广州医药 ›› 2025, Vol. 56 ›› Issue (11): 1473-1481.DOI: 10.20223/j.cnki.1000-8535.2025.11.002
谭洁颖1, 张璐璐2
收稿日期:2024-12-30
出版日期:2025-11-20
发布日期:2025-12-25
通讯作者:
张璐璐,E-mail:llzhang1304@126.com
作者简介:张璐璐 中南大学医学博士,主任医师,研究生导师,博士后合作导师,现任广州市第一人民医院精神心理科主任,荣获广东省杰出青年医学人才、岭南名医、羊城好医生、广州市优秀健康科普专家称号。兼任中华医学会精神医学分会青年委员、中华医学会精神医学分会综合医院精神心理研究协作组委员、中华医学会心身医学分会心身重症医学协作学组委员、中国心理卫生协会老年心理卫生专业委员、中国老年保健协会心理健康和精神卫生分会常务委员、广东省心理学会临床心理专业委员会副主任委员、广东省医学会精神医学分会和心身医学分会常务委员等。发表多篇SCI论文,参编2部国家“十三五”规划教材和1部广东省高等学校“十二五”规划精品课程建设教材。擅长抑郁症、焦虑症、睡眠障碍、青少年情绪障碍的诊治和全病程康复。
基金资助:TAN Jieying1, ZHANG Lulu2
Received:2024-12-30
Online:2025-11-20
Published:2025-12-25
摘要: 非自杀性自伤行为(NSSI)是指个体在没有自杀意图的情况下,故意对自己身体进行伤害的行为。近年来,NSSI在全球范围内整体呈上升趋势,尤其在青少年群体中日益普遍,这与青少年的年龄特点、心理及生物学特征、社会压力等因素密切相关。有研究表明,NSSI是自杀行为的独立危险因素,不仅对青少年健康造成严重影响,也给家庭和社会带来了沉重的负担。因此,本文通过系统回顾NSSI相关文献,阐述其流行病学现况、影响因素和干预措施,旨在为早期识别高危人群、预防青少年NSSI行为的发生以及制定相应的干预策略提供科学依据。
谭洁颖, 张璐璐. 青少年非自杀性自伤行为研究进展[J]. 广州医药, 2025, 56(11): 1473-1481.
TAN Jieying, ZHANG Lulu. Advances in the study of non-suicidal self-injury in adolescents[J]. Guangzhou Medical Journal, 2025, 56(11): 1473-1481.
| [1] POUDEL A,LAMICHHANE A,MAGAR K R,et al.Non suicidal self injury and suicidal behavior among adolescents:Co-occurrence and associated risk factors[J].BMC Psychiatry,2022,22(1):96. [2] LIM K S,WONG C H,MCINTYRE R S,et al.Global lifetime and 12-month prevalence of suicidal behavior,deliberate self-harm and non-suicidal self-injury in children and adolescents between 1989 and 2018:A meta-analysis[J].Int J Environ Res Public Health,2019,16(22):4581. [3] GRIFFIN E,MCMAHON E,MCNICHOLAS F,et al.Increasing rates of self-harm among children,adolescents and young adults:A 10-year national registry study 2007-2016[J].Soc Psychiatry Psychiatr Epidemiol,2018,53(7):663-671. [4] Association A P.Diagnostic and Statistical Manual of Mental Disorders,5th Edition:DSM-5[M].Arlington:American Psychiatric Publishing,2013:726. [5] KAESS M,PARZER P,MATTERN M,et al.Adverse childhood experiences and their impact on frequency,severity,and the individual function of nonsuicidal self-injury in youth[J].Psychiatry Res,2013,206(2-3):265-272. [6] JIANG Z,WANG Z,DIAO Q,et al.The relationship between negative life events and non-suicidal self-injury(NSSI)among Chinese junior high school students:The mediating role of emotions[J].Ann Gen Psychiatry,2022,21(1):45. [7] ABBASI-GHAHRAMANLOO A,KHODADOUST B,ADHAM D,et al.Non-suicidal self-injury and its risk factors among Iranian high school and university students[J].Front Psychiatry,2024(15):1425411. [8] KIEKENS G,HASKING P,CLAES L,et al.Predicting the incidence of non-suicidal self-injury in college students[J].Eur Psychiatry,2019(59):44-51. [9] SUN K,LI A,LI Y,et al.A cross-sectional study of non-suicidal self-injury in a Chinese adolescent inpatient cohort[J].Front Psychiatry,2023(14):1109334. [10] YANG F,JIANG L,MIAO J,et al.The association between non-suicidal self-injury and negative life events in children and adolescents in underdeveloped regions of south-western China[J].PeerJ,2022(10):e12665. [11] LIN M P,YOU J,REN Y,et al.Prevalence of nonsuicidal self-injury and its risk and protective factors among adolescents in Taiwan[J].Psychiatry Res,2017(255):119-127. [12] LIU R T.The epidemiology of non-suicidal self-injury:Lifetime prevalence,sociodemographic and