疼痛阈值对非自杀性自伤行为的影响：情绪调节的中介作用

The Influence of Pain Threshold on Non-Suicidal Self-Harm Behavior: The Mediating Role of Emotion Regulation

摘要: 目的：非自杀性自伤行为(NSSI)是青年群体中严重的公共卫生问题，其形成机制复杂，涉及心理与生理的交互作用。本研究旨在探讨疼痛阈值在NSSI行为中的作用，并重点检验情绪调节困难在二者之间的中介机制。方法：采用横断面设计，以124名在校大学生为研究对象，依据《青少年自我伤害行为量表》得分分为NSSI组(n = 79)与非NSSI组(n = 45)。通过冷痛刺激法测量疼痛阈值，并使用情绪调节困难量表(DERS)与青少年自我伤害行为量表(AS-HS)评估心理行为特征。数据分析采用独立样本t检验、Pearson相关分析及基于Bootstrap法的中介效应检验。结果：NSSI组疼痛阈值与情绪调节困难得分均显著高于对照组(均P < 0.001)。NSSI组的组内相关分析显示，疼痛阈值与NSSI行为呈显著正相关(β = 0.187, P < 0.05)，与情绪调节困难亦呈显著正相关(β = 0.37, P < 0.001)。中介分析表明，情绪调节困难在疼痛阈值与NSSI行为间起部分中介作用(标准化间接效应值 = 0.179, 95% CI [0.077, 0.293])，总模型解释变异量为33.5%。结论：疼痛阈值的升高与情绪调节困难是NSSI个体的重要特征，情绪调节困难部分解释了疼痛感受与自伤行为之间的联系。本研究为理解NSSI的生理和心理联动机制提供了实证依据，提示在未来的风险评估与临床干预中，应同时关注个体的疼痛感知特性和情绪调节能力。

Abstract: Objective: Non-suicidal self-injury (NSSI) constitutes a critical public health concern among youth populations, characterized by a complex etiological mechanism involving the interplay of psychological and physiological factors. The present study aims to investigate the role of pain threshold in NSSI behavior and, more specifically, to examine the mediating mechanism of emotion regulation difficulties in the relationship between these two variables. Methods: A cross-sectional design was employed, with 124 college students recruited as participants. Based on scores from the Adolescent Self-Harm Scale (ASHS), participants were categorized into the NSSI group (n = 79) and the non-NSSI group (n = 45). Pain threshold was assessed via the cold pain stimulation paradigm. Psychological and behavioral characteristics were evaluated using the Difficulties in Emotion Regulation Scale (DERS) and the Adolescent Self-Harm Scale (ASHS). Data analyses included independent samples t-tests, Pearson correlation analysis, and mediation effect testing using the Bootstrap method. Results: Compared with the control group, the NSSI group exhibited significantly higher scores on both pain threshold and emotion regulation difficulties (all P < 0.001). Within-group correlation analysis of the NSSI group revealed a significant positive correlation between pain threshold and NSSI behavior (β = 0.187, P < 0.05), as well as a significant positive correlation between pain threshold and emotion regulation difficulties (β = 0.37, P < 0.001). Mediation analysis demonstrated that emotion regulation difficulties exerted a partial mediating effect on the relationship between pain threshold and NSSI behavior (standardized indirect effect = 0.179, 95% confidence interval [0.077, 0.293]). The total model accounted for 33.5% of the variance in NSSI behavior. Conclusion: Elevated pain threshold and difficulty in emotional regulation are important characteristics of individuals with NSSI. Difficulty in emotional regulation partly explains the connection between pain perception and self-harm behavior. This study provides empirical evidence for understanding the physiological and psychological linkage mechanism of NSSI, suggesting that in future risk assessment and clinical intervention, both the individual’s pain perception characteristics and emotional regulation ability should be paid attention to simultaneously.