青少年非自杀性自伤发病机制及治疗研究进展

宦宗素; 何旭斌; 杜娜; 吴冬梅; 岳玉川

doi:10.16835/j.cnki.1000-9817.2023.04.036

青少年非自杀性自伤发病机制及治疗研究进展

doi: 10.16835/j.cnki.1000-9817.2023.04.036

宦宗素¹,
何旭斌¹,
杜娜²,
吴冬梅^{3, 4},
岳玉川^5, ,

1.
遵义医科大学护理学院，贵州 563006
2.
成都市第四人民医院心身医学中心
3.
成都市第四人民医院护理部
4.
护理学四川省重点实验室
5.
成都市第四人民医院院办

基金项目:

四川省医学科研青年创新课题项目 Q20017

护理学四川省重点实验室开放课题项目 HLKF2022-2

详细信息

作者简介:
宦宗素(1997-)，女，贵州遵义人，在读硕士，主要研究方向为精神病护理

通讯作者:
岳玉川，E-mail：807646982@qq.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: B844.2 R179
计量
- 文章访问数: 401
- HTML全文浏览量: 302
- PDF下载量: 93
- 被引次数: 0
出版历程
- 收稿日期: 2022-10-18
- 修回日期: 2022-11-18
- 网络出版日期: 2023-04-26
- 刊出日期: 2023-04-25

Progress in the pathogenesis and treatment of non-suicidal self-injury in adolescents

HUAN Zongsu¹,
HE Xubin¹,
DU Na²,
WU Dongmei^{3, 4},
YUE Yuchuan^{5
, ,}

1.
Department of Nursing, Zunyi Medical University, Zunyi(563006), Guizhou Province, China

摘要

摘要: 非自杀性自伤(non-suicide self-injury, NSSI)高发于青少年人群，严重威胁其身心健康，是未来发生自杀的重要预测因子，已成为全球公共卫生关注的热点。目前对青少年NSSI的研究尚处于起步阶段，其形成过程复杂，发病机制尚不完全明确，治疗方面的相关研究较少。研究将从遗传学、神经生物学、神经影像学及社会心理学多视角对青少年NSSI的发病机制及治疗研究进行阐述，旨在为改善青少年NSSI提供理论依据。
- 自我伤害行为 /
- 精神卫生 /
- 发病机制 /
- 青少年
Abstract: Non-suicide self-injury is highly common in adolescents, which is seriously threatening their physical and mental health. It is an important predictor of future suicide, and has become a focus of global public health concern. At present, the research on adolescent non-suicidal self-injury is still in its infancy, and its formation process is complex. The pathogenesis is not completely clear, and the relevant treatment studies are relatively few. The paper expounds the pathogenesis and treatment of the nonsuicidal adolescent NSSI from the perspectives of genetics, neurobiology, neuroimage and social psychology, aiming to provide a theoretical basis for adolescent NSSI prevention and intervention.
- Self-injurious behavior /
- Mental health /
- Pathogenesis /
- Adolescent
注释:

1) 利益冲突声明 所有作者声明无利益冲突。

HTML全文

参考文献(55)

