Translational Approaches to the Study of Emotion in Self-Injury

描述（由申请人提供）：非自杀性自伤（NSSI）描述了故意和直接伤害身体组织，没有自杀意图，目的是不受社会认可的（国际自伤研究协会；ISSS）。越来越多的证据表明，自伤最常见的功能是调节负面情绪体验（例如，阻止不良情绪）。事实上，自残者报告的负面情绪更频繁、更强烈，在自残行为后负面情绪减少，而且比非自残者更容易出现情绪失调。综上所述，研究表明，自伤对那些努力调节情绪的人有一种情绪调节功能。因此，仔细检查自伤患者的情绪失调可以大大提高对病因、预防和治疗的认识。到目前为止，我们对自伤中的情绪的了解大多是基于自我报告研究，这可以说只是对情绪缺陷的粗略理解。在情感科学框架指导下的研究可以提供更多关于自伤情绪的细致入微和临床有用的信息。具体来说，情绪可以分为多个部分，每个部分都代表了以情绪失调为特征的障碍的潜在损害来源。本研究将这一框架应用于研究自伤时的情绪，方法是使用眨眼惊吓反射，这是一种经过验证的用于研究情绪处理的生理测量方法。更具体地说，将检查两种可能的情绪失调来源：惊吓反射的大小将被测量：1)在呈现情绪和中性图片期间（即，指数情绪反应）和2)在呈现这些刺激后的几秒钟（即，指数回到情绪基线）。厌恶刺激后情绪恢复的时间过程将在第二项研究中进一步研究。研究方案将在一个自我伤害和两个非伤害控制样本（即，情感痛苦的非伤害者和非情感痛苦的非伤害者）中执行。长期目标是产生关于自伤中情绪失调的来源和性质的更精确的知识，从而指导治疗的设计和实施。公共卫生相关性：青少年和年轻人的自伤率高得不成比例。辩证行为疗法（DBT）是一种针对边缘型人格障碍自残者的强化治疗方案，大多数情况下是住院治疗，目前没有治疗自残的方法。该项目代表了程序化研究的第一步，该研究旨在生成临床有用的自伤情绪失调模型，以指导有效干预措施的发展。

DESCRIPTION (provided by applicant): Non-suicidal self-injury (NSSI) describes the deliberate and direct injuring of body tissue without suicidal intent for purposes not socially sanctioned (International Society for the Study of Self-injury; ISSS). Converging evidence suggests that the most common function of NSSI is to regulate negative emotional experiences (e.g., to stop bad feelings). In fact, self-injurers report more frequent and intense negative emotions, a reduction in negative emotions following a self-injurious act, and more emotion dysregulation than non-injurers. Taken together, research suggests that NSSI serves an emotion regulation function for individuals who struggle to regulate emotion. Therefore, careful examination of emotion dysregulation in NSSI could substantially improve knowledge about etiology, prevention, and treatment. Thus far, most of what we know about emotion in NSSI is based on self-report studies, which arguably provide only a crude understanding of emotional deficits. Research guided by an affective science framework could provide more nuanced and clinically useful information about emotion in NSSI. Specifically, emotion can be separated into multiple components, each of which represents a potential source of impairment in disorders characterized by emotion dysregulation. The present study will apply this framework to the study of emotion in NSSI by employing the eyeblink startle reflex, a well-validated physiological measure used to study emotional processing. More specifically, two possible sources of emotion dysregulation will be examined: the magnitude of the startle reflex will be measured 1) during the presentation of emotional and neutral pictures (i.e., to index emotional reactivity) and 2) several seconds following the presentation of these stimuli (i.e., to index return to emotional baseline). The time-course of emotional recovery following aversive stimuli will be further examined in a second study. The study protocol will be administered to a self-injuring and two non-injuring control samples (i.e., affectively distressed non-injurers and non-affectively distressed non-injurers).The long-term goal is to generate more precise knowledge regarding the source and nature of emotional dysregulation in NSSI that can guide the design and implementation of treatments. PUBLIC HEALTH RELEVANCE: Rates of NSSI are disproportionately high in adolescents and young adults. Other than Dialectical Behavior Therapy (DBT), which is an intensive, most often inpatient, treatment program for self-injurers with borderline personality disorder, there is currently no treatment for self-injury. This project represents the first step in a programmatic line of research to generate clinically useful models of emotion dysregulation in NSSI to guide the development of effective interventions.