非自杀性自伤青少年执行功能障碍的研究进展

doi:10.3969/j.issn.1674-8115.2024.04.013

上海交通大学学报（医学版） ›› 2024, Vol. 44 ›› Issue (4): 518-524.doi: 10.3969/j.issn.1674-8115.2024.04.013

• 综述 • 上一篇

非自杀性自伤青少年执行功能障碍的研究进展

何山¹(), 吕钦谕¹^,²(), 易正辉¹^,²

^1.上海交通大学医学院附属精神卫生中心精神科，上海 200030
^2.复旦大学附属华山医院精神心理科，上海 200040

收稿日期:2023-06-19 接受日期:2024-02-06 出版日期:2024-04-28 发布日期:2024-04-28
通讯作者: 吕钦谕 E-mail:hscxth@163.com;lvqinyu_louis@163.com
作者简介:何山（1995—），男，住院医师，硕士；电子信箱：hscxth@163.com。
基金资助:
科技创新2030—“脑科学与类脑研究”重大项目(2022ZD0208500)

Research progress in executive dysfunction among adolescents with non-suicidal self-injury

HE Shan¹(), LÜ Qinyu¹^,²(), YI Zhenghui¹^,²

^1.Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
^2.Department of Psychiatry, Huashan Hospital, Fudan University, Shanghai 200040, China

Received:2023-06-19 Accepted:2024-02-06 Online:2024-04-28 Published:2024-04-28
Contact: Lü Qinyu E-mail:hscxth@163.com;lvqinyu_louis@163.com
Supported by:
Chinese National Programs for Brain Science and Brain-like Intelligence Technology(2022ZD0208500)

摘要/Abstract

摘要：

青少年的非自杀性自伤行为（non-suicidal self-injury，NSSI）正逐渐成为全世界关注的精神心理问题。在全球范围内，NSSI的检出率呈现逐年增长的趋势，其检出群体有低龄化的趋势。与既往传统的观点有所不同，NSSI行为不仅存在于有情绪障碍或精神病性障碍的群体中，还可能存在于品行障碍、物质使用障碍和神经发育障碍等群体；其特征和神经生理机制也与单纯的自杀行为和观念存在差异。NSSI青少年往往在学业、社交等多方面存在困难和问题，这些问题往往又都与个体的执行功能障碍存在关联。执行功能的成分众多，不同成分的损害提示个体存在相应的功能缺陷。目前的研究发现，包括注意力、工作记忆、抑制功能在内的执行功能障碍与NSSI发生存在关联，甚至能预测未来NSSI的发生。此外，越来越多的研究也证实，与正常儿童青少年群体相比，NSSI群体存在脑部功能及结构的差异；其中部分研究者通过应用执行功能的相关范式获得了NSSI青少年任务态磁共振影像和神经电生理学的证据。该文就近几年NSSI青少年的执行功能障碍及其神经机制方面的研究进行综述。

关键词: 青少年, 非自杀性自伤, 执行功能障碍, 神经机制

Abstract:

Non-suicidal self-injury (NSSI) in adolescents has gradually become a mental and psychological problem around the world. Globally, the detection rate of NSSI is yearly increasing, and the detection group is also becoming younger. Different from the previous traditional views, NSSI not only exists in the people with affective disorders or psychotic disorders, but may also be present in the people with conduct disorders, substance use disorders, and neurodevelopmental disorders. Its characteristics and neurophysiological mechanisms are also different from pure suicidal behavior and ideation. Adolescents with NSSI often have difficulties and problems in academic performance and social interaction, and these problems are often related to executive dysfunction. There are many components of executive functions, and the impairment of different components indicates that the individual has corresponding dysfunction. Recent research has found that executive dysfunction, including impairments of attention, working memory, and inhibition, is associated with the occurrence of NSSI, and even indicates the occurrence of NSSI in the future. In addition, more and more studies have also confirmed that compared with the normal group, there are differences in brain functions and structures in the NSSI group. In these studies, some researchers have applied executive function-related paradigms and obtained the evidence in task-functional MRI and neuroelectrophysiology. This article reviews the research on executive dysfunction and its neural mechanisms in adolescents with NSSI in recent years.

