A Mixed Methods Approach to Implicit and Explicit Identification with NSSI

 描述（由申请人提供）：精神病成人中非自杀性自伤（NSSI）的预测因素和维持因素仍然是一个需要经验关注的关键研究领域。越来越多的研究阐明了NSSI的几个横截面风险因素（例如，情绪失调，抑郁症; Andover，Morris，Wren，& Bruzzese，2012）。这些发现与理论模型一致，包括四功能模型（Nock & Prinstein，2004，2005）和情感调节模型（Klonsky，2007），突出了消极情感在NSSI中的作用。最近的研究结果表明，一些人自我认定为“自我伤害者”，并参与NSSI以保持身份（Breen，刘易斯，&萨瑟兰，2013）。然而，对NSSI身份的作用的调查（例如，识别为“切割器”） 和维护NSSI仍然很少，现有的研究包含方法上的限制（例如，自我报告方法; Nock & Banaji，2007）。拟议的研究旨在推进知识的作用，NSSI身份的维护和严重程度的NSSI在混合方法的研究设计。总体目标与国家精神卫生研究所的战略目标2.3一致，即“开发工具，以更好地定义和确定整个生命周期中精神疾病的风险和保护因素。“具体来说，我们将通过收集原始的定量和定性数据来研究NSSI身份的构建，这些数据既包括隐含的（即，自动的;基于实验室的）和明确的（即，自我报告）与NSSI的认同。 拟议的项目将通过使用混合方法设计来增强现有的知识，以在NSSI研究的背景下探索这种新的结构。本研究的目的是：（1）通过一周的重测设计，考察内隐NSSI认同的稳定性，并与对NSSI的态度进行比较;（2）探讨内隐NSSI认同对NSSI维持和严重程度的影响;（3）通过定性访谈和混合方法分析，探讨外显NSSI认同及其与内隐NSSI认同的关系。拟议的研究和培训计划将为PI提供以下方面的培训：（1）在NSSI科学研究中对混合方法设计的理论和分析理解，（2）定量和定性方法和分析的高级培训，（3）使用NSSI特定的基于实验室的NSSI行为评估措施，即自我伤害内隐联想任务（SI-IAT; Nock & Banaji，2007），（4）理解与NSSI相关的内隐和外显过程，（5）在科学写作和研究传播方面的进一步经验，以及（6）在急性治疗环境中创新NSSI研究的道德行为。这项研究对临床实践有直接的意义。关于NSSI身份在治疗依从性和开发替代应对策略以管理痛苦中可能发挥的作用的知识的提高将增强对维持NSSI的因素的理解，为预防和干预工作，治疗开发以及风险评估和管理提供关键信息。

 DESCRIPTION (provided by applicant): The predictors and maintaining factors of non-suicidal self-injury (NSSI) among psychiatric adults remains a critical area of research requiring empirical attention. A growing body of research has elucidated several cross-sectional risk factors for NSSI (e.g., emotional dysregulation, depression; Andover, Morris, Wren, & Bruzzese, 2012). These findings are consistent with theoretical models, including the four function model (Nock & Prinstein, 2004, 2005) and the affect regulation model (see Klonsky, 2007), highlighting the role of negative affect in NSSI. Recent findings indicate that some individuals self-identify a "self-injurers" and engage in NSSI to preserve identity (Breen, Lewis, & Sutherland, 2013). However, investigation of the role of NSSI identity (e.g., identifying as a "cutter") for the onset and maintenance of NSSI remains scarce and the available research contains methodological limitations (e.g., self-report methodology; Nock & Banaji, 2007). The proposed study aims to advance knowledge of the role of NSSI identity in the maintenance and severity of NSSI in a mixed methods study design. The overall goal is congruent with National Institute of Mental Health's Strategic Objective 2.3, to "develop tools to better define and identify risk and protective factors for mental illness across the lifespan." Specifically, we will examine the construct of NSSI identity through the collection of original quantitative and qualitative data examining both implicit (i.e., automatic; laboratory-based) and explicit (i.e., self-reported) identification with NSSI. The proposed project will enhance existing knowledge by using a mixed methods design to explore this novel construct in the context of NSSI research. The aims of the project are (1) examine the stability of implicit NSSI identity, compared to attitude toward NSSI, in a one week, test-retest design, (2) explore the impact of implicit NSSI identity on maintenance and severity of NSSI, and (3) explore explicit NSSI identity and its relationship to implicit NSSI identity through qualitative interviews and mixed methods analysis. The proposed research and training plan will provide the PI with training in (1) theoretical and analytical understanding of mixed methods design in the scientific study of NSSI, (2) advanced training in both quantitative and qualitative methodology and analysis, (3) use of a NSSI-specific laboratory-based behavioral assessment measure of NSSI, the Self-Injury Implicit Association Task (SI-IAT; Nock & Banaji, 2007), (4) understanding implicit and explicit processes associated with NSSI, (5) further experience in scientific writing and research dissemination, and (6) the ethical conduct of innovative NSSI research in an acute treatment setting. This research has direct implications for clinical practice. Improved knowledge about the role NSSI identity may play in treatment adherence and development of alternative coping strategies to manage distress will enhance understanding of factors that maintain NSSI, offering critical information fo prevention and intervention efforts, treatment development, and risk assessment and management.