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عنوان فارسی مقاله:
رفتارهای خودآزاری غیرخودکشی نوجوانان: آخرین اپیدمی برای ارزیابی و درمان
عنوان انگلیسی مقاله:
Adolescent non-suicidal self-injurious behavior: The latest epidemic to assess and treat
سال انتشار : 2008
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بخشی از مقاله انگلیسی :
Despite growing concern about NSSI and the need to find effective treatments, there are very few studies that focus on reducing this behavior directly (Miller & Glinski, 2000;Walsh, 2006). Current research evaluating the efficacy of treatments of suicidal behavior have typically subsumed or ignored non-suicidal self-injury. While the results from research on treatments for suicidal behavior are somewhat promising (e.g., Brown et al., 2005; Linehan, Comtois, Murray, et al., 2006; Tryer et al., 2003; Verheul et al., 2003), they are mostly limited to suicidal behavior in adult populations and their effectiveness within adolescent groups is unknown. Still, these positive findings suggest that there may be a range of potentially effective treatments available to practitioners. Most recently, Wallerstein and Nock (2007) published an interesting case study of a 26-year-old woman, who demonstrated a significant decrease in the number of incidents of NSSI following repeated physical exercise, which was the sole “therapeutic” intervention of this study. The authors suggested that exercise contributed to the release of endogenous opioids and beta-endorphins which may be central to the process of emotion regulation and thereby decreased her frequency of NSSI. The results of this single case study were promising as the NSSI completely remitted and remained so at the 8-week follow-up phase. Further research is necessary to investigate the effectiveness of exercise as a legitimate treatment for NSSI. There are only a few randomized controlled trials of therapy for NSSI among adolescent samples and the results are mixed. To further complicate the picture, many of these studies below do not differentiate NSSI from suicide attempts so interpretation of the findings warrants caution. For example, Harrington et al. (1998) examined the efficacy of adding a four-session family problemsolving therapy to routine care for adolescents who deliberately poisoned themselves. Of note, the intent of such behaviors was not formally assessed to distinguish suicidal from NSSI behavior. Results indicated that there were no significant differences between treatment groups on general outcomes or on acts of repeated self-poisoning. However, within the treatment group, a subgroup of adolescents who were diagnosed with major depressive disorder reported a significant reduction in suicidal ideation. Huey et al. (2004) reported significant findings in their study, which also emphasized working with families systems. One hundred and fifty-six adolescents who presented to an emergency department following an act of self-harm (unclear whether suicidal or NSSI) were randomly assigned to receive either multi-systemic family therapy (MST) or inpatient treatment as usual. The authors reported that MST resulted in significantly fewer acts of self-harm and greater reduction of symptoms than treatment as usual over a 1- year follow-up. However, the findings are confounded by the fact that 44% of the MST sample also received inpatient care during the treatment period.
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کلمات کلیدی:
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