Key words: adolescent, non-suicidal self-injury (NSSI), executive dysfunction, neural mechanism

中图分类号:

R749.4

何山, 吕钦谕, 易正辉. 非自杀性自伤青少年执行功能障碍的研究进展[J]. 上海交通大学学报（医学版）, 2024, 44(4): 518-524.

HE Shan, LÜ Qinyu, YI Zhenghui. Research progress in executive dysfunction among adolescents with non-suicidal self-injury[J]. Journal of Shanghai Jiao Tong University (Medical Science), 2024, 44(4): 518-524.

参考文献 50

1	NIXON M K, LEVESQUE C, PREYDE M, et al. The Ottawa Self-Injury Inventory: evaluation of an assessment measure of nonsuicidal self-injury in an inpatient sample of adolescents[J]. Child Adolesc Psychiatry Ment Health, 2015, 9: 26.
2	American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders[M]. 5th ed. Washington DC: American Psychiatric Association Publishing, 2013: 803.
3	FAN Y Y, LIU J, ZENG Y Y, et al. Factors associated with non-suicidal self-injury in Chinese adolescents: a meta-analysis[J]. Front Psychiatry, 2021, 12: 747031.
4	KAESS M, PARZER P, MATTERN M, et al. Adverse childhood experiences and their impact on frequency, severity, and the individual function of nonsuicidal self-injury in youth[J]. Psychiatry Res, 2013, 206(2/3): 265-272.
5	LANG J J, YAO Y S. Prevalence of nonsuicidal self-injury in Chinese middle school and high school students: a meta-analysis[J]. Medicine, 2018, 97(42): e12916.
6	PLENER P L, SCHUMACHER T S, MUNZ L M, et al. The longitudinal course of non-suicidal self-injury and deliberate self-harm: a systematic review of the literature[J]. Borderline Personal Disord Emot Dysregul, 2015, 2: 2.
7	RUCH D A, SHEFTALL A H, SCHLAGBAUM P, et al. Trends in suicide among youth aged 10 to 19 years in the United States, 1975 to 2016[J]. JAMA Netw Open, 2019, 2(5): e193886.
8	LIU R T, WALSH R F L, SHEEHAN A E, et al. Prevalence and correlates of suicide and nonsuicidal self-injury in children: a systematic review and meta-analysis[J]. JAMA Psychiatry, 2022, 79(7): 718-726.
9	LIANG K L, ZHAO L, LEI Y L, et al. Nonsuicidal self-injury behaviour in a city of China and its association with family environment, media use and psychopathology[J]. Compr Psychiatry, 2022, 115: 152311.
10	RUIZ-CASTAÑEDA P, SANTIAGO-MOLINA E, AGUIRRE-LOAIZA H, et al. "Cool" and "Hot" executive functions in patients with a predominance of negative schizophrenic symptoms[J]. Front Psychol, 2020, 11: 571271.
11	ZHOU J H, ZHANG J Z, HUANG Y L, et al. Associations between coping styles, gender, their interaction and non-suicidal self-injury among middle school students in rural West China: a multicentre cross-sectional study[J]. Front Psychiatry, 2022, 13: 861917.
12	BRAUSCH A M, CLAPHAM R B, LITTLEFIELD A K. Identifying specific emotion regulation deficits that associate with nonsuicidal self-injury and suicide ideation in adolescents[J]. J Youth Adolesc, 2022, 51(3): 556-569.
13	HAMZA C A, WILLOUGHBY T, HEFFER T. Impulsivity and nonsuicidal self-injury: a review and meta-analysis[J]. Clin Psychol Rev, 2015, 38: 13-24.
14	张丽萍, 王纯, 杭亚明, 等. 非自杀性自伤行为的关键生物基础[J]. 中华精神科杂志, 2022, 55(2): 150-153.
	ZHANG L P, WANG C, HANG Y M, et al. The neurobiological basis of non-suicidal self-injury[J]. Chinese Journal of Psychiatry, 2022, 55(2): 150-153.
15	MÜRNER-LAVANCHY I, KOENIG J, LERCH S, et al. Neurocognitive functioning in adolescents with non-suicidal self-injury[J]. J Affect Disord, 2022, 311: 55-62.
16	FIKKE L T, MELINDER A, LANDRØ N I. Executive functions are impaired in adolescents engaging in non-suicidal self-injury[J]. Psychol Med, 2011, 41(3): 601-610.
