心境障碍青少年再次非自杀性自伤冲动及情景因素的生态瞬时评估OACHSSCD

Objective:To explore the patterns and contextual factors of recurrent nonsuicidal self-injury(NS-SI)urges in daily life among adolescents with mood disorders.Methods:Using a WeChat based EMA assessment applet,120 adolescents(12-24 years old)with history of NSSI urges were randomly assessed three times daily for consecutive 14 days.Data on NSSI urges,and emotional states,interpersonal and environmental contexts were col-lected and Multilevel linear models were used to analyze correlates of NSSI urges.Results:Eighty-two point five percent of participants reported at least one NSSI urge,and 39.4%of which progressed to actual self-injury.A total of 882 instances of suicidal ideations were reported,of which 30.8%(272)were co-occurring with recurrent NSSI urges predominantly occurred on weekdays(72.6%),in the afternoon(48.1%),at home(65.4%),while alone(48.6%),and during rest/inactivity(34.1%).Automatic negative reinforcement(ANR)was the primary motive(74.9%),with common co-occurrence of multiple motives,especially ANR combined with other func-tions.Transient negative affect was significantly associated with both current(OR=19.85)and future(OR=9.56)NSSI urges.Resting/inactivity,being alone,and interpersonal life events were linked to transient NSSI urges.Conclusion:Recurrent NSSI urges in adolescents with mood disorders are associated with dynamic negative affect,solitude,and resting states,with prevalent co-occurring motives.