[1]	BROWN R C, PLENER P L. Non-suicidal self-injury in adolescence[J]. Curr Psychiatry Rep, 2017, 19(3): 20. doi: 10.1007/s11920-017-0767-9
[2]	BATTLE D E. Diagnostic and statistical manual of mental disorders(DSM)[J]. Codas, 2013, 25(2): 191-192.
[3]	韩阿珠, 徐耿, 苏普玉. 中国大陆中学生非自杀性自伤流行特征的Meta分析[J]. 中国学校卫生, 2017, 38(11): 1665-1670. https://www.cnki.com.cn/Article/CJFDTOTAL-XIWS201711022.htm HAN A Z, XU G, SU P Y. A Meta-analysis of characteristics of non-suicidal self-injury among middle school students in China's mainland[J]. Chin J Sch Health, 2017, 38(11): 1665-1670. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-XIWS201711022.htm
[4]	ABOUSSOUAN A, SNOW A, CEREI J, et al. Non-suicidal self-injury, suicide ideation, and past suicide attempts: comparison between transgender and gender diverse veterans and non-veterans[J]. J Affect Disord, 2019, 259: 186-194. doi: 10.1016/j.jad.2019.08.046
[5]	HANKIN B L, BARROCAS A L, YOUNG J F, et al. 5-HTTLPR×interpersonal stress interaction and nonsuicidal self-injury in general community sample of youth[J]. Psychiatry Res, 2015, 225(3): 609-612. doi: 10.1016/j.psychres.2014.11.037
[6]	LITTLE K, OLSSON C A, WHITTLE S, et al. Association between serotonin transporter genotype, brain structure and adolescent-onset major depressive disorder: a longitudinal prospective study[J]. Transl Psychiatry, 2014, 4(9): e445. doi: 10.1038/tp.2014.85
[7]	喻承甫, 李美金, 张卫. 童年期创伤、亲子冲突与青少年非自杀性自伤: 催产素受体基因rs53576多态性的调节作用[J]. 中国青年社会科学, 2021, 40(5): 97-108. https://www.cnki.com.cn/Article/CJFDTOTAL-ZQNZ202105015.htm YU C F, LI M J, ZHANG W. Childhood trauma, parent-child conflict, and adolescent non-suicidal self-injury: the regulatory rale of oxytocin receptor gene rs53576 polymorphism[J]. J Chin Youth Soc Sci, 2021, 40(5): 97-108. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZQNZ202105015.htm
[8]	WANG J, QIN W, LIU B, et al. Neural mechanisms of oxytocin receptor gene mediating anxiety-related temperament[J]. Brain Struct Funct, 2014, 219(5): 1543-1554. doi: 10.1007/s00429-013-0584-9
[9]	DAVIS T S, MAUSS I B, LUMIAN D, et al. Emotional reactivity and emotion regulation among adults with a history of self-harm: laboratory self-report and functional MRI evidence[J]. J Abn Psychol, 2014, 123(3): 499-509. doi: 10.1037/a0036962
[10]	BRESIN K, GORDON K H. Endogenous opioids and nonsuicidal self-injury: a mechanism of affect regulation[J]. Neurosci Biobehav Rev, 2013, 37(3): 374-383. doi: 10.1016/j.neubiorev.2013.01.020
[11]	POON J A, THOMPSON J C, FORBES E E, et al. Adolescents' reward-related neural activation: links to thoughts of nonsuicidal self-injury[J]. Suic Life Threat Behav, 2019, 49(1): 76-89. doi: 10.1111/sltb.12418
[12]	KOENIG J, RINNEWITZ L, WARTH M, et al. Psychobiological response to pain in female adolescents with nonsuicidal self-injury[J]. J Psychiatry Neurosci, 2017, 42(3): 189-199. doi: 10.1503/jpn.160074
[13]	KIRTLEY O J, O'CARROLL R E, O'CONNOR R C. The role of endogenous opioids in non-suicidal self-injurious behavior: methodological challenges[J]. Neurosci Biobehav Rev, 2015, 48: 186-189. doi: 10.1016/j.neubiorev.2014.11.007
[14]	CORDER G, CASTRO D C, BRUCHAS M R, et al. Endogenous and exogenous opioids in pain[J]. Ann Rev Neurosci, 2018, 41: 453-473. doi: 10.1146/annurev-neuro-080317-061522
[15]	STANLEY B, SHER L, WILSON S, et al. Non-suicidal self-injurious behavior, endogenous opioids and monoamine neurotransmitters[J]. J Affect Disord, 2010, 124(1/2): 134-140.
[16]	BLASCO-FONTECILLA H, FERNANDEZ-FERNANDEZ R, COLINO L, et al. The addictive model of self-harming (non-suicidal and suicidal) behavior[J]. Front Psychiatry, 2016, 7: 8.
[17]	VOLKOW N D, KOOB G F, MCLELLAN A T. Neurobiologic advances from the brain disease model of addiction[J]. N Engl J Med, 2016, 374(4): 363-371. doi: 10.1056/NEJMra1511480
