Exploring Two Emotion-Focused Treatment Modules in Non-Suicidal Self-Injury

描述(由申请人提供)：这项研究的广泛目标是开始建立一种有效的治疗方法来治疗那些从事非自杀性自我伤害(NSSI)的个人。 目前还没有直接针对这种跨诊断、适应不良行为的循证心理干预(1)。流行病学研究表明，NSSI发生在19%至25%的成人临床样本中(8)，并存在于一系列Axis I和Axis II疾病中(3、15、16)。在减少NSSI方面表现出初步希望的现有治疗方法结合了复杂的多组分治疗方案中嵌入的多种技能(例如，26、52、63)；因此，负责改善NSSI的治疗组分(S)并不是很明显。越来越多的研究强调了情绪失调在NSSI中的重要性(例如，27、28、36)。以情绪为中心的心理程序，尤其是旨在培养更大的情绪意识和更多地参与认知重新评估策略的程序，可能是有效的NSSI治疗的关键(例如，34、60、65)。为这一奖学金提出的TE研究研究的具体目标是调查两种特定的情绪集中治疗元素对NSSI参数的影响，同时在研究设计和执行、生态瞬时评估(EMA)方法的使用、跨诊断精神病理学过程的探索和治疗发展研究方面提供宝贵的培训。参与者将是十个人(N=10)，他们符合建议的DSM-5关于NSSI障碍的标准(9)，并报告参与NSSI以减少或逃避负面情绪。调查员将调整《情绪障碍跨诊断治疗统一议定书》(UP；70)的两个核心模块，目的是减少参与者的非自杀自残想法和行为(SITBS；2)。每个治疗模块将包括每周四次50分钟的情绪意识训练或认知重新评估。这项研究将使用平衡的组合系列设计(多个基线和相变)，这将允许受试者之间的比较和受试者作为自己的对照(即受试者内的比较)。阶段变化将根据每个参与者非自杀性SITB频率的变化而特殊确定。这种单病例实验设计方法提供了根据需要灵活地为个人量身定做干预措施的机会(115)，并被推荐用于研究由于治疗阶段结束而导致的有害行为，该阶段可以扩展以允许良好的临床护理(71)。通过智能手机上的EMA，将持续监测非自杀性SITB的频率和特征。与拟议研究密切相关的课程、培训和指导将支持申请人成为心理健康这一关键领域的独立科学家和实践者的长期目标。

DESCRIPTION (provided by applicant): The broad aim of this study is to begin establishing an effective treatment for individuals who engage in non- suicidal self-injury (NSSI), as there are currently no evidence-based psychological interventions that directly target this transdiagnostic, maladaptive behavior (1). Epidemiological studies suggest that NSSI occurs in 19 to 25% of adult clinical samples (8), and is present across a range of Axis I and Axis II disorders (3, 15, 16). Extant treatments that have demonstrated initial promise in reducing NSSI incorporate a multitude of skills embedded in complex multi-component treatment programs (e.g., 26, 52, 63); thus, the treatment component(s) responsible for improvements in NSSI are not readily apparent. A growing body of research emphasizes the importance of emotion dysregulation in NSSI (e.g., 27, 28, 36). Emotion-focused psychological procedures, particularly that aim to foster greater emotional awareness and increase engagement in cognitive reappraisal strategies, may be critical in effective NSSI treatment (e.g., 34, 60, 65). The specific goals of te research study proposed for this fellowship are to investigate the effects of two specific emotion-focused treatment elements on parameters of NSSI while simultaneously providing invaluable training in research design and execution, use of ecological momentary assessment (EMA) methods, exploration of transdiagnostic psychopathological processes, and treatment development research. Participants will be ten individuals (N=10) who meet proposed DSM-5 criteria for NSSI disorder (9) and report engaging in NSSI to reduce or escape from negative emotions. The investigator will adapt two core modules of the Unified Protocol Transdiagnostic Treatment of Emotional Disorders (UP; 70) with the aim of reducing participants' non-suicidal self-injurious thoughts and behaviors (SITBs; 2). Each treatment module will consist of four 50-minute individual weekly sessions of emotion awareness training or cognitive reappraisal. The study will use a counterbalanced, combined-series (multiple baseline and phase change) design, which will allow for both between-subjects comparison and clients to serve as their own control (i.e., within-subjects comparison). Phase change will be determined idiosyncratically based on each participant's changes in frequency of non- suicidal SITBs. This single-case experimental design methodology offers the opportunity to flexibly tailor interventions to the individual as needed (115), and is recommended in research of harmful behaviors due to ending on a treatment phase, which can be extended to allow for good clinical care (71). The frequency and characteristics of non-suicidal SITBs will be monitored continuously with EMA on a smart-phone. Coursework, training, and mentorship germane to the proposed research will support the applicant's long-term goal to become an independent scientist-practitioner in this key field of mental health.