clinical correlates,and treatment use in a nationally representative sample of adults in England[J].Psychol Med,2023,53(1):274-282. [13] GANDHI A,LUYCKX K,ADHIKARI A,et al.Non-suicidal self-injury and its association with identity formation in India and Belgium:A cross-cultural case-control study[J].Transcult Psychiatry,2021,58(1):52-62. [14] DENG H,ZHANG X,ZHANG Y,et al.The pooled prevalence and influential factors of non-suicidal self-injury in non-clinical samples during the COVID-19 outbreak:A meta-analysis[J].J Affect Disord,2023(343):109-118. [15] DE LUCA L,GILETTA M,NOCENTINI A,et al.Non-suicidal self-injury in adolescence:The role of pre-existing vulnerabilities and COVID-19-related stress[J].J Youth Adolesc,2022,51(12):2383-2395. [16] KAESS M,HILLE M,PARZER P,et al.Alterations in the neuroendocrinological stress response to acute psychosocial stress in adolescents engaging in nonsuicidal self-injury[J].Psychoneuroendocrinology,2012,37(1):157-161. [17] KLIMES-DOUGAN B,BEGNEL E,ALMY B,et al.Hypothalamic-pituitary-adrenal axis dysregulation in depressed adolescents with non-suicidal self-injury[J].Psychoneuroendocrinology,2019(102):216-224. [18] REICHL C,SCHÄR S,LERCH S,et al.Two-year course of non-suicidal self-injury in an adolescent clinical cohort:The role of childhood adversity in interaction with cortisol secretion[J].Psychoneuroendocrinology,2024(167):107093. [19] FAYE P.Addictive characteristics of the behavior of self-mutilation[J].J Psychosoc Nurs Ment Health Serv,1995,33(6):36-39. [20] BLASCO-FONTECILLA H,FERNÁNDEZ-FERNÁNDEZ R,COLINO L,et al.The addictive model of self-harming(non-suicidal and suicidal)behavior[J].Front Psychiatry,2016(7):8. [21] VICTOR S E,GLENN C R,KLONSKY E D.Is non-suicidal self-injury an “addiction”? A comparison of craving in substance use and non-suicidal self-injury[J].Psychiatry Res,2012,197(1-2):73-77. [22] van der VENNE P,BALINT A,DREWS E,et al.Pain sensitivity and plasma beta-endorphin in adolescent non-suicidal self-injury[J].J Affect Disord,2021(278):199-208. [23] GAVCAR E G,KABUKÇU BAŞAY B,AVCI E,et al.Relationship between saliva opiorphin levels,pain threshold,and cutting number in adolescents with non suicidal self injury[J].J Psychiatr Res,2022(151):611-618. [24] VEGA D,RIPOLLÉS P,SOTO À,et al.Orbitofrontal overactivation in reward processing in borderline personality disorder:The role of non-suicidal self-injury[J].Brain Imaging Behav,2018,12(1):217-228. [25] LEE J O,MOON H,ZOH S M,et al.Neural correlates of reward valuation in individuals with nonsuicidal self-injury under uncertainty[J].Psychol Med,2024,54(12):1-10. [26] POON J A,THOMPSON J C,FORBES E E,et al.Adolescents’ reward-related neural activation:Links to thoughts of nonsuicidal self-injury[J].Suicide Life Threat Behav,2019,49(1):76-89. [27] MONTO M A,MCREE N,DERYCK F S.Nonsuicidal self-injury among a representative sample of US adolescents,2015[J].Am J Public Health,2018,108(8):1042-1048. [28] WANG Y J,LI X,NG C H,et al.Risk factors for non-suicidal self-injury(NSSI)in adolescents:A meta-analysis[J].EClinicalMedicine,2022(46):101350. [29] LIU X,LIU Z Z,FAN F,et al.Menarche and menstrual problems are associated with non-suicidal self-injury in adolescent girls[J].Arch Womens Ment Health,2018,21(6):649-656. [30] 徐明图,李敬阳,付聪,等.