Early maladaptive schemas, distress tolerance and self-injury in Iranian adolescents: serial mediation model of transdiagnostic factors.

IF 3.9 3区 医学 Q1 PSYCHIATRY
BJPsych Open Pub Date : 2024-05-21 DOI:10.1192/bjo.2024.708
Maryam Babaeifard, Mehdi Akbari, Shahram Mohammadkhani, Jafar Hasani, Reza Shahbazian, Edward A Selby
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引用次数: 0

Abstract

Background: Non-suicidal self-injury (NSSI) is prevalent behaviour among adolescents. Although there are different etiological models of NSSI, there is a general lack of evidence-based, comprehensive and transdiagnostic models of NSSI in adolescents.

Aims: The aim of this study was to investigate a model of transdiagnostic factors of NSSI in adolescents, testing a serial mediation model of the relationship between early maladaptive schemas (EMS), distress tolerance and NSSI through experiential avoidance and rumination.

Method: A community sample was identified of 1014 adolescents aged 13-17, of whom 425 had a history of NSSI. A serial mediation path analytic method was utilised to examine the relationships between NSSI and its associated functions as criterion variables, EMS and distress tolerance as predictors, experiential avoidance as the first mediator and rumination as the second mediator.

Results: The path analytic model fit indices were good (X2/d.f. = 2.25, goodness of fit index = 0.98, normed fit index = 0.97, comparative fit index = 0.98, root mean square error of approximation = 0.054, standardised root mean squared residual = 0.028). Rumination significantly mediated the relationship between schemas of 'vulnerability to harm', 'emotional deprivation', 'social isolation', 'insufficient self-control', and NSSI frequency and intrapersonal functions. In serial fashion, experiential avoidance mediated the role of rumination in the relationship between social isolation, and insufficient self-control and NSSI frequency and intrapersonal functions. All indirect effects were significant.

Conclusions: Key indirect effects were found linking maladaptive schemas and distress tolerance to NSSI frequency, and NSSI intrapersonal functions via experiential avoidance and rumination. Thus, it is important to address these transdiagnostic factors with particular emphasis on the sequential mediating role of experiential avoidance and rumination in conceptualisation and therapeutic interventions for NSSI.

伊朗青少年的早期适应不良模式、痛苦容忍度和自我伤害:跨诊断因素的序列中介模型。
背景:非自杀性自伤(NSSI)是青少年中普遍存在的行为。目的:本研究旨在调查青少年非自杀性自残的跨诊断因素模型,测试早期适应不良图式(EMS)、痛苦容忍度和通过体验性回避和反刍的非自杀性自残之间关系的序列中介模型:方法:确定了 1014 名 13-17 岁青少年的社区样本,其中 425 人有 NSSI 史。结果:路径分析模型的拟合指数为 0.05,而 EMS 和痛苦容忍度的拟合指数为 0.05,两者之间的关系为:第一中介是体验性回避,第二中介是反刍:路径分析模型拟合指数良好(X2/d.f. = 2.25,拟合优度指数 = 0.98,规范拟合指数 = 0.97,比较拟合指数 = 0.98,近似均方根误差 = 0.054,标准化均方根残差 = 0.028)。反刍在 "易受伤害"、"情感匮乏"、"社会孤立"、"自我控制能力不足 "等图式与 NSSI 频率和人际功能之间起着重要的中介作用。在社会隔离、自我控制能力不足与 NSSI 频率和个人内部功能之间的关系中,体验性回避在反刍中起到了串联中介的作用。所有间接效应均具有显著性:结论:研究发现,适应不良图式和痛苦耐受性与 NSSI 频率和 NSSI 人际功能之间存在关键的间接效应,而这些间接效应是通过体验性回避和反刍产生的。因此,在对 NSSI 进行概念化和治疗干预时,必须解决这些跨诊断因素,并特别强调体验性回避和反刍的顺序中介作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
BJPsych Open
BJPsych Open Medicine-Psychiatry and Mental Health
CiteScore
6.30
自引率
3.70%
发文量
610
审稿时长
16 weeks
期刊介绍: Announcing the launch of BJPsych Open, an exciting new open access online journal for the publication of all methodologically sound research in all fields of psychiatry and disciplines related to mental health. BJPsych Open will maintain the highest scientific, peer review, and ethical standards of the BJPsych, ensure rapid publication for authors whilst sharing research with no cost to the reader in the spirit of maximising dissemination and public engagement. Cascade submission from BJPsych to BJPsych Open is a new option for authors whose first priority is rapid online publication with the prestigious BJPsych brand. Authors will also retain copyright to their works under a creative commons license.
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