引导自助干预法在非自杀性自伤行为大学生中的应用

高昶; 闫业浩; 杨真真; 张翠翠; 刘传新

doi:10.16835/j.cnki.1000-9817.2025248

引导自助干预法在非自杀性自伤行为大学生中的应用

doi: 10.16835/j.cnki.1000-9817.2025248

1.
济宁医学院精神卫生学院山东 272067
2.
济宁医学院公共卫生学院
3.
山东省戴庄医院儿童青少年心理科
4.
济宁医学院附属医院重症医学三科

基金项目:

山东省自然科学基金项目 ZR2021QB184

山东省本科教学改革研究重点项目 Z2024238

详细信息

作者简介:
高昶(1983-), 男, 山东汶上人, 硕士, 高级实验师, 主要从事公共卫生、行为医学与脑科学等方面工作

通讯作者:
刘传新, E-mail: liuchuanxin2003b@163.com

利益冲突声明 所有作者声明无利益冲突。
中图分类号: R179 C913.5 B844.2
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- 被引次数: 0
出版历程
- 收稿日期: 2025-03-24
- 修回日期: 2025-06-27
- 网络出版日期: 2025-08-30
- 刊出日期: 2025-08-25

Application of guided self-help intervention in college students with non-suicidal self-injury behaviors

1.
School of Mental Health, Jining Medical University, Jining 272067, Shandong Province, China

摘要

摘要: 目的探讨基于辩证行为疗法的引导自助干预在大学生非自杀性自伤(NSSI)行为中的应用效果, 为减少大学生NSSI行为发生提供参考。方法选取济宁医学院第二附属医院儿童青少年心理科2021年1月—2023年1月收治的106例大学生NSSI患者, 采用随机数字表法分为观察组和对照组(各53例)。对照组接受常规药物治疗和心理干预, 观察组在对照组的基础上进行基于辩证行为疗法的引导自助, 采用团体活动、个别辅导和自助学习相结合的方式, 涵盖正念训练、痛苦耐受、人际效能、情绪调节4个核心模块, 同时通过微信小程序进行数据收集、技能打卡及个性化建议推送, 两组均干预12周。分别在干预前后通过青少年非自杀性自伤行为问卷、渥太华自我伤害调查表(OSI)、Barratt冲动性量表(BIS)评估患者病情, 并检测血清神经递质水平, 采用χ²检验、t检验、Cochran's Q检验对数据进行比较分析。结果观察组干预3, 6, 12周后的NSSI发生率分别为47.17%, 16.98%, 5.66%, 均低于对照组(67.92%, 35.85%, 20.75%)(χ²值分别为4.67, 4.85, 5.27);干预12周后, NSSI行为问卷中观察组总分为(17.94±2.69)分, 低于对照组(23.04±5.11)分; 功能问卷中观察组总分为(53.24±8.94)分, 高于对照组(47.74±8.00)分; OSI量表, 观察组总分为(4.49±0.62)分, 低于对照组的(6.25±0.81)分; BIS量表, 观察组总分为(80.76±7.94)分, 低于对照组的(87.74±9.34)分, 组间差异均有统计学意义(P值均＜0.05)。观察组干预后5-羟色胺水平为(67.93±7.42)ng/mL, 高于对照组的(44.72±5.54)ng/mL, P物质、皮质醇水平分别为(35.82±4.47)ng/L、(75.64±8.02)μg/L, 均低于对照组[(48.14±5.32)ng/L、(94.53±10.78)μg/L], 差异均有统计学意义(t值分别为18.25, -12.91, -10.24, P值均＜0.05)。结论基于辩证行为疗法的引导自助干预有助于降低大学生NSSI行为。
- 干预性研究 /
- 自我伤害行为 /
- 精神卫生 /
- 学生
Abstract: Objective To explore the application effect of a guided self-help intervention based on dialectical behavior therapy (DBT) to address non-suicidal self-injury (NSSI) behavior among college students, so as to provide a reference for reducing the occurrence of NSSI behavior in this population. Methods A total of 106 college students with NSSI admitted to the Department of Child and Adolescent Psychology, the Second Affiliated Hospital of Jining Medical University from January 2021 to January 2023 were selected and divided into an observation group and a control group, with 53 cases in each group, using a random number table method. The control group received routine medication treatment and psychological intervention, while the observation group, on the basis of the interventions provided to the control group, implemented dialectical behavior therapy-based guided self-help. The approach combines group activities, individual counseling, and self-directed learning, covering four core modules: mindfulness training, distress tolerance, interpersonal effectiveness, and emotion regulation. Meanwhile, data collection, skill check-ins, and personalized recommendation pushes were conducted through a WeChat. Both groups were intervented for 12 weeks. Before the intervention and after the intervention, the Adolescent Non-suicidal Self-injury Behavior Questionnaire, Ottawa Self-injury Inventory (OSI), and Barratt Impulsiveness Scale (BIS) were used to evaluate the patients, and the levels of serum neurotransmitters were detected. The χ² test, t test, and Cochran's Q test were used for data comparison and analysis. Results The incidence rates of NSSI in the observation group after 3, 6, and 12 weeks of intervention were 47.17%, 16.98%, and 5.66%, respectively, all lower than those in the control group (67.92%, 35.85%, 20.75%) (χ²=4.67, 4.85, 5.27, all P < 0.05). After 12 weeks of intervention, in the NSSI Behavior Questionnaire, the total score of the observation group was (17.94±2.69) points, which was lower than that of the control group (23.04±5.11) points; in the Function Questionnaire, the total score of the observation group was (53.24±8.94) points, which was higher than that of the control group (47.74±8.00) points(both P < 0.05). In terms of the OSI, the total score of the observation group was (4.49±0.62) points, lower than that of the control group (6.25±0.81) points; in the BIS, the total score of the observation group was (80.76±7.94) points, lower than that of the control group (87.74±9.34) points, and the differences between groups were statistically significant(both P < 0.05). After the intervention, the level of 5-hydroxytryptamine in the observation group was (67.93±5.42) ng/mL, higher than (44.72±5.54) ng/mL of the control group; the levels of substance P and cortisol in the observation group were (35.82±4.47) ng/L and (75.64±8.02) μg/L, respectively, both lower than (48.14±5.32) ng/L and (94.53±10.78) μg/L of the control group, and the differences were statistically significant (all P < 0.05). Conclusion The guided self-help intervention based on DBT is helpful for reducing NSSI behavior among college students.
- Intervention studies /
- Self-injurious behavior /
- Mental health /
- Students
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表 1 干预前后两组OSI各项评分比较(x±s)