青少年消极身体意象潜在类别与自杀意念和非自杀性自伤的关系[J].吉林大学学报(医学版),2023,49(4):1053-1059. [31] 郝阳,安献丽,朱传林,等.上行外貌比较与青少年非自杀性自伤的关系及作用机理[J].中国临床心理学杂志,2023,31(6):1414-1420. [32] KENNEDY G A,JEAN FORNEY K,PINNER D,et al.Reducing anticipated non-suicidal self-injury by improving body esteem in individuals with weight suppression:A proof of concept study[J].Int J Eat Disord,2019,52(2):206-210. [33] CASSELS M,NEUFELD S,van HARMELEN A L,et al.Prospective pathways from impulsivity to non-suicidal self-injury among youth[J].Arch Suicide Res,2022,26(2):534-547. [34] REN T,WEN Y,MA L,et al.Psychosocial factors affect the occurrence of nonsuicidal self-injury in adolescents with major depressive disorder through chain mediation[J].Eur Arch Psychiatry Clin Neurosci,2024. [35] GRATZ K L,DIXON-GORDON K L,CHAPMAN A L,et al.Diagnosis and characterization of DSM-5 nonsuicidal self-injury disorder using the clinician-administered nonsuicidal self-injury disorder index[J].Assessment,2015,22(5):527-539. [36] LANG A N,ZHONG Y,LEI W,et al.Neural mechanism of non-adaptive cognitive emotion regulation in patients with non-suicidal self-injury[J].Compr Psychiatry,2024(133):152487. [37] HAN X,ZHANG Y,CHEN D,et al.The impact of negative cognitive bias on NSSI:Mediating non-adaptive cognitive emotion regulation strategies[J].BMC Nurs,2024,23(1):358. [38] 严惠茹,李明珠,葛宇琪,等.青少年及成年早期精神障碍患者非自杀性自伤功能与成瘾特征和神经质人格的关系[J].中国心理卫生杂志,2024,38(4):332-337. [39] KIEKENS G,HASKING P,BRUFFAERTS R,et al.Non-suicidal self-injury among first-year college students and its association with mental disorders:Results from the World Mental Health International College Student(WMH-ICS)initiative[J].Psychol Med,2023,53(3):875-886. [40] ZHANG F,CLOUTIER P F,YANG H,et al.Non-suicidal self-injury in Shanghai inner bound middle school students[J].Gen Psychiatr,2019,32(4):e100083. [41] CRUMP C,SUNDQUIST K,SUNDQUIST J,et al.Sociodemographic,psychiatric and somatic risk factors for suicide:A Swedish national cohort study[J].Psychol Med,2014,44(2):279-289. [42] ROSARIO-WILLIAMS B,KAUR S,MIRANDA R.Examining decentering as a moderator in the relation between non-suicidal self-injury and suicide ideation via cognitive-affective factors[J].Suicide Life Threat Behav,2021,51(4):741-754. [43] YADLOSKY L B,MOWREY W B,PIMENTEL S S.Risky business:Considerations of emotion regulation and high-risk behaviors in anxious adolescents[J].J Anxiety Disord,2023(99):102760. [44] BODUSZEK D,DEBOWSKA A,OCHEN E A,et al.Prevalence and correlates of non-suicidal self-injury,suicidal ideation,and suicide attempt among children and adolescents:Findings from Uganda and Jamaica[J].J Affect Disord,2021(283):172-178. [45] BROWN N,MCLAFFERTY M,O’NEILL S M,et al.The mediating roles of mental health and substance use on suicidal behavior among undergraduate students with ADHD[J].J Atten Disord,2022,26(11):1437-1451. [46] OJALA O,KUJA-HALKOLA R,BJUREBERG J,et al.Associations of impulsivity,hyperactivity,and inattention with nonsuicidal self-injury and suicidal behavior:Longitudinal cohort study following children at risk for neurodevelopmental disorders into mid-adolescence[J].BMC Psychiatry,2022,22(1):679. [47] BALÁZS J,GYŐRI D,HORVÁTH L O,et al.Attention-deficit hyperactivity disorder and nonsuicidal self-injury in a clinical sample of adolescents:The role of comorbidities and