17	MCHUGH C M, CHUN LEE R S, HERMENS D F, et al. Impulsivity in the self-harm and suicidal behavior of young people: a systematic review and meta-analysis[J]. J Psychiatr Res, 2019, 116: 51-60.
18	MEZA J I, OWENS E B, HINSHAW S P. Childhood predictors and moderators of lifetime risk of self-harm in girls with and without attention-deficit/hyperactivity disorder[J]. Dev Psychopathol, 2021, 33(4): 1351-1367.
19	OJALA O, KUJA-HALKOLA R, BJUREBERG J, et al. Associations of impulsivity, hyperactivity, and inattention with nonsuicidal self-injury and suicidal behavior: longitudinal cohort study following children at risk for neurodevelopmental disorders into mid-adolescence[J]. BMC Psychiatry, 2022, 22(1): 679.
20	GROSS J J. The emerging field of emotion regulation: an integrative review[J]. Rev Gen Psychol, 1998, 2(3): 271-299.
21	HU Z Z, YUAN X, ZHANG Y Y, et al. Reasoning, problem solving, attention/vigilance, and working memory are candidate phenotypes of non-suicidal self-injury in Chinese Han nationality[J]. Neurosci Lett, 2021, 753: 135878.
22	SHEN J B, WANG Y, KURPAD N, et al. A systematic review on the impact of hot and cool executive functions on pediatric injury risks: a meta-analytic structural equation modeling approach[J]. Prev Sci, 2022, 23(3): 366-377.
23	DAJANI D R, UDDIN L Q. Demystifying cognitive flexibility: implications for clinical and developmental neuroscience[J]. Trends Neurosci, 2015, 38(9): 571-578.
24	POLANCO-ROMAN L, JURSKA J, QUIÑONES V, et al. Brooding, reflection, and distraction: relation to non-suicidal self-injury versus suicide attempts[J]. Arch Suicide Res, 2015, 19(3): 350-365.
25	PARK Y, AMMERMAN B A. For better or worse?: The role of cognitive flexibility in the association between nonsuicidal self-injury and suicide attempt[J]. J Psychiatr Res, 2023, 158: 157-164.
26	HU Z Z, YU H J, ZOU J Z, et al. Relationship among self-injury, experiential avoidance, cognitive fusion, anxiety, and depression in Chinese adolescent patients with nonsuicidal self-injury[J]. Brain Behav, 2021, 11(12): e2419.
27	SCHATTEN H T, ANDOVER M S, ARMEY M F. The roles of social stress and decision-making in non-suicidal self-injury[J]. Psychiatry Res, 2015, 229(3): 983-991.
28	LUTZ N M, CHAMBERLAIN S R, GOODYER I M, et al. Behavioral measures of impulsivity and compulsivity in adolescents with nonsuicidal self-injury[J]. CNS Spectr, 2022, 27(5): 604-612.
29	IMUTA K, HENRY J D, SLAUGHTER V, et al. Theory of mind and prosocial behavior in childhood: a meta-analytic review[J]. Dev Psychol, 2016, 52(8): 1192-1205.
30	LAGHI F, TERRINONI A, CERUTTI R, et al. Theory of mind in non-suicidal self-injury (NSSI) adolescents[J]. Conscious Cogn, 2016, 43: 38-47.
31	POLLAK O H, KWON S J, JORGENSEN N A, et al. Neural reactivity to social punishment predicts future engagement in nonsuicidal self-injury among peer-rejected adolescents[J]. Biol Psychiatry, 2023, 94(1): 40-49.
32	BEAUCHAINE T P, SAUDER C L, DERBIDGE C M, et al. Self-injuring adolescent girls exhibit insular cortex volumetric abnormalities that are similar to those seen in adults with borderline personality disorder[J]. Dev Psychopathol, 2019, 31(4): 1203-1212.
33	WESTLUND SCHREINER M, MUELLER B A, KLIMES-DOUGAN B, et al. White matter microstructure in adolescents and young adults with non-suicidal self-injury[J]. Front Psychiatry, 2020, 10: 1019.
34	PIETRZYKOWSKI M O, DAIGLE K M, WATERS A B, et al. The central executive network and executive function in healthy and persons with schizophrenia groups: a meta-analysis of structural and functional MRI[J]. Brain Imaging Behav, 2022, 16(3): 1451-1464.