[18]	HOOPS D, REYNOLDS L M, RESTREPO-LOZANO J M, et al. Dopamine development in the mouse orbital prefrontal cortex is protracted and sensitive to amphetamine in adolescence[J]. eNeuro, 2018, 5(1): 1-30.
[19]	LUDASCHER P, GREFFRATH W, SCHMAHL C, et al. A cross-sectional investigation of discontinuation of self-injury and normalizing pain perception in patients with borderline personality disorder[J]. Acta Psychiatr Scand, 2009, 120(1): 62-70. doi: 10.1111/j.1600-0447.2008.01335.x
[20]	STORKEL L M, KARABATSIAKIS A, HEPP J, et al. Salivary beta-endorphin in nonsuicidal self-injury: an ambulatory assessment study[J]. Neuropsychopharmacology, 2021, 46(7): 1357-1363. doi: 10.1038/s41386-020-00914-2
[21]	冉杭林, 赖顺凯, 严舒雅, 等. 青少年非自杀性自伤行为相关脑功能机制影像学研究进展[J]. 中国神经精神疾病杂志, 2021, 47(3): 186-189. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSJJ202103017.htm RAN H L, LAI S K, YAN S Y, et al. Progress in imaging studies of mechanisms of brain function related to non-suicidal self-injury behavior in adolescents[J]. Chin J Nerv Ment Dis, 2021, 47(3): 186-189. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZSJJ202103017.htm
[22]	WESTLUND-SCHREINER M, KLIMES-DOUGAN B, MUELLER B A, et al. Multi-modal neuroimaging of adolescents with non-suicidal self-injury: amygdala functional connectivity multi-modal neuroimaging of adolescents with non-suicidal self-injury: amygdala functional connectivity[J]. J Affect Disord, 2017, 221: 47-55. doi: 10.1016/j.jad.2017.06.004
[23]	BONENBERGER M, PLENER P L, GROSCHWITZ R C, et al. Differential neural processing of unpleasant haptic sensations in somatic and affective partitions of the insula in non-suicidal self-injury(NSSI)[J]. Psychiatry Res, 2015, 234(3): 298-304. doi: 10.1016/j.pscychresns.2015.10.013
[24]	WESTLUND-SCHREINER M, MUELLER B A, KLIMES-DOUGAN B, et al. White matter microstructure in adolescents and young adults with non-suicidal self-injury[J]. Front Psychiatry, 2020, 10: 1019. doi: 10.3389/fpsyt.2019.01019
[25]	张丽萍, 王纯, 杭亚明, 等. 非自杀性自伤行为的关键生物基础[J]. 中华精神科杂志, 2022, 55(2): 150-153. ZHANG L P, WANG C, HANG Y M, et al. Key biological basis of non-suicidal NSSI behavior[J]. Chin J Psychiatry, 2022, 55(2): 150-153. (in Chinese)
[26]	黄倩, 况利. 自杀与非自杀性自伤青少年额边缘系统脑区神经影像学研究进展[J]. 中国神经精神疾病杂志, 2021, 47(11): 689-693. https://www.cnki.com.cn/Article/CJFDTOTAL-ZSJJ202111014.htm HUANG Q, KUANG L. Progress in neuroimaging of frontolimbic system in suicide and non-suicidal self-injured adolescents[J]. Chin J Nerv Ment Dis, 2021, 47(11): 689-693. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZSJJ202111014.htm
[27]	CASEY B, JONES R M, SOMERVILLE L H. Braking and accelerating of the adolescent brain[J]. J Res Adolesc, 2011, 21(1): 21-33. doi: 10.1111/j.1532-7795.2010.00712.x
[28]	ALLMAN J M, HAKEEM A, ERWIN J M, et al. The anterior cingulate cortex. The evolution of an interface between emotion and cognition[J]. Ann N Y Acad Sci, 2001, 935: 107-117.
[29]	ANDO A, REICHL C, SCHEU F, et al. Regional grey matter volume reduction in adolescents engaging in non-suicidal self-injury[J]. Psychiatry Res Neuroimag, 2018, 280: 48-55. doi: 10.1016/j.pscychresns.2018.08.005
[30]	BEAUCHAINE T P, SAUDER C L, DERBIDGE C M, et al. Self-injuring adolescent girls exhibit insular cortex volumetric abnormalities that are similar to those seen in adults with borderline personality disorcler[J]. Dev Psychopathol, 2019, 31(4): 1203-1212. doi: 10.1017/S0954579418000822
[31]	TAKAHASHI T, CHANEN A M, WOOD S J, et al. Insular cortex volume and impulsivity in teenagers with first-presentation borderline personality disorder[J]. Prog Neur Biol Psychiatry, 2009, 33(8): 1395-1400. doi: 10.1016/j.pnpbp.2009.07.017