Table 1. Comparison of OSI scores between the two groups before and after the intervention among college students(x±s)

干预前后	组别	人数	统计值	内部情绪调节	社交影响	外部情绪调节	寻求刺激	总分
干预前	对照组	53		2.42±0.36	1.26±0.21	2.63±0.57	1.39±0.21	6.67±1.06
	观察组	53		2.45±0.38	1.28±0.23	2.67±0.59	1.38±0.24	6.76±1.11
			t值	-0.42	-0.47	-0.36	0.23	-0.43
			P值	0.68	0.64	0.72	0.82	0.67
干预后	对照组	53		2.06±0.23	1.18±0.19	2.02±0.21	0.99±0.18	6.25±0.81
	观察组	53		1.51±0.20	0.76±0.11	1.51±0.16	0.71±0.15	4.49±0.62
			t值	13.14	13.93	14.06	8.70	12.56
			P值	＜0.01	＜0.01	＜0.01	＜0.01	＜0.01

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表 2 干预前后两组大学生BIS评分和神经递质水平比较(x±s)

Table 2. Comparison of BIS scores and neurotransmitter levels between two groups before and after intervention among college students(x±s)

干预前后	组别	人数	统计值	BIS评分				神经递质水平
干预前后	组别	人数	统计值	运动性冲动	认知性冲动	无计划性冲动	总分	5-羟色胺/(ng·mL^-1)	P物质/(ng·L^-1)	皮质醇/(μg·L^-1)
干预前	对照组	53		35.12±3.46	33.74±3.61	34.71±3.42	105.13±11.58	26.82±3.14	67.94±7.20	123.26±19.45
	观察组	53		34.83±3.31	33.49±3.54	35.06±3.49	104.58±10.39	27.14±3.39	68.20±7.35	121.84±18.36
			t值	0.44	0.36	-0.52	0.26	-0.50	-0.18	0.39
			P值	0.66	0.72	0.60	0.80	0.62	0.85	0.70
干预后	对照组	53		28.14±3.19	29.48±3.01	30.12±3.14	87.74±9.34	44.72±5.54	48.14±5.32	94.53±10.78
	观察组	53		26.12±2.87	27.63±2.59	27.01±2.48	80.76±7.94	67.93±7.42	35.82±4.47	75.64±8.02
			t值	3.43	3.39	5.66	4.15	-18.25	12.91	10.24
			P值	＜0.01	＜0.01	＜0.01	＜0.01	＜0.01	＜0.01	＜0.01

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