% after one year, and further to 10% after two years. After five years, 37% reported engaging in NSSI within the past six months. Notably, all but one participant who reported NSSI after five years had engaged in NSSI already at baseline. The study identified that higher adolescent-rated but lower parent-rated BPD severity was associated with engagement in NSSI at baseline. Furthermore, ongoing NSSI after five years was predicted by lower parent-rated BPD severity and externalizing behaviors.
NSSI is frequent in the early course of BPD, and persists in more than one-third after five years. Our findings highlight that baseline engagement in NSSI is a risk factor for persistence of NSSI in the transition period into early adulthood. Furthermore, the findings underscore the significance of integrating both adolescent and parent perspectives on BPD pathology in the assessment and management of NSSI.
边缘型人格障碍（BPD）青少年中，非自杀性自伤行为（NSSI）的发生率很高，但从青春期到成年期过渡阶段的NSSI轨迹尚不清楚，因此非常需要研究持续性的预测因素。
本研究对111名年龄在14至17岁之间的BPD青少年进行了为期五年的跟踪，以观察NSSI的患病率和预测因素。NSSI的信息基于自我报告和临床医生进行的访谈。
一开始，92.8%的人报告有NSSI病史，平均有近五种不同类型的NSSI。尽管初始患病率很高，但过去两周内的NSSI发生率随时间下降，从基线时的48%降至一年后的26%，两年后进一步降至10%。五年后，37%的人报告在过去六个月内有NSSI行为。值得注意的是，五年后报告有NSSI行为的参与者中，除一人外，其他人在基线时就已经有NSSI行为。该研究发现，青少年自评的BPD严重程度较高但父母自评的较低，与基线时的NSSI行为有关。此外，五年后持续的NSSI行为可由父母自评的较低BPD严重程度和外化行为预测。
NSSI在BPD早期很常见，五年后仍有超过三分之一的人持续存在。我们的研究结果表明，基线时参与NSSI是向成年早期过渡阶段NSSI持续存在的一个危险因素。此外，研究结果强调了在评估和管理NSSI时整合青少年和父母对BPD病理学观点的重要性。