[32]	喻承甫, 邓玉婷, 李美金, 等. 非自杀性自伤的认知神经与遗传学机制[J]. 华南师范大学学报(社会科学版), 2021(2): 137-145. https://www.cnki.com.cn/Article/CJFDTOTAL-HNSB202102012.htm YU C F, DENG Y T, LI M J, et al. The cognitive neural and genetic mechanisms of non-suicidal self-injury[J]. J South China Norm Univ(Soci Sci Edit), 2021(2): 137-145. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-HNSB202102012.htm
[33]	DEMERS L A, SCHREINER M W, HANT R H, et al. Alexithymia is associated with neural reactivity to masked emotional faces in adolescents who self-harm[J]. J Affect Disord, 2019, 249: 253-261. doi: 10.1016/j.jad.2019.02.038
[34]	林明婧, 厉萍, 卢庆华. 青少年非自杀性自伤的研究现状[J]. 精神医学杂志, 2018, 31(1): 67-70. https://www.cnki.com.cn/Article/CJFDTOTAL-SDJB201801024.htm LIN M J, LI P, LU Q H. Current research status of non-suicidal self-injury in adolescents[J]. J Psychiatry, 2018, 31(1): 67-70. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-SDJB201801024.htm
[35]	LIU Y, XIAO Y, RAN H, et al. Association between parenting and non-suicidal self-injury among adolescents in Yunnan, China: a cross-sectional survey[J]. Peer J, 2020, 8: e10493. doi: 10.7717/peerj.10493
[36]	李振阳, 王皋茂, 班晨, 等. 青少年非自杀性自伤现状及危险因素研究进展[J]. 国际精神病学杂志, 2021, 48(4): 586-589. https://www.cnki.com.cn/Article/CJFDTOTAL-GWYJ202104004.htm LI Z Y, WANG G M, BAN C, et al. Progress in the status and risk factors of non-suicidal self-injury among adolescents[J]. J Int Psychiatry, 2021, 48(4): 586-589. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-GWYJ202104004.htm
[37]	VANGEEL M, GOEMANS A, VEDDER P. A Meta-analysis on the relation between peer victimization and adolescent non-suicidal self-injury[J]. Psychiatry Res, 2015, 230(2): 364-368. doi: 10.1016/j.psychres.2015.09.017
[38]	KEENAN K, HIPWELL A E, STEPP S D, et al. Testing an equifinality model of nonsuicidal self-injury among early adolescent girls[J]. Dev Psychopathol, 2014, 26(3): 851-862. doi: 10.1017/S0954579414000431
[39]	BUELENS T, LUYCKX K, VERSCHUEREN M, et al. Temperament and character traits of female eating disorder patients with (out) non-suicidal self-injury[J]. J Clin Med, 2020, 9(4): 1207. doi: 10.3390/jcm9041207
[40]	陆心传, 朱峰, 刘艳秋, 等. 伴与不伴非自杀性自伤抑郁障碍青少年的冲动和自我意识对照研究[J]. 精神医学杂志, 2018, 31(5): 325-327. https://www.cnki.com.cn/Article/CJFDTOTAL-SDJB201805002.htm LU X C, ZHU F, LIU Y Q, et al. A comparative study of impulsivity and self-consciousness between depressive adolescents with and without nonsuicidal self-injury[J]. J Psychiatry, 2018, 31(5): 325-327. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-SDJB201805002.htm
[41]	孙蒙, 史战明, 陈登国, 等. 非自杀性自伤与精神障碍关系研究进展[J]. 国际精神病学杂志, 2020, 47(1): 11-13, 24. https://www.cnki.com.cn/Article/CJFDTOTAL-GWYJ202001004.htm SUN M, SHI Z M, CHEN D G, et al. Progress in studying the relationship between non-suicidal self-injury and mental disorders[J]. J Int Psychiatry, 2020, 47(1): 11-13, 24. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-GWYJ202001004.htm
[42]	曾巧羚, 王皋茂. 精神类药物治疗非自杀性自伤的临床疗效的研究进展[J]. 伤害医学(电子版), 2021, 10(4): 47-53. https://www.cnki.com.cn/Article/CJFDTOTAL-SHYD202104009.htm ZENG Q L, WANG G M. Clinical effects of phychotropic drugs in treatment of non-suicidal self-injuries[J]. Inj Med(Electr Edit), 2021, 10(4): 47-53. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-SHYD202104009.htm
[43]	WITT K G, HETRICK S E, RAJARAM G, et al. Psychosocial interventions for self-harm in adults[J]. Cochran Databas Syst Rev, 2021, 4(4): CD013668.
[44]	王桂珍, 王艳郁, 孙宏伟, 等. 青少年自杀行为的保护性因素探讨[J]. 医学与哲学, 2016, 37(9): 35-38. https://www.cnki.com.cn/Article/CJFDTOTAL-YXZX201605011.htm WANG G Z, WANG Y Y, SUN H W, et al. Research on the protective factors of adolescent suicide[J]. Med Philos, 2016, 37(9): 35-38. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-YXZX201605011.htm
