Unterschemmann Sarah-Louise, Mueller Erik Malte, Lux Silke, Philipsen Alexandra, Schulze Marcel
Department of Psychology, University of Marburg, Gutenbergstr.18, Marburg, 35032, Germany.
Department of Psychiatry and Psychotherapy, University of Bonn, Venusberg-Campus 1, Bonn, 53127, Germany.
Borderline Personal Disord Emot Dysregul. 2025 Jul 12;12(1):27. doi: 10.1186/s40479-025-00304-4.
Nonsuicidal self-injury (NSSI) has been identified as one of the most important predictors of suicidal ideation and attempts. Nevertheless, previous research on NSSI has been limited, with different experimental designs leading to inconsistent findings regarding its underlying factors. This is especially true for time-related processes of NSSI. To address this, a standardized set of symptom-specific emotional stimuli was developed (Emotional Picture Set of Self-Injury Images, EPSI), depicting differing stages of NSSI. This study offers a first evaluation of the EPSI picture set as a measurement of emotional reactivity by using emotional self-reports and psychophysiological measures in a sample of healthy participants.
The EPSI picture set, which includes images with neutral objects, self-injury objects, and self-injury scenes, was presented to N = 64 (age: 22.42 (1.4) years, sex: 18 m/ 46f) healthy participants. Emotional reactivity was assessed using emotional self-reports (Self-Assessment Manikin, SAM-Rating) for valence and arousal dimensions. Additionally, psychophysiological measures including skin conductance response, heart period, and the acoustic evoked startle response were recorded.
Overall, the intraclass correlation coefficient and item-total correlation were sufficiently high, indicating good reliability at both the picture and category level. Participants rated self-injury pictures as significantly more unpleasant and arousing compared to pictures showing objects of self-injury and neutral objects. The skin conductance response to pictures with scenes of self-injury was significantly increased compared to pictures with neutral objects, as was heart period deceleration.
This initial evidence suggests that EPSI elicits distinct emotional responses and may serve as a valid measure for studying the process of NSSI. Future research could investigate the EPSI as a standardized measure, particularly in patients with NSSI and borderline personality disorder, to validate its clinical utility and gain insight into its psychophysiological mechanisms.
非自杀性自伤（NSSI）已被确定为自杀意念和自杀未遂的最重要预测因素之一。然而，先前关于NSSI的研究有限，不同的实验设计导致关于其潜在因素的研究结果不一致。这在NSSI与时间相关的过程中尤为明显。为了解决这个问题，开发了一套标准化的特定症状情绪刺激集（自伤图像情绪图片集，EPSI），描绘了NSSI的不同阶段。本研究首次通过在健康参与者样本中使用情绪自我报告和心理生理测量方法，对EPSI图片集作为情绪反应测量工具进行了评估。
向N = 64名（年龄：22.42（1.4）岁，性别：18名男性/46名女性）健康参与者展示了EPSI图片集，其中包括带有中性物体、自伤物体和自伤场景的图像。使用情绪自我报告（自我评估人体模型，SAM评分）评估情绪效价和唤醒维度的反应。此外，记录了包括皮肤电反应、心动周期和声诱发惊吓反应在内的心理生理测量指标。
总体而言，组内相关系数和项目-总分相关系数足够高，表明在图片和类别层面都具有良好的可靠性。与显示自伤物体和中性物体的图片相比，参与者将自伤图片评为明显更不愉快和更具刺激性。与中性物体图片相比，对自伤场景图片的皮肤电反应显著增加，心动周期也出现减速。
这一初步证据表明，EPSI能引发独特的情绪反应，可能是研究NSSI过程的有效测量工具。未来的研究可以将EPSI作为一种标准化测量方法进行研究，特别是在患有NSSI和边缘性人格障碍的患者中，以验证其临床效用并深入了解其心理生理机制。