35	HO T C, WALKER J C, TERESI G I, et al. Default mode and salience network alterations in suicidal and non-suicidal self-injurious thoughts and behaviors in adolescents with depression[J]. Transl Psychiatry, 2021, 11(1): 38.
36	KAISER R H, ANDREWS-HANNA J R, WAGER T D, et al. Large-scale network dysfunction in major depressive disorder: a meta-analysis of resting-state functional connectivity[J]. JAMA Psychiatry, 2015, 72(6): 603-611.
37	DAHLGREN M K, HOOLEY J M, BEST S G, et al. Prefrontal cortex activation during cognitive interference in nonsuicidal self-injury[J]. Psychiatry Res Neuroimaging, 2018, 277: 28-38.
38	MALEJKO K, HAFNER S, BROWN R C, et al. Neural signatures of error processing in depressed adolescents with comorbid non-suicidal self-injury (NSSI)[J]. Biomedicines, 2022, 10(12): 3188.
39	VEGA D, RIPOLLÉS P, SOTO À, et al. Orbitofrontal overactivation in reward processing in borderline personality disorder: the role of non-suicidal self-injury[J]. Brain Imaging Behav, 2018, 12(1): 217-228.
40	CASE J A C, MATTONI M, OLINO T M. Examining the neurobiology of non-suicidal self-injury in children and adolescents: the role of reward responsivity[J]. J Clin Med, 2021, 10(16): 3561.
41	WESTLUND SCHREINER M, ROBERTS H, DILLAHUNT A K, et al. Negative association between non-suicidal self-injury in adolescents and default mode network activation during the distraction blocks of a rumination task[J]. Suicide Life Threat Behav, 2023, 53(3): 510-521.
42	ZHANG Y L, LAI S K, WU W G, et al. Associations between executive function impairment and biochemical abnormalities in depressed adolescents with non-suicidal self-injury[J]. J Affect Disord, 2022, 298(Pt A): 492-499.
43	TOYOSHIMA K, TOYOMAKI A, MIYAZAKI A, et al. Associations between cognitive impairment and P300 mean amplitudes in individuals with bipolar disorder in remission[J]. Psychiatry Res, 2020, 290: 113125.
44	DU M, PENG Y W, LI Y W, et al. Effect of trait anxiety on cognitive flexibility: evidence from event-related potentials and resting-state EEG[J]. Biol Psychol, 2022, 170: 108319.
45	WEN Y J, ZHANG X M, XU Y F, et al. Cognitive impairment in adolescent major depressive disorder with nonsuicidal self-injury: evidence based on multi-indicator ERPs[J]. Front Hum Neurosci, 2021, 15: 637407.
46	于丽霞, 凌霄, 江光荣. 自伤青少年的冲动性[J]. 心理学报, 2013, 45(3): 320-335.
	YU L X, LING X, JIANG G R. Impulsivity in non-suicidal self-injurious adolescents in China[J]. Acta Psychologica Sinica, 2013, 45(3): 320-335.
47	JAMES K M, MISKOVIC V, WOODY M L, et al. Attentional capture by angry faces in girls who self-injure: evidence from steady state visual evoked potentials[J]. Suicide Life Threat Behav, 2022, 52(6): 1149-1158.
48	TURNER B J, AUSTIN S B, CHAPMAN A L. Treating nonsuicidal self-injury: a systematic review of psychological and pharmacological interventions[J]. Can J Psychiatry, 2014, 59(11): 576-585.
49	CALVO N, GARCÍA-GONZÁLEZ S, PEREZ-GALBARRO C, et al. Psychotherapeutic interventions specifically developed for NSSI in adolescence: a systematic review[J]. Eur Neuropsychopharmacol, 2022, 58: 86-98.
50	DUAN S Q, VALMAGGIA L, FENNEMA D, et al. Remote virtual reality assessment elucidates self-blame-related action tendencies in depression[J]. J Psychiatr Res, 2023, 161: 77-83.

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非自杀性自伤青少年执行功能障碍的研究进展

Research progress in executive dysfunction among adolescents with non-suicidal self-injury

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