An Eye-tracking Study And Cognitive Behavioral Group Therapy Intervention On Emotion Regulation Of Adolescents With Non-suicidal Self-injury

Objective Non-suicidal self-injury(NSSI)is an act in which an individual intentionally injures himself without risking his life and is often seen as a way to manage negative emotions.More frequent NSSI behaviors are associated with impaired Emotion Regulation(ER)function.There is limited research on Cognitive Behavioral Group Therapy(CBGT)interventions for NSSI and a lack of examination of eye tracking.In this study,we used eye-tracking technology to test the emotion regulation ability of adolescents with NSSI,and investigated the effect of CBGT based on emotion regulation on negative emotions,emotion regulation ability and self-injurious behaviors of adolescents with NSSI.Methods19 and 20 adolescents with NSSI were included in the experimental group and the control group,respectively.The experimental group was required to undergo CBGT twice a week for a total of 8 sessions while receiving medication.The control group received only pharmacological treatment and psychological education.Both groups completed the Hamilton Depression Inventory(HAMD),Hamilton Anxiety Inventory(HAMA),the Adolescent Suicidal Ideation Scale(PANSI),the Adolescent Non-Suicidal Self-Injurious Behavior Rating Scale(ANSAQ),the Emotion Regulation Scale(ERQ),the Chinese version of the Multidimensional Empathy Competence Test(MET-C),and the Emotion Regulation Eye Movement Test before and after the intervention.Results Before intervention,there were no significant differences between the two groups in cognitive tests and tasks.After the intervention,there were differences between the two groups in emotion regulation ability and clinical symptoms:(1)On the emotional regulation scale,the experimental group had significantly lower "expression inhibition" score than the control group(t=-2.919,p=0.006);(2)On the MET-C,the experimental group had a greater rate of correct emotion identification than the control group,t=2.804,p=0.008;there was no significant difference in the intensity of emotional experience between the two groups;(3)On the cognitive reappraisal-eye-movement paradigm,the experimental group had significantly more fixation time(t=3.650,p=0.001)and fixation count(t=3.524,p=0.001)on the emotional interest area in the "reappraisal" condition than the control group;(4)In terms of clinical symptoms,HAMD(t=-3.237,p=0.003),HAMA(t=-2.050,p=0.048)and suicidal ideation(t=-3.503,p=0.001)were significantly lower in the experimental group compared with the control group,and the number of NSSI with tissue loss(t=-2.506,p=0.017)was significantly lower in the post-test.Conclusion Compared with the control group,NSSI adolescents who received CBGT intervention showed significant improvements in emotion regulation,negative emotions,and suicidal ideation.The experimental group found alternatives to NSSI through the learning of emotion regulation skills,and NSSI behaviors were significantly reduced compared to the control group.This study confirms that CBGT can improve the emotion regulation ability,alleviate negative emotions,and reduce suicidal ideation and NSSI behaviors in adolescents with non-suicidal self-injury.