[45]	KAESS M, KOENIG J, BAUER S, et al. Self-injury: treatment, assessment, recovery (STAR): online intervention for adolescent non-suicidal self-injury: study protocol for a randomized controlled trial[J]. Trials, 2019, 20(1): 425.
[46]	张迎黎, 冯飞, 梁炜, 等. 认知行为治疗对自杀症状疗效的系统评价和meta分析[J]. 中国心理卫生杂志, 2019, 33(1): 8-14. https://www.cnki.com.cn/Article/CJFDTOTAL-ZXWS201901002.htm ZHANG Y L, FENG F, LIANG W, et al. A systematic review and Meta-analysis of cognitive behavioral therapy for suicidal symptoms[J]. Chin Ment Health J, 2019, 33(1): 8-14. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-ZXWS201901002.htm
[47]	IN-ALBON T. Non-suicidal self-injuryin adolescents: what is known about this new research diagnosis?[J]. Eur Psychol, 2015, 20(3): 167-175.
[48]	王瑶, 何文知, 梁丽君, 等. 辩证行为治疗在青少年非自杀性自伤行为中的应用[J]. 四川精神卫生, 2021, 34(1): 92-96. https://www.cnki.com.cn/Article/CJFDTOTAL-WANT202101021.htm WANG Y, HE W Z, LIANG L J, et al. Application of dialectical behavior therapy in adolescents with non-suicidal self-injury behaviors[J]. Sichuan Ment Health, 2021, 34(1): 92-96. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-WANT202101021.htm
[49]	李泓志, 况利. 辩证行为疗法治疗非自杀性自伤的效果研究进展: 来自脑功能影像的证据[J]. 四川精神卫生, 2021, 34(3): 280-284. https://www.cnki.com.cn/Article/CJFDTOTAL-WANT202103019.htm LI H Z, KUANG L. Advances in the efficacy of dialectical behavior therapy in the treatment of non-suicidal self-injury: evidence from brain function imaging[J]. Sichuan Ment Health, 2021, 34(3): 280-284. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-WANT202103019.htm
[50]	薛毅, 周小艳, 范征莉, 等. 家庭参与式接纳和承诺疗法在青少年非自杀性自伤患者中的应用[J]. 重庆医学, 2022, 51(7): 1131-1134. https://www.cnki.com.cn/Article/CJFDTOTAL-CQYX202207010.htm XUE Y, ZHOU X Y, FAN Z L, et al. Application of family participatory acceptance and commitment therapy in the adolescent patients with non-suicidal self-injury[J]. Chongqing Med, 2022, 51(7): 1131-1134. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-CQYX202207010.htm
[51]	宋京瑶, 王皋茂, 李振阳. 青少年非自杀性自伤治疗的研究进展[J]. 神经疾病与精神卫生, 2020, 20(9): 643-646. https://www.cnki.com.cn/Article/CJFDTOTAL-JBJS202009007.htm SONG J Y, WANG G M, LI Z Y, et al. Research progress on treatment of non-suicidal self-injury in adolescents[J]. J Neurosci Ment Health, 2020, 20(9): 643-646. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-JBJS202009007.htm
[52]	陈俊名, 孙学礼. 无抽搐电休克治疗自闭症严重自伤行为一例[J]. 精神医学志, 2018, 31(5): 379. https://www.cnki.com.cn/Article/CJFDTOTAL-SDJB201805018.htm CHEN J M, SUN X L. A case of severe self-injury in autism treated with non convulsive electroshock[J]. J Psychiatry, 2018, 31(5): 379. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-SDJB201805018.htm
[53]	ROOTES-MURDY K, CARLUCCI M, TIBBS M, et al. Non-suicidal self-injury and electroconvulsive therapy: outcomes in adolescent and young adult populations[J]. J Affect Disord, 2019, 250: 94-98.
[54]	高骏波. 重复经颅磁刺激治疗对青少年抑郁症自我伤害的影响作用: 低频刺激右背外侧前额叶疗效研究[D]. 成都: 电子科技大学, 2020. GAO J B. Effect of repeated rTMS treatment on self-harm in adolescent depression: the therapeutic effect of right dorsolateral prefrontal frequency stimulation[D]. Chengdu: University of Electronic Science and Technology of China, 2020. (in Chinese)
[55]	余寒, 龙珊珊, 周勇. 舍曲林联合重复经颅磁低频刺激右侧腹内侧前额叶(VMPFC)治疗青少年抑郁症非自杀性自伤行为(NSSI)临床观察[J]. 国际精神病学志, 2021, 48(6): 987-990, 993. https://www.cnki.com.cn/Article/CJFDTOTAL-GWYJ202106008.htm YU H, LONG S S, ZHOU Y. A clinical study of low frequency rtms stimulation in the right ventromedial prefrontal cortex (VMPFC)combined with sertraline on the treatment of the adolescents with nonsuicidal self-injurious behaviors[J]. J Inter Psychiatry, 2021, 48(6): 987-990, 993. (in Chinese) https://www.cnki.com.cn/Article/CJFDTOTAL-GWYJ202106008.htm