ABSTRACT Dialectical Behavior Therapy (DBT) has long been successfully applied to such behaviors such as nonsuicidal self-injury (NSSI) and more recently, bulimic behaviors. However, it is less clear how patients experiencing these comorbid symptoms may benefit from this treatment modality. Self-criticism, defined as a highly negative attitude towards the self, has been implicated in both EDs and NSSI and is amenable to DBT; thus, further examination of this construct may be beneficial in informing DBT treatment approaches. However, research has only examined these relationships cross-sectionally and no published research has examined self-criticism as a longitudinal predictor of NSSI and ED symptoms. Thus, this study examined self-criticism as a potential driving factor of NSSI in EDs in order to inform treatments, particularly DBT. Data were collected from 92 treatment-seeking adults at ED treatment facilities in the United States. Participants self-reported ED pathology, NSSI engagement, and self-criticism at baseline and a two-month follow-up. A path analysis revealed that self-criticism at baseline was associated with NSSI frequency at follow-up over and above baseline NSSI and ED symptomology. Self-criticism at baseline was not associated with ED pathology at follow-up. Self-criticism longitudinally predicted NSSI, but not ED pathology, in an ED sample. As such, it may be important for clinicians to assess for self-criticism and consider treatments that target both self-criticism and self-injury, like DBT, for this population.

中文翻译：

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自我批评纵向预测饮食失调中的非自杀性自伤

摘要 辩证行为疗法 (DBT) 长期以来一直成功应用于诸如非自杀性自伤 (NSSI) 和最近的暴食行为等行为。然而，尚不清楚经历这些合并症的患者如何从这种治疗方式中受益。自我批评，被定义为对自我高度消极的态度，与 ED 和 NSSI 都有关联，并且适用于 DBT；因此，进一步检查这种结构可能有助于为 DBT 治疗方法提供信息。然而，研究仅对这些关系进行了横断面研究，并且没有已发表的研究将自我批评作为 NSSI 和 ED 症状的纵向预测因子进行了研究。因此，这项研究检查了自我批评作为 ED 中 NSSI 的潜在驱动因素，以便为治疗提供信息，尤其是 DBT。数据来自美国 ED 治疗机构的 92 名寻求治疗的成年人。参与者在基线和两个月的随访中自我报告 ED 病理、NSSI 参与和自我批评。路径分析显示，基线时的自我批评与随访时的 NSSI 频率相关，超过基线 NSSI 和 ED 症状。基线时的自我批评与随访时的 ED 病理学无关。在 ED 样本中，自我批评纵向预测 NSSI，但不预测 ED 病理。因此，临床医生评估自我批评并考虑针对该人群的自我批评和自我伤害的治疗（如 DBT）可能很重要。在基线和两个月的随访中进行自我批评。路径分析显示，基线时的自我批评与随访时的 NSSI 频率相关，超过基线 NSSI 和 ED 症状。基线时的自我批评与随访时的 ED 病理学无关。在 ED 样本中，自我批评纵向预测 NSSI，但不预测 ED 病理。因此，临床医生评估自我批评并考虑针对该人群的自我批评和自我伤害的治疗（如 DBT）可能很重要。在基线和两个月的随访中进行自我批评。路径分析显示，基线时的自我批评与随访时的 NSSI 频率相关，超过基线 NSSI 和 ED 症状。基线时的自我批评与随访时的 ED 病理学无关。在 ED 样本中，自我批评纵向预测 NSSI，但不预测 ED 病理。因此，临床医生评估自我批评并考虑针对该人群的自我批评和自我伤害的治疗（如 DBT）可能很重要。在 ED 样本中，自我批评纵向预测 NSSI，但不预测 ED 病理。因此，临床医生评估自我批评并考虑针对该人群的自我批评和自我伤害的治疗（如 DBT）可能很重要。在 ED 样本中，自我批评纵向预测 NSSI，但不预测 ED 病理。因此，临床医生评估自我批评并考虑针对该人群的自我批评和自我伤害的治疗（如 DBT）可能很重要。