青少年非自杀性自伤行为与多维度冲动性的 研究进展

Research Progress on Non-Suicidal Self-Injury Behavior and Multi-Dimensional Impulsivity in Adolescents

摘要: 非自杀性自伤(Non-suicidal self-injury, NSSI)在我国青少年群体中患病率较高，已成为严重的公共卫生问题。冲动性作为影响NSSI发生发展的核心风险因素，呈现多维结构特征，主要包括特质冲动、决策冲动、行为冲动三大维度，各维度与青少年NSSI行为的联系各有不同。在特质冲动维度上，紧迫性是与NSSI行为相关的稳定核心因素，预谋缺乏、非计划、认知和运动冲动性均与青少年NSSI行为显著相关，而感觉寻求、毅力缺乏的影响尚未形成统一结论，需结合其他因素综合考量。决策冲动维度上，NSSI青少年在风险决策任务中呈现对风险的偏好与对负性反馈的不敏感，但在共病抑郁时可能表现出矛盾的风险回避。行为冲动层面的反应抑制功能研究结论存在分歧，部分研究证实NSSI青少年存在潜在反应抑制缺陷，另有研究发现其反应抑制能力异常增强，这一差异可能与NSSI行为和自我保护本能的优势竞争相关。当前研究显示，青少年NSSI行为是多维度冲动性在认知、情绪与行为层面协同作用的结果，但不同任务范式及共病因素导致研究结论存在异质性。未来研究应进一步整合多维冲动性指标，明确其在青少年NSSI行为中的作用机制，为精准干预提供理论依据。

Abstract: Non-suicidal self-injury (NSSI) has a relatively high prevalence among adolescents in China and has become a serious public health issue. Impulsivity, as a core risk factor influencing the occurrence and development of NSSI, exhibits multi-dimensional structural characteristics, mainly including trait impulsivity, decision-making impulsivity, and behavioral impulsivity. Each dimension has a different connection with NSSI behavior in adolescents. In the trait impulsivity dimension, urgency is a stable core factor related to NSSI behavior. Lack of premeditation, unplanned, cognitive and motor impulsivity are all significantly associated with NSSI behavior in adolescents, while the influence of sensation seeking and lack of perseverance has not yet reached a unified conclusion and requires comprehensive consideration in combination with other factors. In the decision-making impulsivity dimension, adolescents with NSSI show a preference for risk and insensitivity to negative feedback in risk decision-making tasks, but may exhibit contradictory risk avoidance when comorbid with depression. Research conclusions on the response inhibition function at the behavioral impulsivity level are inconsistent. Some studies have confirmed that adolescents with NSSI have potential response inhibition deficits, while others have found that their response inhibition ability is abnormally enhanced. This difference may be related to the competitive advantage between NSSI behavior and the instinct for self-protection. Current research indicates that NSSI behavior in adolescents is the result of the coordinated action of multi-dimensional impulsivity at the cognitive, emotional, and behavioral levels. However, different task paradigms and comorbid factors lead to heterogeneity in research conclusions. Future research should further integrate multi-dimensional impulsivity indicators, clarify their mechanism of action in adolescent NSSI behavior, and provide a theoretical basis for precise intervention.