Fluctuations in Affective States and Self-Efficacy to Resist Non-Suicidal Self-Injury as Real-Time Predictors of Non-Suicidal Self-Injurious Thoughts and Behaviors
Fluctuations in Affective States and Self-Efficacy to Resist Non-Suicidal Self-Injury as Real-Time Predictors of Non-Suicidal Self-Injurious Thoughts and Behaviors
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DOI：
10.3389/fpsyt.2020.00214
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发表时间：
2020-03-20
影响因子：
4.7
通讯作者：
Claes, Laurence
中科院分区：
文献类型：
--
作者：
Kiekens, Glenn;Hasking, Penelope;Claes, Laurence
虽然过去十年的研究已经导致对非自杀性自伤（NSSI）远端危险因素的认识显著增加，但对预测自伤思想和行为的短期（近端）因素知之甚少。根据当时的自伤理论，以及概念到行动的概念，本研究澄清了(a)预测自伤想法的实时因素，(b)理论上重要的瞬间因素（即消极情绪、积极情绪和抵抗自伤的自我效能）在日常生活中预测自伤行为的程度，超出了自伤想法。方法采用经验抽样方法，对30例过去一年中经常自伤的年轻成人进行深入的纵向调查。参与者每天完成多达8次评估，连续12天（信号随机抽样）。结果收集了2222份评估（中位依从性= 79.2%），其中记录了591份自伤想法和270份自伤行为。采用动态结构方程建模框架，构建了多层向量自回归模型。结果在同一评估中，消极情绪与自伤思想呈正相关，而积极情绪和抗自伤自我效能感均与自伤思想呈负相关。在评估中，高于平时的负面情绪和抵抗自伤的自我效能可以预测自伤想法的短期变化。虽然消极情绪和积极情绪的波动都能预测自伤行为，但在控制自伤想法预测作用的模型中，这些因素变得不显著。相比之下，抵抗自伤的自我效能递增地预测了从事自伤的可能性较低，超出了自伤的想法。本研究提供了初步证据，表明情感波动可能唯一地预测自伤想法，但不能预测自伤行为，并指出个人信仰在抵抗自伤能力中的作用，在预防自伤行为中起作用。这些发现表明，有必要区分自伤想法的发展和从自伤想法到行为的进展，因为这些可能是不同的过程，具有不同的预测因素。
IntroductionAlthough research over the past decade has resulted in significantly increased knowledge about distal risk factors for non-suicidal self-injury (NSSI), little is known about short-term (proximal) factors that predict NSSI thoughts and behaviors. Drawing on contemporaneous theories of NSSI, as well as the concept of ideation-to-action, the present study clarifies (a) real-time factors that predict NSSI thoughts and (b) the extent to which theoretically important momentary factors (i.e., negative affect, positive affect, and self-efficacy to resist NSSI) predict NSSI behavior in daily life, beyond NSSI thoughts.MethodsUsing experience sampling methodology, intensive longitudinal data was obtained from 30 young adults with frequent NSSI episodes in the last year. Participants completed assessments up to eight times per day for 12 consecutive days (signal-contingent sampling). This resulted in the collection of 2,222 assessments (median compliance = 79.2%) during which 591 NSSI thoughts and 270 NSSI behaviors were recorded. Using the dynamic structural equation modeling framework, multilevel vector autoregressive models were constructed.ResultsWithin the same assessment, negative affect was positively associated with NSSI thoughts, whereas positive affect and self-efficacy to resist NSSI were each negatively associated with NSSI thoughts. Across assessments, higher-than-usual negative affect and self-efficacy to resist NSSI were predictive of short-term change in NSSI thoughts. While fluctuations in both negative affect and positive affect prospectively predicted NSSI behavior, these factors became non-significant in models that controlled for the predictive effect of NSSI thoughts. In contrast, self-efficacy to resist NSSI incrementally predicted a lower probability of engaging in NSSI, above and beyond NSSI thoughts.DiscussionThis study provides preliminary evidence that affective fluctuations may uniquely predict NSSI thoughts but not NSSI behaviors, and point to the role of personal belief in the ability to resist NSSI in preventing NSSI behavior. These findings illustrate the need to differentiate between the development of NSSI thoughts and the progression from NSSI thoughts to behavior, as these are likely distinct processes, with different predictors.