Self-criticism is a real-time predictor of non-suicidal self-injury and disordered eating: An ecological momentary assessment study among treatment-seeking individuals.

IF 4.9 2区 医学 Q1 CLINICAL NEUROLOGY
Christina L Robillard, Laurence Claes, Sarah E Victor, Inez Myin-Germeys, Glenn Kiekens
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Abstract

Background: Although theory and research implicate self-criticism as a risk factor for non-suicidal self-injury (NSSI), the nature of this association in daily life remains unclear. This study used ecological momentary assessment (EMA) to address whether (1) trait and state self-criticism elevate the risk of NSSI, (2) state self-criticism predicts NSSI behavior in real-time via increased NSSI urge intensity, and (3) the risk pattern extends to disordered eating (DE; binge eating, purging, restrictive eating).

Methods: A total of 125 treatment-seeking individuals who self-injure (87.20 % female; Mage = 22.98, SD = 5.32) completed measures of trait self-criticism at intake, followed by six daily assessments for 28 days (15,098 assessments; median compliance = 78.6 %) measuring self-critical thoughts, NSSI, and DE. Multilevel vector autoregressive models were constructed within a dynamic structural equation modeling framework.

Results: Patients who reported higher mean state self-critical thoughts experienced more intense NSSI urges and an increased risk for NSSI behavior during treatment. Higher-than-usual self-critical thoughts predicted NSSI urge intensity and NSSI behavior within the following 2 h. NSSI urge intensity partially mediated the effect of self-critical thoughts on NSSI behavior. Trait self-criticism did not predict comorbid DE, but aggregated state self-critical thoughts were associated with binge and restrictive eating. The within-person risk pattern of self-criticism generally extended to DE, with full mediation via DE urges for purging and restrictive eating, but not binge eating.

Conclusions: Self-criticism is a real-time predictor of NSSI and comorbid DE. These findings underscore the relevance of monitoring self-criticism outside the therapy room, as it may be an important treatment target.

自我批评是非自杀性自伤和饮食失调的实时预测因子:一项针对寻求治疗者的生态瞬间评估研究。
背景:尽管理论和研究都认为自我批评是非自杀性自伤(NSSI)的风险因素,但日常生活中这种关联的性质仍不清楚。本研究使用生态瞬间评估(EMA)来探讨:(1)特质和状态自我批评是否会提高非自杀性自残的风险;(2)状态自我批评是否会通过增加非自杀性自残冲动强度来实时预测非自杀性自残行为;以及(3)这种风险模式是否会延伸至饮食紊乱(DE;暴饮暴食、清除性饮食、限制性饮食):共有 125 名寻求治疗的自我伤害者(87.20% 为女性;Mage = 22.98,SD = 5.32)在入院时完成了特质自我批评的测量,随后在 28 天内进行了六次每日评估(15,098 次评估;中位数符合率 = 78.6%),测量自我批评想法、NSSI 和 DE。在动态结构方程建模框架内构建了多层次向量自回归模型:结果发现:在治疗过程中,平均自我批评想法较高的患者会有更强烈的 NSSI 冲动,NSSI 行为的风险也会增加。高于正常水平的自我批评想法预示着随后两小时内的NSSI冲动强度和NSSI行为。NSSI冲动强度部分介导了自我批评想法对NSSI行为的影响。特质自我批判并不能预测合并 DE,但综合状态下的自我批判想法与暴饮暴食和限制性进食有关。自我批判的个人内部风险模式一般会延伸到强迫进食,通过强迫进食冲动对清除性进食和限制性进食进行完全调解,但不会对暴饮暴食进行完全调解:结论:自我批判是NSSI和合并DE的实时预测因子。这些发现强调了在治疗室外监测自我批评的意义,因为它可能是一个重要的治疗目标。
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来源期刊
Journal of affective disorders
Journal of affective disorders 医学-精神病学
CiteScore
10.90
自引率
6.10%
发文量
1319
审稿时长
9.3 weeks
期刊介绍: The Journal of Affective Disorders publishes papers concerned with affective disorders in the widest sense: depression, mania, mood spectrum, emotions and personality, anxiety and stress. It is interdisciplinary and aims to bring together different approaches for a diverse readership. Top quality papers will be accepted dealing with any aspect of affective disorders, including neuroimaging, cognitive neurosciences, genetics, molecular biology, experimental and clinical neurosciences, pharmacology, neuroimmunoendocrinology, intervention and treatment trials.
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