Reducing nonsuicidal self-injury in depressed adolescents: The role of cognitive defusion as a behavioral mechanism.

IF 3.8 1区心理学 Q2 PSYCHOLOGY, CLINICAL

Psychotherapy Research Pub Date : 2026-06-23 DOI:10.1080/10503307.2026.2689625

Xin Yu, Tianyi Hu, Xu Chen, Hongyu Li, Wen He

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引用次数: 0

Abstract

Objective: Nonsuicidal self-injury (NSSI) is prevalent among adolescents with depression, yet the mechanisms through which psychotherapy reduces NSSI remain unclear. This study evaluated the efficacy of Acceptance and Commitment Therapy (ACT) and examined whether reductions in NSSI were associated with changes in specific psychological flexibility (PF) processes.

Methods: In this randomized controlled trial, 120 adolescents with comorbid depression and NSSI were assigned to ACT or treatment as usual (TAU). PF, depressive symptoms, and NSSI frequency were assessed at baseline and post-treatment. Network intervention analysis (NIA) examined treatment-related changes within the PF system. A parallel change-score structural equation model estimated indirect effects of PF processes on NSSI reduction.

Results: Compared with TAU, ACT was associated with greater improvements in PF and larger reductions in depressive symptoms and NSSI. NIA indicated that treatment exposure was most strongly linked to changes in cognitive defusion and contact with the present moment. Structural modeling suggested a significant indirect effect of PF on NSSI reduction, with cognitive defusion emerging as the only specific process significantly associated with change in NSSI.

Conclusion: Findings support a process-based account of ACT and identify cognitive defusion as a central mechanism of change in adolescent NSSI.

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减少抑郁青少年的非自杀性自伤：认知融合作为一种行为机制的作用。

目的：非自杀性自伤（NSSI）在青少年抑郁症患者中普遍存在，但心理治疗减少自伤的机制尚不清楚。本研究评估了接受和承诺疗法（ACT）的有效性，并研究了自伤的减少是否与特定心理灵活性（PF）过程的变化有关。方法：在这项随机对照试验中，120名患有抑郁症和自伤的青少年被分配到ACT或照常治疗（TAU）。在基线和治疗后评估PF、抑郁症状和自伤频率。网络干预分析（NIA）检查了PF系统中与治疗相关的变化。一个平行的变化得分结构方程模型估计了PF过程对减少自伤的间接影响。结果：与TAU相比，ACT与PF的更大改善以及抑郁症状和自伤的更大减少相关。NIA表明，治疗暴露与认知融合和与当下接触的变化最密切相关。结构模型表明，PF对减少自伤有显著的间接影响，认知融合是唯一与自伤变化显著相关的特定过程。结论：研究结果支持基于过程的ACT解释，并确定认知融合是青少年自伤变化的核心机制。

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

Psychotherapy Research PSYCHOLOGY, CLINICAL-

CiteScore

7.80

自引率

10.30%

发文量

期刊介绍： Psychotherapy Research seeks to enhance the development, scientific quality, and social relevance of psychotherapy research and to foster the use of research findings in practice, education, and policy formulation. The Journal publishes reports of original research on all aspects of psychotherapy, including its outcomes, its processes, education of practitioners, and delivery of services. It also publishes methodological, theoretical, and review articles of direct relevance to psychotherapy research. The Journal is addressed to an international, interdisciplinary audience and welcomes submissions dealing with diverse theoretical orientations, treatment modalities.