Variability in the Functions of Nonsuicidal Self-Injury: Evidence From Three Real-Time Monitoring Studies.
Variability in the Functions of Nonsuicidal Self-Injury: Evidence From Three Real-Time Monitoring Studies.
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非自杀性自残功能的变异性：来自三项实时监测研究的证据。
DOI：
10.1016/j.beth.2021.05.003
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发表时间：
2021-11
期刊：
影响因子：
3.7
通讯作者：
Nock, Matthew K
中科院分区：
文献类型：
--
作者：
Coppersmith, Daniel D L;Bentley, Kate H;Kleiman, Evan M;Nock, Matthew K
尽管非自杀性自伤的功能模型有助于解释为什么人们会从事这种令人困惑的行为，但我们仍然缺乏对自伤功能的一些关键特性的理解。在这里，我们解决了关于自伤功能的三个未解决的问题：不同的自伤功能(1)随时间在人与人之间变化多少，(2)随时间在人体内变化多少，(3)随时间同时发生多少？数据来自三个生态瞬间评估（EMA）研究，分别是自残的成年精神科门诊患者（n=7）、社区青少年（n=15）和社区成年人（n=9）。在这三项研究中，共有271次自伤发作（均有相应的功能被EMA捕获）。绝大多数（31人中27人，87%）的参与者在监测期间表现出独特的自伤功能模式，这表明人与人之间的差异很大。绝大多数（31人中有26人，84%）的参与者也表现出自伤功能随时间的变化，表明人与人之间的高度可变性。尽管在给定的自伤事件中，只有一种功能被报告是最常见的，但在22%至43%的自伤事件中，参与者认可了不止一种功能，这表明不同的功能确实同时发生。这些结果强调，自伤的强化过程因人而异，具有时变和多面性，这对这一临床现象的个性化评估和治疗具有重要意义。
Despite functional models of non-suicidal self-injury (NSSI) helping to explain why people engage in this perplexing behavior, we still lack an understanding of some of the key properties of NSSI functions. Here, we address three unanswered questions about NSSI functions: how much do distinct NSSI functions (1) vary between people over time, (2) vary within people over time, and (3) simultaneously co-occur over time? Data were drawn from three ecological momentary assessment (EMA) studies of self-injurious adult psychiatric outpatients (n=7), community-based adolescents (n=15), and community-based adults (n=9). Across the three studies, there was a total of 271 NSSI episodes (all with corresponding functions captured by EMA). The vast majority (27 of 31; 87%) of participants exhibited unique patterns of NSSI functions during the monitoring periods, indicating high variability between people. The vast majority (26 of 31; 84%) of participants also showed changes in NSSI functions over time, indicating high variability within people. Although it was most common for only one function to be reported for a given NSSI episode, participants endorsed more than one function for 22% to 43% of NSSI episodes, indicating that different functions did simultaneously co-occur. These results underscore that reinforcement processes for NSSI differ from person-to-person, and are both time-varying and multifaceted, which has implications for personalized assessment and treatment of this clinical phenomenon.