The Proximal Risk Factors Of Non-suicidal Self-injury

Non-suicidal self-injury(NSSI)refers to any deliberate action(e.g.cutting,burning,stabbing,beating,and rubbing excessively)that leads to damage of body tissues like bleeding,bruise and pain.Such actions result in mild and moderate damage to individuals,but they have no intention to commit suicide(Association,2013).Why people hurt themselves is one of the most concerned questions for the researchers of Non-suicidal Self-injury(NSSI).Researchers try to solve the problem by two ways:one is to find the risk factors which may induce NSSI,and find which factors may increase the possibility of NSSI;the other is to try to comprehend the purpose of individual NSSI based on its function,try to understand the individuals hurt themselves for what reasons.Researchers have discovered many risk factors and functions of NSSI,although these risk factors,functions or the combination can predict the NSSI at the population level,they failed to explain such phenomenon:there are two adolescents in the same difficulties and have the same risk factors,one of them choose to attack others,while the other hurts himself.And the researches about the risk factors of NSSI showed that despite of some statistically significant risk factors(e.g.history of self-injury and despair),all these risk factors have a very weak ability to predict NSSI in future,and no risk factor that can predict NSSI very well has been found yet.Besides,the vast majority of the existing researches about the risk factors of NSSI focus on the distal risk factors of NSSI,like the grow-up experience,the susceptivity,etc.But there are few research about the proximal risk factors of NSSI:the direct induction factors of NSSI.On this foundation,this study tries to solve this problem from the proximal risk factors of NSSI to learn more about "why people hurt themselves",that is exploring what which factors lead individuals to generate NSSI rather than other actions.Firstly a detailed deep analysis of the situation before NSSI was carried out through qualitative research method,then discover some key factors which lead to individual NSSI,and make further examination on these factors through quantitative study.Specifically,there are four parts of studies included in the project:Study 1:The qualitative research of the proximal risk factors of NSSI.Previously,most researcher propose some potential risk factors of NSSI based on existing theories,and then prove them.While,this study make deep analysis from the event occurrence to NSSI appearance based on self-injurers' practical experience.We selected 18 self-injurers for deep interview,and analyzed the interviews through consensual qualitative research(CQR).The results showed that,there are five factors lead to final NSSI:triggers,the state of mind,motivations,action ways,functions.All these factors combined with each other to outline the entire development process of NSSI.Among them,the emphasis focus on the "action ways" which lack of in-depth discussion(shows that why individual finally choose NSSI but not other behaviors):On the one hand,some factors support individuals to choose NSSI,including."advantage" of NSSI,support from objective conditions,NSSI produces pain,imitate others,and resistance against NSSI weakens at high emotional intensity.On the other hand,there also exist some factors that restricted on other solutions:Restricted cognitive abilities,awareness of self-protection and restricted objective conditions.Among which there variables were paid further attention:high emotional arousal,the"advantage" of NSSI and the cognition limitation.Study 2 to Study 4 focused on the relationship between NSSI and these three factors,and have further exploration of them.Study 2:High emotional arousal and NSSI.This research focused on the impact of high emotional arousal on the behavior of NSSI.The results of the qualitative researches showed that individuals always hurt themselves in highly negative emotions.Consequently,we hypothesized that the self-injurers would choose NSSI under highly negative emotions,rather than under lowly emotions.We used the revised modified Stroop task method to compare the different reactions between High arousal group(29 self-injurers included)and Low arousal group(20 self-injurers included).And the results supported the aboved hypothesis:under highly negative emotions,the reaction time of their NSSI is the longest,this demonstrated that the self-injurers would choose NSSI under highly negative emotions.Study 3:The comparison of NSSI and other emotion regulation ways:the "'advantages of NSSI".We analyzed the causes which lead to NSSI rather than other actions,and found that the self-injurers may get their way more effectively though NSSI.Our study compared NSSI(pain)with other emotional regulation ways(listening music),and adopted the regulate-time and self-focus as dependent variables.42 self-injurers were randomized into the pain group or music group.The results manifested that NSSI could help the individuals to calm down more shortly compared to other regulation ways;but there were no significant differences between NSSI and music treatment in individual self-focus.Study4:The cognition limitation and the NSSI.According to the qualitative research outcome,the main reason which lead them to NSSI is that they are "trapped"-they cannot figure out more efficiently coping methods.This study used the Social Problem-Solving Skill Test(SPST)to compare the social problem solving skills between the self-injuriers group(22 subjects included)and non self-injuriers group(20 subjects included).The results showed that,there were no significant differences between them under different emotions.However,the self-efficacy of self-injurers decreased under highly negative emotions,while there were no such alterations in non-self-injurers.This demonstrated that highly negative emotions would lead to cognitive trapped,but this is a kind of universal phenomenon not only for the self-injurers;but the self-injurers may be more sensitive to emotional intensity,when under the highly negative emotions,the self-efficacy of solving problems of them may reduce quickly.