A functional analysis of two transdiagnostic, emotion-focused interventions on nonsuicidal self-injury.
A functional analysis of two transdiagnostic, emotion-focused interventions on nonsuicidal self-injury.
复制标题
DOI：
10.1037/ccp0000205
复制
发表时间：
2017-06
影响因子：
5.9
通讯作者：
Barlow DH
中科院分区：
文献类型：
--
作者：
Bentley KH;Nock MK;Sauer-Zavala S;Gorman BS;Barlow DH
非自杀性自残(NSSI)非常普遍，并与临床上的重大后果相关。鉴于NSSI治疗的关键组成部分在很大程度上仍不为人所知，开发具有时间效益和成本效益的NSSI干预措施已被证明是困难的。这项研究的目的是考察正念情绪意识训练和认知重新评估这两种跨诊断治疗策略对NSSI敦促和行为的具体影响，这两种策略据称解决了被认为保持自我伤害行为的功能过程。采用平衡的组合系列(多基线和数据驱动的相变)聚合单例实验设计，对10名诊断不同的自伤成人进行了这两种为期四周的干预措施的独特和综合影响的评估。在所有研究阶段，生态瞬时评估被用来提供NSSI敦促和行为的每日评级。10名参与者中有8名显示NSSI在临床上有意义的降低；6名参与者单独对一种干预措施做出反应，而2名参与者在添加替代干预措施后做出反应。群体分析表明，研究阶段对NSSI的总体影响具有统计学意义，在引入干预措施后，NSSI的敦促和行为较少。这些干预措施还与焦虑和抑郁自我报告水平的中等到较大程度的降低有关，并与正念情绪意识和认知重新评估技能的大幅提高有关。研究结果表明，短暂的正念情绪意识和认知重新评估干预可以减少NSSI的冲动和行为。以时间限制的形式提供的跨诊断、以情感为重点的治疗策略可能是实用而有效的治疗方法，特别是对于风险较低的自伤患者。
Nonsuicidal self-injury (NSSI) is prevalent and associated with clinically significant consequences. Developing time-efficient and cost-effective interventions for NSSI has proven difficult given that the critical components for NSSI treatment remain largely unknown. The aim of this study was to examine the specific effects of mindful emotion awareness training and cognitive reappraisal, two transdiagnostic treatment strategies that purportedly address the functional processes thought to maintain self-injurious behavior, on NSSI urges and acts. Using a counterbalanced, combined series (multiple baseline and data-driven phase change) aggregated single-case experimental design, the unique and combined impact of these two four-week interventions was evaluated among ten diagnostically heterogeneous self-injuring adults. Ecological momentary assessment was used to provide daily ratings of NSSI urges and acts during all study phases. Eight of 10 participants demonstrated clinically meaningful reductions in NSSI; six participants responded to one intervention alone, whereas two participants responded after the addition of the alternative intervention. Group analyses indicated statistically significant overall effects of study phase on NSSI, with fewer NSSI urges and acts occurring after the interventions were introduced. The interventions were also associated with moderate to large reductions in self-reported levels of anxiety and depression, and large improvements in mindful emotion awareness and cognitive reappraisal skills. Findings suggest that brief mindful emotion awareness and cognitive reappraisal interventions can lead to reductions in NSSI urges and acts. Transdiagnostic, emotion-focused therapeutic strategies delivered in time-limited formats may serve as practical yet powerful treatment approaches, especially for lower-risk self-injuring individuals.