gender[J].BMC Psychiatry,2018,18(1):34. [48] DENG W,YAN S,XU Y,et al.Effects of BPD tendencies and subjective well-being on NSSI in adolescents with PTSD[J].Front Psychiatry,2023(14):1152352. [49] ZHAO X,LUKITO S,HUANG X,et al.Longitudinal associations between pandemic post-traumatic stress symptoms and subsequent non-suicidal self-injury in adolescents:A multiple mediation model[J].J Affect Disord,2023(323):707-715. [50] PATEL T A,BLAKEY S M,HALVERSON T F,et al.Experiential avoidance,posttraumatic stress disorder,and self-injurious thoughts and behaviors:A moderation analysis in a national veteran sample[J].Int J Cogn Ther,2023,1 :10.1007/s41811-10.1007/s41023-00164-2. [51] FAN Y Y,LIU J,ZENG Y Y,et al.Factors associated with non-suicidal self-injury in chinese adolescents:A meta-analysis[J].Front Psychiatry,2021(12):747031. [52] CHEN H,GUO H,CHEN H,et al.Influence of academic stress and school bullying on self-harm behaviors among Chinese middle school students:The mediation effect of depression and anxiety[J].Front Public Health,2023(10):1049051. [53] VICTOR S E,HIPWELL A E,STEPP S D,et al.Parent and peer relationships as longitudinal predictors of adolescent non-suicidal self-injury onset[J].Child Adolesc Psychiatry Ment Health,2019(13):1. [54] JEWETT P I,TALIAFERRO L A,BOROWSKY I W,et al.Structural adverse childhood experiences associated with suicidal ideation,suicide attempts,and repetitive nonsuicidal self-injury among racially and ethnically minoritized youth[J].Suicide Life Threat Behav,2025,55(1):e13084. [55] TANG J,MA Y,LEWIS S P,et al.Association of internet addiction with nonsuicidal self-injury among adolescents in China[J].JAMA Netw Open,2020,3(6):e206863. [56] MÉSZÁROS G,GYŐRI D,HORVÁTH L O,et al.Nonsuicidal self-injury:Its associations with pathological internet use and psychopathology among adolescents[J].Front Psychiatry,2020(11):814. [57] MA Y,LI Y,XIE X,et al.The role of depressive symptoms and social support in the association of internet addiction with non-suicidal self-injury among adolescents:A cohort study in China[J].BMC Psychiatry,2023,23(1):322. [58] YING W,SHEN Y,OU J,et al.Identifying clinical risk factors correlated with addictive features of non-suicidal self-injury among a consecutive psychiatric outpatient sample of adolescents and young adults[J].Eur Arch Psychiatry Clin Neurosci,2024,274(2):291-300. [59] WANG Y,XU S,ZHANG X,et al.Effects of tobacco versus electronic cigarette usage on nonsuicidal self-injury and suicidality among Chinese youth:Cross-sectional self-report survey study[J].JMIR Public Health Surveill,2023(9):e47058. [60] SANTAMARINA-PEREZ P,MENDEZ I,SINGH M K,et al.Adapted dialectical behavior therapy for adolescents with a high risk of suicide in a community clinic:A pragmatic randomized controlled trial[J].Suicide Life Threat Behav,2020,50(3):652-667. [61] BERK M S,GALLOP R,ASARNOW J R,et al.Remission,recovery,relapse,and recurrence rates for suicide attempts and nonsuicidal self-injury for suicidal youth treated with dialectical behavior therapy or supportive therapy[J].J Am Acad Child Adolesc Psychiatry,2024,63(9):888-897. [62] BJUREBERG J,SAHLIN H,HELLNER C,et al.Emotion regulation individual therapy for adolescents with nonsuicidal self-injury disorder:A feasibility study[J].BMC