非自杀性自伤与疼痛的关联：机制与干预进展研究

The Association between Nonsuicidal Self-Injury and Pain: Mechanisms and Progress in Interventions Research

摘要: 非自杀性自伤(NSSI)是一种无自杀意图的反复自我伤害行为，疼痛作为其核心生理与心理体验，在行为的发起、维持中发挥双重作用。本文系统梳理NSSI与疼痛的关联机制，指出疼痛既通过内源性阿片系统激活、疼痛敏感性调节等生理机制形成神经反馈循环，又作为情绪调节工具实现心理痛苦的具象化、自我惩罚及人际信号传递。基于上述机制，本研究分析认知行为疗法、辩证行为疗法、接受与承诺疗法的干预进展：认知行为疗法通过认知重构、疼痛感知分化训练修正认知偏差与行为习惯；辩证行为疗法以情绪调节、冲动控制模块改善情绪耐受与即时冲动管理；接受与承诺疗法依托接纳训练、价值观导向行为打破情绪回避循环。三种疗法均靶向疼痛-NSSI强化循环的关键环节。未来需结合个体疼痛感知特征制定个体化方案，探索家庭参与等长效干预机制，整合神经科学手段与心理疗法实现跨学科干预，为NSSI临床治疗提供理论与实践参考。

Abstract: Non-suicidal self-injury (NSSI) is a repetitive self-harming behavior without suicidal intent. Pain, as the core physiological and psychological experience, plays a dual role in the initiation and maintenance of the behavior. This article systematically reviews the association mechanism between NSSI and pain, indicating that pain not only forms a neural feedback loop through physiological mechanisms such as endogenous opioid system activation and pain sensitivity regulation, but also serves as an emotional regulation tool to materialize psychological distress, self-punishment, and interpersonal signal transmission. Based on the above mechanisms, this study analyzes the intervention progress of cognitive behavioral therapy, dialectical behavioral therapy, and acceptance and commitment therapy: cognitive behavioral therapy corrects cognitive biases and behavioral habits through cognitive restructuring and pain perception differentiation training; dialectical behavioral therapy improves emotional tolerance and immediate impulse management through emotion regulation and impulse control modules; acceptance and commitment therapy breaks the emotional avoidance cycle through acceptance training and value-oriented behavior. All three therapies target the key links in the pain-NSSI reinforcement cycle. In the future, individualized plans need to be developed based on individual pain perception characteristics, and long-term intervention mechanisms such as family participation should be explored. The integration of neuroscience methods and psychological therapies should be achieved for interdisciplinary intervention, providing theoretical and practical references for the clinical treatment of NSSI.