Impulsivity and self-harm in adolescence: a systematic review.
Impulsivity and self-harm in adolescence: a systematic review.
复制标题
DOI：
10.1007/s00787-016-0915-5
复制
发表时间：
2017-04
影响因子：
6.4
通讯作者：
Sayal K
中科院分区：
文献类型：
--
作者：
Lockwood J;Daley D;Townsend E;Sayal K
研究支持冲动和自我伤害之间的联系，然而不同研究方法的不一致使人们对这种关系的理解变得复杂。这项系统的综述考察了11-25岁社区青少年冲动和自我伤害之间的联系，旨在根据不同的概念和方法整合研究结果。电子检索EMBASE、MEDLINE、SouInfo、CINAHL、PubMed和Cochrane图书馆，手工检索相关综述的参考文献列表，发现截至2015年7月发表的文章4496篇，其中28篇符合纳入标准。其中24项研究报告了广义冲动和自我伤害之间的联系。然而，根据冲动的概念和测量以及自我伤害行为被指定的精确度，研究结果有所不同。具体地说，终生非自杀性自我伤害与基于情绪的冲动相关特征最为一致。然而，冲动的认知方面(与难以保持注意力或在没有事先考虑的情况下行事有关)将当前的自我伤害与过去的自我伤害区分开来。这些方面还区分了那些有自我伤害想法(意念)的人和那些根据想法采取行动的人(制定)。研究结果表明，基于情绪的冲动与自我伤害的启动有关，而冲动的认知方面与自我伤害的维持有关。此外，在消极情绪的情况下，行为冲动与自我伤害最为相关。总而言之，这些发现表明，不同的冲动因素会在自我伤害的整个生命过程中带来独特的风险。从临床角度来看，这项综述表明，专注于减少对情绪的鲁莽反应或改善自我调节和决策的干预措施，可能在支持那些自我伤害的人方面提供最大的好处。
Research supports an association between impulsivity and self-harm, yet inconsistencies in methodology across studies have complicated understanding of this relationship. This systematic review examines the association between impulsivity and self-harm in community-based adolescents aged 11–25 years and aims to integrate findings according to differing concepts and methods. Electronic searches of EMBASE, MEDLINE, PsychINFO, CINAHL, PubMed and The Cochrane Library, and manual searches of reference lists of relevant reviews identified 4496 articles published up to July 2015, of which 28 met inclusion criteria. Twenty-four of the studies reported an association between broadly specified impulsivity and self-harm. However, findings varied according to the conception and measurement of impulsivity and the precision with which self-harm behaviours were specified. Specifically, lifetime non-suicidal self-injury was most consistently associated with mood-based impulsivity-related traits. However, cognitive facets of impulsivity (relating to difficulties maintaining focus or acting without forethought) differentiated current self-harm from past self-harm. These facets also distinguished those with thoughts of self-harm (ideation) from those who acted on thoughts (enaction). The findings suggested that mood-based impulsivity is related to the initiation of self-harm, while cognitive facets of impulsivity are associated with the maintenance of self-harm. In addition, behavioural impulsivity is most relevant to self-harm under conditions of negative affect. Collectively, the findings indicate that distinct impulsivity facets confer unique risks across the life-course of self-harm. From a clinical perspective, the review suggests that interventions focusing on reducing rash reactivity to emotions or improving self-regulation and decision making may offer most benefit in supporting those who self-harm.