Psychiatry,2017,17(1):411. [63] DAI L,ZHANG X,YU R,et al.Abnormal brain spontaneous activity in major depressive disorder adolescents with non-suicidal self injury and its changes after sertraline therapy[J].Front Psychiatry,2023(14):1177227. [64] LIU C,YE X,CHEN M.Sertraline medications plus dialectical behavior therapy for depressed adolescents with nonsuicidal self-injury behaviors[J].Suicide Life Threat Behav,2025,55(1):e13132. [65] LIU W,LI G,WANG C,et al.Can fluoxetine combined with cognitive behavioral therapy reduce the suicide and non-suicidal self-injury incidence and recurrence rate in depressed adolescents compared with fluoxetine alone? A meta-analysis[J].Neuropsychiatr Dis Treat,2022(18):2543-2557. [66] DAVEY C G,CHANEN A M,HETRICK S E,et al.The addition of fluoxetine to cognitive behavioural therapy for youth depression(YoDA-C):A randomised,double-blind,placebo-controlled,multicentre clinical trial[J].Lancet Psychiatry,2019,6(9):735-744. [67] SØRENSEN J Ø,RASMUSSEN A,ROESBJERG T,et al.Suicidality and self‐injury with selective serotonin reuptake inhibitors in youth:Occurrence,predictors and timing[J].Acta Psychiatr Scand,2022,145(2):209-222. [68] ZHANG T,ZHU J,XU L,et al.Add-on rTMS for the acute treatment of depressive symptoms is probably more effective in adolescents than in adults:Evidence from real-world clinical practice[J].Brain Stimul,2019,12(1):103-109. [69] ZHAO L,ZHOU D,HU J,et al.Changes in microstates of first-episode untreated nonsuicidal self-injury adolescents exposed to negative emotional stimuli and after receiving rTMS intervention[J].Front Psychiatry,2023(14):1151114. [70] LIU J,GUAN J,XIONG J,et al.Effects of transcranial magnetic stimulation combined with sertraline on cognitive level,inflammatory response and neurological function in depressive disorder patients with non-suicidal self-injury behavior[J].Actas Esp Psiquiatr,2024,52(1):28-36. |
| [1] | 肖招秀, 郑小兰, 陈娴, 高婷, 何影. 肾移植术后患者膀胱痉挛发生现状及影响因素[J]. 广州医药, 2025, 56(9): 1225-1231. |
| [2] | 姜福香, 王梅, 陈秋红, 崔娜, 杨梅, 景兰梅. 肝癌根治术后恶心呕吐现状及影响因素分析[J]. 广州医药, 2025, 56(9): 1245-1250. |
| [3] | 梁惠琼, 程宏基, 卓裕丰. 成年急性心力衰竭患者服药依从性预测模型的建立及评价[J]. 广州医药, 2025, 56(9): 1268-1276. |
| [4] | 张高华, 梁方惠. 基于结构方程模型的腹股沟疝患者住院费用的影响因素分析[J]. 广州医药, 2025, 56(9): 1283-1287. |
| [5] | 郭俊坤, 曾维德, 施向东, 吕忠其. 2022—2024年南宁市食源性疾病流行病学分析及卫生管理建议[J]. 广州医药, 2025, 56(7): 935-944. |
| [6] | 邓浩辉, 邱玖香, 刘惠媛. 戊型肝炎病毒感染诊疗的研究进展[J]. 广州医药, 2025, 56(6): 735-745. |
| [7] | 陈娴, 邓伟霞, 肖招秀, 温容娟, 黄惠华. 心脏瓣膜置换术后患者异常出血的判断与处理[J]. 广州医药, 2025, 56(6): 754-759. |
| [8] | 李春芳, 刘佳, 姜艳红, 潘晓婷, 王菲菲. 泌尿外科达芬奇机器人手术患者术中低体温的影响因素分析[J]. 广州医药, 2025, 56(6): 787-792. |
| [9] | 崔群, 杜维, 张少柯, 刘通, 费灵芝. CT增强碘对比剂急性不良反应发生及影响因素分析[J]. 广州医药, 2025, 56(6): 829-835. |
| [10] | 唐启群, 于杰, 张涵飞, 胡惠菊, 王宇昕. 分析护理专业学生死亡态度的潜在类别及其影响因素[J]. 广州医药, 2025, 56(6): 836-842. |
| [11] | 钟煜民, 黄冬连, 谢祖刚, 郭耿耿. 单克隆免疫球蛋白血症患者M蛋白质量浓度检测的临床意义[J]. 广州医药, 2025, 56(5): 669-674. |
| [12] | 李红, 王耀楷, 刘燕香, 刘丽洲, 杨元娟, 陈凤. 女性医务人员月经改变的影响因素及与心理状态的相关性研究[J]. 广州医药, 2025, 56(4): 486-493. |
| [13] | 冉欣, 左晓晓, 于楠湘, 张玲. 运动干预联合治疗性聆听对孤独症谱系障碍儿童社会交往功能的影响[J]. 广州医药, 2025, 56(3): 403-409. |
| [14] | 王新, 石丹丹, 张爽, 王青, 张亚莉. 剖宫产后再次分娩阴道试产失败的影响因素[J]. 广州医药, 2025, 56(3): 410-415. |
| [15] | 张德兰, 王燕香, 郭秋霞, 高闽清, 徐华丽. 阴道分娩后尿失禁患者疾病应对方式及其相关影响因素分析[J]. 广州医药, 2025, 56(2): 211-215. |
| 阅读次数 | ||||||
|
全文 |
|
|||||
|
摘要 |
|
|||||
本系统由北京玛格泰克科技发展有限公司设计开发